CAMRIA Media and AMR

CAMRIA Media and AMR

Risk communication and perception of AMR in the public and among healthcare workers: Knowledge needed to develop new policies and interventions


The COVID-19 pandemic is a case study on how swift (mis)information and communication can change people's attitudes and behaviors. It led to improved adherence to infection prevention and control (IPC) measures among the public and healthcare workers (HCWs). The pandemic of antimicrobial resistance (AMR) has not elicited the same level of interest nor behaviour change. However, it also presupposes some needed changes in attitudes and behaviors to contain it, such as improved adherence to IPC measures and antibiotic prescribing practices and use. Thus, it is of interest to understand how people's beliefs and attitudes are formed, and how their perception of risk connected to AMR and their willingness to act, can be an important determinant of citizen behavior and policy influence.

We need to study communication on AMR in media over time to get a better understanding of HCWs' and citizens’ knowledge, attitudes and risk perception of AMR, along with their motivation to act. This knowledge is needed in order to bring about needed change in behaviors, both among the general public and healthcare workers.

Our three main research questions are:

  1. What is the perception of the AMR-related risk among HCWs and how willing are they to act to the AMR and COVID-19 pandemics (with focus on the influence of different sources of information)?
  2. How does the public’s knowledge of - and attitudes towards AMR, along with their willingness to act, compare to similar existing data on the COVID-19 pandemic and the climate crisis?
  3. Has the framing of AMR in selected online news media and debated through the spread in social-media changed over time, and if so, how?

The knowledge gained from this project will enable the development of improved health policies and communication based interventions, which intentionally will promote desirable behaviour changes and thereby contain AMR.

The project applies a mixed methods approach. In Work Package 1, we will perform focus group interviews with healthcare workers, using a semi-structured interview guide. The data will consist of the interviewees’ quotes and expressions from which we will extract themes related to risk perception and motivation of action and change of behavior. In Work Package 2, AMR-related questions are a part of the citizen panel survey. Data, comprising of participants' answers, will be analyzed with the use of quantitative methods, and provide information as to suggest remedies specific for decision makers at macro- (politicians/ bureuacrats), meso- (health sector leaders) and micro- level (individual health care workers). Work Package 3 will explore how media audiences experience risk in the coverage of AMR, and accept, refuse or negotiate the framing of AMR in the news. Retrospective analyses will provide a framing of AMR in selected online news media over the past 10 years, through both quantitative and more detailed qualitative rhetorical analyses, to uncover the rhetoric and argumentative structures of the mediated debate and communication on AMR, and possible historical changes.

Meet the project leader

© Kommunikasjonsavdelingen, Haukeland universitetsjukehus
© Kommunikasjonsavdelingen, Haukeland universitetsjukehus

Ingrid Smith

MD, MSc, PHD. Specialist in infectious diseases. Deputy Medical Director/ Head of Patient Safety Unit, Dept. of Research and Development, Haukeland University Hospital.

Ingrid, a hospital physician, became part of the director`s staff in 2009, promoting pandemic flu vaccines and IPC measures, and was involved in implementation of the Norwegian Patient Safety Campaign. From 2012, she worked at the Norwegian advisory unit for antibiotic use in hospitals and rational use of antibiotics became her number one passion. She was technical lead on antimicrobial stewardship at the WHO Geneva for three years, developing a toolkit for antimicrobial stewardship programmes in low- and middle-income countries, before becoming Head of the Patient Safety Unit at Haukeland University Hospital. Ingrid's research background is connected to antimicrobial resistance, infectious diseases, epidemiology, antimicrobial stewardship, implementation and behavior change.


For more information connected to the project you can check the following resources.

"Mitigation of AMR: Infection prevention and antimicrobial stewardship, implementation and behavior change" - presentation by Ingrid Smith and Stig Harthug.

"Attitudes in the Norwegian Citizen Panel - some relevant examples" - presentation by Anne Lise Fimreite and Erla Løvseth.

The presented data is preliminary.