Children against antibiotics misuse and antimicrobial resistance: assessing effectiveness of storytelling and picture drawing as public engagement approaches
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Background : Interventions delivered in schools have been found to be effective in improving knowledge of antibiotics and antimicrobial resistance (AMR) among school-aged children, particularly those in high-income countries, but the evidence is largely lacking in low- and middle-income countries. This study aimed to design, implement and assess storytelling in one school and picture drawing in another school as engagement approaches for improving knowledge, attitudes and beliefs about antibiotics and AMR among schoolchildren in Ghana. Methods : Two schools with a total population of 375 schoolchildren ages 11-15 years in Tema, a city in Ghana, participated in public engagement interventions involving storytelling in one school and picture drawing in another school. The interventions included eight weeks of engagement led by science teachers and a competition held in each school. For quantitative outcome-based evaluation, schoolchildren were randomly sampled in each school (31 in the storytelling school and 32 in the picture-drawing school). Purposive sampling was also used to select 20 schoolchildren in each school for qualitative outcome-based evaluation. Respondents completed identical knowledge, attitudes and beliefs questionnaires and were interviewed at two time points (before and at most a week) after key interventions to assess changes in antibiotics and AMR knowledge, attitudes and beliefs. McNemar test was conducted to assess statistical significance between baseline and endline scores. Framework analysis was used for analysing the qualitative data. Results: Picture drawing had more significant effects (both positive and negative) on schoolchildren’s AMR knowledge, attitudes and beliefs, whereas storytelling had a negative effect on children’s AMR knowledge and no significant impact on beliefs and attitudes. Conclusions: Our project’s findings suggest that public engagement interventions that use picture drawing and storytelling may influence the knowledge, attitudes and beliefs of schoolchildren regarding antibiotic misuse and AMR. However, modifications are required to make them much more effective.
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Research by Appiah et al (2021) and Ngoh and Shepherd (1997) demonstrates the value of culturally sensitive communication strategies, such as storytelling, visual aids and picture drawing.
“Research by Appiah et al (2021) and Ngoh and Shepherd (1997) demonstrates the value of culturally sensitive communication strategies, such as storytelling, visual aids and picture drawing.”
From Public-targeted interventions addressing antimicrobial resistance and antibiotic use in Sub-Saharan Africa: a scoping review (2025) · cites this paper as Appiah et al (2021)
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- Authors
- Appiah, B., Anum-Hagin, D., Gyansa-Luterrodt, M., Samman, E., Agyeman, F. K. A., Appiah, G., Odonkor, G., Ludu, J. Y., Osafo, J., & Rene, A.
- Affiliations
- Syracuse University (US)
- Texas A&M University (US)
- University of Ghana (GH)
- Corresponding author
- Appiah, Bernard
- Venue
- Wellcome Open Research
- Publisher
- F1000 Research Ltd
- Published
- 2021-10-22
- Volume
- 6
- Pages
- 202
- ISSN
- 2398-502X (ISSN-L)
- PMC
- PMC8546736
- OpenAlex
- W3193234815
- Cited by
- 15
- References
- 25
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 5
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Wellcome Open Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Wellcome Trust (200253/15)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- antimicrobial resistance, antibiotic misuse, storytelling, picture drawing, citizen participation, elementary school students, health education, knowledge, attitudes and beliefs, low- and middle-income countries, Ghana
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