Guidance

AMR engagement guide: continuous improvement

Published 3 September 2026

This section outlines how to gather feedback and evaluate the impact of antimicrobial resistance (AMR) communication activities so they can continually improve. It explains simple ways to collect user insights, measure changes in knowledge or behaviour and ensure information stays accurate and evidence based.

It also highlights the importance of using trusted sources, sharing findings and regularly updating materials so that AMR messages remain effective, relevant and aligned with national and local campaigns.
Role of feedback and evaluation

Effective measures to reduce the burden of AMR require not only well-designed interventions but also a system for feedback, evaluation, and continuous improvement.

This section is relevant to all organisations using this guide, whether you are a government body, NHS organisation, local authority, voluntary group, NGO, or working in animal health, agriculture, food production, or environmental settings.

As part of the National Action Plan, a number of human health targets have been developed to guide progress. Target 2a states that by 2029 the UK aims to increase public and healthcare professionals’ knowledge of AMR by 10%, using 2018 and 2019 baselines respectively. Evaluation is therefore essential to understand whether engagement and communication activities are contributing to this goal, and to measure progress against national priorities.

Evaluation is essential for AMR engagement because it shows whether activities are reaching the right audiences, being delivered as intended, and producing meaningful changes in knowledge or behaviour. By collecting data on what works and what does not, evaluation helps refine interventions, ensures resources are used effectively, and strengthens accountability. It also reveals why certain approaches succeed or fail, allowing engagement to be tailored more effectively to different communities. Ultimately, robust evaluation builds the evidence base needed to improve AMR communication locally and inform wider public health policy and practice (Introduction to evaluation in health and wellbeing).

The approach you take to evaluation should be proportionate to the scale and resource of your activity. The three tiers below set out what good evaluation looks like depending on the size of your activity. You do not need to be a professional communicator to evaluate your work. At every level, the goal is simply to understand what happened, what changed, and what you would do differently next time.

For government bodies and agencies with dedicated communications resource, the GCS Evaluation Cycle provides a detailed framework for planning and measuring communications and is recommended as a companion resource at the large campaign level.

Potential approaches

Small: low or no-cost activities

This applies to one-off events, social media posts, information stands, community sessions, leaflet distribution, or other low-resource activities. This tier is relevant to all types of organisation, including community groups, voluntary organisations, and frontline health or care settings. Even at this level, some evidence of impact is valuable.

Establish feedback loops by:

• pre-testing communications with a small sample of your intended audience before wider rollout where possible
• gathering informal feedback from participants after events or sessions, for example through a short verbal debrief, a show of hands, or a simple feedback form
• ensuring feedback mechanisms are accessible, including for those with limited English, low literacy, or disabilities - consider easy-read formats or asking community intermediaries to gather insights on your behalf

Monitor and measure impact by:

• using simple measures such as pre- and post-event surveys, attendance numbers, social media engagement rates, or informal feedback forms to provide evidence of impact
• using a small number of straightforward questions to assess basic shifts in knowledge, attitudes, or intended behaviour, for example asking participants what they know about AMR before and after a session can reveal whether understanding has improved - UKHSA WAAW 2025 AMR knowledge questions can provide a useful starting point, though the exact questions should reflect the specific knowledge you want to impart
• noting any qualitative observations about audience response, for example whether questions asked during a session suggest misconceptions or gaps in understanding

Update, improve and share learning by:

• recording what worked and what did not, however informally, so that future activities can benefit
• sharing findings with colleagues and partner organisations where relevant
• feeding any learnings back into future planning, even if this is just a brief conversation with your team

Medium: targeted campaigns or programme activity

This applies to planned communications programmes, local campaigns, or multi-channel activities involving some planning, budget, and coordination. This tier is relevant to local authorities, NHS trusts, integrated care systems, public health teams, animal health organisations, agricultural bodies, and voluntary sector organisations running defined programmes.

Establish feedback loops by:

• creating structured ways for your intended audiences and delivery partners to share insights, such as short surveys, feedback forms, or follow-up conversations
• encouraging those involved in delivering the activity to report on what worked well and what barriers they encountered
• pre-testing and piloting communications with sample audiences before wider rollout
• reviewing learnings from previous AMR campaigns, both your own and others, before designing your approach
• ensuring feedback mechanisms are accessible to diverse audiences, including those with limited English, low literacy, or disabilities - consider translated surveys, easy-read formats, or community intermediaries to gather insights from harder-to-reach groups

Monitor and measure impact by:

• structuring your evaluation around 4 core questions, which reflect the underlying logic of good evaluation frameworks including the GCS Evaluation Cycle (recommended for government bodies), which asks:
  • what did you put in? (Your planning, resources, and preparation)
  • what did you deliver? (The reach and experience you created for your audience)
  • what did your audience take away? (Changes in knowledge, attitudes, or intentions)
  • what changed in behaviour? (Actions your audience took as a result)
• using tools such as surveys, digital analytics, attendance records, and anecdotal feedback to measure engagement
• building in pause points during your activity to review what the data is telling you and adjust your approach while it is still live, rather than waiting until the end
• using local and regional indicators or targets where possible to measure performance
• using key questions to assess knowledge, attitudes, and behaviours - UKHSA WAAW 2025 AMR knowledge questions can provide a useful starting point, though the exact questions should reflect what you want your audience to learn

Update, improve and share learning by:

• regularly updating content and approaches based on emerging research and user feedback
• feeding learnings back into the next planning cycle, linking what you found to how you will communicate in future
• celebrating successes and acknowledging challenges openly within your team and with partners
• sharing evaluation results to build trust and accountability with your audiences and funders
• using insights to inform local AMR strategies and share with partner organisations where learnings can be applied more broadly
• considering how results are presented so they are accessible and meaningful to different audiences, from frontline health professionals to community volunteers, when sharing findings

Large: full campaigns with dedicated resource

This applies to large-scale, multi-channel campaigns with dedicated resource for evaluation. This tier is most likely to apply to national or regional government bodies, such as NHS England and UKHSA, and other well-resourced organisations running major public communications campaigns. For government communicators, the full GCS Evaluation Cycle should be followed at this level, with approximately 5 to 10% of total campaign resources allocated to evaluation.

For non-government organisations operating at significant scale, such as large charities or national veterinary or agricultural bodies, the principles below remain relevant even if the GCS Evaluation Cycle is not your primary framework. Consider using an equivalent evaluation framework appropriate to your sector.

Establish feedback loops by:

• creating structured ways for your audiences and delivery partners to share insights across multiple channels, including surveys, digital platforms, and forums
• encouraging those delivering the campaign to report formally on effectiveness and barriers throughout its duration
• pre-testing and piloting communications with sample audiences before wider rollout
• conducting thorough reviews of learnings from previous AMR campaigns before designing your approach
• ensuring feedback mechanisms are accessible to all audiences, including those with limited English, low literacy, or disabilities, using translated surveys, easy-read formats, and community intermediaries as needed

Monitor and measure impact by:

• structuring your evaluation against the following stages, in line with recognised best practice for communications evaluation:
  • planning and preparation - what evidence, research, and resources informed your approach
  • reach and delivery - the scale and quality of what your audience experienced
  • audience perceptions - what your audience thinks, feels, or intends to do as a result
  • behaviour change - the actions your audience took
  • broader impact - contribution to organisational, policy, or public health objectives
  • learning and improvement - what you will take forward to future activities
• using tools such as public perception trackers, bespoke surveys, and real-time digital metrics throughout the campaign.
• building in formal pause points to review performance data and adjust activity while it is still live
• using local and regional indicators alongside national indicators, such as the National Action Plan Appendix B human health targets, as indicators of success
• using key questions to assess public knowledge, attitudes, and behaviours - UKHSA WAAW 2025 AMR knowledge questions can provide a useful framework, though the exact questions should reflect the specific knowledge you want to impart to your target audience
• setting clear, measurable objectives at the outset with defined targets so you can assess whether you have succeeded

Update, improve and share learning by:

• regularly updating tools and campaigns based on emerging research and user feedback throughout and after the campaign
• feeding learnings back into the next planning cycle, linking evaluation findings directly to future communication planning
• celebrating successes and acknowledging challenges openly
• sharing evaluation results publicly where appropriate to build trust and accountability
• using insights to inform both national and local AMR strategies
• sharing learnings across partner organisations and, where relevant, across government
• considering how results are presented so they are accessible and meaningful to different audiences, from frontline health professionals to community volunteers, when sharing findings
• contributing evaluation findings to national AMR surveillance and learning networks where appropriate, helping to build a shared evidence base across sectors

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