The use of creative arts to engage Nepali schools with antimicrobial-resistance and create positive behaviour change on health-seeking behaviours.

该项目将把AH/R 005869/1中的方法和经验应用于新的受众，即尼泊尔学校中9-11岁的儿童。这一群体成为寻求健康行为的主要参与者，包括在我们最初的项目中购买非处方抗菌药物，因此所有合作伙伴都希望修改最初的项目以覆盖这一群体。这将涉及在现有社区参与方法的基础上共同制作一个教育方案，使尼泊尔社区能够通过参与性电影制作探索他们与抗菌素耐药性问题的关系。抗生素耐药性是一个主要的健康威胁，在尼泊尔等发展中国家尤其严重，因为人口不断增长，卫生基础设施有限，而且在没有医疗建议或处方的情况下可获得抗菌药物。虽然之前的项目涉及成年参与者，但我们最初的研究项目强调了尼泊尔儿童在AMR相关的寻求健康行为中发挥的关键作用。他们经常是被派去购买非处方抗菌药物的家庭成员。这些药物的滥用加剧了AMR，但公众对这种风险的理解很低。特别是儿童对抗生素耐药性的了解或改变有害行为的能力有限，因为有关抗生素耐药性的对话主要是在部长一级进行的，目前学校没有教授抗生素耐药性的风险。我们共同制作的教育计划将使用参与式艺术来鼓励儿童分享他们的行为如何与AMR相互作用。这将显着扩大上一个项目的社区层面影响力，使尼泊尔儿童能够发展知识和信心，以促进他们自己的抗菌素耐药性行为的改变，并通过他们的社区传播这一信息。在筹备这一教育方案时，该项目将大力投资于培训社区志愿人员作为促进者。这将涉及AH/R 005869/1参与者的重新参与和使用他们的原始成果（参与性电影），两者都是我们教育计划的社区参与方面的组成部分。他们最大限度地发挥现有社区资源的价值，确保全球南方对项目的所有权，并提供当地背景，以帮助年轻人了解这一复杂的“同一健康”问题。现有的AH/R 005869/1电影将被用作教育资源，AH/R 005869/1参与者将被培训为社区AMR冠军，以促进教育计划。培训将提高他们的AMR知识和信心，同时发展他们在公开演讲，与儿童合作（包括保护和无意识的偏见）以及他们对参与式艺术方法的理解方面的技能。然后，培训计划将扩展到学校，让校长、学校护士和分科教师参加同样的培训计划。在社区AMR冠军的支持下，这些参与者将共同制作AMR教育计划的最终内容，并在他们的学校提供。这个项目的设计是可扩展的。定期与参与者进行汇报，对教育计划和促进者培训包进行严格评估，将提供丰富的数据集，以评估社区参与和参与式艺术方法对创造AMR行为改变的影响。这将有助于创建最佳做法资源（手册），使其他从业人员能够重复这种干预。此外，它还将允许最初的研究小组继续与尼泊尔卫生和人口部合作，制定国家AMR行动计划。

This project will apply the methodology and learnings from AH/R005869/1 to a new audience, children aged 9-11 in Nepali schools. This group emerged as key actors within health seeking behaviours including the purchasing of non-prescription antimicrobials in our original project, hence all partners wish to modify the initial project to reach this group. This will involve community co-production of an education programme based upon existing community engagement methodology which allowed Nepali communities to explore their relationship with the issue of antimicrobial resistance (AMR) through participatory filmmaking. AMR is a major One Health threat, particularly acute in developing countries such as Nepal due to growing populations, limited health infrastructure and the accessibility of antimicrobials without medical advice or prescription. While the previous project engaged adult participants, our original research project highlighted the key role that Children in Nepal play in AMR-related health-seeking behaviour. They are frequently the member of the family sent to purchase non-prescription antimicrobials. The misuse of these drugs exacerbates AMR, but public understanding of this risk is low. Children especially have limited AMR knowledge or empowerment to change harmful behaviours because conversations regarding AMR are mainly held at Ministerial level and the risks of AMR are not currently taught in schools. Our co-produced education programme will use participatory arts to encourage children to share how their behaviours interact with AMR. This will significantly extend the community-level reach of the previous project, allowing children in Nepal to develop knowledge and confidence to facilitate changes in their own AMR behaviour, and spread this message through their communities. In preparation for this education programme, the project will invest heavily in training community volunteers as facilitators. This will involve the re-engagement of AH/R005869/1 participants and the use of their original outputs (participatory films), both are integral to the community engagement aspect of our educational programme. They maximise the value of existing community resources, ensure Global-South ownership of the project, and provide local-contextualisation to help young people understand this complex 'One Health' issue. Existing AH/R005869/1 films will be used as educational resources and AH/R005869/1 participants will be trained as Community AMR Champions to facilitate the educational programme. Training will enhance their AMR knowledge and confidence whilst at the same time developing their skills in public speaking, working with children (including safeguarding and unconscious bias) and their understanding of participatory arts methodology. The training programme will then reach out to schools engaging head teachers, school nurses and subject specific teachers with the same training programme. Supported by Community AMR Champions, these participants will then co-produce the final content of the AMR education programme to be delivered in their school. This project is designed to be scalable. Regular debriefing sessions with participants, robust evaluations of the both the education programme and facilitator training package will provide a rich dataset to assess the impact of community engagement and participatory arts methodology for creating behaviour change with regard to AMR. This will allow the creation of best-practice resources (manuals), allowing other practitioners to repeat this intervention. It will, moreover, allow the original research team to continue to engage the Nepali Ministry of Health and Population as it develops its national AMR action plan.