Evaluation of the Antibiotic Guardian campaign to help tackle antimicrobial resistance, Katerina...

Evaluation of the Antibiotic Guardian (AG) campaign

Combating AMR (CPC Conference) Dr Diane Ashiru-Oredope

The National Institute for Health Research Health Protection Research Unit in Evaluation of Interventions at

University of Bristol

Katerina Chaintarli, DVM, MSc

Background-Aims• Aim of European Antibiotic Awareness Day (EAAD): Raise awareness

towards antibiotic use

• England has participated in EAAD activities since 2008

• UK EAAD 2014: • Move from raising awareness to increasing engagement and changing behaviour• Public Health England developed the Antibiotic Guardian campaign available all

year round

online pledge system


Pledge system (http://antibioticguardian.com)


http://antibioticguardian.com/



Background-Aims

• Purpose of Antibiotic Guardian (AG) campaign:• Increase engagement with the rising threat of Antimicrobial Resistance (AMR)• Concrete personal and collective action to help keep antibiotics active• Provide a system to measure behaviour change

• First example of online pledge system to improve AMR related knowledge and behaviour amongst healthcare professionals and the general public

• Aim of current evaluation: assess whether the AG achieved its goals


Methods - Questionnaire• Online questionnaire: Evaluation of the Antibiotic Guardian campaign

2014

• Sent via e-mail to 9016 out of all 11833 Antibiotic Guardians who consented for follow up (3rd of February 2015)

• Survey included questions on:• Type of pledge & Motivation• Change in behaviour (acting according to pledge)• Knowledge acquired• Clarity of promotion materials• Demographics (age, sex, health-related profession, use of social media)


Methods – Statistical Analysis• Distribution of demographic variables

• Questions analysed as the outcomes of interest:• Change in behaviour: “Since you became an Antibiotic Guardian, have you acted

in line with your pledge?” (categorical)• Change in knowledge: “After becoming an Antibiotic Guardian, do you feel that

you have acquired more knowledge on what antibiotic resistance is?” (binary)• Promotion of the AG campaign: “Indicate your agreement with the statement: “I

think the AG campaign is well promoted” (categorical)

• Logistic and Ordinal Logistic regression models, adjusted for age, sex and pledge group used to estimate associations


Results - Respondents

• 2478 AGs responded: 27.5% response rate• 1696 pledged as healthcare professionals (68%)• 782 pledged as members of public (32%)

↓similar to proportions at total population of 11,833 AGs

• 76.9% were connected to the healthcare system

• 96.3% had prior knowledge of AMR


Results - Demographics


• 73.5% female

• 27.5% 45-54 years old

Results - Behaviour

• 43.9% remembered completely the meaning of their pledge

• 63.4% reported always acting according to their pledge

• Members of public more likely to act according to their pledge than healthcare professionals (OR=3.60, CI: 2.88-4.51)

• Respondents without positive pre-campaign pledge behaviour less likely to have positive post campaign pledge behaviour (OR=0.23, CI: 0.16-0.34)

• AGs that remembered the pledge more likely to have positive post campaign behaviour (OR=1.96, CI: 1.63-2.36)


Results - Knowledge

• 44.5% acquired more knowledge about AMR post campaign

• Sense of personal responsibility towards tackling AMR increased by 12.2% post campaign

• People confused about AMR prior to the AG campaign acquired more knowledge after the campaign (OR =3.10, CI: 1.36 – 7.09)

• Respondents without pre-campaign knowledge more likely to acquire knowledge on AMR post campaign (OR=4.21, CI: 2.04 – 8.67)

• Members of the public less likely to have acquired more knowledge post campaign than healthcare professionals (OR= 0.79, CI: 0.66 – 0.96)


Results - Promotion

• 61.7% agreed to different extents that the AG campaign was well promoted

• 56.7% seemed to think that the website itself was the best source of information

but

more than half of AGs have not seen most promotion materials


Conclusion• Good response of an overall representative sample in terms of proportions

of different pledge groups

• Effective in achieving positive changes in behaviour and an increase in knowledge amongst people with prior awareness of the topic

• Less successful in engaging people without previous professional or personal experience of AMR

• Majority thought the campaign was well promoted but most materials were not seen


Recommendations

• Regular communication with pledgees via e-mails or newsletters to remind their pledge and provide information

• Engage wider members of public → initiatives for alternative promotion methods to get the public aware and engaged with the campaign

• Evaluations should be built into the design of future campaigns → capture pre and post campaign effects


Next steps

• Qualitative methods applied to explore the results from the quantitative analysisQualitative interview study will seek to identify how the AG campaign was engaged with and the mechanisms of impact from the perspective of those who became AG


Thank youAcknowledgements

•Public Health England, AMRs and HCAI Programme Team, London: Dr Diane Ashiru-Oredope, Alex Bhattacharya

•Public Health England, Field Epidemiology Services, Bristol: Dr Maya Gobin, Dr Isabel Oliver

•Health Protection Research Unit in Evaluation of Interventions, School of Social and Community Medicine, University of Bristol: Dr Suzanne M. Ingle

The study was supported by the NIHR Health Protection Research Unit in Evaluation of Interventions. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England.


Evaluation of the Antibiotic Guardian campaign to help tackle antimicrobial resistance, Katerina...

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