Background: Antimicrobial resistance (AMR) is driven by antimicrobial exposure. Engaging the general public with this issue is vital in order to shape attitudes and change behaviour. A primary school musical (‘The Mould that Changed the World’) was developed as a novel educational strategy with the explicit aim of engaging the public in the fight against AMR.

Methods: The musical was implemented in two primary schools as workshops followed by public performances. There were 166 child participants aged 9 to 11 years. Quantitative data was collected through a classroom questionnaire before the musical, two weeks after, and six months after. Qualitative data were collected through children’s focus groups before the musical and two weeks after.

Results: Knowledge of the key messages of the musical had increased two weeks after the musical (proportion test, 0.65, 0.77, p<0.001) and this gain in knowledge was sustained six months later (proportion test, 0.65, 0.82, p<0.001). Children recognised factors contributing to AMR, felt empowered to change their own health behaviours and demonstrated antimicrobial stewardship with intention to reduce antibiotic use. They suggested the musical had stimulated discussion around these topics at home. The musical was perceived as an enjoyable and memorable way to learn about AMR.

Conclusion: This study demonstrates potential for the use of musical theatre in this field as a novel device to improve long-term knowledge, change attitudes and emotionally engage the general public through children. Alongside existing interventions, it represents a further unique and valuable tool in the fight against AMR.


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