Guidance

AMR engagement guide: engagement and communication

Published 3 September 2026

This chapter introduces how to design effective communication and engagement strategies that support awareness and meaningful participation in antimicrobial resistance (AMR) prevention across different communities.

Effective engagement is essential for tackling AMR, and evidence shows that successful communication must be clear, culturally relevant and built on two way communication rather than one directional awareness campaigns. A scoping review of 88 studies highlights how factors such as language, culture, media use and opportunities for participation strongly influence whether people understand and act on AMR messages (5). Building on this, the chapter offers practical guidance on tailoring messages for diverse audiences and supporting clinicians, educators, organisations and community leaders involved in AMR engagement.

Research also shows that simply informing people about AMR is not enough. A 2024 commentary argues that the public must be actively involved in shaping AMR solutions, as awareness remains low and messaging is often too technical or inconsistent. Since everyday behaviours, such as how people use antibiotics or seek healthcare, directly drive AMR, communication needs to help people make informed, practical decisions (6). This is reinforced by a systematic review demonstrating that people’s understanding of AMR is shaped by their personal experiences with antibiotics, the trust they place in healthcare professionals and how clearly risks are communicated (7). Further evidence indicates that communication often fails when AMR information is unclear, overly technical or not personally relevant. To be effective, messages must use simpler language, reflect cultural contexts and include persuasive, engaging cues that support behaviour change (8).

Together, this research shows the need for communication that is culturally sensitive, easy to understand, and designed to reduce health inequalities, so messages genuinely reach and connect with the people who need them most. This chapter can be used to support the planning of campaigns, workshops, educational sessions and digital content that help people understand AMR and feel confident to take action.

Strategies for communication and engagement

Messaging

You should:

• maintain consistency while tailoring for meaning - use a universal theme and core message across all communication, and tailor content, tone, and examples to ensure it resonates with specific audiences
• combine national consistency with local relevance - draw on national campaigns and messages to ensure alignment and recognition and adapt materials and create new content where needed to address local priorities and specific infections
• ensure clarity through accessible language - use non-technical, plain language to support understanding for all audiences, and avoid jargon and unnecessary complexity
• drive behaviour change through clear calls to action - communicate precisely what actions individuals or groups should take, and ensure every message leads to a clear, actionable next step
• avoid harm and strengthen trust through testing - review messaging to avoid reinforcing stereotypes or unintentionally excluding groups, and test content with representatives from the target audience before broader rollout

Audience

You should:

• co-design with communities to ensure relevance and credibility - engage people with lived experience and representatives from diverse and marginalised groups in designing messaging and approaches and use their insights to shape content that reflects real needs and builds trust
• promote equity by understanding audience characteristics - consider age, ethnicity, disability, language proficiency, faith, and digital access, and identify groups at risk of exclusion and adapt formats and channels accordingly
• segment audiences to increase relevance and impact - develop distinct approaches for patients, carers, healthcare professionals, and the public, and match the level of detail, motivation triggers, and tone to each group’s needs

Timing and context

You should:

• make every contact count, including webpages
• align with World Antimicrobial Awareness Week (November) and other relevant health awareness dates
• target seasonal moments, such as winter when antibiotic requests for colds and flu peak
• use ‘teachable moments’ when people are already engaged with health services, such as GP visits, pharmacy interactions, and hospital discharge

Channels and formats

You should:

• host community workshops, webinars, and information sessions for a range of community groups
• conduct engagement activities in schools and early years settings
• use TV and radio advertising and develop print materials such as education brochures, posters, and outdoor displays with QR codes linking to further information, if budget allows
• create hashtags for awareness campaigns
• remember that digital engagement should complement, not replace, offline routes - not everyone has reliable digital access or confidence

Misinformation and counter-messaging

You should:

• monitor social media channels for AMR misinformation, particularly myths about antibiotics known to circulate online
• avoid amplifying false claims by repeating them directly - lead with the accurate message instead
• signpost audiences to authoritative sources such as GOV.UK, UKHSA, and established public awareness campaigns
• identify trusted digital voices, such as local NHS accounts or well-followed healthcare professionals, who can help counter myths credibly and authentically

Communicating with the media

Note that:

• national, trade, regional and online media are important platforms to communicate important messages to the public around antibiotics
• journalists are interested to hear about new evidence, research or findings that enhance or provide a new understanding of antimicrobial resistance
• if you have something that you think could make an interesting news story, it can be helpful to email or call a journalist up to ask their view
• working with the media can provide less control over messaging, as ultimately journalists will be the ones to determine the key points of a story depending on what they feel will spark most interest for their readers
• media are always very interested in case studies, to bring the human impact of AMR to life for their audiences

Digital communications

Channel guidance

You should:

• use short-form video on YouTube, TikTok, and Instagram Reels to reach younger adults - the Andi Biotic campaign demonstrates this can work well for AMR messaging
• use Facebook and WhatsApp to reach older demographics and community groups, where these platforms typically see higher engagement
• use LinkedIn to reach healthcare professionals and veterinary networks, where professional norms and peer influence are strong
• recognise that each platform has different content norms, optimal post lengths, and algorithmic behaviours that affect reach - treat them as distinct channels rather than interchangeable

Content formats

You should:

• prioritise short video with captions, as evidence suggests this performs significantly better for behaviour change messaging than static images
• use interactive content such as quizzes to generate stronger engagement and recall
• use infographics, animated videos, and downloadable resources to present complex information accessibly
• provide tools for people to keep track of their use of antimicrobials, such as the free NHS Medication Passport or digital equivalents

Accessibility in digital content

You should:

• add captions and transcripts to all video content
• include alt text for all images, charts, and graphics
• ensure sufficient colour contrast across all digital materials
• use descriptive hyperlinks rather than phrases such as ‘click here’
• offer British Sign Language versions of key video content
• produce both digital and hard copies of key materials to ensure access for those with limited digital connectivity

Influencer and partner amplification

You should:

• identify relevant influencers, including micro-influencers with high-trust niche audiences in health and veterinary spaces, not just those with the largest following
• provide partner organisations with ready-to-use digital assets to support consistent amplification of key messages
• ensure influencer selection reflects the diversity of the intended audience
• track the reach of partner activity alongside your own to build a complete picture of campaign impact

Measuring digital engagement

You should:

• use a simple hierarchy of metrics: reach and impressions indicate visibility; engagement metrics (shares, comments, saves, click-throughs) indicate resonance; behavioural metrics (website visits, pledge completions, resource downloads) to indicate impact
• link digital measurement to the broader evaluation framework outlined in the Feedback, Evaluation and Continuous Improvement section of this guide

Engagement strategy

Co-design and lived experience

You should:

• co-design engagement activities with representatives of the target audience, ensuring you include those from diverse and marginalised communities and people with lived experience to shape the approach
• identify and link up with AMR campaigns being co-ordinated by other organisations to avoid duplication and strengthen consistency of messaging

Partnerships and trusted voices

You should:

• explore a range of people to lead on engagement activities, including youth representatives, healthcare influencers, and AMR survivors
• engage healthcare professionals as messengers, including GPs, pharmacists, nurses, and vets
• work with patient groups and charities representing people most affected, such as cancer charities
• involve faith leaders and community organisations, particularly for reaching communities where English is not the first language or where trust in official sources may be lower
• ensure partner and influencer selection reflects the diversity of your intended audience and does not default to the most prominent or mainstream voices

Case study: Meaningful engagement of patients, survivors and carers in addressing antimicrobial resistance – WHO Taskforce of AMR Survivors

The WHO Taskforce of AMR Survivors, established in 2023, gives a platform to those with experience of resistant infection. Patients, survivors, and carers provide first-hand perspectives on antimicrobial use and its impact, which can inform people- and patient-centred solutions. Engaging survivors can raise awareness and motivate changes in the behaviour of the wider public.

Meaningful engagement of patients, survivors and carers in addressing antimicrobial resistance – WHO Taskforce of AMR Survivors

Case study: Rose’s Story - British Society of Antimicrobial Chemotherapy

AMR is often described using statistics, but real-life stories help bring it to life, showing the true impact and long-lasting consequences, helping audiences understand risk, challenge misconceptions, and motivate action.

Rose’s story shows how a serious an infection can become when it does not respond to antibiotics. It highlights that AMR can affect anyone, even after everyday accidents, and demonstrates the importance of infection prevention, wound care, and responsible antibiotic use.

Case study: WHO Cares? Podcast - Devon Integrated Social Care Alliance

This podcast demonstrates an alternative format for communicating and engaging the public on AMR. Episodes cover topics including the benefits of vaccination in reducing infections and preserving antibiotic effectiveness, the role of hydration in preventing infections, and an overview of vaccines that help protect vulnerable people. It focuses on practical, local action to support infection control and national AMR plans, showing how trusted community voices can reach audiences in accessible and conversational ways.

• WHO Cares? Podcast - Devon Integrated Social Care Alliance

Factors associated with health inequalities

Infections disproportionately affect people experiencing health inequalities (9 to 11). Evidence from England has shown that socioeconomic deprivation, comorbidities and learning disabilities are associated with an increased risk of developing sepsis and higher 30-day mortality (12).

Populations affected by health inequalities include individuals with protected characteristics, such as children and older adults, people with disabilities, and people from diverse ethnic, religious and sexual orientation groups. They also include wider inclusion health populations, such as people experiencing homelessness, vulnerable migrants, Gypsy, Roma and Traveller communities, individuals with drug or alcohol dependence, and those in contact with the criminal justice system. People experiencing social exclusion, those living or working in closed settings (for example, care homes and prisons), and those affected by geographic inequalities may also face a disproportionate burden of infection and poorer health outcomes ([13 to 15]](#ref13)).

This is driven by factors including increased exposure to infections associated with overcrowded housing or unstable housing and in environments with limited access to basic amenities. In addition, lower vaccine uptake in some communities further increases vulnerability to infection. Barriers to accessing high-quality healthcare also play a significant role, often leading to delayed presentation, reduced use of diagnostic testing, and inappropriate or suboptimal antibiotic prescribing (16 to 17).

It is important to acknowledge the diversity of your audiences by:

• working with community groups and influencers, which may be more trusted than government organisations, to reach a wider audience
• providing stories from different cultural, religious and ethnic groups
• choosing words carefully, making sure they are ethically, culturally, contextually and age appropriate
• using different tones for messages (for example, messages can be formal, informal or encouraging)
• recognise the geographical variation in the availability of resources
• understanding how inequalities may affect people’s choices including, (such as living conditions)
• acknowledging living conditions (such as mould infested housing) and its link to infection
• understanding how AMR affects different age groups (for example, elderly compared to children)

It is also important to make information accessible by:

• considering different literacy levels (for example, the average reading age in England is about 11 years old)
• finding different ways to share information to reduce the effect of language barriers (such as Antibiotic Guardian – Translation Antibiotic Guardian for translated pledges, translated videos, images, podcasts)
• including hyperlinks and different formats (such as high-contrast text and colour to improve readability)
• including ‘alternative texts’ (ALT texts) for images, charts and graphs to make sure they are accessible to people who use screen readers or have poor eyesight
• adding transcripts and captions for audio and video content, and subtitles on videos, for people with hearing difficulties
• using descriptive and meaningful links that accurately reflect the destination, rather than using phrases like ‘click here’
• produce both digital and hard copies of leaflets
• use tools to evaluate accessibility

As part of the NAP 2024 to 2029 a health inequalities toolkit has been co-developed through collaboration across all four UK nations. The toolkit collates and signposts to existing resources and is intended as a practical guide to support organisations in identifying and addressing AMR-related health inequalities within the populations they serve.

The aim is to help users identify resources that can be adapted to local needs and contexts.

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References

Numbers refer to the complete list of references found in the References section.

5. Joubert M, Botes M. ‘Public communication of antimicrobial resistance: a decade of scholarship (2015 to 2024)’ Public Health 2025

6. Scott-Dearing E, Carter V, Corley M, Mathew P, Darzi A. ‘Patient and public involvement and engagement to improve impact on antimicrobial resistance’ Nature Communications 2025: volume 16, issue 1, article 1022

7. Colquhoun G, Afseth J, Fagan R, Thomson F, Ring N. ‘Patient and public understanding of antimicrobial resistance: a systematic review and meta-ethnography’ JAC-Antimicrobial Resistance 2024: volume 6, issue 4, article dlae117

8. Krockow EM, Jenkins DR, Mkumbuzi S, Flusberg SJ, Tarrant C. ‘Why antimicrobial resistance messaging fails: qualitative insights interpreted through the elaboration likelihood model’ JAC-Antimicrobial Resistance 2025: volume 7, issue 4, article dlaf148

9. UKHSA (2025). ‘English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report 2024 to 2025’

10. Ayorinde A, Ghosh I, Ali I, Zahair I, Olarewaju O, Singh M and others. ‘Health inequalities in infectious diseases: a systematic overview of reviews’ BMJ Open 2023: volume 13, issue 4, article e067429

11. Harvey EJ, De Brún C, Casale E, Finistrella V, Ashiru-Oredope D. ‘Influence of factors commonly known to be associated with health inequalities on antibiotic use in high-income countries: a systematic scoping review’ Journal of Antimicrobial Chemotherapy 2023: volume 78, issue 4, pages 861 to 870

12. Zhong X, Ashiru-Oredope D, Pate A, Martin GP, Sharma A, Dark P and others. ‘Clinical and health inequality risk factors for non-COVID-related sepsis during the global COVID-19 pandemic: a national case-control and cohort study’ EClinicalMedicine 2024: volume 66, article 102321

13. Jenks NP, Pardos de la Gandara M, D’Orazio BM, Correa da Rosa J, Kost RG, Khalida C and others. ‘Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York community health centers’ Travel Medicine and Infectious Disease 2016: volume 14, issue 6, pages 551 to 560

14. Aldridge RW, Story A, Hwang SW, Nordentoft M, Luchenski SA, Hartwell G and others. ‘Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis’ The Lancet 2018: volume 391, issue 10117, pages 241 to 250

15. Pini A, Stenbeck M, Galanis I, Kallberg H, Danis K, Tegnell A and others. ‘Socioeconomic disparities associated with 29 common infectious diseases in Sweden, 2005–14: an individually matched case-control study’ The Lancet Infectious Diseases 2019: volume 19, issue 2, pages 165 to 176

16. WHO (2023). ‘13 critical interventions that support countries to address antimicrobial resistance in human health’

17. Shutt AE, Ashiru-Oredope D, Price J, Padoveze MC, Shafiq N, Carter E and others. ‘The intersection of the social determinants of health and antimicrobial resistance in human populations: a systematic review’ BMJ Global Health 2025: volume 10, article e017389