This study aims to compare the effectiveness of health education facilitated by neighborhood food and beauty establishments with that facilitated by clinics in increasing the public's knowledge of antibiotic use and antimicrobial resistance (AMR) and improving antibiotic behaviors.
The quasi-experimental study will involve a total of 3300 patrons of the 10 most popular consenting clinics, food and beauty establishments respectively, in two neighborhoods in Singapore.
Recruitment Process
1. Participants will scan the QR code on the posters in the participating clinics/establishments 2. Read the study information sheet 3. Consent will be implied on submission of survey 4. Total recruitment period: One year 5. Target: 3300 patrons of the 30 establishments (10 each of clinics, food, and beauty establishments)
Intervention Structure
1. Participants will complete a pre-intervention/baseline survey (#1) 2. Intervention includes an animated educational video with key messages on appropriate antibiotic use and AMR 3. Followed by immediate post-intervention survey (#2) 4. Provide contact details (mobile phone number) for reimbursement \& future follow-up online surveys 5. Complete follow-up online surveys: at 1 month post-intervention (#3), 3 months post-intervention (#4) and 6 months post-intervention (#5)
Expected Outcomes Increase in public knowledge of antibiotic use and AMR, and antibiotic behaviors through health education facilitated by neighborhood food and beauty establishments, in addition to that facilitated by clinics
Adults aged 21 years and above
Patrons of the 30 participating healthcare clinics, food and beauty establishments
Patrons who are already enrolled in the study at one of the 30 participating establishments
Parallel
Animated educational video on antibiotic use
BehavioralThe intervention features a concise animated video on antibiotic use and AMR. The video's content and format will be developed based on the results of a survey conducted among the community residents in the two neighborhoods. Through the survey, the participants evaluated multiple message options including the various delivery formats. The animated video was designed incorporating the community's preferred key message and delivery method. The resulting video uses graphics, voice-overs, captions \[in all 4 official national languages\] to convey key messages about appropriate antibiotic use and AMR.
Knowledge of antibiotic use - 3 questions from the World Health Organization's Antibiotic Resistance Multi-country Public Awareness Survey questionnaire
Proportion of participants with good knowledge of antibiotic use at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
Knowledge of AMR - 8 questions from the World Health Organization's Antibiotic Resistance Multi-country Public Awareness Survey questionnaire
Proportion of participants with good knowledge of AMR at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
Appropriate antibiotic use - 6 questions adapted from the US Centers for Disease Control and Prevention's advisory on appropriate antibiotic use
Proportion of participants who use antibiotics appropriately at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
Reach - using the RE-AIM framework
The absolute number and proportion of participants who enrol in the study over the one year duration, and also enrollment rate by establisment type over one year
Implementation fidelity - using the RE-AIM framework
Monthly physical visits at all 30 participating establishments for checking poster integrity at the premises and whether staff invite patrons to enrol in the study
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