Phase 1

• Screening Day at PPR (Week 1 to 3)

Phase 1 (Part 1): Community Baseline Screening, Health Assessment and Champion Recruitment

Phase 1 is the foundation stage of the project, focusing on understanding the community’s current health needs, medication practices, and antibiotic-related behaviours before any intervention begins. This phase is designed to gather baseline data, identify common health and medication risks, and build trust with residents so that later interventions can be more targeted and effective.

Residents will be invited to attend a community screening day where they will register and complete a simple baseline questionnaire assessing their knowledge, attitudes, and practices related to medicine use and antibiotics. Topics assessed may include self-medication, sharing medicines, stopping treatment early, keeping leftover medicines at home, understanding when antibiotics are needed, and awareness of antimicrobial resistance (AMR).

A health screening booth will also be provided to offer basic checks such as blood pressure, blood glucose (if feasible), weight, and body mass index (BMI). This helps identify residents who may be at risk of common chronic diseases such as Hypertension and Diabetes Mellitus, while promoting preventive health awareness within the community.

In addition, a “Bring Your Medication” booth will encourage residents to bring medicines currently kept at home, including prescription medicines, over-the-counter medicines, supplements, herbal products, and antibiotics. The project team will review these medicines for expiry dates, duplicate medications, incorrect storage, poor understanding of dosage instructions, medication adherence issues, and potential misuse. This allows the project to address overall medication safety rather than focusing solely on antibiotics.

Residents who demonstrate leadership qualities, good communication skills, and willingness to help others will be identified as potential Community Health Champions and invited to participate in the training phase of the programme.

By the end of Phase 1, the project aims to obtain a clear understanding of community health needs, common medication-related problems, and antibiotic use behaviours, while establishing a strong foundation for the targeted behaviour change activities in the next phase.

Phase 1 (Part 2) - Training Day for Health Champions (Week 4)

Phase 1 (Part 2): Community Health Champion Training

Day 2 is the capacity-building phase of the project, where selected residents from the community will be trained to become Community Health Champions. These champions play an important role because long-term behavioural change is often more effective when health messages are delivered not only by healthcare professionals, but also by trusted members of the community.

Residents identified during Day 1 who demonstrate leadership potential, good communication skills, reliability, and willingness to help others will be invited to participate in this training session. The aim is to equip them with the knowledge, confidence, and practical skills needed to promote safe medicine practices and responsible antibiotic use among their neighbours and families.

The training module will cover key topics such as what antibiotics are and when they should be used, the difference between bacterial and viral infections, dangers of self-medication, risks of sharing antibiotics, importance of completing prescribed antibiotic courses, and how antibiotic misuse contributes to antimicrobial resistance (AMR). In addition, champions will learn general medication safety practices including proper medicine storage, checking expiry dates, understanding labels, medication adherence, and seeking professional medical advice before taking medicines.

Beyond health knowledge, the session will also focus on communication and leadership development. Champions will be trained on how to explain health information in simple language, address common myths respectfully, encourage hesitant residents, and conduct short peer-education activities in a culturally appropriate manner.

Interactive methods such as role-play, scenario discussions, question-and-answer sessions, myth-versus-fact games, and small group activities will be used to build confidence and improve engagement. Champions will practise responding to common real-life situations, such as a neighbour asking for leftover antibiotics, someone requesting antibiotics for flu symptoms, or a resident unsure how to take their medicines correctly.

At the end of the training, champions will receive simple educational materials and be assigned roles for the next project phase. These roles may include assisting with community workshops, reminding residents of key health messages, encouraging attendance, supporting booth activities, and serving as positive role models for responsible medicine use.

This approach helps create a sustainable peer-led system where health promotion efforts can continue within the community even after the student-led programme has ended.

Phase 2 - Workshops

(Week 5 - Week 12)

Phase 2: Multi-Component Community Behaviour Change Intervention

Phase 2 is the main implementation stage of the project, where findings from the baseline screening phase and skills developed during the Community Health Champion training phase are translated into practical behavioural change within the community. This phase aims to move beyond awareness alone by addressing common antibiotic-related behaviours that contribute to antimicrobial resistance (AMR), such as self-medication, unnecessary demand for antibiotics, premature discontinuation of treatment, sharing antibiotics, and storing leftover antibiotics for future use.

Recognising that behaviour change is unlikely to occur through a single lecture or one-time campaign, Phase 2 adopts a multi-component intervention model that combines education, peer support, household reinforcement, public commitment strategies, and repeated engagement over time. This approach is designed to improve understanding, strengthen motivation, and help residents adopt safer antibiotic practices in their daily lives.

The phase will include interactive community workshops conducted in small groups using simple language and practical examples. Residents will learn when antibiotics are needed, why they do not treat viral illnesses such as flu or common cold, and the risks of misuse. Activities such as myth-versus-fact games, case discussions, medicine label reading exercises, and question-and-answer sessions will be used to make learning engaging and memorable.

Trained Community Health Champions will play an important role by conducting peer education sessions, sharing reminders, facilitating discussions, and acting as relatable role models within the neighbourhood. Their involvement helps improve trust, cultural relevance, and community ownership of the programme.

Household reinforcement strategies will also be carried out through posters, reminder cards, and educational materials distributed to families. Residents will be encouraged to review medicines stored at home, avoid keeping leftover antibiotics, avoid sharing medicines, and seek professional advice before antibiotic use.

In addition, a Safe Antibiotic Practices Campaign will invite residents to make simple public pledges such as not self-medicating, not sharing antibiotics, following prescription instructions correctly, and asking a doctor or pharmacist before use. These visible commitments help strengthen accountability and create positive social norms within the community.

Messages will be reinforced over several weeks through repeated touchpoints, champion follow-up, and continued engagement to increase retention and support long-term behavioural change.

By the end of Phase 2, the project aims to achieve improved antibiotic knowledge, increased awareness of AMR, reduced unsafe antibiotic practices, and stronger community participation in responsible medicine use.

Phase 3: Week 13-16

Phase 3: Follow-Up, Evaluation and Sustainability

• Phase 3 is the final stage of the project, focusing on measuring the impact of the intervention, reinforcing positive behavioural changes, and ensuring that the programme can continue within the community after the formal project period ends. This phase is important because it allows the project team to determine whether residents have genuinely improved their antibiotic-related practices rather than only gaining short-term knowledge.
• Residents who participated in earlier phases will be invited for follow-up reassessment using a post-intervention questionnaire or simple interviews. The reassessment will compare baseline findings with post-intervention outcomes in areas such as self-medication with antibiotics, sharing antibiotics with others, premature discontinuation of treatment, storage of leftover antibiotics, healthcare-seeking behaviour, and understanding of antimicrobial resistance (AMR).
• Community Health Champions will continue supporting the programme during this phase by conducting reminder sessions, informal peer education, and neighbourhood engagement activities. They may help identify residents who still require guidance, reinforce key messages on responsible antibiotic use, and encourage continued adoption of safer habits.
• Community feedback sessions or small group discussions may also be carried out to understand participants’ experiences, barriers to change, and suggestions for future improvement. This provides valuable insight into which parts of the intervention were most effective and how the programme can be strengthened for future communities.
• To promote sustainability, champions will be provided with simple educational materials and guidance so that health promotion efforts can continue beyond the project timeline. A peer-led support model may be maintained where trained champions continue sharing antibiotic safety messages and encouraging appropriate healthcare-seeking behaviour among neighbours and families.
• By the end of Phase 3, the project aims to demonstrate measurable improvements in antibiotic-related behaviours, stronger awareness of AMR, continued engagement of Community Health Champions, and the establishment of a sustainable community-led model that can be replicated in other communities.