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July 11th: Pilot study of “Beat the Bugs” community education course on hygiene & antibiotics

Beat the Bugs (available from www.e-Bug.eu/Beat-The-Bugs) is designed to target hard-to-reach groups in the community including vulnerable adults, young parents, guides, scouts etc, to increase awareness and change behaviour around hygiene, self-care and antibiotic use in an interactive and fun way. Itis is designed to be delivered by community leaders including school nurses, public health nurses, health visitors and support workers, to community groups,  Messages are framed in a way that is accessible and appropriate to vulnerable adults, a group often underrepresented when interventions are developed.

The study piloted the education tool in two different groups to assess impact on knowledge and self-reported behaviour. The first was conducted with adults with learning, physical and/or mental health difficulties in a community learning environment by a Community Leader who regularly delivers training to this group. The second was delivered in a children’s centre with young parents by a Family Support Worker who regularly gives training to parent groups

Session 1: Meet the Bugs was about microbes and explored types and shapes of microbes and discussed useful and harmful microbes. Both pilots reported the lowest baseline knowledge (40% and 42%) but  overall this session had the greatest improvement in knowledge - a significant (P < 0.05) improvement in knowledge was seen in every sessions except Food Bugs which was approaching significance (P = 0.06).

Session 2: Spreading Bugs was about spread of infection, learning how microbes are spread through sneezing and how correct hand-washing with soap can break the chain of infection. Both pilots reported average baseline knowledge of > 50% and both reported an improvement in knowledge by 24% and 25%, respectively. Results at six-week follow-up showed that participants could explain why it is important to wash their hands and reported an increase in appropriate hand-washing behaviour and an increase in appropriate behaviours around using tissues when sneezing.

Session 3: Food Bugs looked at how easily harmful microbes in raw food can transfer to humans causing illness, and how to store foods to prevent microbes spreading from one food to another. Both pilots had high baseline knowledge (61% and 70%, respectively) so there was less opportunity to increase knowledge. Qualitative results at follow-up showed that participants could explain why it is important to store food correctly.

Session 5: Bug Busters gave an overview of what antibiotics are, when to take antibiotics and how to take antibiotics correctly. Higher baseline knowledge was reported in Pilot 2 of parents (75%) compared to Pilot 1 of adults with learning difficulties (48%). Both pilots saw a positive change in knowledge by 31% and 25%, respectively. In the antibiotics session, participant knowledge in Pilot 1 improved the most on the ‘right’ statements: ‘You should only take antibiotics if your doctor has prescribed them to you’ (50% to 100%). Participant knowledge in Pilot 2 improved the most of statement ‘Antibiotics affect other bacteria in your body, not just the ones which cause infection’ (0 to 100%). Qualitative results at follow-up showed that adults with learning difficulties in Pilot 1 struggled to explain what antibiotics where and when they should take them; however, they did understand that they should only take antibiotics if they really needed them and should only take antibiotics as the doctor or nurse has prescribed.

Session 6: Know Your Bugs: This session dealt with self-care at home for common infections, how to make decisions on your own health, think about your own antibiotic use and action plan for the future. Both pilots had high baseline knowledge (71% and 80%, respectively), probably because participants had already completed the previous sessions. Participants reported an increase in knowledge following the session (22% and 10% respectively). Qualitative results at follow-up showed that participants had retained knowledge around self-care

The study shows how Beat the Bugs is a valuable intervention to help increase individuals’ confidence and knowledge on managing their own infections and change behaviour around hygiene, self-care and antibiotic use. e-Bug is continuing to work with the community to develop and promote resources to educate the public including hard to reach individuals about hygiene, self-care and antibiotics.


The report of this study can be found in: Journal of Infection Prevention 2018.

DOI: 10.1177/1757177418780990; http://journals.sagepub.com/doi/10.1177/1757177418780990