Community MembersNCT06998576
Using Social Influencers for Public Health Education on Antibiotic Use and Antimicrobial Resistance
A study testing Animated educational video on antibiotic use in people with Community Members, run by Tan Tock Seng Hospital at 1 site in Singapore.
Trial summary
This study aims to compare the effectiveness of health education facilitated by neighborhood food and beauty establishments with that facilitated by clinics in increasing the public's knowledge of antibiotic use and antimicrobial resistance (AMR) and improving antibiotic behaviors. Read more about this study
- Who is it for?
- Ages 21 years and olderHealthy volunteers can take part
- Conditions the study is for
- Community Members
- What is being tested?
- Animated educational video on antibiotic use
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3,300 participants
- Where
- 1 siteSingapore
- Study dates
- 21 Jul 2025to Jun 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Adults aged 21 years and above
- Patrons of the 30 participating healthcare clinics, food and beauty establishments
Who cannot join
- Patrons who are already enrolled in the study at one of the 30 participating establishments
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Singapore1 site, 1 recruiting
- Recruiting
Tan Tock Seng Hospital
Singapore, Singapore, 308433
Chow Angela, MBBS, MMed(PH), PhD, +65-62566011, Angela_Chow@ttsh.com.sg
Seema K Aithal, MBBS, MPH, +65-62566011, seema_k_aithal@ttsh.com.sg
About this study
Official title: Different Strokes for Different Folks - Leveraging on Social Networks for Public Health Education on Antibiotic Use and Antimicrobial Resistance
This study aims to compare the effectiveness of health education facilitated by neighborhood food and beauty establishments with that facilitated by clinics in increasing the public's knowledge of antibiotic use and antimicrobial resistance (AMR) and improving antibiotic behaviors.
The quasi-experimental study will involve a total of 3300 patrons of the 10 most popular consenting clinics, food and beauty establishments respectively, in two neighborhoods in Singapore.
Read more
Recruitment Process
- Participants will scan the QR code on the posters in the participating clinics/establishments
- Read the study information sheet
- Consent will be implied on submission of survey
- Total recruitment period: One year
- Target: 3300 patrons of the 30 establishments (10 each of clinics, food, and beauty establishments)
Intervention Structure
- Participants will complete a pre-intervention/baseline survey (#1)
- Intervention includes an animated educational video with key messages on appropriate antibiotic use and AMR
- Followed by immediate post-intervention survey (#2)
- Provide contact details (mobile phone number) for reimbursement \& future follow-up online surveys
- Complete follow-up online surveys: at 1 month post-intervention (#3), 3 months post-intervention (#4) and 6 months post-intervention (#5)
Expected Outcomes Increase in public knowledge of antibiotic use and AMR, and antibiotic behaviors through health education facilitated by neighborhood food and beauty establishments, in addition to that facilitated by clinics
Read the detailed description
According to the World Health Organisation (WHO), antimicrobial resistance (AMR) is one of top 10 global public health threats facing humanity [1,2] and is primarily driven by overuse and misuse of antibiotics [3]. Majority of the population-based national AMR educational campaigns focused on raising public awareness of appropriate antibiotic use and promoting action against antimicrobial resistance have shown mixed results largely due to its "one-size-fits-all" approach [4,5,6].
While healthcare providers are key players in health communication and considered most trusted sources of health information across all age groups [7], there is a need to identify and harness non-healthcare related establishments which can serve as trusted sources of health information especially for younger age groups who are less likely to have healthcare encounters [8-10]. The present study aims to engage non-healthcare establishments (food and beauty) with high degree centrality in the community identified through social network analysis, and evaluate the effectiveness of sharing health information about antibiotic use facilitated by non-healthcare establishments (food and beauty) as compared to traditional healthcare sources (clinics).
The Investigators conducted an exploratory sequential mixed methods study to identify both healthcare and non-healthcare (food and beauty) establishments which were highly frequented by the residents in the community. Findings from the above study were used to select the top 10 highly frequented healthcare and non-healthcare (food and beauty) establishments.
A quasi-experimental study will be conducted to compare the effectiveness of sharing health information about antibiotic use and AMR facilitated through healthcare clinics, and beauty and food establishments in 2 neighborhoods. Participants (patients/patrons) who visit the participating establishments (clinics/food establishments/beauty establishments) will be invited to take part in the study by scanning the QR code on the recruitment posters placed inside the premises. Upon scanning the QR code, participants will proceed to complete a pre-intervention questionnaire survey (#1) on an online platform after going through the study information sheet. Upon completion of the survey #1, participants will be guided through embedded instructions to click on a link to access the health educational intervention. The educational intervention includes a short 2-minute animated video (developed based on the preferences of the community as identified from the results of the quantitative survey) will be hosted on a multimedia online platform providing key information on appropriate antibiotic use and AMR. After viewing the video, the participants will be subsequently led to the post-intervention survey #2 via a link. Before submitting survey #2, contact details (mobile number) and the preferred payment method will be collected for reimbursement purposes and future follow-up surveys. The enrolled participants will be re-contacted by the study team via a mobile messaging service (such as WhatsApp), and will be guided through embedded instructions to complete three more surveys (#3, #4 \& #5) at 1-, 3-, and 6-month post-intervention to assess knowledge on antibiotic use and AMR and behaviors on antibiotic use. Participants will be recruited from all 30 participating establishments (10 clinics, 10 F\&B shops, 10 beauty salons) for the entire study duration of one year and will be followed up for 6 months after the intervention.
- Conditions
- Community Members
- Being tested
- Animated educational video on antibiotic use
- Keywords
- public health education, antimicrobial resistance, antibiotic use, animated educational video, neighborhood establishments
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Animated educational video on antibiotic useBehavioural
The intervention features a concise animated video on antibiotic use and AMR. The video's content and format will be developed based on the results of a survey conducted among the community residents in the two neighborhoods. Through the survey, the participants evaluated multiple message options including the various delivery formats. The animated video was designed incorporating the community's preferred key message and delivery method. The resulting video uses graphics, voice-overs, captions [in all 4 official national languages] to convey key messages about appropriate antibiotic use and AMR.
| Study group | Role | What they receive |
|---|---|---|
| Healthcare clinics | Experimental | Ten healthcare clinics will be chosen. Patients will enrol into the study by scanning the QR code on the recruitment poster at the participating healthcare clinics will access the health educational intervention. Receives: Behavioral: Animated educational video on antibiotic use |
| Food establishments | Experimental | Ten food establishments will be chosen. Patrons will enrol in the study by scanning the QR code on the recruitment poster at the participating F\&B shops will access the health educational intervention. Receives: Behavioral: Animated educational video on antibiotic use |
| Beauty establishments | Experimental | Ten beauty etablishments will be chosen. Patrons will enrol in the study by scanning the QR code on the recruitment poster at the participating beauty establishments will access the health educational intervention. Receives: Behavioral: Animated educational video on antibiotic use |
What is being measured
The primary outcome is the main question the study is designed to answer.
Knowledge of antibiotic use - 3 questions from the World Health Organization's Antibiotic Resistance Multi-country Public Awareness Survey questionnaire
Proportion of participants with good knowledge of antibiotic use at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
Measured: The participants will be followed up for 6 months following the intervention.
Knowledge of AMR - 8 questions from the World Health Organization's Antibiotic Resistance Multi-country Public Awareness Survey questionnaire
Proportion of participants with good knowledge of AMR at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
Measured: The participants will be followed up for 6 months following the intervention.
Appropriate antibiotic use - 6 questions adapted from the US Centers for Disease Control and Prevention's advisory on appropriate antibiotic use
Proportion of participants who use antibiotics appropriately at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
Measured: The participants will be followed up for 6 months following the intervention.
Secondary outcomes (2)
Reach - using the RE-AIM framework
The absolute number and proportion of participants who enrol in the study over the one year duration, and also enrollment rate by establisment type over one year
Measured: one year study duration for enrollment
Implementation fidelity - using the RE-AIM framework
Monthly physical visits at all 30 participating establishments for checking poster integrity at the premises and whether staff invite patrons to enrol in the study
Measured: one year study duration for doing fidelity checks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 May 2025
- Study start21 Jul 2025
- Primary completionDec 2026 (estimated)
- Study completionJun 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Community MembersStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- A quasi-experimental study will be conducted to compare the effectiveness of public health education via an animated educational video on antibiotic use and AMR that is facilitated by neighborhood food and beauty establishments (social influencers) with that facilitated through clinics (traditional source of information).
- Masking
- None (open label)
- Enrolment
- 3,300 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Tan Tock Seng Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Chow Li Ping Angela, Tan Tock Seng Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06998576
- Sponsor's protocol ID
- CSAINV22jul-0010
- Status last verified
- Jul 2025
- First submitted
- 22 May 2025
- Last updated
- 29 Jul 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Chow A, Aithal S, Guo H, Lwin MO, Hildon ZJ. Using social influencers for public health education on antibiotic use and antimicrobial resistance: protocol for a quasi-experimental study. BMC Public Health. 2025 Sep 24;25(1):3120. doi: 10.1186/s12889-025-24338-z.
PubMed 40993665
Study at a glance
From the registry record, last updated by the sponsor on 29 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Different Strokes for Different Folks - Leveraging on Social Networks for Public Health Education on Antibiotic Use and Antimicrobial Resistance
- ClinicalTrials.gov ID
- NCT06998576
- Acronym / sponsor ID
- CSAINV22jul-0010
- Conditions
- Community Members
- Keywords
- public health education, antimicrobial resistance, antibiotic use, animated educational video, neighborhood establishments
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 3,300 participants (estimated)
- Lead sponsor
- Tan Tock Seng HospitalUniversity, hospital or other
- Study start
- 21 Jul 2025 (actual)
- Primary completion
- Dec 2026 (estimated)
- Study completion
- Jun 2027 (estimated)
- First posted
- 31 May 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to compare the effectiveness of health education facilitated by neighborhood food and beauty establishments with that facilitated by clinics in increasing the public's knowledge of antibiotic use and antimicrobial resistance (AMR) and improving antibiotic behaviors.
The quasi-experimental study will involve a total of 3300 patrons of the 10 most popular consenting clinics, food and beauty establishments respectively, in two neighborhoods in Singapore.
Recruitment Process
- Participants will scan the QR code on the posters in the participating clinics/establishments
- Read the study information sheet
- Consent will be implied on submission of survey
- Total recruitment period: One year
- Target: 3300 patrons of the 30 establishments (10 each of clinics, food, and beauty establishments)
Intervention Structure
- Participants will complete a pre-intervention/baseline survey (#1)
- Intervention includes an animated educational video with key messages on appropriate antibiotic use and AMR
- Followed by immediate post-intervention survey (#2)
- Provide contact details (mobile phone number) for reimbursement \& future follow-up online surveys
- Complete follow-up online surveys: at 1 month post-intervention (#3), 3 months post-intervention (#4) and 6 months post-intervention (#5)
Expected Outcomes Increase in public knowledge of antibiotic use and AMR, and antibiotic behaviors through health education facilitated by neighborhood food and beauty establishments, in addition to that facilitated by clinics
Detailed description
According to the World Health Organisation (WHO), antimicrobial resistance (AMR) is one of top 10 global public health threats facing humanity [1,2] and is primarily driven by overuse and misuse of antibiotics [3]. Majority of the population-based national AMR educational campaigns focused on raising public awareness of appropriate antibiotic use and promoting action against antimicrobial resistance have shown mixed results largely due to its "one-size-fits-all" approach [4,5,6].
While healthcare providers are key players in health communication and considered most trusted sources of health information across all age groups [7], there is a need to identify and harness non-healthcare related establishments which can serve as trusted sources of health information especially for younger age groups who are less likely to have healthcare encounters [8-10]. The present study aims to engage non-healthcare establishments (food and beauty) with high degree centrality in the community identified through social network analysis, and evaluate the effectiveness of sharing health information about antibiotic use facilitated by non-healthcare establishments (food and beauty) as compared to traditional healthcare sources (clinics).
The Investigators conducted an exploratory sequential mixed methods study to identify both healthcare and non-healthcare (food and beauty) establishments which were highly frequented by the residents in the community. Findings from the above study were used to select the top 10 highly frequented healthcare and non-healthcare (food and beauty) establishments.
A quasi-experimental study will be conducted to compare the effectiveness of sharing health information about antibiotic use and AMR facilitated through healthcare clinics, and beauty and food establishments in 2 neighborhoods. Participants (patients/patrons) who visit the participating establishments (clinics/food establishments/beauty establishments) will be invited to take part in the study by scanning the QR code on the recruitment posters placed inside the premises. Upon scanning the QR code, participants will proceed to complete a pre-intervention questionnaire survey (#1) on an online platform after going through the study information sheet. Upon completion of the survey #1, participants will be guided through embedded instructions to click on a link to access the health educational intervention. The educational intervention includes a short 2-minute animated video (developed based on the preferences of the community as identified from the results of the quantitative survey) will be hosted on a multimedia online platform providing key information on appropriate antibiotic use and AMR. After viewing the video, the participants will be subsequently led to the post-intervention survey #2 via a link. Before submitting survey #2, contact details (mobile number) and the preferred payment method will be collected for reimbursement purposes and future follow-up surveys. The enrolled participants will be re-contacted by the study team via a mobile messaging service (such as WhatsApp), and will be guided through embedded instructions to complete three more surveys (#3, #4 \& #5) at 1-, 3-, and 6-month post-intervention to assess knowledge on antibiotic use and AMR and behaviors on antibiotic use. Participants will be recruited from all 30 participating establishments (10 clinics, 10 F\&B shops, 10 beauty salons) for the entire study duration of one year and will be followed up for 6 months after the intervention.
Study design
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- A quasi-experimental study will be conducted to compare the effectiveness of public health education via an animated educational video on antibiotic use and AMR that is facilitated by neighborhood food and beauty establishments (social influencers) with that facilitated through clinics (traditional source of information).
| Arm | Type | Receives |
|---|---|---|
| Healthcare clinics | Experimental | Behavioral: Animated educational video on antibiotic useTen healthcare clinics will be chosen. Patients will enrol into the study by scanning the QR code on the recruitment poster at the participating healthcare clinics will access the health educational intervention. |
| Food establishments | Experimental | Behavioral: Animated educational video on antibiotic useTen food establishments will be chosen. Patrons will enrol in the study by scanning the QR code on the recruitment poster at the participating F\&B shops will access the health educational intervention. |
| Beauty establishments | Experimental | Behavioral: Animated educational video on antibiotic useTen beauty etablishments will be chosen. Patrons will enrol in the study by scanning the QR code on the recruitment poster at the participating beauty establishments will access the health educational intervention. |
Who may qualify
- Ages
- 21 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Adults aged 21 years and above
- Patrons of the 30 participating healthcare clinics, food and beauty establishments
Key exclusion criteria (1 listed)
- Patrons who are already enrolled in the study at one of the 30 participating establishments
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Animated educational video on antibiotic useThe intervention features a concise animated video on antibiotic use and AMR. The video's content and format will be developed based on the results of a survey conducted among the community residents in the two neighborhoods. Through the survey, the participants evaluated multiple message options including the various delivery formats. The animated video was designed incorporating the community's preferred key message and delivery method. The resulting video uses graphics, voice-overs, captions [in all 4 official national languages] to convey key messages about appropriate antibiotic use and AMR. | Behavioural | Beauty establishments, Food establishments, Healthcare clinics |
Primary outcome
Knowledge of antibiotic use - 3 questions from the World Health Organization's Antibiotic Resistance Multi-country Public Awareness Survey questionnaire
Time frame: The participants will be followed up for 6 months following the intervention.
Proportion of participants with good knowledge of antibiotic use at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
Knowledge of AMR - 8 questions from the World Health Organization's Antibiotic Resistance Multi-country Public Awareness Survey questionnaire
Time frame: The participants will be followed up for 6 months following the intervention.
Proportion of participants with good knowledge of AMR at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
Appropriate antibiotic use - 6 questions adapted from the US Centers for Disease Control and Prevention's advisory on appropriate antibiotic use
Time frame: The participants will be followed up for 6 months following the intervention.
Proportion of participants who use antibiotics appropriately at baseline (pre-intervention), immediate post-intervention, and at 1-month, 3-month and 6-month post-intervention.
2 secondary outcomes
Reach - using the RE-AIM framework
Time frame: one year study duration for enrollment
Implementation fidelity - using the RE-AIM framework
Time frame: one year study duration for doing fidelity checks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jul 2025.
- Derived from this study: PubMed 40993665Chow A, Aithal S, Guo H, Lwin MO, Hildon ZJ. Using social influencers for public health education on antibiotic use and antimicrobial resistance: protocol for a quasi-experimental study. BMC Public Health. 2025 Sep 24;25(1):3120. doi: 10.1186/s12889-025-24338-z.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Animated educational video on antibiotic use in people with Community Members, run by Tan Tock Seng Hospital at 1 site in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 29 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Angela Chow, MBBS, MMed(PH), PhD (+65-62566011, Angela_Chow@ttsh.com.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Knowledge of antibiotic use - 3 questions from the World Health Organization's Antibiotic Resistance Multi-country Public Awareness Survey questionnaire (time frame: The participants will be followed up for 6 months following the intervention.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06998576, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jul 2025.