Projects focused on community OR public engagement - 2017, 2018 and 2019 entries

EU-JAMRAI (European Joint Action on Antimicrobial Resistance and Healthcare Associated Infections)

Provide a brief overview of your project?

“Don’t leave it halfway” (www.dontleaveithalfway.eu) is a video series of four announcements, each lasting one minute, where the general public, patients, health professionals, veterinarians and politicians are called to action to work on addressing the problem of resistance to antibiotics from all sectors of society.

The aesthetics of the episodes are cinematographic and four different stories are offered, with fictional characters, where tasks that would be unthinkable to abandon in real life are be left halfway. At the end of each episode, the motto that appears is: “Would you leave it halfway? Well, you shouldn’t do it with antibiotics either”, and it is follows by the explanation: “Bacteria are winning the battle and antibiotics are losing their effectiveness. Your role is crucial: take antibiotics only when prescribed by healthcare professionals and follow their advice on how to use them”.

The stories are: a birthday party that is left halfway; an old woman that is walking on a pedestrian crossing and stops in the middle with the traffic light in green; a dog that is being combed, and a concert that is not finished.

​The videos have been distributed through the social media channels of the Joint Action (Facebook, Instagram and Twitter) and social media promotions have been hired to reach a greater number of people. It was launched on the EAAD (European Antibiotic Awareness Day) 2018.

“Don’t leave it halfway” is an action included in the communication work package of the European Joint Action on Antimicrobial Resistance and Healthcare-Associated Infections (EU-JAMRAI).

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

In just one month the results were:

* 2,7 million people reached
* 1,6 million reproductions
* 89.742 people engaged (comments, likes, shares, etc.)

How is the project to be developed in the future?

“Don’t Leave It Halfway” is the first video series from EU-JAMRAI. Due to the success of the campaign, the communication team have proposed to film another video series focussed in another key topic about Antimicrobial Resistance such as “they won’t cure your cold or flu” or “the wonder drug in extinction”.

Gloucestershire County Council

Provide a brief overview of your project?

There is currently low awareness of the importance of antimicrobial resistance (AMR) among the public, and the positive actions that they can take to protect themselves. Young people aged 16 to 24 years old have been identified as a particularly risky group in terms of high and inappropriate use of antibiotics, low awareness of AMR and it’s implication for them, coupled with high rates of sexually transmitted infections. A multi-professional group came together to develop a communications, media and engagement approach, targeting 16 to 24 year olds. The focus of the project was a competition for young people, primarily aimed at students from local schools and colleges, to develop a multi-media communications campaign targeted at their age group which would be rolled out across Gloucestershire. The entries had to develop a concept and campaign materials promoting messages on: what AMR is; the importance of AMR; and positive actions to tackle AMR. The competition took a one health approach, asking participants to reflect both human and animal health in their designs. A judging panel, which included representatives from a range of Local Authority Public Health and NHS professionals, as well as young people, selected the winner.

The winning entry, which was from a local college, had the opportunity to work with designers and media professionals to refine their campaign and materials. The campaign includes social media, billboard and bus advertising, promotion throughout schools in Gloucestershire, promotion through NHS providers, and promotion through posters and coasters in coffee shops and recreational venues. The concept and materials are also being taken on by the Local Pharmaceutical Committee as a county-wide health promotion campaign on AMR. Local media have been engaged to promote the story and to showcase the winning students talking about the importance of AMR and their role in protecting the local community.

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

Gloucestershire County Council’! engaging young people in AMR: A key strength of this project was the engagement of young people in AMR and giving them an active role in leading the project. Those who entered the competition did so in groups as part of their programmes of study. It gave them the chance to direct their own learning and to frame AMR in a way that makes sense to them and their peers. The young people’s leadership in developing their campaigns has helped to establish young AMR champions in our County. D2

– Increasing awareness of the issue of AMR among young people: This project has two approaches to raise awareness of the importance of AMR to the public:  through the promotion of and participation in the competition element; and through the County wide communications and media campaign. There was a comprehensive promotion of the competition, which included information on AMR shared to a range of groups and through various media.  The winning campaign had messages in a range of formats (video, posters, coasters) developed by young people, which were advertised through social media, billboard advertising, bus advertising, as well as targeted promotion through relevant venues. The competition and materials are promoted through local media where the young people are the mouth piece for the campaign, describing why it is important and relevant to them and their peers.

– Increasing understanding of positive actions to protect against AMR: The competition process and the winning entry materials focused on the positive practical actions that people can take to protect themselves and their communities against AMR. This highlights their important role in fighting AMR. The positive actions also include animal care to reduce risk of infection spread between animals and humans. This has been a neglected area in campaigns so far.

How is the project to be developed in the future?

The competition element of the project has proved to be very successful. We will look to further develop the competition format in the future, using feedback from the evaluation process to further refine the approach and to ensure that it is inclusive. We will explore the potential to open future competitions up to other groups within our community, and will review with key stakeholders how to do this most effectively.

The campaign concept and materials have been very positively received by partners. We have already agreed with the Local Pharmaceutical Committee that they will promote the winning campaign materials as their annual health promotion campaign through all community pharmacies in Gloucestershire.  The local NHS including primary care are working with us to use the materials in their local health promotion mediums, to help engage patients and members of staff.

We are also reviewing opportunities to promote the campaign through schools and further education establishments across Gloucestershire. We will work with the Gloucestershire associations for primary, secondary and further education head teachers, as well as our dedicated schools healthy living and learning programme, to identify opportunities to further engage students and teachers in Gloucestershire through the current campaign, and the future development of the competition.

Roll Back Antimicrobial Resistance Initiative

Provide a brief overview of your project?

The project was known as “Tokomeza Usugu wa Dawa” which is a Kiswahili language phrase stands for eradicate antimicrobial resistance this was a nationwide  campaign led by me when I was the president of Tanzania Pharmaceutical Students Association.The campaign  was conducted voluntary from September to November 2017 with the following objectives ,raising antimicrobial resistance  awareness to the whole community ,imparting early antimicrobial resistance knowledge to the young generation,enlisting secondary school students as antimicrobial resistance ambassadors and joining the government and global efforts in implementing action plan on fighting antimicrobial resistance. The campaign reached 23 administrative regions of Tanzania .A total of 122 volunteers were registered from different pharmaceutical universities and colleges in Tanzania also other health care students joined the campaign .The campaign was conducted by visiting secondary schools and provide awareness on antimicrobial resistance, conducting radio and television sessions on antimicrobial resistance ,publications in newspapers, social media accounts and other mass media
A small feature about this campaign was also put on WHO Antimicrobial resistance newsletter number 32 of November 2017.

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

A total of 114 secondary schools and 46,644 secondary school students  were reached during the campaign  where antimicrobial resistance  awareness was raised to both students and teachers .
A total of 20 radios and 6 television were used to conduct antimicrobial resistance awareness we estimated to reach more than 6,240,000 people through different radio stations.
Antimicrobial resistance awareness was also done at community gatherings like churches ,hospitals, parents meetings where 1052 people were reached in 5 regions where this method was used.

How is the project to be developed in the future?

Currently I have founded a non governmental organization registered in Tanzania with special focus on combating antimicrobial resistance it’s name is Roll Back Antimicrobial Resistance Initiative (RBA Initiative ) one among its coming project is RBA- AND club which will involve forming antimicrobial resistance clubs to secondary school students and build antimicrobial resistance  capacity to their teachers notably club guardians ,students will be educated and be good antimicrobial resistance ambassadors .I am also one of the co founders of International Students Partnership for Antibiotics resistance Education (ISPARE Global ) the platform is encouraging students from different countries  to fight back antimicrobial resistance I am also in touch with the new leaders of Tanzania Pharmaceutical Students Association where the same work of raising antimicrobial resistance awareness to students is still done.

Sociedad Española de Microbiologia

Provide a brief overview of your project?

MicroMundo is a network that integrates Microbiologists of 25 Universities in Spain and Portugal, coordinated from the Spanish Microbiology Society. It engages two educational levels on creating scientific culture on bacterial resistance to antibiotics in our society. Associated with the Small World Initiative and Tiny Earth in the USA, it involves a crowdsourcing research project that is managed from university hubs towards their local communities. We involve Secondary and High School students in antibiotic discovery by analysing the soil microbiota in search for antibiotic bioactivities. Teams are led by University Undergraduate Students by a Service-Learning pedagogic strategy, with the aim of disseminating the WHO recommendations about the proper use of antibiotics and the One Health perspective for tackling this global health crisis, while involving the community in experimental research aimed to explore the microbial biodiversity of local environments. During the latest academic course 2017-18, over 2000 Secondary and High School students from 86 schools around Spain, coordinated from 16 universities, and a total of 368 University students were involved in the project, which was sponsored by Merck Sharp & Dohme Spain, the National Plan for Antibiotic Resistance (PRAN/AEMPS) and the Fundación Española para la Ciencia y Tecnología (FECYT). In the present course 2018-19, we have expanded the network to other 8 universities, including one in Portugal, reaching a higher coverage. The results of this education and communication programme on antibiotic resistance awareness are very satisfactory, according to surveys performed on the different actors involved. The goals of (1) promoting scientific culture in society about the value of antibiotics and the threat of resistance, and (2) inspiring vocations on our young students for STEM higher education and R&D-oriented careers are very efficiently fulfilled by this coordinated Service-Learning approach which merges two educational levels.

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

1. When asked about their perception and involvement as a result of their participation in the SWI@Spain/MicroMundo project in surveys, the pre-universitary students involved as researchers, 76 % of the students claim to have gained considerable knowledge on antibiotic awareness and the correct use of these drugs, 84% declare that working in the project has enhanced their interest for Science and research, and 97% would recommend the experience to other colleagues. The impact of the project in University students was also very high, leading to a higher interest on Postgraduate studies related to Biomedical research.
   2. A National Symposium was held in Madrid in July 2018 which was monographic on the SWI@Spain/MicroMundo project. Over 120 people participated in the project. This is to our knowledge the first symposium on the communication and education on antibiotic awareness at the national level. In the Symposium there were participants of all levels (University and Schools, teachers and students). A total of 53 communications were presented in this forum: 18 oral communications and 35 posters.
   3. Besides articles published in specialized journals and the presentation of the project activities in congresses, local media and other forums, the project has been widely folloed in social networks. The Facebook group SWI@Spain: Small World Initiative en España, has 402 members (01/09/2019) and Twitter (@SWISpain) has 802 followers (01/09/2019).

How is the project to be developed in the future?

The MicroMundo network will continue operating, provided that its hubs can be financed by entreprises, foundations or public calls. The Spanish Society for Microbiology will keep on hosting the initiative and the Tiny Earth network (in Madison, USA) has the will to partner with MicroMundo. The Swiss Microbiology Society has made a series of contacts with the Spanish-Portuguese network in the past months to organize a Swiss hub of the project, that would also partner with MicroMundo. We expect to extend our operational abilities and educational activities on antibiotic awareness along the following years. We plan to involve non-academic partners related to drug discovery and apply to EU funds to consolidate the strategy.

The Association of the British Pharmaceutical Industry

Provide a brief overview of your project?

Building on successful public engagement with our award-winning Schools website AMR resources last year, we identified an opportunity to promote AMR awareness through linking to the high-profile Industrial Strategy Grand Challenges which aim to ‘put the UK at the forefront of the industries of the future, ensuring that the UK takes advantage of major global changes, improving people’s lives…’
We focused on the global trends of: Artificial Intelligence & Data, and Ageing Society.  Consequently, we drew on our extensive content (covering key subtitles below) to develop 2 new projects for the British Science Association’s CREST award programme.
• What are antimicrobials?
• Development of antimicrobial resistance
• How can mutations cause antimicrobial resistance?
• Antimicrobial misuse
• Consequences of antimicrobial resistance
• Tackling antimicrobial resistance
The projects pose the following questions and are aimed at key stages 4 and 5: How could AI prevent infection? How might antimicrobial resistance affect healthy ageing?
Pupils are given the following situation: Antimicrobials, especially antibiotics, are becoming less effective due to unnecessarily prescribing for many patients (and farmers), who then unnecessarily use them. Action regarding antimicrobial resistance (AMR) is necessary so that it does not impede ambitions for people to enjoy at least 5 extra healthy, independent years of life, by 2035.
Pupils are given starters and can draw on:
• AMR animations and text
• An interactive glossary
• Summary diagrams
• Interactive links to reputable further reading
Entrants must produce one of the following:
Ageing society: produce a speech together with a summary infographic, that you would use to give a lecture/speech to a global non-specialist audience on: How might antimicrobial resistance affect healthy ageing?
AI: design an app which monitors your health and lifestyle to identify, as early as possible, the likelihood of a person developing a disease which affects the immune system and increases susceptibility to infection from multi-resistant bacteria.

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

1. Extending the engagement with this issue across 2 school key stages and by working with the British Science Association, we are guaranteed to reach an even larger audience than with the AMR resources we developed in 2017.
   2. Engaging with those which might not have engaged as AMR, as we have linked the issue to AI and healthy ageing.
   3. Providing novel ideas from the next generation of youngsters who will live with this real issue is not addressed

How is the project to be developed in the future?

We are now working with Children’s University Trust to develop and provide them with a specific AMR project for learning outside the classroom which will encourage students to try new experiences, develop new interests and acquire new skills.  We are also looking at what can be provided for primary school children.

University of Oxford

Provide a brief overview of your project?

‘Me You and The Superbugs’ held on 13th October 2018 from 12 – 4pm. The event aimed to raise awareness of antibiotic resistance and gather information on public experiences and knowledge of antibiotic resistance. 52 people, including 9 school pupils and 43 members of the public attended. With 135 additional LIVE viewers on Periscope TV. Recordings are available at https://www.pscp.tv/lifeofascientist/1dRKZgdjggwGB.
4 Speakers from Nigeria and the UK presented on antibiotic resistance and career development.
Mrs Folasade O Lawal, MD Victory Drugs Pharmacy – Nigeria, gave a practical session on the importance of good hand hygiene to prevent spread of infections
Dr Orode Aniejurengho, the event organiser and University Oxford Scientist, used engaging props to showcase the emergence of antibiotic resistant bacteria and how to reduce the spread of drug-resistant infections. She also held an ‘Antibiotic Guardian’ sign up session
Dr Udeme Nwabuko of Bethesda Clinic, Nigeria spoke on ‘how to use antibiotics the right way’. Attendees learnt the different illnesses that antibiotics should not be used for.
Dr Chinyere Okoro, a UK AMR researcher at the University of Surrey, led the ‘Careers in Science’ talk. Attendees were able to network with professionals and gain insight into bioscience research careers.
18 volunteers helped during the event and attended a 3-hour training 1 week before the event.
A drop-in microscopy session for the school children was included. This allowed them to observe simple biology specimens to inspire them in the sciences. For some it was their first time looking through a light microscope.
Event evaluation was performed using questionnaires.
A £500 Royal Society of Biology (RSB) outreach grant was used to part-fund the event. As a condition of the grant, an information session on the role of the RSB and benefits of membership was included.

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

Three main outcomes were obtained from the events.
First, 21 antibiotic guardians were recruited including healthcare professionals, undergraduate and postgraduate students and business professionals including local market traders.
Secondly, awareness about how antibiotic resistance occurs was increased. 85.7% of those who completed the questionnaires said “The information I heard changed my views on antibiotic use” while only 9.5% replied “I already knew about antibiotics”. In the post-event questionnaire, attendees commented that “among strains of bacteria there are resistant ones – improper use of antibiotic empowers them” another commented “the demonstration on how resistance happens and spread is a useful tool to employ in creating awareness”.
Third was a learning outcome, this was achieved by gathering information on public experiences and knowledge through the use of the questionnaire-based survey. The first set of questionnaires were administered before the presentations began and the second at the end of the event. The findings from this case study are being prepared for submission to a peer-reviewed journal. This survey was administered following approval from both local and UK research ethics committees. Replies such as my last course of antibiotics were “obtained from elsewhere without prescription”, were common and highlight the need for continued awareness events in Nigeria. Some reported obtaining antibiotics from a pharmacy without prescription.
The Royal Society of Biology (RSB) info/signup session held during the day saw 17 people sign up interest in membership. This can create opportunities for the teachers, students and researchers to widen their network and potentially access grants for similar events in Lagos Nigeria.

How is the project to be developed in the future?

Following the 2018 event, Dr Orode Aniejurengho was approached by ‘Inqaba Biotech’ a leading molecular biology company to organise ‘Me You and The Superbugs’ in Ibadan. Hence, in 2019, two events are being planned, one in Lagos and the other in Ibadan – the largest city in West Africa. Following feedback from the 2018 event, it is important to reach more school pupils, as they are the future generation of adult antibiotic users. Thus schools in Ibadan will be invited to attend a ‘Me You and The Superbugs’ competition. Secondary school students will be asked to design posters on the theme “Towards better Health”. The focus will be on the creation of innovative and easy to implement ideas to reduce the spread of antibiotic resistant infections in Nigeria. During the finale, tentatively on November 9th 2019, ten top applicants will present their poster and 3 winners will be selected. The session will also include a ‘how antibiotic resistance occurs’ demonstration.
To reach more people in the local communities in Lagos, the event will be organised in a similar format to the 2018 event. The main hurdle will be to source funds from both local and international sponsors.
The event is planned to be held annually in Nigeria, adding on at least one city every year. Collaboration with local healthcare professionals is vital for this to occur, hence we are actively reaching out to more people with interest in AMR to organise ‘Me You and The Superbugs’ in their local cities.
The main tool in this program is to use simple props in communicating how antibiotic resistance occurs. The target audience is members of the public who would not ordinarily attend a science-focused event. To the best of our understanding this is a new strategy in Nigeria and based on feedback from the 2018 evaluation, it is a method that attendees connected with. Since it is different from usual PowerPoint focused presentations at awareness conferences held in Nigeria. Speakers will be supported with training on how to use simple props to communicate with the public.  There remains a strong need to raise awareness of antibiotic resistance amongst the Nigerian public by using simple communication tools. Thus it is hoped that sponsorship for future events and partnerships with more established health bodies will arise and establish ‘Me You and The Superbugs’ .

University of Reading, Department of Typography & Graphic Communication

Provide a brief overview of your project?

Beat Bad Bugs Rwanda (BBBR) introduces design thinking and user-centred design to communicate information about Antimicrobial resistance (AMR) and antibiotic misuse, and to influence behaviour change. BBBR extends the Arts and Humanities Research Council-funded ‘Information Design and Architecture in Persuasive Pharmacy Space: combating AMR’ (IDAPPS) research project to a Rwandan context. The team includes Universities of Reading and Rwanda, Design Science (DS), the Rwandan Community Pharmacists’ Union (RCPU) and the Commonwealth Pharmacy Association (CPA).

IDAPPS considered how the socially inclusive and convenient environment of a community pharmacy can be used to raise awareness of AMR and specifically of the misuse of antibiotics. An IDAPPS outcome, Beat Bad Bugs was developed by Design Science whereby life size characters offered a perspective on antibiotic usage. These messages were reinforced through leaflets and other materials. BBB was successfully piloted in a Day Lewis pharmacy in Reading engaging people with issues around AMR and antibiotic misuse.

University of Reading’s Global Challenges Research Fund developing strategic partnerships has supported BBBR affirming not only the importance of links between universities and professional organisations, but also of working with the people who distribute and use information about AMR.  Our work in Rwanda, therefore, includes contributions from the CPA, who assessed current initiates and gathered baseline data of AMR through interviews with Rwandan pharmacists to identify factors unique to the Rwanda. The RCPU ensured that we connected with Rwandan pharmacists, patients and community leaders in Rwanda.

Our workshops used principles of co-design to understand how information about AMR could be conveyed in Rwandan community pharmacists. The materials developed as a result of our first workshop have been reviewed by Rwandan pharmacists, patients and community leaders in workshop 2, and are being piloted in Rwandan pharmacies.

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

Workshops
In workshop 1, (January 2019, Kigali), pharmacists, pharmacy students, patients and pharmacy business owners worked with the project team to explore access to antibiotics in Rwanda and interventions that the attendees thought would be helpful to help prevent the development of AMR. The well-received workshops identified interventions relevant to Rwandan community pharmacies and patients. Workshop 2 (March 2019, Kigali) reviewed the materials and considered how they will be used in community pharmacies. Day 1 focused on discussions with pharmacists, pharmacy students, and patients about the kinds of illustrations that may help with AMR explanation, and role play where participants enacted scenarios using the prototype materials to develop communication strategies to discuss AMR in pharmacies. Day 2 had a community focus. Held in a village primary school, teachers, children, sports reps and village chiefs gave initial feedback on the ‘antibiotic record card’.

Pilot materials
Development of the materials took account of information gathered in workshop 1, and of the findings from the IDAPPS project.  A set of cards explaining how to take antibiotics was produced to assist pharmacists in communicating to patients. An ‘antibiotic record card’ for patients enabled pharmacists to record details of what was dispensed. The materials were produced in English and Kinyarwanda and developed with colours and messages suggested by the workshop participants. The materials are being piloted in 4 pharmacies selected by RCPU.

Partnership
Partnerships between the University of Reading and Rwanda, DS, RCPU, and the CPA has affirmed the value of cross-disciplinary working and of a design-led approach that prioritises the engagement of stakeholders and end-users. The breadth and depth of the collaboration partners has resulted in strong relationships which go beyond and build community engagement which will bring greater benefits for any future work as well as setting an example for building strong partnerships.

How is the project to be developed in the future?

Workshop 3 in Reading will bring together colleagues from Rwanda and other members of the team to consider how to take further this public engagement work in Rwanda, and how this might be funded.
This workshop will also bring together other partners working on design-led AMR projects to consider new collaborations to address the global AMR challenge. It will:
– generate ideas for future work, including the development of an AMR communications toolkit of resources, guidelines and materials which other countries can use to implement Beat Bad Bugs in a low resource setting
– build these ideas into a funding application that draws together academics and partners in Rwanda and other low-middle income countries in Africa that we have engaged through this developing partnership project
-continue developing collaborations with these partner and builder a deeper network with local community leaders which have been key to BBBR success.

Association of the British Pharmaceutical Industry

Provide a brief overview of your project:

The ABPI award winning Schools website contains a wide range of free, up to date educational resources for students and teachers from Key Stage 1 to A-level. This website has an average 30,000 users per month, most of whom are teachers who then use the material with their pupils – hence a large audience.

We commissioned an independent review of our website content through The Association for Science Education, whilst conducting an audit of where antimicrobial resistance falls within curricula across the United Kingdom, to be sure of how best we could support educating about antimicrobial resistance. We then dedicated a staff member to producing specific antimicrobial resistance ‘free to use’ content for schools and colleges. Analytics from our website show our material is being accessed globally, with the United States, Australia, Canada and Kazakhstan being other key users outside the UK.  We also ensured all material was laptop, mobile and tablet friendly to maximise usage.

The finished material, which included text, diagrams, specially commissioned animations, test yourself questions and ‘stretch and challenge’ exam style questions, was launched alongside other blogs and commentaries, in a concerted media campaign to coincide with World Antibiotic Awareness Week in November 2017.

The content covered the following key subtitles:

• What are antimicrobials?
• Development of antimicrobial resistance
• How can mutations cause antimicrobial resistance?
• Antimicrobial misuse
• Consequences of antimicrobial resistance
• Tackling antimicrobial resistance

Other key features included:

• The specially commissioned animations for: How antibiotics work; Resistance Mechanisms and Immunity.
• An interactive glossary
• Interactive Exam Style Questions
• Suggestions for sparking topical discussions/debates
• Summary diagrams
• Interactive links to reputable further reading

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

• https://www.abpischools.org.uk/topic/antimicrobial-resistance/1/1 the first page of contents which explains antimicrobial resistance, together with contextual statistics, and which finishes with: Antimicrobial resistance is a huge threat to global health – we must take action!
• https://www.abpischools.org.uk/topic/antimicrobial-resistance/5/1 An extended page on: antimicrobial misuse; inappropriate prescribing; uncontrolled access to microbials. As we felt engaging the young population in thinking about antimicrobial resistance is crucial, this page also features links to articles from the NHS and daily newspapers with the idea of recommending reading of the articles prior to discussion of the following 3 questions:

o          Should patients decide when to finish a course of antibiotics?

o          Should doctors rethink prescribing practices to reduce use of antibiotics?

o          Does the media have a social responsibility to give the public accurate information? (in relation to the above).

• https://www.abpischools.org.uk/topic/antimicrobial-resistance/6/1 and https://www.abpischools.org.uk/topic/antimicrobial-resistance/7/1 – 2 pages devoted to the consequence of antimicrobial resistance and how to tackle AMR.

How is the project to be developed in the future?:

We will review activity on these pages, some of the content will then be developed further and would be uploaded to our Times Education Supplement account to increase yet further the audience who can benefit from the resources.

Malaysian Pharmaceutical Society

Provide a brief overview of your project:

In Malaysia, Malaysian Pharmaceutical Society (MPS) had conducted the project of Antibiotics Resistance Awareness Campaign through the incorporation and implementation of activities related to the campaign within several programs that were organized in collaboration with several organizations. The activities conducted were in the form of exhibitions, talks, games, pledges, etc. The project aimed to increase the awareness of the public (including students) regarding the severity of the issue and hence encourage more public engagement in joining this war against the inclining incidence of resistance to antibiotics nowadays. In addition to the activities carried out physically, online platform was also utilised to engage with more pharmacists and encourage them to join the pledge against the improper and unnecessary use of antibiotics.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

1.National Antimicrobial Resistance Committee (NAMRC)

Appointed members (including MPS President and the MPS AMR chapter head) are permanent members of NAMRC  involved in the development framework and execution that links prescribers, patients, consumers in antibiotic resistance.Several hospitals at level of secondary  and tertiary care (including General Hospital Kuala Lumpur) held impactful events for the public participation to increase antibiotics resistance awareness.

2. Supply of antibiotics on valid prescriptions only by Community Pharmacists (Primary care)

Awareness campaigns were launched to emphasise to the public on the dispensing of antibiotics on doctors prescription. Social media and traditional media were enlisted as well as continuous communication (via i-bulletin) to the MPS members of the message to deliver to their patients.Involved publicising to the 2000 private community pharmacies in Malaysia.

3.MPS Antibiotic Guardian Pledge on website

Online Antibiotic Guardian Pledge in early 2017 was launched by MPS to engage the involvement of more pharmacists and the public to join the fight against the increasing incidence of resistance to antibiotics.  Pharmacists were urged to control the antibiotics use within the hospitals and outside the hospital as well as in the community. At every opportunity for public engagement at World Pharmacists Day events and Alliance Against Dengue, MPS booth engaged the public to sign up.

In conjunction with the Road to World Pharmacists Day (WPD) Selangor 2017, MPS had successfully conducted activities related to antibiotics resistance awareness during the series of programs held at 5 Selangor districts and the Grand Finale.  The programs targeted on public were started on 6th May 2017 and ended on 7th October 2017. In addition to the exhibition highlighting on antibiotics resistance, pledge to have rational use of antibiotics was carried out during the programs. Around 30-50 people were successfully attracted to join the pledge at each program. Approximately 60% of the pledge was made by the public while another 40% by the healthcare professionals.  ( 1380 people have pledged to date)

How is the project to be developed in the future?:

The World Pharmacists Day is celebrated on a large scale in Malaysia with collaboration with Pharmacy Services, MInistry of Health and State Health Departments with Malaysian Pharmaceutical Society organisation and Area Committees (branches of MPS at state/area level).It is a public health event which focuses on pharmacists roles and in addition includes the legal,practice and clinical delivery advocacy for antibiotic stewardship.

Currently 19 pharmacy schools totalling around 4000 students are united under the MyPSA (Malaysian Pharmacy Students’ Association,a chapter under MPS) that conducts as many as 20 public health events throughout the country in collaboration with the universities.Themes are health and Antibiotic resistance (AMR).

NHS Tayside

Provide a brief overview of your project:

In previous years, NHS Tayside EAAD and WAAW activities and promotion have primarily focused on fellow healthcare professionals. For 2017 the AMT agreed to promote Antibiotic Guardian and ‘Keep Antibiotics Working’ messages using the popular activity of rock painting to attempt to better engage members of the public.

Rocks from the garden, or purchased from craft/diy shops, are painted and have social media contact information written on the back.  The rocks are then hidden and the finder can post a photo via social media and then keep or re-hide the rock.

The project was supported by Carnoustie Rocks, a popular local community scheme set up in 2017 and known to the AMT.  A number of fantastic painted rocks were provided by Carnoustie Rocks with around 70 more created by the AMT.

The written message on the rocks provided information on how to post a photo on Carnoustie Rocks’ Facebook, Twitter or Instagram pages – plus the Antibiotic Guardian website address and reference to WAAW/EAAD 2017.  Fun cartoon images depicting antibiotic resistant bugs were painted on the front of the rocks.  Posters, NHS Tayside media release and an AMT information document were distributed to provide further information about the project.

Local businesses, schools, community pharmacies, NHS departments became involved either by displaying posters, by posting photos or by hiding rocks.  Photos of the AMT appeared in local press with details of the project.

Carnoustie Rocks shared all posted photos with the AMT and NHS Tayside social media pages; the photos were then shared onwards, tagging useful resources and individuals/groups.  This proved successful; comments, likes and shares were received from many countries around the world.

Rocks were still being found and photos shared as late as March 2018.  Far from being a project restricted to one day/week it has provided sustained publicity for the antimicrobial resistance programme and in an extremely cost effective and inclusive manner.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

Social media was used to share photos of found ‘bug rocks’ or ‘germ stones’.  When sharing photos the AMT, NHS Tayside Communications Department and Carnoustie Rocks included useful links; for example the Antibiotic Guardian website.  Relevant hashtags were included; for example #KeepAntibioticsWorking, #EAAD17, #AntibioticGuardian.

Due to the inclusive and modern approach of this project, members of the public who may not usually be aware of WAAW, EAAD or the national antimicrobial stewardship programme were exposed to these resources and many expressed an interest in learning more.

A school and nursery informally approached the AMT to request learning sessions for their children, due to them opportunistically finding rocks, posting on social media, and finding the topic of interest.

The rocks themselves highlighted WAAW, EAAD and Antibiotic Guardian.  Some rocks were found and hidden again for others to find; some remained unfound until recent weeks.  Everyone who found a rock, whether they posted a photo on social media or not, will have seen the messages painted on the back.  This reinforces a strength of this project; bringing the subject of antibiotic resistance to people who would not usually be aware of it.

Posters were developed and displayed in some community pharmacies, local businesses and hospital departments throughout Tayside.  The posters highlighted the rocks, the aims of the project and included the Antibiotic Guardian logo and website address.

How is the project to be developed in the future?:

Due to the success and popularity of the project it will be repeated to help promote WAAW and EAAD in 2018.  The project will be expanded and it is planned that more groups will be involved in the production of the rocks to enable as wide a geographical spread as possible.

Collaboration with selected Tayside primary schools is in the final agreement process; it has been seen as the ideal opportunity to introduce education sessions using the e-Bug toolkit.  Children and teachers can then be given the chance to paint their own bug rocks once they have gained some knowledge on the subject.

Carnoustie Rocks was an enormous support for the 2017 and future help and input would be welcomed.

Further promotion of the project will be explored with community newsletters and local councils being approached.

The AMT have recently opened a Twitter account and this will be used alongside other social media accounts to further publicise the project.

Shropshire young health champions (Commended - Antibiotic Guardian Awards 2018)

Provide a brief overview of your project:

A member of my family was hospitalised due to infections which caused her to develop antibiotic resistance, I want the public and young people to understand that medication, especially antibiotics, should be taken with care and not to misuse them. Because of this, we have created a leaflet and a short film.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

I created a leaflet about what antibiotic resistance is and how it happens. then we teamed up with Fixers to create a short film about the project. In the process of making the film we interviewed some members of the public in the square in Shrewsbury asking about their knowledge on the matter. Not only have we created the leaflet and made the short film which was broadcast on ITV central news. We distributed the leaflets out to members of the public and to local doctors surgeries and pharmacies to raise the awareness.

How is the project to be developed in the future?:

We aim for the leaflets to be distributed through GP’s and pharmacies so that more people can learn about the project, a three page power point is also being sent out to pharmacies and GP’s to be shown in waiting rooms.

University of Plymouth

Provide a brief overview of your project:

At the University of Plymouth (UoP), we strongly support the need to maintain a clear, ongoing message about the threat of antimicrobial resistance (AMR) and the need to preserve antibiotics for future generations. We enthusiastically engage with local stakeholders, the general public and the UoP community throughout the year to deliver this message using a wide range of events and media types.

The focus of our activities is to increase awareness about the threat of AMR, the need to take antibiotics as prescribed by clinicians, and the use of self-help approaches to improve health. Wherever we can, we encourage people to become Antibiotic Guardians, to help raise awareness among target audiences and inspire and drive behaviour change. We also use our events to highlight some of the research into AMR we are conducting and to help engage the local community in our activities.

The events are delivered by academic staff, post-doctoral researchers, PhD candidates and undergraduate project students. Substantial support is supplied by UoP through resources in the Media, Events and Marketing teams, which has increased the reach and level of engagement and participation in our activities. Audiences attending our events have ranged in age from sixth form pupils (age 16-18) to University of the Third Age members (over 60). Activities vary from informal lectures through to fully interactive events, where attendees have been involved in the initial stages of antibiotic discovery. Feedback has been excellent, with requests for additional and longer sessions. And so we are developing  a portfolio of new events, with supporting material that will be added to and used on future occasions, and we encourage adoption of any of our practice by relevant groups in other institutions.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

1. a) World Antibiotics Awareness Week 2017 campaign

An opinion piece (appendix) by AMR researcher Dr Mathew Upton created regional print and broadcast coverage. These items and other content, including a specially designed animation (appendix), were shared through the University’s website and social media channels. The campaign team also promoted and held a pub quiz, an interactive lab session on beta-lactamase resistance, a screening of the film Resistance with associated Q&A session, and a research poster exhibition. The size of audience is difficult to measure, but thousands of impressions were recorded on social media and more than 80 people attended the events.

1. b) Inaugural UoP Research Festival

Following social media action and approaches to community groups, 72 people attended an AMR event in January 2018, which included a talk on AMR and UoP research, and two interactive sessions (appendix). Session one, on antibiotic discovery, saw attendees take swabs of the local environment, which were processed in the lab, with sample progress posted on a bespoke Facebook page (appendix – https://www.facebook.com/pg/Plymouth-Research-Festival-AMR-project-421311134971382/posts/?ref=page_internal). The second session involved sixth form pupils providing samples from around their schools to use in a minion DNA sequencing device. The metagenomic DNA sequences produced were examined for genes relating to AMR; demonstrating that these genes are present in the natural environment.

1. c) UoP internal engagement campaign

With nearly 3,000 staff across a variety of disciplines, UoP has conducted a purposeful internal engagement campaign, promoting both the protection of antibiotics, how to become an Antibiotic Guardian and the work of the AMR team. Media used include the weekly Staff bulletin (appendix), staff poll (appendix), noticeboard posters (appendix), and keynote speeches at internal events. By actively instilling the importance of protecting antibiotics among its staff, UoP hopes that the message has the potential to be carried and shared among many more external stakeholders.

How is the project to be developed in the future?:

Having made strides in engaging staff, UoP is now looking to instil the importance of protecting antibiotics among its 21,000 students. With the majority of our students under the age of 25, the team is aware of the need to make the subject relatable. Dr Tina Joshi is taking part in Soapbox science event (appendix) this year to highlight how STIs may become untreatable if AMR is realised. Dr Joshi will work with the UoP Students’ Union and Wellbeing teams to discuss how this AMR message in relation to STIs can be shared through UoP student support services.

Regular messages on AMR-related events and research will be posted in the weekly Student bulletin and on the Student intranet portal. In the lead up to World Antibiotics Awareness Week, holding slides (appendix) on AMR and how to become an Antibiotic Guardian will be provided to all UoP lecturers to share at the start of their teaching sessions.

UoP is committed to promoting the protection of antibiotics across disciplines. To this end, UoP composer Professor Eduardo Miranda is set to launch a composition focused on AMR, where antibiotic resistance genes are presented as music, bringing a new dimension to visualisation of AMR. Through all of these activities, we aim to inspire the next generation of interdisciplinary scientists working to combat AMR.

Finally, during the Royal opening of the University’s new research facility in May, HRH The Princess Royal will launch a new AMR research project, led by Dr Mathew Upton, that will reveal the genome sequence of an exciting novel antibiotic producing bacterium isolated from deep-sea sponges. Local media will be attending and, as well as using this opportunity to engage the public, the story will be used to inspire students to embark on further study in the sphere of AMR.

W5 Interactive Science Centre (Highly Commended - Antibiotic Guardian Awards 2018)

Provide a brief overview of your project:

This event was a collaboration between W5 Interactive Discovery Centre (https://w5online.co.uk/), the Centre of Excellence for Public Health Northern Ireland (https://www.qub.ac.uk/research-centres/CentreofExcellenceforPublicHealthNorthernIreland/) and the Public Health Agency (http://www.publichealth.hscni.net/). On European Antibiotic Awareness Day W5 hosted an event called “Become an Antibiotic Guardian”.

The aim of this event was to inform and educate children and their parents on the importance of appropriate antimicrobial use and to help demonstrate their key role in preventing an increase in antimicrobial resistance.

The Antibiotic Guardian event invited children and their families on a journey through W5 – the children received an Antibiotic Guardian Passport which they had to complete by attending a range of different activities and demonstrations located throughout W5. Each activity was delivered by a group of volunteers with knowledge of antimicrobial resistance. This group included scientists, nurses, pharmacists and doctors.

During the journey they discovered what microbes are and the difference between bacteria, fungi and viruses and were tasked with designing their own microbes which could be ‘good’ or bad’. A balloon demonstration explained how resistant bacteria aren’t able to be penetrated by antibiotics and a UV germ light visually demonstrated to the children how these bacteria can be spread by not washing our hands correctly. Tablets at each activity had various games from the E-bug resources and the Longitude Prize Superbugs game which demonstrated how antimicrobial resistance can develop. This range of activities ensured there was something to engage and educate the broad range of age groups that attend W5.

At the end of their Antibiotic Guardian journey, the children received a certificate for taking part in the event with some friendly toy antibiotic bugs and colouring pencil freebies. At the collection point for their reward doctors and pharmacists discussed the challenges of antimicrobial resistance and how everyone can play their part it tackling this threat. Several of the parents chose to sign up to become antibiotic guardians.

89% of those who completed evaluation forms would attend this event again and 89% felt that the information provided had given them a better understanding of when antibiotics are necessary. 91% reported they knew more about antibiotic resistance after attending the event. A video showing the highlights of the event released on social media has reached 4,635 people (as of 9th March 2018).

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

1. The Antibiotic Passport: Children each were given an “Antibiotic Guardian Passport”. When they completed an activity at each of the stations set up throughout the W5 complex they received a passport stamp. A completed passport could then be traded in for a certificate with their name to confirm they had successfully completed their journey. This motivated the children to attend each station. The stations were strategically designed to communicate the key elements of protecting antibiotics – from “what is a microbe?” or “are all microbes bad?” through to “how do antibiotics become resistant to antibiotics?” and “when do I need an antibiotic?”. Age appropriate highly interactive activities at each station communicated these key messages and engaged the children in exploring and discussing the concepts.
2. Certificate of Completion: At the completion of the activities the children attended a station to collect their certificate. This station was designed to provide opportunity to engage their parents/guardians in discussion on the challenges of antibiotic resistance and what they as a family could do. Doctors and Pharmacists were strategically placed at this station and sought opportunity to chat with the adults and explore their views and opinions. In the background key visuals were displayed such as the Keep Antibiotics Working Campaign video. Awareness of the antibiotic guardian campaign was raised, and parent/guardians were given the opportunity to sign up for one of the family pledges either on paper or via tablets. A large proportion chose to do so – with others agreeing to consider it further.
3. Take home Reminders: Each child who completed the activities in full received a small gift. They were able to choose from an antibiotic guardian bug, a set of coloured pencils, or a lanyard. Each of these carried the antibiotic guardian logo and colour theme. On the back of the antibiotic passport card was an antibiotic myth buster. This was contained common myths that exist about antibiotics e.g. ‘I can stop taking antibiotics when I start to feel better’. Each myth was challenged by the current scientific evidence e.g. ‘If you don’t finish the course, you may increase your risk of developing drug-resistant bacteria’. In recognition that many of the passports would make their way into homes this provided another opportunity to communicate our messages on what families could do about antibiotic resistance.

How is the project to be developed in the future?:

The success of this project has resulted in the team seeking further opportunities to meet with and discuss the key issues with members of the public.  An opportunity has been identified to participate in Northern Science Festival http://www.nisciencefestival.com/ This well established event provides an opportunity for the best scientists to discuss their work, cutting-edge research and what the future might hold. It is open to any interested member of the public and over 50,000 individuals attend the festival. We will be delivering many of our activities from the W5 event at an antimicrobial resistance themed workshop, and a member of the team will be participating in a panel discussion on the threat of antimicrobial resistance.

The Balmoral show is Northern Ireland’s largest agricultural show with an attendance annually of approximately 115,000 attendees. We are planning to contribute to this event by hosting a stand with a focus on antibiotic resistance; and currently are exploring options to co-run this with veterinary colleagues. Such an approach will fit with the One Health approach to antimicrobial resistance – and will also enable us to engage fully with the attendees who will range from families to agricultural professionals to the food industry. The interactive activities used successfully at our event will be expanded and developed to meet the interests of this diverse group.

NHS SOUTHWARK CCG

Name: Tara Patel, Primary Care Pharmacist

Provide a brief overview of your project? Max 400 words: For World Antibiotic Awareness Week, the Medicines Optimisation Team (MOT) took a multifactorial approach to promote awareness to the public in Southwark – these have been highlighted below:

1. National Public Health England Antibiotic Guardian campaign material was utilised and sent to community pharmacists, via the Local Pharmaceutical Committee who were encouraged to promote WAAW/EAAD messages via their twitter account.

2. The MOT liaised with Southwark Council to share antimicrobial stewardship (AMS) messages with local people via:
i) Southwark resident e-letter
ii) Southwark Life Magazine (50, 000 residents on the mailing list)

3. Infection prevention and AMS messages were promoted to the public through the local media via our CCG Chair’s “Dr Know” column and a “Get Well Soon without Antibiotics” advertorial in Southwark News

4. The CCG’s twitter account was utilised to tweet twice daily messages throughout WAAW, which was continued throughout the winter period. This was linked in further with the Stay Well This Winter campaign

5. The team worked with the Southwark Council school’s lead to promote infection prevention and control to schools via letters to Southwark head teachers and parents

6. An awareness stand was set up in the foyer of the Southwark Council building – visitors were encouraged to complete an Antibiotic Guardian Quiz to educate and also estimate awareness levels. 118 quizzes were completed

7. The awareness stand also included a hand washing station with a UV light box. Visitors to the stand were given a demonstration on correct hand washing technique and encouraged to try for themselves

8. With all of the areas listed above, the public were encouraged to sign up to be an Antibiotic Guardian.

To view the information sent to stakeholders outlined above, please see the attachments.

List any supporting partners or organisations worked with:

1. 1. Southwark Public Health

1. 2. Southwark Council

3. Lambeth Southwark Lewisham Local Pharmaceutical Committee

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category?: Antibiotic guardian resources were utilised to raise awareness. In terms of demonstrating success, Southwark CCG has the highest number of Antibiotic Guardians per 100,000 population per calendar year out of all of the London CCGs, and is the 4th best in England.

The Antibiotic Guardian quiz used as a tool with the aim to provide education to the visitor around antibiotic prescribing and AMS. Participants were encouraged to include their age and sex at the top of the answer sheet. Although not a validated tool, we analysed the results of this to estimate levels of awareness, and to see whether there were any differences between genders and age groups. 118 quizzes were completed. “My GP has only given me a short prescription of antibiotics but I think I need them for longer” was the most correctly answered question, with the exception of 1 person (male, aged 20-29) answering incorrectly. “Drug resistant infections, also known as antibiotic resistant infections are serious because…” was the most incorrectly answered question, with almost 30% of participants answering incorrectly. This information and success of the quiz has increased our focus of the need for more education on antibiotic resistance and inspired further work to be carried out in conjunction with local Public Health on more strategic awareness raising.

Please cite 3 examples within the project which highlight promotion of the protection of antibiotics? Max 400 words:

1. Dr Know column
   Written by the CCG’s Chair, this column is included in the local newspaper on a fortnightly basis, and is used to provide information to the public, looking at the issue from the GP’s perspective. For WAAW, we used this as a forum to communicate relevant messages about self-care, and antibiotic resistance to the people of Southwark. The column has been emailed through for you to view.2. Get well soon without antibiotics advertorial
   This column was also included in Southwark News just before WAAW, to remind the public about hand washing, overuse of antibiotic leading to resistance and promotion of self-care for self-limiting conditions such as coughs and colds. This advertorial has been emailed3. Antibiotic guardian quiz
   As highlighted in the previous question, the quiz was used to educate visitors to our stand on antibiotic prescribing, antimicrobial resistance and self-care for self-limiting conditions, as well as estimate levels of awareness

Key outcomes of project?:

• The Antibiotic Quiz results analysed showed:

1. 111 out of 112 answered they would ‘take antibiotics exactly as prescribed’, showing that most people follow advice given by their GP
   ii. Awareness on the difference between bacterial/viral infections and how this relates to antibiotic use and awareness around using community pharmacists with self-care appears to be reasonably high amongst all age groups.
   iii. There is still some lack of awareness on how antimicrobial resistance develops. Further public education around this is required.• Southwark has the highest number of Antibiotic Guardian for 2016 out of all of the London CCGs, demonstrating that the people of Southwark care about AMS and protecting these drugs for the future.

How is the project to be developed in the future?: – The CCG will be supporting WAAW and EAAD 2017

– The MOT are looking to continue working with Public Health colleagues and Southwark School’s lead with the aim to influence nurseries/school’s exclusion policies, and also provide some education resources to parents, helping them to self-manage self-limiting conditions when appropriate
– We would like to look into the possibility of creating and conducting a validated survey in a wider patient group in Southwark, to get an meaningful insight into public awareness locally. This may be beneficial in identifying particular areas which we can then work on to fill gaps in knowledge and amend patient perception of appropriate prescribing of antibiotics.

Public Health England South West Centre

Name: Chaamala Klinger; Consultant in Communicable Disease Control

Provide a brief overview of your project? e-Bug is an educational resource for children and young people which educates on hygiene, the spread of infection and antibiotics. e-Bug mainly has resources for schools, but the interactive e-Bug activities are suitable for a range of audiences and environments. Co-ordinated by the PHE South West regional team, e-Bug worked alongside the At-Bristol Science Centre to develop activities to run in the Science Centre Live Lab area. This area has activities which are run and facilitated by members of the At-Bristol staff. The activities aimed to increase knowledge on antibiotics, antibiotic resistance and treating common infections. The activities included information on Antibiotic Guardian, a campaign to increase awareness and knowledge on antibiotics.

The activity was divided into three stations and took around 10-15 minutes to complete:

1. The scientist: students were introduced to microbes, bacteria and antibiotic resistance. Students studied agar plates which had been touched with hands and microbes left to grow for at least 2 weeks. Students also saw images of bacteria and antibiotic resistant bacteria growing on agar plates in a lab.
2. The doctor: students listened to 3 scenarios in a GP consultation. One where the patient had a cold and did not need antibiotics, one where the patient had a sore throat and was otherwise healthy and so was not prescribed antibiotics, and the final scenario where the patient had pneumonia and was given antibiotics.
3. Ourselves: students were shown the “snot gun” to demonstrate how far a sneeze can travel. Students stopped the sneeze with their hands, and then they caught the sneeze in a tissue and put the tissue in the bin.

Over six weeks in 2016, children who visited the At-Bristol Science Centre with their school or families took part in the antibiotic activity.
The ability of the activities to improve knowledge on antibiotics was evaluated through knowledge change questionnaires with the students.

Please list any supporting partners or organisations worked with: eBug
At Bristol
South West Public Health England Centre

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category? The evaluation took place over six days. Over these days, students from six primary schools and children who attended with family or home educators completed the activity and participated in the evaluation.

69 before questionnaires and 54 after questionnaires were completed by children aged between 7 and 14 years.

All eight questions showed an improvement in knowledge around antibiotics and antibiotic resistance. The greatest knowledge improvement came in the question “The more we take antibiotics, the more antibiotic resistant bacteria develop”. This had the lowest knowledge prior to the activity.

The questionnaire results suggest that the activities were successful in improving knowledge and awareness of antibiotics in young people. It is hoped that through these activities, key messages around antibiotics will also be passed to family members at home.

Please cite 3 examples within the project which highlight promotion of the protection of antibiotics? Max 400 words: 1. The GP consultation – promoting the idea that antibiotics are not needed for all infections
2. Promoting good hand hygiene and infection control to prevent the spread of infections and therefore reduce the demand for antibiotics
3. Promoting the idea that we can all make a difference and have a role to play in protecting antibiotics.

Key outcomes of project?: This is the first time that PHE and eBug have collaborated with a science centre to promote infection control and AMR messages. At-Bristol provided an informal learning environment where an activity could be piloted. The partnership allowed to pilot a different format for e-Bug activities thus exploring other learning environments than the formal one (i.e. schools). This allowed AMR messages to reach a wider and more diverse range of audiences: for example, mostly family visits during weekends, parents with younger children and school groups during weekdays.

The project was successful and provides support for this method of public engagement being tried elsewhere in the country.

A collaborative partnership between PHE and At-Bristol was established. This will allow further public engagement events to take place in the future.

How is the project to be developed in the future?: We plan to build on the partnership and will develop further public engagement projects; for example around Antibiotic Awareness Week.

At-Bristol is opening its spaces and piloting new formats to expose visitors to contemporary research through partnerships with research groups and initiatives, such as the e-Bug project.

NHS Leeds North Clinical Commissioning Group

Name: Gillian Chapman

Provide a brief overview of your project: Please see tables

List any supporting partners or organisations worked with:

Brainbox Research
Leeds City Council Public Health Dept
S+W Yorkshire and Bassetlaw Commissioning Support Unit
Leeds Involving People
Engaging Voices

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category? The project has produced some evidence of improvement in public understanding about antibiotics (see below)
Antibiotic insight results:
Insight work completed by: W+S Yorks + Bassettlaw CSU When: Jan – March 14 How many people surveyed: 383 Method: A paper based survey covering established networks and patient groups. GP practice waiting rooms in high prescribing areas were also targeted.
RESULTS: answer to survey questions
Would you go to GP for advice for themselves or family member for cough, sore throat or cold (% yes) % who wouldn’t expect antibiotics for cold cough sore throat % who said doctor had explained why antibiotics not appropriate for them % who thought taking antibiotics would make them less effective in future % who said they understood about superbugs and MHSA
53% 68% 66% 78% 50%

Insight work completed by: Leeds Involving People When: May 15 How many people surveyed: 1274 Method: On line and face to face surveys.
RESULTS: answer to survey questions
Would you go to GP for advice for themselves or family member for cough, sore throat or cold (% yes) % who wouldn’t expect antibiotics for cold cough sore throat % who said doctor had explained why antibiotics not appropriate for them % who thought taking antibiotics would make them less effective in future % who said they understood about superbugs and MHSA
17% 85% 18% 75% 78%

During September 2016 the insight work used different question sets but still with the same purpose of ascertaining different populations’ health beliefs about antibiotics and giving recommendation for the most effective format for future campaigns. They contacted 786 people via an online survey distributed to the Leeds City Councils’ Citizen’s Panel, to organisations and individuals affiliated with Voluntary Action Leeds (VAL) and via the CCG’s social media channels. They also conducted two focus groups with elderly Asian and Eastern European communities.
Results of the 2016 research revealed:
• Majority of people said they believe coughs, colds and sore throats get better on their own, and that antibiotics do not work on these types of illnesses.
• There is a general perception among people that antibiotics are to be avoided; however the link between overuse of antibiotics and antibiotic resistance is not often made in people’s minds.

Please cite 3 examples within the project which highlight promotion of the protection of antibiotics:

1. Results of the insight work lead us to produce a pictorial non-prescription pad for use in non -English speaking communities
   2. Results of the insight work lead us to translate the ‘Antibiotics are not for you’ leaflet into 15 different languages
   3. Results of insight work has confirmed which are the optimal locations for promotional materials eg outsides of buses was cited as a commonly seen location

Key outcomes of project?:

1. We have been able to show improvement in our populations knowledge about antibiotics
   2. We have been able to target our campaigns to meet the needs of local communities

How is the project to be developed in the future?: Our research leads us to make the following recommendations regarding antibiotics interventions and campaigns.

1. Local campaigns to address inappropriate antibiotic use should be increased to reflect the magnitude of the AMR crisis. These should reflect local conditions, features and norms.
   2. A targeted plan of action to raise AMR awareness should be developed, including schools, work-places and engaging local leaders to raise awareness of AMR.
   3. Campaigns should consider which condition they address and what images they feature. Messages about the common cold have become embedded, but people are less sure about the appropriateness of self-care for coughs, sore throats and flu.
   4. Campaigns should specifically highlight AMR, providing people with an understanding of why it is important to reduce antibiotic prescribing and strengthen understanding of the role they each play in reducing the risk AMR presents.
   5. Campaigns should consider utlising the dramatic power of the ‘antibiotic apocalypse’, to facilitate higher levels of behaviour change and reduce the propensity to request antibiotics for coughs, colds and sore throats.
   6. Further interventions/materials to support GPs to be more confident to not prescribe antibiotics should be developed and evaluated.
   7. Materials should include information on self-care and average length of time each condition lasts.
   8. Targeted work to raise the awareness of Eastern European communities should be undertaken. Community Educators could be a suitable way to address this, but also placing mainstream campaign materials, in appropriate languages, in non-health locations would develop this understanding.

Shropshire Clinical Commissioning Group

Name: Nicola Riley

Provide a brief overview of your project?: Shropshire medicine management team and young health champion coordinators created a summer school for young health champions (11- 25years old) to learn about antibiotic resistance and how to be guardians of antibiotics for the future.

The young people met with Fixers a youth charity and used what they had learnt from their summer school to come up with a campaign for Shropshire to raise awareness of antibiotic resistance and how to use, dispose of and safeguard antibiotics for future generations.

The young people designed a capsule which opens to reveal a young and trendy information leaflet about antibiotic resistance and how to best use antibiotics and when they are really needed.

The young people launched their capsules and their campaign at a local swimming pool filled with plastic balls to signify how antibiotics can get into the water system if they are disposed down the toilet. They explain how the best way to dispose of old medicines is to return them to your pharmacy.

The young health champions then gave out capsules in the town over the Christmas period as the gift of health for the new year.

List any supporting partners or organisations worked with: Medicines Management Shropshire Clinical Commissioning Group, Young Health Champions in partnership with Fixers

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category?: 30 young health champions attended the Summer School participated in fun interactive activities which explored antibiotic resistance the dangers and how we can help safeguard antibiotics for future generations. Such as going to your pharmacist for advice. How to treat coughs and colds. When and how to use antibiotics safely.

The young health champions were all set with homework to talk about antibiotic resistance to their families and check, with the help of a adult, their medicines cabinet for unused or half used antibiotics and return them to their local pharmacy and to educate their families about what they’d learnt about antibiotic stewardship at summer school.

As part of their developing their antibiotic campaign they devised a short questionnaire which they asked people of all ages in the town what they knew about antibiotic resistance and as part of that questionnaires gave passers by the facts about how they could help save antibiotics.

Young health champions designed a young person friendly leaflet to look like an antibiotic when placed in its large clear capsule. These were then given out to the public over the Christmas period 2015.

By delivering this work we estimate we have reached 700 people so far with our work locally.

Please cite 3 examples within the project which highlight promotion of the protection of antibiotics?: Always take the full prescription even if you feel better

Never share antibiotics with others.

Only use antibiotics when prescribed by a certified professional.

Are 3 of the 6 things “you can do” on they leaflet the young people are giving out.

Key outcomes of project?: An awareness of antibiotic resistance and stewardship among young people 11 – 25 in Shropshire.

An awareness of antibiotic resistance and stewardship among their friends family and the public within Shropshire.

A wider awareness raising and stewardship to other young people nationally through Fixers.

For young Health Champions to become peer educators about antibiotic guardianship.

How is the project to be developed in the future?: We hope to expand our reach by adding the capsule leaflet into prescription bags for those who are prescribed antibiotics in Shropshire until our leaflets run out.

We hope to train up more young health champions so they can deliver “antibiotic guardian training” in schools around the county.

Oxford University Hospitals NHS Foundation Trust

Name: Rakhee Mistry, Rotational Specialist Pharmacist, Renal and Antimicrobials

Provide a brief overview of your project? Max 400 words: At Oxford University Hospitals NHS Foundation Trust (OUHFT), the Antimicrobial Stewardship Team (AMST) is trying to empower staff, patients and the local community to contribute to the fight against antibiotic resistance. World Antibiotic Awareness Week and European Antibiotic Awareness Day (EAAD) provided opportunities to raise awareness within the local community about resistance and encourage appropriate prescribing and use of antibiotics.

The younger generation has a key role in influencing their friends and families to use antibiotics appropriately. AMST approached a local primary school to engage them with the EAAD campaign. A consultant microbiologist and an antimicrobial pharmacist gave a school assembly to local primary school children about ‘mean microbes and awesome antibiotics’. The assembly focused on antibiotic resistance and how to use antibiotics correctly. An information leaflet was developed for children to discuss with their family. The children were asked to design posters about antibiotic resistance to display within OUHFT on EAAD.

Healthcare students are crucial to support the appropriate prescribing and use of antibiotics. As part of preparation for EAAD, junior doctors and medical students at Oxford University were given an educational session about stewardship and invited to develop posters about resistance and stewardship which could be displayed throughout the hospital. The poster competition was a success and engaged many students.

Pre-registration pharmacists within OUHFT were given a seminar about stewardship and asked to develop literature for patients, visitors and staff members that could be distributed on EAAD. They also developed T-shirts for staff members to wear on EAAD and designed posters about resistance and the Antibiotic Guardian campaign to be displayed throughout the Trust.

On EAAD, stands in the hospital entrances were created displaying posters by the school children, the medical students and the pre-registration pharmacists. PHE EAAD resources were available as well as the locally developed information. The pre-registration pharmacists and AMST actively approached members of the public and staff and shared information about appropriate antibiotic use whilst encouraging people to pledge to be an Antibiotic Guardian.

A radio broadcast on BBC Oxford and a press release and social media posts via Facebook and Twitter about OUHFT EADD activities were used to raise awareness of the importance of appropriate antibiotic use and the commitment of OUHFT to do this.

The OUHFT EAAD campaign successfully used a variety of innovative approaches to interact with staff and the local community to raise awareness about antibiotic resistance and stewardship.

List any supporting partners or organisations worked with: 1. John Hampden School, Thame, Oxfordshire
2. Oxford University Medical School

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category?: The EAAD campaign at OUHFT engaged with a local school and university and reached out to patients, staff members and the visitors of the hospital sites.

Following on from the school assembly, the children were given information leaflets and were asked to demonstrate their learning with a poster competition. Many posters were submitted to OUHFT and most of them included information about taking antibiotics appropriately to avoid resistance; to avoid taking antibiotics for colds and flu and good hand hygiene. This demonstrates that the school assembly and leaflets had successfully educated the children and potentially their families about appropriate use of antibiotics.

Similarly, the medical students at Oxford University were also asked to demonstrate their learning following on from a teaching session, in the form of a poster competition. Several entries were received which primarily focused on appropriate antibiotic prescribing and use of local guidelines. These posters were displayed within the doctors mess and were well-received by the junior doctors.

Lastly, stands were created at the hospital entrances which were manned by pre-registration pharmacists and AMST. Discussions which developed between the pre-registration pharmacists and patients and visitors demonstrated the learning about antibiotic stewardship that they had gained from their teaching session. Additionally, the numbers of pledges to become Antibiotic Guardians have increased in the Oxford area.

Overall, OUHFT developed a very successful EAAD campaign which demonstrated that the local community and staff members learnt about antibiotic stewardship and how to help to fight resistance.

Please cite 3 examples within the project which highlight promotion of the protection of antibiotics?: Protection of antibiotics was paramount throughout the OUHFT campaign. The first example of how this important topic was highlighted was within the school assembly. The school assembly involved a PowerPoint presentation which explained the topic of antibiotic resistance and this led on to the importance of protecting our current antibiotics to avoid resistance. The resulting poster competition demonstrated the children’s understanding of protecting our current antibiotic supply.

The second example of this was in the medical student educational session and subsequent poster competition which aimed to highlight the importance of appropriate antibiotic prescribing to future prescribers and current junior doctors. The use of local guidelines was also promoted in the poster competition to encourage appropriate prescribing which would protect our current antibiotics.

Lastly, on EAAD the pre-registration pharmacists and AMST were encouraging members of the public to protect current antibiotics. Active discussions about taking antibiotics appropriately to protect current antibiotics were common within the general public and patients. The pre-registration pharmacists reiterated to patients and members of the public that protection of antibiotics is the forefront of being an Antibiotic Guardian.

Key outcomes of project?: Key outcomes of this project include:
1. Increased understanding about antibiotic resistance and knowledge of how to take antibiotics properly amongst children and families.
2. Increased awareness of appropriate prescribing of antibiotics amongst medical students and junior doctors.
3. Education of patients, visitors and other members of the general public about antibiotic resistance and how to prevent it.
4. Increased number of Antibiotic Guardian pledges in the Oxford area.

How is the project to be developed in the future?: The OUHFT EAAD campaign could be developed in the future to include greater use of multimedia, for example, a short video. This video could be uploaded onto the Trust Intranet, social media and broadcast via the hospital television.

Furthermore, AMST could build upon the contact made with the local primary school by having a teaching session which could involve an assembly and a class so the children can complete e-bug games and activities with the teachers and AMST.