Results: Attitudes towards antibiotics and Vaccinations amongst 15-18 year olds

Results:Attitudes towards antibiotics and Vaccinations amongst 15-18 year olds Meredith Hawking, Public Health England

Presentation Outline • Final Sample • Vaccination results • Agree Learning Objectives • 3. Antibiotics results • Agree Learning Objectives • 4. Resource Suggestions • Final Recommendations for educational resource • 5. Introduction to discussion group topics 15-18 years project qualitative results

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Solutions • Include information about vaccines, how they work and the vaccines they need • Link to relevant examples e.g. outbreaks amongst 15-18 year olds • Include debate about side effects and critique of media coverage around vaccines Vaccines: Attitudes • Dislike having vaccinations • Low knowledge • Not sure if they work • Don’t consider them in everyday life • Concerns about side effects Not having vaccinations Subjective Norms & Normative Beliefs Control Beliefs & Perceived Behavioural Control “There are vaccines that seem unnecessary…I am not being vaccinated because I do not see the point.” Student, FR 15-18 years project qualitative results

Solutions • Include case studies and viewpoints around vaccines • Resource should be available for students when they need vaccines, via website and vaccine clinics and link to travelling, university and work placements • Include parents by take-home resources and links to school campaigns Vaccines: Subjective Norms Attitude towards behaviour & behavioural beliefs • Perceived objections in society • Peers don’t think they are important • Parents influence views and withhold consent Not having vaccinations Control Beliefs & Perceived Behavioural Control “Young people are not particularly interested.” Student, CY 15-18 years project qualitative results

Solutions • Include phobia reducing resources, such as a video of having a video • Information and guidance on where and how students can get vaccines and find out their vaccine history • Focus on the news coverage around vaccines and how it influences the public, e.g. MMR leading to measles outbreaks today. Vaccines: Control Beliefs Attitude towards behaviour & behavioural beliefs Subjective Norms & Normative Beliefs Not having vaccinations • Fear of needles and foreign bodies • Organisational factors – cost, accessibility, communication • Negative media coverage “The worst bit is actually the needle” Student, UK 15-18 years project qualitative results

Vaccines: Learning Objectives 1 • Understanding Vaccines • Why vaccines are important to young people • How vaccines work • The important diseases prevented by vaccines, and why these are important to young people including you. • Why some vaccinations need boosters when you are a teenager and later. • That a vaccine is only introduced by Ministries of Health if it is effective • Natural immunity is not better than a vaccine induced immunity, and comes with the risk of severe disease due to the infection. • Vaccines prevent against many different infections or many types of a single infectious disease in one injection • How new vaccines are made. 15-18 years project qualitative results

Vaccines: Learning Objectives 2 • Vaccine Controversy • How media can affect vaccine uptake positively and negatively • Be able to evaluate different views about vaccines and the reasons for them • Understand their future role if they become parents • The role of herd immunity. • That major side effects are very rare • Having Vaccinations and Practical help • The importance of getting the correct vaccines for travel • How/where to access vaccines (including non-standard vaccines), your vaccine history, and which vaccinations you need • There is no need to be afraid of vaccines, the process is almost painless 15-18 years project qualitative results

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Low knowledge • Worry about side effects • Don’t like taking medication Why don’t students finish their course? Solutions • Increase knowledge through educational resource • Information on how to manage common side effects • Explain how antibiotics work and the consequences if you don’t finish the course Not finishing the course of antibiotics Subjective Norms & Normative Beliefs Control Beliefs & Perceived Behavioural Control “We are cured, why continue?” Student, SA 15-18 years project qualitative results

Why don’t students finish their course? Attitude towards behaviour & behavioural beliefs Solutions • ‘Normal’ to not finish course • Not an interesting or important topic to their peers Not finishing the course of antibiotics • Challenge the belief that it is normal to not finish the course via peer education and case studies • Make the resource and examples relevant to students and available for when they are taking them (and are more open to information). Control Beliefs & Perceived Behavioural Control “They don’t talk about it because it is not important for them” Student, SA 15-18 years project qualitative results

Attitude towards behaviour & behavioural beliefs Solutions Why don’t students finish their course? • Suggestions to help them swallow, e.g. practicing with TicTacs, breaking tablets in half • Simple ways to remind students, e.g. phone app • Include information on alcohol and antibiotics • Information on what to do if they forget a tablet Subjective Norms & Normative Beliefs Not finishing the course of antibiotics • Taking tablets is difficult, e.g. swallowing and taste • Forget when they feel better • Think they are too busy “A lot of young people have so much on their plate… so they forget” Student, UK 15-18 years project qualitative results

Solutions Why do students take antibiotics for RTIs? • Low knowledge • Personal experience of taking antibiotics • Do not use viral/bacterial distinction but focus on symptoms instead • Information on how antibiotics work • Include information about illness duration, self-limiting illnesses and managing symptoms Taking antibiotics for an RTI Subjective Norms & Normative Beliefs Control Beliefs & Perceived Behavioural Control “He wasn’t sure whether it was viral or bacterial so he gave me antibiotics. After the first week I was still not better, but then after the second week I was better, so taking them must work.” Student, UK 15-18 years project qualitative results

Why do students take antibiotics for RTIs? Attitude towards behaviour & behavioural beliefs Solutions • Highlight the special nature of antibiotics and the difference between antibiotics and painkillers • Include parents by take-home resources and in consultations • Peers see them as ‘cure all’ • It is normal to take them • Parents agree with use Taking antibiotics for an RTI Control Beliefs & Perceived Behavioural Control “Friends talk about it because it is a treatment for everything, even anaemia.” Student, SA 15-18 years project qualitative results

Why do students take antibiotics for RTIs? Solutions Attitude towards behaviour & behavioural beliefs • Students are happy to re-consult so delayed prescribing or no-prescribing are options • This finding supports interventions for GPs to help manage patient expectations for antibiotics Taking antibiotics for an RTI Subjective Norms & Normative Beliefs • Easy to get from the GP (expect antibiotics) or Pharmacy “There is a reckless use, they can even get them from pharmacies without a prescription” Educator, CY 15-18 years project qualitative results

Antibiotics: Learning Objectives 1 • Understanding Antibiotics • Antibiotics are special they are not like other every day medicines • Bacteria are continually adapting to develop ways of not being killed by antibiotics, this is called antibiotic resistance. • Use of antibiotics affects all the bacteria in your body not just the ones causing an infection. • Antibiotic resistant bacteria remain in your body for at least a year • Antibiotic resistance spreads between our own different bacteria within our body, and between people. • We need to use antibiotics only when we are advised by a doctor or nurse • Development of new antibiotics takes at least 10 years, and there are very few new ones in the pipeline. 15-18 years project qualitative results

Antibiotics: Learning Objectives 2 • Understanding Antibiotics (Continued) • Bacteria and viruses have different structures. • As each antibiotic only works on specific parts of bacteria, each antibiotic only works against particular types of bacteria. • Antibiotics do not have any effect against your immune system • Taking antibiotics and practical help • Antibiotics should always be taken as instructed by a doctor or nurse. • If you forget an antibiotic dose, always take it as soon as you remember, even if it means taking two at once. Then finish the rest of the course as instructed. • You should care for yourself at home for most sore throats, earache, coughs, colds and flu using painkillers and other remedies to reduce your symptoms 15-18 years project qualitative results

Resource Suggestions 15-18 years project qualitative results

What can and should we create? • Websites - The internet is the first point of call for students, easily accessible, time to process information, hard to reach students • Peer Education – suggested by students so that they can relate to the person teaching them • Films and Animations – popular suggestions from students in all countries • Debate – engage their thinking and debating skills, hearing other peoples viewpoints and expressing opinions • Case studies – relevant to their lives, respond well to personal stories • Leaflets – suitable for different environments, practical health information • Reminder App – to tackle forgetfulness around taking antibiotics • Interviews or Q&A with experts – students wanted expert advice and visitors to teach them 15-18 years project qualitative results

Discussion Groups • There are 8 Discussion Packs • Please move on to the next topic when Amy gives the signal. 15-18 years project qualitative results

Resource Option 1: Lesson Plans • Is a 40-50 minute academic science lesson plan covering: 1) antibiotics and 2) vaccines relevant to the educational structure in your country? • Are shorter 10-20 minute flexible activities covering 1) antibiotics and 2) vaccines relevant to the educational structure in your country? 15-18 years project qualitative results

Resource Option 1: Activities • What are the pros and cons of each of these ideas? • Are there any other ideas you have for the activities? Peer Education Interviews with an Expert Films and Animations 15-18 years project qualitative results

“The student as the actor” French Teacher Peer Education Educators Learning for students Peers Peer Educators Parents Develop a range of skills Other students Parents Learning from their peers 15-18 years project qualitative results

Resource Option 2: Activities • What are the pros and cons of each of these ideas? • Are there any other ideas you have for the activities? Student Debate Case Studies 15-18 years project qualitative results

Resource Option 2: Leaflets and Apps • Should we create a leaflet? • Where and how do you think the leaflet could be used? • Should we link to a reminder app for taking medication? Reminder App Health Leaflets 15-18 years project qualitative results

Resource Option 3: Websites • Should we have an e-bug 16-18 year old website, or should we create links? • Which key functions are the most important? • Topics (a-z style) (e.g. AMR, immunity) or sections (revision section, lesson resources) • “Ask an expert” function or feedback/ contact us section (Example on Teenage Health Freak website) • Chat room style forum or links to social media (e.g. Twitter and Facebook) • Search function • App store links to download reminder apps (Example on S-Cool site) • ‘What’s new?’ section (like the news section on the teacher e-Bug site) • 3. Is there a well known website in your country young people go to for health? 15-18 years project qualitative results

Thank you • To collaborating partners for your hard work, and to educators and students for taking part. 15-18 years project qualitative results

Results: Attitudes towards antibiotics and Vaccinations amongst 15-18 year olds