Antimicrobial ResistanceNCT06356285
Testing New Ways to Name Antimicrobial Resistance
A study testing Presentation of Antimicrobial Resistance in people with Antimicrobial Resistance and Attitude to Health, run by Imperial College London at 1 site in United Kingdom.
Trial summary
This study aims to investigate the public's views on antibiotics and the impact of different ways to name the potential consequences of antibiotics not working in the future. It is known that current ways to name this don't resonate well with the public, and the study team have worked with members of the public… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Antimicrobial Resistance, Attitude to Health
- What is being tested?
- Presentation of Antimicrobial Resistance
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 4,296 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- 10 Apr 2024to 1 May 2024
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Adults aged over 18
- Resident in the United Kingdom (UK)
- Have passed the attention check at the start of the online survey.
Who cannot join
- Individuals not signed up a market research panel, and will therefore not have access to the online survey
- Those resident outside the UK
- Those who fail the attention check at the start of the online survey.
- Individuals aged under 18.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: How Can we Frame Antimicrobial Resistance in the Best Way to Inspire Behaviour Change? An Online Randomised Controlled Trial.
This study aims to investigate the public's views on antibiotics and the impact of different ways to name the potential consequences of antibiotics not working in the future. It is known that current ways to name this don't resonate well with the public, and the study team have worked with members of the public through focus groups and community workshops to develop new ways of describing this in a process of co-design. This study aims to test four different ways of presenting this potential crisis to the public, some of which are new communication strategies designed by the public themselves, to evaluate which are the most memorable and investigate the impact on behaviour change.
Adults aged over 18, living in the United Kingdom, who have already signed up to a market panel research company will be eligible to participate in this study.
Read more
Participants will be invited to complete a short online survey (this should take around five minutes), advertised to them by the market research panel they have already signed up to. This survey is completely anonymous, and contains some multiple-choice questions, and some that require a short free text response. At the start of the survey one of the four ways to name AMR will be presented to participants in the form of a poster.
This study aims to result in an improved understanding regarding the general public's understanding of antibiotic use and investigate the impact of communication on behaviour change. The data from this study may be used to inform future public health campaigns on this topic and improve the use of antibiotics.
This study will be conducted online using the Predictiv platform, an online platform built by the Behavioural Insights Team. The study is being run in collaboration between the Behavioural Insights Team and the Institute of Global Health Innovation at Imperial College London.
Is it anticipated that the survey will open in April 2024 and be open until recruitment of 4000 participants is complete. This is expected to take 4-6 weeks.
Read the detailed description
Antimicrobial resistance (AMR) refers to the process by which bacteria become resistant to antibiotics, rendering them ineffective in treating infections. Public behaviour change is needed to use antibiotics more sparingly and wisely (for example, only taking them when needed and finishing the course). However, studies and public engagement work have shown that the current language around the crisis of AMR is not well known or understood by the general public. It is felt to be too scientific, not memorable, and doesn't convey sufficient meaning to inspire behaviour change.
Building on previous studies, this project aims to identify whether different ways to present or frame Antimicrobial Resistance (AMR) can lead to improved comprehension and change attitudes towards the crisis. Through extensive public engagement and involvement work three different ways to frame AMR to the public have been developed. One of these ways is a novel name developed through co-design with public members, and the other two were existing terms that the public believed were better than AMR during our engagement activities.
An online randomised controlled trial (RCT) has been designed to test these three names against the control of AMR/Antimicrobial resistance, to see if they can improve comprehension, attitudes towards and recall of the subject.
This online RCT will be delivered in collaboration with the Behavioural Insights Team using their well established online platform, called Predictiv. 4,000 participants will be recruited (to be representative of the UK population). They will see one of our four names (this will be presented in the typical community setting of seeing a poster at a bus stop), and be asked to complete a short five minute survey, answering a series of questions to explore their understanding of the topic and their future attitudes to antibiotic use.
Statistical analysis will be conducted to see which of the four communication strategies were most effective across the different outcomes, helping us to understand which communication strategies for AMR are most useful at inspiring behaviour change. Data will additionally be analysed to explore whether different messaging strategies are more effective in certain population subgroups - for example by age or previous antibiotic use.
- Conditions
- Antimicrobial Resistance, Attitude to Health
- Being tested
- Presentation of Antimicrobial Resistance
- Keywords
- Antimicrobial Resistance, Behaviour Change
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Presentation of Antimicrobial ResistanceBehavioural
Participants will be presented with a poster containing information about antibiotics, each intervention poster will have a different name at the top, representing a new way to frame antimicrobial resistance.
| Study group | Role | What they receive |
|---|---|---|
| Control Arm - Antimicrobial Resistance | No intervention | Participants will be shown an image of a poster at a bus stop. This will contain information about antibiotics, and will have the words "Antimicrobial Resistance" at the top. |
| Intervention Arm 1 - Superbugs | Experimental | Participants will be shown an image of a poster at a bus stop. This will contain information about antibiotics, and will have the word "Superbugs" at the top. Receives: Behavioral: Presentation of Antimicrobial Resistance |
| Intervention Arm 2 - Antibiotic Resistance | Experimental | Participants will be shown an image of a poster at a bus stop. This will contain information about antibiotics, and will have the words "Antibiotic Resistance" at the top. Receives: Behavioral: Presentation of Antimicrobial Resistance |
| Intervention Arm 3 - Antibiotic Crisis | Experimental | Participants will be shown an image of a poster at a bus stop. This will contain information about antibiotics, and will have the words "The Antibiotic Crisis" at the top. Receives: Behavioral: Presentation of Antimicrobial Resistance |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Correct Answers by Participants on Questions Designed to Evaluate Attitudes Towards Antimicrobial Resistance (Sentiment)
Evaluation of participant's attitudes towards antimicrobial resistance, related to questions within the survey that assess sentiment (including agreement that antimicrobial resistance is an urgent issue that needs to be addressed, antimicrobial resistance poses a risk to human health and antimicrobial resistance is an issue that may impact the participants own health).
This was conducted using a quasi-binominal regression model using the sum of binary ratings of sub-sentiment questions as the primary outcome analysis.
Measured: 6 weeks
Secondary outcomes (3)
Percentage of Correct Answers by Participants on Questions Designed to Evaluate Comprehension of Antimicrobial Resistance
Comprehension of the meaning of Antimicrobial Resistance, related to questions within the survey that evaluate comprehension (what has caused antimicrobial resistance, what is the solution to antimicrobial resistance, what antimicrobial resistance is).
This was conducted using a quasi-binominal regression model using the number of correct answers to comprehension questions.
Measured: 6 weeks
Percentage of Participants Who Stated They Would Request Antibiotics
Intention regarding antibiotic use in the context of antimicrobial resistance related to questions within the survey that evaluate intent - asking participants about whether they would request antibiotics in certain scenarios.
This was conducted using a separate logistic regression for each scenario (binary - Yes or No).
Measured: 6 weeks
Percentage of Participants Who Correctly Recalled the Terminology Related to Antimicrobial Resistance
Recall of the term used to describe antimicrobial resistance in the intervention. This was conducted using a separate logistic regression for each question (asking about recall of the name at the top of the poster and the content of the poster) (binary - Yes or No).
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Apr 2024
- Study start10 Apr 2024
- Primary completion18 Apr 2024
- Study completion1 May 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Antimicrobial ResistanceStudies of the same condition, open and under way.
- More trials run by Imperial College LondonThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This study has been designed as a four-armed online randomised control trial (RCT). This will be conducted using Predictiv, an online platform for running behavioural experiments built by the Behavioural Insights Team The 4,000 participants will be randomised in a 1:1:1:1 ratio to one of four trial arms.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 4,296 participants (actual)
Sponsor and investigators
- Lead sponsor
- Imperial College London
- Sponsor type
- University, hospital or other
- Collaborators
- The Behavioural Insights Team
- Responsible party
- Sponsor
- Investigators
- Kate Grailey, Principal investigator, Imperial College London
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06356285
- Sponsor's protocol ID
- 6995049
- Status last verified
- Jan 2025
- First submitted
- 4 Apr 2024
- Last updated
- 14 Jan 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: No personal IPD will be collected in this study. Aggregate participant data will be shared between the Behavioural Insights Team and Imperial College London
Study at a glance
From the registry record, last updated by the sponsor on 14 Jan 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- How Can we Frame Antimicrobial Resistance in the Best Way to Inspire Behaviour Change? An Online Randomised Controlled Trial.
- ClinicalTrials.gov ID
- NCT06356285
- Acronym / sponsor ID
- 6995049
- Conditions
- Antimicrobial Resistance, Attitude to Health
- Keywords
- Antimicrobial Resistance, Behaviour Change
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 4,296 participants (actual)
- Lead sponsor
- Imperial College LondonUniversity, hospital or other
- Collaborators
- The Behavioural Insights Team
- Study start
- 10 Apr 2024 (actual)
- Primary completion
- 18 Apr 2024 (actual)
- Study completion
- 1 May 2024 (actual)
- First posted
- 10 Apr 2024 (actual)
- Results
- Posted 14 Jan 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to investigate the public's views on antibiotics and the impact of different ways to name the potential consequences of antibiotics not working in the future. It is known that current ways to name this don't resonate well with the public, and the study team have worked with members of the public through focus groups and community workshops to develop new ways of describing this in a process of co-design. This study aims to test four different ways of presenting this potential crisis to the public, some of which are new communication strategies designed by the public themselves, to evaluate which are the most memorable and investigate the impact on behaviour change.
Adults aged over 18, living in the United Kingdom, who have already signed up to a market panel research company will be eligible to participate in this study.
Participants will be invited to complete a short online survey (this should take around five minutes), advertised to them by the market research panel they have already signed up to. This survey is completely anonymous, and contains some multiple-choice questions, and some that require a short free text response. At the start of the survey one of the four ways to name AMR will be presented to participants in the form of a poster.
This study aims to result in an improved understanding regarding the general public's understanding of antibiotic use and investigate the impact of communication on behaviour change. The data from this study may be used to inform future public health campaigns on this topic and improve the use of antibiotics.
This study will be conducted online using the Predictiv platform, an online platform built by the Behavioural Insights Team. The study is being run in collaboration between the Behavioural Insights Team and the Institute of Global Health Innovation at Imperial College London.
Is it anticipated that the survey will open in April 2024 and be open until recruitment of 4000 participants is complete. This is expected to take 4-6 weeks.
Detailed description
Antimicrobial resistance (AMR) refers to the process by which bacteria become resistant to antibiotics, rendering them ineffective in treating infections. Public behaviour change is needed to use antibiotics more sparingly and wisely (for example, only taking them when needed and finishing the course). However, studies and public engagement work have shown that the current language around the crisis of AMR is not well known or understood by the general public. It is felt to be too scientific, not memorable, and doesn't convey sufficient meaning to inspire behaviour change.
Building on previous studies, this project aims to identify whether different ways to present or frame Antimicrobial Resistance (AMR) can lead to improved comprehension and change attitudes towards the crisis. Through extensive public engagement and involvement work three different ways to frame AMR to the public have been developed. One of these ways is a novel name developed through co-design with public members, and the other two were existing terms that the public believed were better than AMR during our engagement activities.
An online randomised controlled trial (RCT) has been designed to test these three names against the control of AMR/Antimicrobial resistance, to see if they can improve comprehension, attitudes towards and recall of the subject.
This online RCT will be delivered in collaboration with the Behavioural Insights Team using their well established online platform, called Predictiv. 4,000 participants will be recruited (to be representative of the UK population). They will see one of our four names (this will be presented in the typical community setting of seeing a poster at a bus stop), and be asked to complete a short five minute survey, answering a series of questions to explore their understanding of the topic and their future attitudes to antibiotic use.
Statistical analysis will be conducted to see which of the four communication strategies were most effective across the different outcomes, helping us to understand which communication strategies for AMR are most useful at inspiring behaviour change. Data will additionally be analysed to explore whether different messaging strategies are more effective in certain population subgroups - for example by age or previous antibiotic use.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 4
- Model description
- This study has been designed as a four-armed online randomised control trial (RCT). This will be conducted using Predictiv, an online platform for running behavioural experiments built by the Behavioural Insights Team The 4,000 participants will be randomised in a 1:1:1:1 ratio to one of four trial arms.
| Arm | Type | Receives |
|---|---|---|
| Control Arm - Antimicrobial Resistance | No intervention | –Participants will be shown an image of a poster at a bus stop. This will contain information about antibiotics, and will have the words "Antimicrobial Resistance" at the top. |
| Intervention Arm 1 - Superbugs | Experimental | Behavioral: Presentation of Antimicrobial ResistanceParticipants will be shown an image of a poster at a bus stop. This will contain information about antibiotics, and will have the word "Superbugs" at the top. |
| Intervention Arm 2 - Antibiotic Resistance | Experimental | Behavioral: Presentation of Antimicrobial ResistanceParticipants will be shown an image of a poster at a bus stop. This will contain information about antibiotics, and will have the words "Antibiotic Resistance" at the top. |
| Intervention Arm 3 - Antibiotic Crisis | Experimental | Behavioral: Presentation of Antimicrobial ResistanceParticipants will be shown an image of a poster at a bus stop. This will contain information about antibiotics, and will have the words "The Antibiotic Crisis" at the top. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Adults aged over 18
- Resident in the United Kingdom (UK)
- Have passed the attention check at the start of the online survey.
Key exclusion criteria (4 listed)
- Individuals not signed up a market research panel, and will therefore not have access to the online survey
- Those resident outside the UK
- Those who fail the attention check at the start of the online survey.
- Individuals aged under 18.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Presentation of Antimicrobial ResistanceParticipants will be presented with a poster containing information about antibiotics, each intervention poster will have a different name at the top, representing a new way to frame antimicrobial resistance. | Behavioural | Intervention Arm 1 - Superbugs, Intervention Arm 2 - Antibiotic Resistance, Intervention Arm 3 - Antibiotic Crisis |
Primary outcome
Percentage of Correct Answers by Participants on Questions Designed to Evaluate Attitudes Towards Antimicrobial Resistance (Sentiment)
Time frame: 6 weeks
Evaluation of participant's attitudes towards antimicrobial resistance, related to questions within the survey that assess sentiment (including agreement that antimicrobial resistance is an urgent issue that needs to be addressed, antimicrobial resistance poses a risk to human health and antimicrobial resistance is an issue that may impact the participants own health). This was conducted using a quasi-binominal regression model using the sum of binary ratings of sub-sentiment questions as the primary outcome analysis.
3 secondary outcomes
Percentage of Correct Answers by Participants on Questions Designed to Evaluate Comprehension of Antimicrobial Resistance
Time frame: 6 weeks
Percentage of Participants Who Stated They Would Request Antibiotics
Time frame: 6 weeks
Percentage of Participants Who Correctly Recalled the Terminology Related to Antimicrobial Resistance
Time frame: 6 weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Jan 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: No. No personal IPD will be collected in this study. Aggregate participant data will be shared between the Behavioural Insights Team and Imperial College London
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Nasopharyngeal Carriage of S. Pneumoniae
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kate Grailey principal investigator
Imperial College London
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Presentation of Antimicrobial Resistance in people with Antimicrobial Resistance and Attitude to Health, run by Imperial College London at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 14 Jan 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of Correct Answers by Participants on Questions Designed to Evaluate Attitudes Towards Antimicrobial Resistance (Sentiment) (time frame: 6 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jan 2025.