What are the 'active ingredients' of interventions targeting the public's engagement with antimicrobial resistance (AMR) and how might they work?

TY - JOUR

T1 - What are the 'active ingredients' of interventions targeting the public's engagement with antimicrobial resistance (AMR) and how might they work?

AU - McParland, Joanna L.

AU - Williams, Lynn

AU - Gozdzielewska, Lucyna

AU - Young, Mairi

AU - Smith, Fraser

AU - MacDonald, Jennifer

AU - Langdridge, Darren

AU - Davis, Mark

AU - Price, Lesley

AU - Flowers, Paul

N1 - Acceptance in SAN AAM includes statement of contribution after page 1. Tables 1 and 2 (combined) added as separate document. 11.05.18. DC. Above advised by author JP via email on 11-5-18 OA article - VoR uploaded

PY - 2018/11

Y1 - 2018/11

N2 - Objectives: Changing public awareness of antimicrobial resistance (AMR) represents a global public health priority. A systematic review of interventions that targeted public AMR awareness and associated behaviour was previously conducted. Here we focus on identifying the active content of these interventions and explore potential mechanisms of action. Methods: The project took a novel approach to intervention mapping utilising the following steps: (i) an exploration of explicit and tacit theory and theoretical constructs within the interventions using the Theoretical Domains Framework (TDFv2), (ii) retrospective coding of behaviour change techniques (BCTs) using the BCT Taxonomy v1, and (iii) an investigation of coherent links between the TDF domains and BCTs across the interventions.Results: Of 20 studies included, only four reported an explicit theoretical basis to their intervention. However, TDF analysis revealed that nine out of the 14 TDF domains were utilised, most commonly ‘Knowledge’ and ‘Environmental context and resources’. The BCT analysis showed that all interventions contained at least one BCT, and 14 out of 93 (15%) BCTs were coded, most commonly ‘Information about health consequences’, ‘Credible source’, and ‘Instruction on how to perform the behaviour’. Conclusions: We identified nine relevant TDF domains and 14 BCTs used in these interventions. Only 15% of BCTs have been applied in AMR interventions thus providing a clear opportunity for the development of novel interventions in this context. This methodological approach provided a useful way of retrospectively mapping theoretical constructs and BCTs when reviewing studies that provide limited information on theory and intervention content.

AB - Objectives: Changing public awareness of antimicrobial resistance (AMR) represents a global public health priority. A systematic review of interventions that targeted public AMR awareness and associated behaviour was previously conducted. Here we focus on identifying the active content of these interventions and explore potential mechanisms of action. Methods: The project took a novel approach to intervention mapping utilising the following steps: (i) an exploration of explicit and tacit theory and theoretical constructs within the interventions using the Theoretical Domains Framework (TDFv2), (ii) retrospective coding of behaviour change techniques (BCTs) using the BCT Taxonomy v1, and (iii) an investigation of coherent links between the TDF domains and BCTs across the interventions.Results: Of 20 studies included, only four reported an explicit theoretical basis to their intervention. However, TDF analysis revealed that nine out of the 14 TDF domains were utilised, most commonly ‘Knowledge’ and ‘Environmental context and resources’. The BCT analysis showed that all interventions contained at least one BCT, and 14 out of 93 (15%) BCTs were coded, most commonly ‘Information about health consequences’, ‘Credible source’, and ‘Instruction on how to perform the behaviour’. Conclusions: We identified nine relevant TDF domains and 14 BCTs used in these interventions. Only 15% of BCTs have been applied in AMR interventions thus providing a clear opportunity for the development of novel interventions in this context. This methodological approach provided a useful way of retrospectively mapping theoretical constructs and BCTs when reviewing studies that provide limited information on theory and intervention content.

KW - antimicrobial resistance

KW - AMR

KW - public health interventions

U2 - 10.1111/bjhp.12317

DO - 10.1111/bjhp.12317

M3 - Article

VL - 23

SP - 804

EP - 819

JO - British Journal of Health Psychology

JF - British Journal of Health Psychology

SN - 1359-107X

IS - 4

ER -