Engaging communities to address antimicrobial resistance: Identifying contextualised and sustainable community-led solutions in low resource settings

Lead Research Organisation: University of Leeds
Department Name: School of Medicine

Abstract

This study will make a significant contribution to addressing antimicrobial resistance (AMR). AMR is a major challenge to global health, food sustainability and security, and socio-economic development. If we do not address AMR, in the future we will be less able to prevent and treat common infectious diseases, and major surgery, cancer chemotherapy and organ transplants will become much more dangerous in the absence of effective antibiotics. The quantity of antimicrobials used in food production internationally is at least the same as that in humans, and in some places is higher. Some last-resort antibiotics for humans are being used extensively in animals, and there are currently no replacements. There is a huge global effort to address AMR. One area that is emphasised in global guidance is the importance of raising public awareness on the issue. However, it is important to go beyond raising awareness and actively engage with individuals and communities, by enabling them to identify, develop and implement community-led sustainable solutions. To the best of our knowledge, community engagement approaches to address AMR have not been evaluated anywhere in the world. In order to address this gap, we have established a world-leading research group, which builds partnerships between six research organisations and project partners in Bangladesh, Nepal and the United Kingdom.

Members of this team have already developed two approaches to using community engagement to address AMR. The Community Dialogue Approach (CDA) has previously been used in several countries to address other health issues and we adapted it to address the misuse of antibiotics by humans in Bangladesh. Participatory Video (PV) is an approach whereby community members are supported to make short films about issues that concern them and these films are used to demonstrate to policy makers how people interact with the issue. We adapted this approach to explore the misuse of antibiotics in Nepal. In this study, we plan to combine these two approaches: The PV will help us to identify critical themes to address through the CDA, and it will help to raise the profile of community engagement on national and international policy agendas.

At the start of this study, we will use PV (and other methods) to help us develop materials that are needed to deliver the CDA in Bangladesh and in Nepal. We will ensure that these materials address different issues that impact on AMR in rural communities - these include the ways that humans use antimicrobials, the way they are used for animals, and the way they enter into soil and water. We will implement the CDA across the district of Comilla in Bangladesh to see whether it changes people's knowledge, attitudes and reported behaviour in relation to AMR. We also want to find out how much it would cost to implement it on a national scale and to see whether it is equitable i.e. that it reaches and is used by different population groups, such as males and females, and the poorest in society. We will also introduce our approach into a hill region in Nepal so that we can find out how easy or difficult it is to deliver it in different types of settings. Finally, we will use the outputs from the PV methods - especially films that have been made by community members - to help us to increase awareness of the importance of community engagement in Nepal, Bangladesh, the UK and beyond.

This study will make a major contribution to our understanding of how to address AMR by working with individuals and communities to enable them to identify, develop and implement solutions. It will also help us to understand how our approach to community engagement can be implemented on a large scale and in different settings. Ultimately, we aim to ensure that this study influences policy makers internationally to include community engagement approaches as one of the key strategies for addressing AMR.

Technical Summary

Antimicrobial resistance (AMR) is a major challenge to global health, food sustainability and security and socio-economic development. Multi-sectoral action that addresses human and animal health, agriculture, and the environment through a "One Health" approach is required to address the profound implications of AMR. Public awareness and/or public education on AMR is highlighted in most international guidance. However, to tackle AMR it is critically important to go beyond raising awareness and actively engage with individuals and communities globally. Community Engagement (CE) to address AMR is an under-used and under-researched strategy for addressing AMR globally, and receives little mention in global policy. We interpret CE to mean a participatory process through which equitable partnerships are developed with community stakeholders, who are enabled to identify, develop and implement community-led sustainable solutions using existing or available resources to issues that are of concern to them and to the wider global community.

We will (1) develop contextualised intervention materials for community engagement that address AMR through a One Health perspective; (2) implement and evaluate an approach to CE that tackles AMR at the community level and assess: a. its effectiveness for improving knowledge, attitudes and reported behaviours in relation to AMR; b. its cost-effectiveness and the cost of scale-up; c. the extent to which it is equitable, gender sensitive and participatory; d. its potential for implementation on a national scale (Bangladesh); and e. its potential to be replicated to a different health system and community context (Nepal); (3) implement a capacity building strategy based on principles of equitable partnership; and (4) implement a robust research uptake strategy to increase the visibility of CE approaches within, and their potential impact on, the wider AMR research landscape.

Planned Impact

This research will benefit a wide range of stakeholders, including the research community, national and international policy makers, development partners, the media, the communities with whom we are working, and individuals employed to work on the studies.

Researchers in Bangladesh, Nepal and beyond will benefit from our investigation into the potential of community engagement approaches as a core strategy to tackle the implications of antimicrobial resistance. Knowledge will be shared with them through academic publications, conference presentations and research briefs.

Policy makers and development partners in Bangladesh, Nepal and beyond will benefit from our study through our focus on examining how to embed the Community Dialogue Approach CDA) into existing systems and community infrastructures and our examination of the potential costs to delivering such approaches on a national scale. They will be equipped with information to enable them to make informed choices regarding the extent of the financial and other resource inputs required to deliver the CDA in relation to the potential impact that it may have on preventing disease, addressing the drivers of AMR at community level, and potentially addressing other health and development issues in the longer term.

The communities with whom we will be working will benefit from the research in several ways. First, stakeholders within communities will be equipped with new knowledge and skills. These stakeholders include participants within the PV workshop process, participants within CDAs, facilitators and supervisors of CDAs, Community Health Workers (CHWs) (Community Health Care Providers in Bangladesh; Female Health Volunteers in Nepal), and local leaders. Specifically, participants within CDAs gain new knowledge on AMR, the skills to develop community-led solutions to addressing the drivers of AMR and the skills to monitor shifts in behavioural and social norms; facilitators and supervisors gain new knowledge on AMR and skills in facilitating and supervising CDs; and CHWs and local leaders gain skills in guiding community-based interventions. Moreover, both the PV models and CDA models generate wider impact within communities through (in the case of PV) the dissemination of knowledge and facilitation of dialogue through film-showcasing events; and (in the case of CDA) the implementation of community-led solutions through the diffusion of information within and beyond families and peer networks.

Staff working on the project will build their capability to work across disciplines and in cross-sectoral partnerships, to co-design, analyse and disseminate research, and to build leadership skills. We anticipate building capacity in terms of subject knowledge and a range of research skills, particularly amongst early career researchers, which could be applied in other employment sectors.

This study will directly benefit Bangladesh and Nepal, both on the list of least developed countries on the DAC list of ODA relevant countries. The study proposed here builds on pilot work in which we developed participatory community mobilisation and engagement approaches to address antimicrobial resistance. Here, we plan to evaluate the approach to assess its effectiveness, cost-effectiveness, the extent to which it is equitable and participatory, its potential for implementation on a national scale (Bangladesh), and its potential to be replicated to a different health system and community context (Nepal). If the intervention is shown to be effective, shows potential for scale, and is replicable, we would expect it to have potential for adaptation and replication in multiple low and middle income countries that have the required health system and service infrastructure, in which case it could eventually benefit multiple countries on the DAC list.

This study will be registered with the ISRCTN registry and links to our protocol and main results will be supplied.
 
Title COSTAR introductory video 
Description In 2021 the COSTAR project was launched online through an existing CE4AMR event, This short video was produced by key project partners to explain COSTAR, the collaborations that led to it's formation, COSTAR's aims in Bangladesh and Nepal, and it's relevance within the wider AMR research landscape 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact The video gained a lot of attention and the original launch event and was the focus of Q&A sessions 
URL https://vimeo.com/user164091354/review/668178374/f2258f8c68
 
Title COSTAR logo created 
Description A COSTAR logo for this project was created in early 2021 the logo show the cross pills symbol for antimicrobial resistance with clasped hands representing the impact of community over the top 
Type Of Art Artwork 
Year Produced 2021 
Impact The logo now gives the COSTAR project a unique identity within the CE4AMR research portfolio 
URL https://ce4amr.leeds.ac.uk/costar/
 
Description We have analysed findings from the formative phase of research. Publications on findings from the trial baseline survey in Bangladesh, on the findings from the household survey in Nepal, from the qualitative situation analysis in Nepal, and from two scoping reviews are published (1 paper), submitted (2 papers), or being written up (2 papers). Three further publications discussing the process of developing / adapting the intervention have been published. Most of the key findings are yet to be analysed. We are currently collecting endline / process / feasibility data across all aspects of the study.
Exploitation Route We hope that, when published, others will find the discussions of the processes of developing / adapting the intervention useful to support understanding of how to contextualise an intervention and how to embed a One Health approach across sectors. We also hope that others will find the survey and qualitative data from Bangladesh and Nepal enhances our collective understanding of drivers of AMR at community level. And, we hope that the scoping reviews help to establish our collective knowledge about the way community engagement approaches have been used in animal health interventions, and the community based drivers of AMR in Nepal.

More critically, when our endline / process data is collected, analysed and published, we hope that others will be able to understand how to (or not to) undertake community engagement approaches to address AMR in low resource settings.
Sectors Healthcare

 
Description Contribution to national newsletter
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Interaction with mayors of various municipalities of Kapilvastu districts on multi-sectoral engagement for improving maternal health (Nepal)
Geographic Reach Asia 
Policy Influence Type Participation in a guidance/advisory committee
 
Description Participated Antimicrobial Resistance and Vaccines Workshop by icddr,b, Global Antibiotic Resistance Partnership (GARP) and One Health Trust
Geographic Reach Asia 
Policy Influence Type Participation in a guidance/advisory committee
 
Description Recruitment of Master Trainers from provincial government level
Geographic Reach National 
Policy Influence Type Contribution to new or improved professional practice
Impact Following the sensitization sessions and follow-up meetings a cross-sectional group of policy makers from health, veterinary, environmental and agricultural sectors agreed to take part in a One Health AMR Master training as part of the COSTAR project. This was one of the first cross-sectoral training sessions of its kind in Nepal and was very well received.
 
Description Technical Advisory Group Meeting
Geographic Reach National 
Policy Influence Type Participation in a guidance/advisory committee
 
Description Technical support in providing AMR related orientation to selective pharmacist of Kapilvastu municipality Nepal
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
 
Title Baseline / endline survey tool 
Description Our team has developed a survey tool for our cRCT baseline / endline to investigate antibiotic knowledge, attitudes and practices in a low resource rural setting. This drew on the survey tool that we previously developed, but is aligned to collecting data on primary and secondary outcomes. 
Type Of Material Improvements to research infrastructure 
Year Produced 2022 
Provided To Others? No  
Impact We have administered the baseline survey in 50 community settings in Bangladesh to collect baseline data. In 2024, we are collecting endline data, and the tool will be available with the publications from these surveys. 
 
Description AMR fellowship event organized by Fleming Fund 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact On 29th November 2022, members of the HERDi team were invited to speak at an AMR event, hosted by the Fleming Fund in Kathmandu Nepal. HERD team members were able to share information on the COSTAR project with attendees
Year(s) Of Engagement Activity 2022
URL https://twitter.com/sushilbaral/status/1597483751705305095
 
Description BioInfect Conference 2022: Invited Speakers 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact On March 9th Members of the CE4AMR network were invited to present their work at the BioNow conference which focused on AMR for year of 2022. The conference requested our specific attendance in order to share our work on community/patient engagement in the AMR space. Speakers were Paul Cooke, Nichola Jones and Jessica Mitchell who represented several research projects within the CE4AMR portfolio (EP/T02335X/1, AH/T007915/1, AH/R005869/1, ES/P004075/1, MR/T029676/1)
Year(s) Of Engagement Activity 2022
URL https://bionow.co.uk/event/BIONOW120/2022-bioinfect-conference
 
Description Blog: Delivering PV training online 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In February 2022 we shared a blog on the CE4AMR website discussing the challenges and successes of our online PV training sessions which engaged an international audience within this project. We hope the blog will be useful for other projects attempting to deliver training to international partners during the pandemic
Year(s) Of Engagement Activity 2022
URL https://ce4amr.leeds.ac.uk/participatory-video-training-can-it-be-done-online/
 
Description Blog: Using community produced resources out of context 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact On Wednesday 31st August 2022 the project team developed and published a short blog describing how co-created resources from this project could be utilised by wider audiences. The purpose of this blog is to ensure our outputs have a wide reach and use, but that this is appropriate and sustainable.
Year(s) Of Engagement Activity 2022
URL https://ce4amr.leeds.ac.uk/using-co-produced-resources-out-of-context/
 
Description COSTAR 3rd Quarterly Feedback Meeting- Barua (Bangladesh) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact 1. Participants were reminded again how to fill up the monitoring forms correctly
2. Participants were informed about the key messges for the next three (9,10,11) CD session
3. Participants shared their experience using the intervention toolkit and following up the decisions from the CD participants using a structured group work topic guide
4. Facilitators got a short refresher training on CDA and AMR key messages as well as revised messages on the red strip of Antiibiotics (tables, Syrup and Injectables) also, the research team discussed about the future antibiotic dispensing process from CC as govt. has taken initiative to withdraw all sorts of AB except one from CCs.
5. Facilitators were requested to share some key messages to prevent ongoing Dengue outbreak during their CD discussion
6. Research team members and the trainers took sessions on the different activities from Session 10 and 11, and are requested to exercise those activities during their community dialogue
7. Facilitators were also reminded that SESSION-11 is not included in the Flipbook thus they should follow the DISCUSSION Guide during their Community Dialogue and encourage the CD participants to take actions on how to carry forward the key messages learned from CD sessions to their fellow community members while there won't be any CDs"
Year(s) Of Engagement Activity 2023
 
Description COSTAR 3rd Quarterly Feedback Meeting- Burichang (Bangladesh) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact 1. Participants were reminded again how to fill up the monitoring forms correctly
2. Participants were informed about the key messges for the next three (9,10,11) CD session
3. Participants shared their experience using the intervention toolkit and following up the decisions from the CD participants using a structured group work topic guide
4. Facilitators got a short refresher training on CDA and AMR key messages as well as revised messages on the red strip of Antiibiotics (tables, Syrup and Injectables) also, the research team discussed about the future antibiotic dispensing process from CC as govt. has taken initiative to withdraw all sorts of AB except one from CCs.
5. Facilitators were requested to share some key messages to prevent ongoing Dengue outbreak during their CD discussion
6. Research team members and the trainers took sessions on the different activities from Session 10 and 11, and are requested to exercise those activities during their community dialogue
7. Facilitators were also reminded that SESSION-11 is not included in the Flipbook thus they should follow the DISCUSSION Guide during their Community Dialogue and encourage the CD participants to take actions on how to carry forward the key messages learned from CD sessions to their fellow community members while there won't be any CDs"
Year(s) Of Engagement Activity 2023
 
Description COSTAR 4th Q Feedback Meeting-Daudkandi with Facilitators and supervisors responsible for coordinating community dialogues under COSTAR's project awarding of certificates and the closing ceremony at the Upazila level. 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact This was the last quarterly meeting, hosted by ARK team members with the first cluster of CD Facilitators and Supervisors.
1. the facilitator and supervisors expressed their experiences regarding CD implementation for the past one year.
2. Certificate of Completion was handed over to Facilitators and supervisors through the Local UHC medical Officer (COSTAR Trainers)
3. Facilitators and Supervisors expressed their commitment to carry forward the messages that they learned during their journey to their fellow community members for future.
Year(s) Of Engagement Activity 2023
 
Description COSTAR CD Observation - Homna and daudkandi (Bangladesh) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Researchers at the ARK Foundation (Bangladesh) observed community dialogues facilitated by the local CD facilitators. The most important outcomes included; community people understand why AMR should be important to them and the researchers understood and observed the Community dialogues and discussed some potential issues and way forward around CD and AMR with the facilitators and community people.
Year(s) Of Engagement Activity 2023
 
Description COSTAR CD Observation- Homna (Bangladesh) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Researchers at the ARK Foundation (Bangladesh) observed community dialogues facilitated by the local CD facilitators. The most important outcomes included; community people understand why AMR should be important to them and the researchers understood and observed the Community dialogues and discussed some potential issues and way forward around CD and AMR with the facilitators and community people.
Year(s) Of Engagement Activity 2023
 
Description COSTAR Inception meeting 2 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact On February 24th 2021 all Co-Is on this project came together for the second time to give full introductions to each others background and previous involvement in the pilot studies which led to this project being created. There was detailed background given on the community dialogues approach and Participatory video methods. The name COSTAR was also created in this meeting
Year(s) Of Engagement Activity 2021
 
Description COSTAR Inception meeting 3 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact On March 3rd 2021 the COSTAR team gathered together to speak in detail about beginning the project within the current COVID-19 context. Discussions of responsibilities and working groups were had and field work was agreed to pause for the foreseeable future. Plans for ethics and intervention development were put in place. Team members also agreed to take part in additional desk based work such as review papers

There were again key note talks from project members involved in the two pilot studies which led to COSTAR (ES/P004075/1 AND AH/R005869/1 )

All 30 members of the COSTAR team were invited to the workshop which was recorded and shared
Year(s) Of Engagement Activity 2021
 
Description COSTAR web space created 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In early 2021 a COSTAR space on the wider CE4AMR website was launched. This space includes project details and space for resources and outputs to be added.
Year(s) Of Engagement Activity 2021
URL https://ce4amr.leeds.ac.uk/costar/
 
Description COSTAR's One Health Approach 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In 2021 our capacity building working group created this short section for the COSTAR website which details the One Health components of the COSTAR project and how they interlink to address AMR. The Capacity Building group also survey the perceived capacity and One Health knowledges of the COSTAR team regularly to gauge developments in knowledge as the project moves forward.
Year(s) Of Engagement Activity 2021
URL https://ce4amr.leeds.ac.uk/costar/one-health/
 
Description COVID-19 working Group 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In December 2021 the COSTAR team convened a COVID-19 working group to specifically risk assess travel and field work linked to the COSTAR project. This is a small group of 6 people but workshop notes are shared with the wider COSTAR team of 30. The team met for 2 hours to discuss current COVID situations and risk, they planned deliverables such as the creation of SOPs for different aspects of field work and agreed a regular meeting schedule
Year(s) Of Engagement Activity 2021
 
Description Call-to-Action on the use of Community Engagement approaches to tackle Antimicrobial Resistance. 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In November 2021 an online webinar was held to share the findings of this project which included our handbook, publication and call to action. over 200 people registered for the webinar and 80 attended live with others watching the recording. All outputs are now shared on the website for other interactions
Year(s) Of Engagement Activity 2021
URL https://ce4amr.leeds.ac.uk/news/call-to-action/
 
Description Capacity Building Webinar: AMR in veterinary and agricultural health systems 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact On 30th November our COSTAR colleague Monsur Ahmed delivered an online talk regarding the challenges of AMR in animal health particularly the veterinary health system and agricultural system in Bangladesh. The online webinar was recorded and shared with the 30 strong COSTAR team who also had permission to share with their wider networks/colleagues

The webinar was designed to increase team capacity around veterinary AMR issues and to shape the development of materials for the COSTAR project going forward
Year(s) Of Engagement Activity 2021
 
Description Capacity Building: Animal Health workshops 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In April 2021 two animal health workshops were held within the COSTAR team. The primary aims of these workshops were to share knowledge around antimicrobial resistance in the wild and domestically animal health areas. The workshops were led by animal and veterinary health experts and a zoologist who supported team members to understand the similarities of AMR between human and animal health settings and point out key challenges within the animal health sphere.

All 30 members of the COSTAR team were invited to the workshops which were recorded and shared
Year(s) Of Engagement Activity 2021
 
Description Capacity Building: Community Dialogue Approach workshop 2 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In summer 2021 the COSTAR team led another workshop to discuss modifying the original Community Dialogue approach (used in project ES/P004075/1) to meet the aims of the COSTAR project. Specific discussions around changes to materials and delivery mechanisms were discussed, working groups were formed to take on these changes.

All 30 members of the COSTAR team were invited to the workshop which was recorded and shared
Year(s) Of Engagement Activity 2021
 
Description Capacity Building: Community Dialogue Workshop 1 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In May 2021 the COSTAR team members who had been involved in the pilot project (ES/P004075/1) led a workshop to explain the community dialogue approach to other team members. The workshop's main aim was to build capacity within the team and create plans for future development of CDA materials for the COSTAR project. This was an interactive workshop with activities, presentation slides and Q&A sessions

All 30 members of the COSTAR team were invited to the workshop which was recorded and shared
Year(s) Of Engagement Activity 2021
 
Description Capacity Building: Environmental Health workshops 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In march - April 2021 two workshops were held with the COSTAR team and additional stakeholders from policy and professional backgrounds. The workshops discussed the challenges of antimicrobial resistance specific to the environment and water, sanitation and hygiene sectors. The aims of the workshops was to build capacity within the COSTAR team, share knowledge and target the development of materials for the COSTAR project to take a wider One Health view of AMR.

All 30 members of the COSTAR team were invited to the workshop which was recorded and shared
Year(s) Of Engagement Activity 2021
 
Description Capacity Building: Participatory Video Workshop 2 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In September 2021 a second workshop was held to discuss the use of the Participatory video (PV) approach in the COSTAR project. Team members reflected on learnings from the pilot study AH/R005869/1 and made plans to modify the materials in this study to meet COSTAR's needs. Working groups were established and team members began to plan the timing of PV to fit in with the other research activities within COSTAR

All 30 members of the COSTAR team were invited to the workshop which was recorded and shared
Year(s) Of Engagement Activity 2021
 
Description Capacity Building: Participatory Video workshop 1 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In June 2021 members of the COSTAR team who had been involved in the previous project (AH/R005869/1) discussed the participatory video method and shared learnings from the pilot study with the rest of the group. The primary aim of this meeting was to build capacity in the team and share learnings from previous experiences of using PV methods. The workshop was interactive and included discussions, presentations, activities and Q&A sessions

All 30 members of the COSTAR team were invited to the workshop which was recorded and shared
Year(s) Of Engagement Activity 2021
 
Description Capacity building workshop - Gender & Equity in research 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A workshop event to build capacity around considering equity in research project planning, implementation and analysis. This session was designed to prompt consideration of equity issues (such as gendered power dynamics) within our own research. Colleagues shared considerations they found interesting and highlighted areas where we can put our project to consider issues of equity more closely.
Year(s) Of Engagement Activity 2022
 
Description Capacity building workshop - Process evaluation 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A workshop to build capacity on process evaluation for COSTASR colleagues. Colleagues learned about planning and conducting a process evaluation then added points for focus when planning the COSTAR evaluation process. These points were compiled into a matrix to inform COSTAR process evaluation
Year(s) Of Engagement Activity 2022
 
Description Capacity building workshop - writing academic papers 1 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A series of events designed to build capacity for working professionals within the COSTAR project. Each writing workshops focuses on as different aspect of academic writing, data analysis and publishing work for an international audience.
Year(s) Of Engagement Activity 2022
 
Description Capacity building workshop - writing academic papers 2 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A series of events designed to build capacity for working professionals within the COSTAR project. Each writing workshops focuses on as different aspect of academic writing, data analysis and publishing work for an international audience.
Year(s) Of Engagement Activity 2023
 
Description Capacity building workshop - writing academic papers 3 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A series of events designed to build capacity for working professionals within the COSTAR project. Each writing workshops focuses on as different aspect of academic writing, data analysis and publishing work for an international audience.
Year(s) Of Engagement Activity 2023
 
Description Capacity building workshop - writing academic papers 4 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A series of events designed to build capacity for working professionals within the COSTAR project. Each writing workshops focuses on as different aspect of academic writing, data analysis and publishing work for an international audience.
Year(s) Of Engagement Activity 2023
 
Description Capacity building workshop - writing academic papers 5 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A series of events designed to build capacity for working professionals within the COSTAR project. Each writing workshops focuses on as different aspect of academic writing, data analysis and publishing work for an international audience.
Year(s) Of Engagement Activity 2023
 
Description Community Based Monitoring workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact On December 2nd 2021 COSTAR Co-I and community based monitoring expert Dr Mahua Das led a workshop regarding the use of community based monitoring in health and how this approach could be adapted within the COSTAR project. Professional Practitioners from Dr Das' network also featured in this workshop which was discussion based. The workshop look in detail at the community monitoring attempted within the pilot study (ES/P004075/1) and made plans to expand and develop the approach for COSTAR.

All 30 members of the COSTAR team were invited to the workshop which was recorded and shared
Year(s) Of Engagement Activity 2021
 
Description Community Dialogue Approach: Material modifications workshops 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact From October 2021 the COSTAR team's material development working group have led a series of workshops with the wider COSTAR team regarding updates to the materials initially designed in the pilot study ES/P004075/1. The webinars were all recorded allowing all members of the COSTAR team (~30) to watch and engage with the discussions.

For the COSTAR project many changes need to be made to these materials, mainly a focus on AMR as apposed to just ABR but also animal and environmental health information. The COSTAR material development group works to change materials based on feedback from these workshops and other working groups (such as the randomized control trail group and technical framing group). The workshops themselves serve as capacity building sessions allowing all COSTAR team members to increase their AMR and One Health knowledge as well as knowledge of the CDA approach and its development behind the scenes.
Year(s) Of Engagement Activity 2021,2022
 
Description Community Dialogue Observation 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact International collaborators from the University of Leeds and Malaria Consortium visited the Community Dialogue fieldsite in Cumilla District, Bangladesh. The team observed Community Dialogues activities and discussed with the CD facilitators about their challenges to conduct CD and motivated them to work for the community people
Year(s) Of Engagement Activity 2023
 
Description Community Dialogues - training of facilitators and supervisors 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Training activities and workshops held for community members of the Cumilla District of Bangladesh. Community people learned about AMR and CDA process
Year(s) Of Engagement Activity 2023
 
Description Community Dialogues - training of master trainers in Nepal 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The ARK team, based in Bangladesh, partnered with team members from the UK to deliver training on the Community dialogues Approach to HERDi team members and local stakeholders. The training developed cross-country learning and adaptations of CDA material to better fit the Nepal context
Year(s) Of Engagement Activity 2023
 
Description Conference paper accepted 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The abstract entitled "Community dialogues for preventing and controlling antibiotic resistance in Bangladesh" was accepted on 23rd of August'21 for oral presentation in the annual conference of Public Health Association of Bangladesh (PHAB) in the category of "Public Health Issues". The theme of the conference for year 2021 was "Health Systems Strengthening: Solutions for Tomorrow". Fariza Fieroze who have worked in the Community Dialogue project presented the study on 4th of September'21 on behalf of the CD team. The Chief Guest of the conference was the Health Minister of Bangladesh, the Director General of Directorate General of Health Services, Ministry of Health & Family Welfare, the Vice Chancellor, Bangabandhu Sheikh Mujib Medical University were also present as special guests.
Year(s) Of Engagement Activity 2021
URL http://pha-bangladesh.org/conference/
 
Description Decolonising Research Methods Showcase event - conference presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Members of the University of Leeds teams presented a talk on the development and maintenance of equitable partnerships in research collaborations. This included discussions from experiences from the COSTAR project. At the event, slides and links were shared with other researchers at the university.
Year(s) Of Engagement Activity 2024
 
Description Featured on WHO/Nuffield Joint Web- based post 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact The University of Leeds COSTAR team, as part of their ongoing collaborative work with the WHO, contributed to a news item on the WHO website. This article shared some COSTAR information
Year(s) Of Engagement Activity 2023
URL https://www.who.int/europe/news/item/03-10-2023-who-renews-collaboration-with-nuffield-centre-for-in...
 
Description First quarterly feedback meeting and refreshers training with the facilitators of the first clusters 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact First of a regularly planned set of feedback meetings and refresher training for facilitators based in the first cluster group of the CDA trial in Daudkandi, Cumilla. This meeting was designed to improve knowledge on conducting CDs and allow facilitators to ask any questions about the process.
Year(s) Of Engagement Activity 2023
 
Description First quarterly feedback meeting and refreshers training with the facilitators of the second clusters 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact First of a regularly planned set of feedback meetings and refresher training for facilitators based in the second cluster group of the CDA trial in Homna, Cumilla. This meeting was designed to improve knowledge on conducting CDs and allow facilitators to ask any questions about the process
Year(s) Of Engagement Activity 2023
 
Description Focus Group Discussion with Trainers (Bangladesh) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact ARK team members in Bangladesh hosted a focus group discussion with trainers recruited into the Community Dialogues process.The trainers was updated about the current progress of the project as well as the next plan and prospective outcomes from the intervention. The audience also proposed some strategies to make CDA and stakeholder engagement for effective implementation in future.
Year(s) Of Engagement Activity 2023
 
Description Guest speaker at conference hosted by Nazarbayev University | Graduate School of Public Policy 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact COSTAR PI Dr Rebecca King presented COSTAR findings and insights at a Kazakhstan conference in Nov 2023. Participants requested the presentation slides after the conference. This interest is particularly significant, as many participants were PR managers from the Ministry of Health regional offices, regularly facing communication challenges and public engagement issues.
Year(s) Of Engagement Activity 2023
 
Description How we used lessons learnt to optimize the COSTAR AMR Trainings in Bangladesh - blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact On 23rd November 2022, the COSTAR research team developed and published a short blog reflecting on the learnings that have developed content and training for Community Dialogues, due to be held in the Cumilla district of Bangladesh in 2023. The purpose of this blog is to reflect openly about the process of community engagement in this location and to ensure our outputs have a wide reach and use.
Year(s) Of Engagement Activity 2022
URL https://ce4amr.leeds.ac.uk/how-we-used-lessons-learnt-to-optimize-the-costar-amr-trainings-in-bangla...
 
Description Inception meeting 1 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact On February 10th 2021 all Co-investigators within this project came together to officially begin the project, refresh knowledge on the aims and scope of the project and update on plans for ethics etc, in each setting. COVID-19 issues were also discussed in relation to this project

All 30 members of the COSTAR team were invited to the workshop which was recorded and shared
Year(s) Of Engagement Activity 2021
 
Description Launch event: Nepal 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Partners HERD International organized sub-national launching of COSTAR project in Kapilvastu Municipality in Lumbini Province of Nepal on Monday 28th February 2022. Invitees included elected officials of Kapilvastu Municipality, chief administrative officer and health coordinator of the municipality, chief of the health office, representatives of development partners and non-government organizations working in health and livelihood sector in Kapilvasu district.

We conducted launching event in a workshop format to engage participants. We divided program into following segments.
1. Inauguration of the event by Deputy Mayor of Kapilvastu Municipality Laxmi Gupta, Presentation on local health system's challenges and opportunities and Antimicrobial Resistance by Health Office chief Hemraj Pandey.
2. Group works: Participants were divided in four different groups- who discussed on gaps and best practices on local health system. The discussion was designed to focus on two issues-Health system challenges and AMR. To create synergy and integration among health system actors, we felt need to link AMR issue with local health system so that health sector's policy makers at local government would consider AMR as important area for intervention. The purpose of this group work was to sensitize stakeholders on two issues- i) Factors affecting local health system and ii) Needs for addressing AMR issue at community and system level. We connected AMR issues to the health system so that policy making body- specifically municipality would consider this as the priority of the local health system.
3. HERD International team summarized the discussion and presented objectives, methods and activities of COSTAR project. Mr. Shreeman Sharma, Research Uptake Lead for COSTAR from HERD International presented a power point slide that included definition of AMR, challenges caused by AMR, one health approach to tackle AMR, objective of COSTAR project, methods imbedded in the project (PV, survey, Workshops) and expected outcomes. The presentation was prepared and delivered in local language, Nepali.
4. Key remarks:
Municipal Deputy Mayor Ms. Laxmi gupta, Municipal Chief Administrative Officer Mr. Sheshkanta Paudel, Municipal Health Coordinator Mr. Umesh Gupta, Health Office chief Mr. Hemraj Pandey and other participants representing non-government sector attended all the sessions. They actively participated in group discussions. Time was allocated for each of the official mentioned above to express his/her opinion on the key themes discussed in the workshop. They had agreement on followings.
- Kapilvastu district is vulnerable from the perspective of natural disaster and disease outbreak
- Inappropriate use of medicine could have been one of the problems in Kapilvastu district
Year(s) Of Engagement Activity 2022
URL https://twitter.com/HERDIntl/status/1498888166627250178
 
Description Meeting with CDC, DGHS 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The government officials were informed about all COSTAR project updates. The policymakers are based in Dhaka, Bangladesh and work at the Ministry of Health and with the CDC. The policymakers expressed their satisfaction about the progress of the project so far.
Year(s) Of Engagement Activity 2023
 
Description National COSTAR Launch: Bangladesh 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact On Sunday 13th March the ARK Foundation Team formally launches the COSTAR project in Bangladesh in an online event with key stakeholders and policy makers from across the One Health sphere, academic and charitable sectors. This was shared widely on social media engaging at least 100 people on the day and a wider audience 'catching up' on tweets/posts. Members of the audience have asked to remain in contact with COSTAR and support the project in any way possible. This will embed COSTAR within the Bangladesh policy and AMR space at One Health level.

Several media outlets have covered and shared the launch in well respected Bangladeshi newspapers
Year(s) Of Engagement Activity 2022
URL https://www.tbsnews.net/economy/corporates/ark-foundation-launches-costar-address-antimicrobial-resi...
 
Description Nepali Household survey workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact From November 2021 a small working group of COSTAR colleagues has met regularly to design the household survey questions that will be used to measure community knowledge, attitudes and practice (KAP) toward antimicrobials in Nepal. This survey is heavily influenced by the pilot project ES/P004075/1 but with key contextual modifications for the Nepali audience based on learnings from our other pilot study AH/R005869/1

This workshop was held online on December 10th to discuss in detail the wording of questions, measures of knowledge and methods of delivery for the survey in Nepal. The workshop was interactive and allowed COSTAR colleagues to make plans for future field visits. Around 6 members of the COSTAR team attended live whilst the rest of the 30 strong team were able to watch the recording and contribute to email discussions and padelts.
Year(s) Of Engagement Activity 2021,2022
 
Description Online project launch 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The COSTAR project was officially launched on November 16th 2021 as part of the wider CE4AMR network's call to action event. The Vice Chancellor of the University of Leeds and Wellcome Trust's head of public engagement spoke at the event which discussed the need to involve community and civil society actors in AMR action and decision making. A short video of the COSTAR project was shared to introduce the work

There were around 80 people in attendance with over 200 signed up to the webinar and who received a copy of the recording
Year(s) Of Engagement Activity 2021
URL https://ce4amr.leeds.ac.uk/news/call-to-action/
 
Description PV sensitisation workshops 1 &2 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact The ARK foundation team conducted a sensitisation workshop for members of the Comilla district of Bangladesh. The aim of this activity was to introduce the community to the project & begin to consider gatekeepers and potential participants for the PV work to come. The second workshop continued the process of sensitisation and began the process of recruiting and training gatekeepers to the community.
Year(s) Of Engagement Activity 2022
 
Description Participated in a Twitter Conversation by theAMRNarrative-CIDRAP (Bangladesh) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact The ARK team shared learning and experiences on working with communities regarding language barriers to tackle AMR through @theAMRnarrative organized X Twitter dialogue against different questions and topic posed by the moderator .
Year(s) Of Engagement Activity 2023
 
Description Participatory Video (PV) Showcasing Event (Bangladesh) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact The ARK team supported PV particiaptns to hold a showcasing event in the Mirpur area of Dhaka, Bangladesh. Local community members and policy makers were invited to take part in the event and share their thoughts on the videos after in a participatory feedback session.

People from different walks of life and professions presented their thoughts and opinions about antimicrobial resistance and antibiotics and their own views and stories on the main drivers of antimicrobial resistance through short films.
2. Representatives of the Council Office of Ward No. 7 of Dhaka North City Corporation were present in the event.
The present guests highly appreciated the "short film" produced by the general participants and emphasized on the overall responsibility and awareness of the people including the government to prevent antimicrobial resistance in the society.
Year(s) Of Engagement Activity 2023
 
Description Participatory Video Film Showcasing Event, in District 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact Participatory Video workshop participants were supported (by HERD facilitators) to organise and host a showcasing event for their films. Local community members and local policy makers were invited to attend the event, participants were able to share their films on AMR and spark local-level awareness and discussions on the topic of AMR. Feedback from audience members will be collected via focus groups in the coming weeks.
Year(s) Of Engagement Activity 2022
 
Description Participatory Video Film screening events, in District 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact In August and September 2022, HERD team members supported Participatory Video workshop members to share their films via screening events. The purpose of these screenings was to raise local awareness of AMR and to sensitise policy makers to AMR within their communities.
Year(s) Of Engagement Activity 2022
 
Description Participatory Video Training session 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact From Jan 28th to Feb 11th 2021 the COSTAR team members in Leeds and HERD International delivered an online training session in Participatory Video methods to the team in Bangladesh. Around 12 members of the COSTAR team took part in the daily training sessions but all material has been recorded and will be edited for sharing

the training was an intense period of lectures, workshops and practical sessions to orientate the Bangladesh team on the methods of PV, using cameras in research and communicating AMR with community audiences. The team are now piloting their learnings in the field and have an online workspace to share questions and comments with the wider team. Once it is safe to travel Leeds and HERDi team members will travel to Bangladesh to refresh this training in person
Year(s) Of Engagement Activity 2021
URL https://twitter.com/arkfoundation1/status/1489149807952543745
 
Description Participatory Video workshops - site 1 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact The HERD team conducted a series of interactive workshop with community members aimed at educating on AMR and filmmaking skills. During the workshops, participants were guided to understand the issue of AMR and how it relates to local health issues. Participants were then guided to make films on issues they felt were most relevant to local issues. These workshops ran over multiple days in the Kapilvastu district of Nepal. At the end of these workshops, participants were able to create their own films on AMR and were directed to head into the community to conduct filming tasks.
Year(s) Of Engagement Activity 2022
 
Description Participatory Video workshops - site 2 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact The HERD team conducted a series of interactive workshop with community members aimed at educating on AMR and filmmaking skills. During the workshops, participants were guided to understand the issue of AMR and how it relates to local health issues. Participants were then guided to make films on issues they felt were most relevant to local issues. These workshops ran over multiple days in the Kapilvastu district of Nepal. At the end of these workshops, participants were able to create their own films on AMR and were directed to head into the community to conduct filming tasks.
Year(s) Of Engagement Activity 2022
 
Description Policy maker observations of community dialogues 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact HERDi researchers held a session for community policy makers to observe some of the final community dialogues sessions in the Kapilvastu area of Nepal. Present were HERDi facilitators, community facilitators, researchers and regional policy makers. The policymakers present were:

Six stakeholders from Kapilvastu municiplaity office (human health, animal health, education, administration chief)
- One ward chair (local level - Kapivastu)
- three stakeholders from Kapilvastu distirct health office
- one stakeholder from District Development Committee
- One stakeholder from federal government (MToT participant - M&E section chief, Ministry of Health and Population)
Year(s) Of Engagement Activity 2024
 
Description Pre-testing of PV 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Team members in the ARK foundation conducted piloting exercises for the Participatory Video elements of the COSTAR project. This was conducted in the Brahmanbaria area of Bangladesh, with the aim of testing the methods and sensitising the community to the topic of AMR
Year(s) Of Engagement Activity 2022
 
Description Presentation: Sonar-Global 3rd AMR Hub Meeting - Social Dimensions of Antibiotic Resistance in Asia 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Team members Dr Jessica Mitchell and Professor Paul Cooke presented summary of this project's findings on September 14th at the SONAR Global 3rd AMR Hub Meeting - Social Dimensions of Antibiotic Resistance in Asia: a One Health Perspective. The presentation also included background details of the cluster project's formation and so links to two other projects (Community arts against antibiotic resistance, and Community Dialogues for preventing antibiotic resistance)

This was an interactive meeting, consisting of a series of short presentations (two sessions over two days) followed by an optional one-hour online brainstorming session (on Day 2 after the main meeting) with a focus on identifying research gaps, prioritizing a research agenda, and brainstorming ideas for potential future funding applications. At its peak, it had 80 participants from all over the world.
Year(s) Of Engagement Activity 2021
URL https://www.sonar-global.eu/sonar-global-3rd-amr-hub-meeting/
 
Description Randomized Control Trail discussion 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact On February 9th 2022 COSTAR Co-I Dr Joe Hicks led a webinar to discuss the randomized control trial evaluation of COSTAR. The content was heavily guided by the pilot project ES/P004075/1 and in particular discussed how to map content of the Community Dialogues Approach to the outcome measures of the trail. COSTAR colleagues had the opportunity to ask technical questions about the randomized control trial set-up and methods as well as to reflect on plans for field work and continued material development

Around 6 members of the COSTAR team attended the full webinar but the session was recorded and shared with all 30 team members.
Year(s) Of Engagement Activity 2022
 
Description Reflections on the process of PV making about AMR in Bangladesh - blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact On 22nd November 2022, the COSTAR research team developed and published a short blog reflecting on the experiences of conducting participatory video workshops in the Cumilla district of Bangladesh. The purpose of this blog is to share experiences using the PV method with the wider research community and to reflect openly about the process of community engagement in this location.
Year(s) Of Engagement Activity 2022
URL https://ce4amr.leeds.ac.uk/reflections-on-the-process-of-pv-making-about-amr-in-bangladesh/
 
Description Refresher training for CDA facilitators for 3 batches (Nepal) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact HERDi team hosted a refresher training in three installments for all facilitators and supervisors recruited for the COSTAR Community Dialogues activities. During the training, CDA facilitators and supervisors were reminded of the contents of the project, method of delivery, challenges, difficulties in delivering the sessions were discussed, errors were fixed.
Year(s) Of Engagement Activity 2023
 
Description Safe Guarding Working Group 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact In late 2021 the COSTAR team networked with colleagues in another research project to create a safe guarding working group. The group together attended training provided by an external expert group and worked to develop Safe guarding processes and materials to support the rest of the COSTAR team.

There are 9 members of this working group but notes of the workshops are shared with the wider COSTAR and CHOURS teams which together encompass around 60 people
Year(s) Of Engagement Activity 2021
 
Description Stakeholder consultation (municipality and TOT participants) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact The meeting discussed on what to consider to select supervisors and facilitators and planning for cluster. This activity led to supervisor and facilitator recruitment and identification of cluster to deliver CDA session
Year(s) Of Engagement Activity 2023
 
Description Stakeholder engagement - Master trainers of Nepal 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact HERDi team conducted engagement activities with key stakeholders across Nepal. This resulted in engagement from policy makers across Ministry of Health and Populations, Ministry of Agriculture and Livestock development, Provincial Ministry of Health and Populations Lumbini, Ministry of Forest and Environment. These policy makers then attended master training sessions, delivered by COSTAR partners.
Year(s) Of Engagement Activity 2023
 
Description State of the AMR nation - BioInfect 2024 panel session 'state of the AMR nation' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact NJ reflected on the importance of community engagement in AMR research and response, including specific reflections from the COSTAR work. This led to many further discussions about future collaborations and potential media relationships
Year(s) Of Engagement Activity 2024
 
Description The Power of Community to Combat AMR - blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact On 21st November 2022, the COSTAR research team developed and published a short blog reflecting on the experiences of conducting participatory video workshops in the Kapilvastu district of Nepal. The purpose of this blog is to share experiences using the PV method with the wider research community and to reflect openly about the process of community engagement in this location.
Year(s) Of Engagement Activity 2022
URL https://ce4amr.leeds.ac.uk/the-power-of-community-to-combat-amr/
 
Description Training to facilitators to deliver CDA materials to community members 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Training on use of community dialogue flip book conducted by HERDi team members and researchers from University of Leeds and Malaria Consortium. Facilitators and supervisors were then ready to deliver CDA materials to the community members in 12 wards across Kapilvastu district of Nepal.
Year(s) Of Engagement Activity 2023
 
Description Two-Day interactive workshop with media 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact On 4th and 5th November 2022, HERDi team members conducted a two-day workshop with members of Nepali media. The purpose of this workshop was to generate awareness of AMR within media and mobilise the Nepali media community to share information on AMR nationally
Year(s) Of Engagement Activity 2022
 
Description Video's featured in WHO regional conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dr Rebecca King shared a video about COSTAR to WHO, which was played at the Kazakhstan 73rd session of the
WHO Regional Committee for Europe. The video was seen by researchers, WHO staff and practitioners from across the region.
Year(s) Of Engagement Activity 2023
URL https://www.who.int/europe/about-us/governance/regional-committee/73rd-session-of-the-who-regional-c...
 
Description WAAW Workshop 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact The HERD team were invited to attended and present in WAWW (World Antibiotic Awareness Week) workshop organized by Lumbini provincial government. At the workshop, HERD team members were given the opportunity to share current COSTAR activities with policy makers.
Year(s) Of Engagement Activity 2022
 
Description Webinar Presentation (hosted by REACT) - Impactful approaches for community-wide engagement on antibiotic resistance 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dr Rebecca King and Professor Rumana Huque presented findings and reflections from the COSTAR project at an international conference, hosted by the ReAct group - based in Uppsala. The event was attended by academics, researchers and students from across One Health AMR disciplines.
Year(s) Of Engagement Activity 2023
 
Description Webinar: Articulating Participatory Video interventions into the Community Dialogue Approach 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact From November 2021-Jan 2022 the COSTAR team have attended several workshops lead by PI Dr Rebecca King and Co-I Professor Paul Cooke to discuss how to articulate the two key approaches of Participatory Video (PV) and Community Dialogues (CDA). Around 12 people attended each workshop but all have been recorded and shared to the wider team of 30 plus their wider organisations.

The workshops have focused on how to join up learnings from our two pilot projects on PV (AH/R005869/1) and the CDA ES/P004075/1 They have allowed COSTAR colleagues to build their own capacity and understandings of each approach whilst equitably contributing to the development of the new COSTAR study
Year(s) Of Engagement Activity 2021,2022
 
Description Website article: PV pilot study in Bangladesh 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The team summarized their learnings regarding the recent participatory video work in Bangladesh and shared it on the project website. This page was then shared on social media in order to reach a wider audience.
Year(s) Of Engagement Activity 2022
URL https://ce4amr.leeds.ac.uk/costar/formative-outputs/bangladesh-pv-pilot/
 
Description Workshop of the Core Working Group and Other Stakeholders of AMR (Bangladesh) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Dr. Rumana Huque and Dr. Khaleda Islam joined the 'Workshop of the Core Working Group and Other Stakeholders of AMR' on 1st September, 2021. Dr. Rumana presented the potential investments for AMR containment in Bangladesh. She emphasised on creating awareness about AMR and engaging with community for AMR containment. Line Director, Communicable Disease Control was the chief guest of the workshop. Key stakeholders from health sector, poultry and fisheries joined the event.
Year(s) Of Engagement Activity 2021
 
Description World Antimicrobial Resistance Awareness Week 2023 Celebration (Bangladesh) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact The ARK team conducted a series of posts throughout WAAW 2023 over Twitter and Facebook. Through the posts on several social medias during WAAW 23 week we were being able to create awareness among a huge number of audience and showcasing our previous finding and activities from COSTAR end.
Year(s) Of Engagement Activity 2023