Current Messaging Used for Antimicrobial Resistance in Public Awareness Campaigns: A Scoping Review

Abstract

Bacterial Antimicrobial Resistance (AMR) is a global health threat. The lack of a universal communication strategy remains a limitation in public awareness campaigns related to antibiotic use and AMR. We reviewed the published evidence on current messaging used in public awareness campaigns between 2000 and 2024. Of the 42 studies included, 21 campaigns were reported from European countries compared to one campaign from an African country. Educational campaigns were the most common type reported (57%). Whilst multifaceted approaches were used, print material was the most common communication medium. The three key messaging themes were communicating AMR risks, AMR solutions, and antibiotic use. Sub-themes included inappropriate antibiotic use, self-care, and ineffectiveness of antibiotics against viral infections. In campaigns that included tailored messaging, parenting roles, age, and susceptibility to respiratory infections were strong determinants of targeted behaviors. Risk communication was used in 36% of studies, including focusing on the dangers of AMR to public health and preventative actions such as hand hygiene. Positive outcomes were reported in 69% of the studies. Sociocultural factors were not considered in the design and delivery of messages, yet differences in AMR knowledge, attitudes and behaviors were observed across sociodemographic indices such as literacy, age, and gender of the target population. Whilst consistent messaging in AMR public awareness is being reported, current campaigns fail to use context-specific communication. To our knowledge, these findings are the first to highlight the need for targeted public messages that are sociocultural and context-specific in promoting sustainable action.