Results:
Attitudes towards
antibiotics and
Vaccinations amongst
15-18 year olds
Meredith Hawking, Public Health England
Presentation Outline
1. Final Sample
2. Vaccination results
• Agree Learning Objectives
3. Antibiotics results
• Agree Learning Objectives
4. Resource Suggestions
• Final Recommendations for educational resource
5.
2
Introduction to discussion group topics
15-18 years project qualitative results
Vaccination Results
cancer cause cervical coming decision disease
doctors effects even fear
friends girls good happen hurt important informed injection issue make
much need
needle okay pain parents
personally pressure
still stop students
people
prevent protect quite reasons scares school side
taking talk thought time told
vaccines
3
mean
15-18 years project qualitative results
well worry year young
Vaccines: Attitudes
Solutions
• Dislike having
vaccinations
• Include information
about vaccines, how
they work and the
vaccines they need
• Low knowledge
• Not sure if they work
• Don’t consider them in
everyday life
• Concerns about side
effects
Subjective Norms &
Normative Beliefs
Control Beliefs &
Perceived Behavioural
Control
4
15-18 years project qualitative results
Not having
vaccinations
• Link to relevant
examples e.g.
outbreaks amongst 1518 year olds
• Include debate about
side effects and critique
of media coverage
around vaccines
“There are vaccines that seem
unnecessary…I am not being vaccinated
because I do not see the point.” Student, FR
Vaccines: Subjective Norms
Solutions
Attitude towards
behaviour & behavioural
beliefs
• Include case studies and
viewpoints around
vaccines
• Perceived objections
in society
• Resource should be
available for students
when they need
vaccines, via website and
vaccine clinics and link to
travelling, university and
work placements
• Peers don’t think they
are important
Not having
vaccinations
• Parents influence
views and withhold
consent
• Include parents by takehome resources and
links to school
campaigns
Control Beliefs &
Perceived Behavioural
Control
5
“Young people are not particularly interested.”
15-18 years project qualitative results
Student, CY
Vaccines: Control Beliefs
Solutions
Attitude towards
behaviour & behavioural
beliefs
• Include phobia reducing
resources, such as a
video of having a video
Subjective Norms &
Normative Beliefs
• Fear of needles and
foreign bodies
Not having
vaccinations
• Focus on the news
coverage around
vaccines and how it
influences the public, e.g.
MMR leading to measles
outbreaks today.
• Organisational factors
– cost, accessibility,
communication
• Negative media
coverage
6
• Information and guidance
on where and how
students can get
vaccines and find out
their vaccine history
“The worst bit is actually the needle”
15-18 years project qualitative results
Student, UK
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.
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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
8
15-18 years project qualitative results
Antibiotics Results
actually always
bacteria
feeling
antibiotics
better course doctor effects
anything aware
enough explain
finish follow friends given going happen important infection
informing
instructions issue laugh medications medicine parents
people
persuade
probably problem properly quite realise
reasons remember resistance school sometimes starts still student
tablets taken
9
taking
15-18 years project qualitative results
vaccines whole worry
young
Why don’t students finish their course?
• Low knowledge
Solutions
• Worry about side
effects
• Don’t like taking
medication
Subjective Norms &
Normative Beliefs
Control Beliefs &
Perceived Behavioural
Control
• Increase knowledge
through educational
resource
Not finishing
the course of
antibiotics
• Information on how
to manage common
side effects
• Explain how
antibiotics work and
the consequences if
you don’t finish the
course
“We are cured, why continue?” Student, SA
10
15-18 years project qualitative results
Why don’t students finish their course?
Attitude towards
behaviour & behavioural
beliefs
• ‘Normal’ to not finish
course
• Not an interesting or
important topic to their
peers
Control Beliefs &
Perceived Behavioural
Control
Solutions
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).
“They don’t talk about it because it is not
important for them” Student, SA
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15-18 years project qualitative results
Why don’t students finish their course?
Solutions
Attitude towards
behaviour & behavioural
beliefs
Subjective Norms &
Normative Beliefs
• Taking tablets is
difficult, e.g.
swallowing and taste
• Forget when they feel
better
• Think they are too
busy
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15-18 years project qualitative results
• Suggestions to help
them swallow, e.g.
practicing with
TicTacs, breaking
tablets in half
Not finishing
the course of
antibiotics
• 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
“A lot of young people have so much on
their plate… so they forget” Student, UK
Why do students take antibiotics for RTIs?
Solutions
• Low knowledge
• Do not use
viral/bacterial
distinction but focus
on symptoms instead
• Personal experience of
taking antibiotics
Subjective Norms &
Normative Beliefs
Control Beliefs &
Perceived Behavioural
Control
13
15-18 years project qualitative results
Taking
antibiotics for
an RTI
• Information on how
antibiotics work
• Include information
about illness
duration, self-limiting
illnesses and
managing symptoms
“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
Why do students take antibiotics for RTIs?
Attitude towards
behaviour & behavioural
beliefs
Solutions
• Peers see them as
‘cure all’
• It is normal to take
them
Taking
antibiotics for
an RTI
• Parents agree with use
Control Beliefs &
Perceived Behavioural
Control
15-18 years project qualitative results
• Include parents by
take-home resources
and in consultations
“Friends talk about it because it is a
treatment for everything, even anaemia.”
Student, SA
14
• Highlight the special
nature of antibiotics
and the difference
between antibiotics
and painkillers
Why do students take antibiotics for RTIs?
Attitude towards
behaviour & behavioural
beliefs
Subjective Norms &
Normative Beliefs
• Easy to get from the
GP (expect antibiotics)
or Pharmacy
15
15-18 years project qualitative results
Solutions
Taking
antibiotics for
an RTI
• Students are happy to
re-consult so delayed
prescribing or noprescribing are
options
• This finding supports
interventions for GPs
to help manage
patient expectations
for antibiotics
“There is a reckless use, they can even
get them from pharmacies without a
prescription” Educator, CY
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.
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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
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15-18 years project qualitative results
Resource Suggestions
Academic Lessons
Website
Website (for access at home)
Structured lesson plans
Case studies
Independent research projects
Stimulus questions for debate
Links to evidence/research
Interactive films and animations
Presentations
Peer education (health promotion stands or
Books
conferences)
Take home resources
Guest speakers from experts
GP surgeries and self-care
School nurses and support services
Leaflet for consultations
Leaflet for school support services/school nurse
Reminders (phone app/ automated
Guidance for vaccination campaigns in schools
messaging)
Resources for school nurses
Guidance for GPs
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All students – cross curricular
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
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15-18 years project qualitative results
Discussion Groups
There are 8 Discussion Packs
Discussion topic
Time
1. Lesson Plans
10 minutes
2. Peer Education
3. Interview or Q&A with Experts
4. Films and Animations
40 minutes
5. Case studies
6. Debate cards
7. Leaflets and Apps
15 minutes
8. Websites
20 minutes
Please move on to the next topic when Amy gives the signal.
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15-18 years project qualitative results
Resource Option 1: Lesson Plans
1. Is a 40-50 minute academic science lesson plan covering: 1)
antibiotics and 2) vaccines relevant to the educational structure in
your country?
2. Are shorter 10-20 minute flexible activities covering 1) antibiotics and
2) vaccines relevant to the educational structure in your country?
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15-18 years project qualitative results
Resource Option 1: Activities
1. What are the pros and cons of each of these ideas?
2. Are there any other ideas you have for the activities?
Peer Education
Interviews with an Expert
Films and Animations
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15-18 years project qualitative results
Peer Education
“The student as the actor”
Educators
Learning for students
French Teacher
Peers
Peer Educators
Develop a range of skills
Other students
Learning from their peers
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15-18 years project qualitative results
Parents
Parents
Resource Option 2: Activities
1. What are the pros and cons of each of these ideas?
2. Are there any other ideas you have for the activities?
Student Debate
Case Studies
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15-18 years project qualitative results
Resource Option 2: Leaflets and Apps
1. Should we create a leaflet?
2. Where and how do you think the leaflet could be used?
3. Should we link to a reminder app for taking medication?
Reminder App
Health Leaflets
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15-18 years project qualitative results
Resource Option 3: Websites
1. Should we have an e-bug 16-18 year old
website, or should we create links?
2. 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?
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15-18 years project qualitative results
Thank you
To collaborating partners for your hard work, and to educators
and students for taking part.
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15-18 years project qualitative results