Identifying and Prioritising Behaviours to Slow Antimicrobial Resistance.

As a nation with relatively low levels of AMR, due to both community and agricultural stewardship, as well as geographical isolation, Australia is somewhat unique. As this advantage is being eroded, this project aimed to investigate the spectrum of human behaviours that could be modified in order to slow the spread of AMR, building upon the argument that doable actions are the best-targeted and least complex to change. We conducted a workshop with a panel of diverse interdisciplinary AMR experts (from sociology, microbiology, agriculture, veterinary medicine, health and government) and identified twelve behaviours that, if undertaken by the public, would slow the spread of AMR. These were then assessed by a representative sample of the public (285 Australians) for current participation, likelihood of future participation (likelihood) and perceived benefits that could occur if undertaken (perceived impact). An impact-likelihood matrix was used to identify four priority behaviours: do not pressure your doctor for antibiotics; contact council to find out where you can safely dispose of cleaning products with antimicrobial marketing; lobby supermarkets to only sell antibiotic free meat products; and return unused antibiotics to a pharmacy. Among a multitude of behavioural options, this study also highlights the importance of tailoring doable actions to local conditions, increasing community education, and emphasizing the lack of a one-size fits all approach to tackling this global threat.

Short Message Service Reminders to Parents for Increasing Adolescent Human Papillomavirus Vaccination Rates in a Secondary School Vaccine Program: A Randomized Control Trial.

PURPOSE: In Victoria (Australia), the human papillomavirus (HPV) vaccine is delivered within a state-wide secondary school vaccine program, administered by local government. This study aimed to test the hypothesis that sending a short message service (SMS) reminder to parents who had consented to their child's receiving the HPV vaccine would lead to greater uptake of the vaccine within the program. The secondary aim was to assess the effect of self-regulatory versus motivational message content in the SMS. METHODS: A randomized control trial design was used across 31 schools within seven local government areas. Parents of 4,386 consented adolescents were randomized into three study conditions: motivational SMS versus self-regulatory SMS versus no SMS. Follow-up extended beyond the final school visit to the end of the calendar year to capture those who may have attended a catch-up vaccination session. RESULTS: On the day of the final school visit, 85.71% of consented students in the control condition received the HPV vaccine, compared with 88.35% (2.64% point increase) in the motivational message condition, and 89.00% (3.29% point increase) in the self-regulatory message condition, χ2 (2, N = 4,386) = 8.31, p = .016. Both intervention messages were similarly effective at increasing vaccination rates. This effect was maintained in the extended follow-up period. CONCLUSIONS: The trial findings supported the hypothesis that SMS reminders to parents/guardians would lead to greater uptake of the HPV vaccine in adolescents participating in school-based vaccination. Also, this effect was observed whether we used a motivational or self-regulatory message framework. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12617001307392). Registration Date: September 12, 2017. Retrospectively registered.

Communication-based interventions for increasing influenza vaccination rates among Aboriginal children: A randomised controlled trial.

BACKGROUND: In Australia, the influenza vaccine is funded for Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) children aged 6 months to <5 years old. In Victoria, only 2% of Aboriginal children are vaccinated against influenza. OBJECTIVE: To evaluate whether sending a letter or sending a pamphlet directly to parents/guardians would improve influenza vaccine uptake amongst Aboriginal identified children. DESIGN: The study involved a multi-arm, parallel, randomised controlled trial with two intervention groups and one control group. PARTICIPANTS & SETTING: Participants included parents or guardians of Victorian children (aged 6 months to <5 years) who identified as Aboriginal. Households (n = 5534) were randomised (using a random number generator) to receive either a personalised letter (n = 1845), a pamphlet (n = 1845), or no direct communication (control) (n = 1844). The letter and the pamphlet were designed using the INSPIRE framework - a set of behaviour change techniques for action-oriented communication. MAIN OUTCOME MEASURE: The proportion of households where all eligible children received the influenza vaccine between 2 May 2017 and 1 September 2017. RESULTS: The control group's vaccination rate was 4.4%, higher than previous years. The pamphlet group achieved a similar vaccination rate (4.5%). The letter group's vaccination rate of 5.9% was significantly higher than the control group [χ2 (1, n = 3689) = 4.33, p = .037]. CONCLUSIONS: Sending a personalised letter directly to parents/guardians was an effective strategy for increasing influenza vaccination among Aboriginal children. The ineffectiveness of the pamphlet may be due to the lack of personalisation and the authority associated with the letter. Additional research is required to understand participant responses to the material. TRIAL REGISTRATION: This research was retrospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) on 13 September 2017 (ACTRN12617001315303).

Predictors of illegal dumping at charitable collection points.

Cleaning and disposal of illegal dumping at charitable collection points costs charities and diverts funds from their charitable programs. However, there is no published literature that attempts to better understand this problem. The current study assesses site-specific characteristics, community level indicators and sociodemographic factors as predictors of both charity stores and collection bin dumping in the metropolitan area of Perth, Australia. Multiple regression analyses revealed that higher levels of dumping at stores were predicted by being open on Sundays, the presence of gates/fencing, bringing bins in at night, greater 5-year mobility and lower levels of education and occupation in the area. The analysis also suggests that preventative measures have not necessarily been effective at reducing the amount of illegal dumping at stores. For charity bins, significant predictors of higher levels of dumping included private land ownership, if the site is shared with bins from another charity, the number of bins at the site, the number of days serviced per week, if the bin/s are located at a park/reserve and greater 5-year mobility. These results indicate that there is a combination of site-specific characteristics and community level indicators that play a role in illegal dumping at charitable collection points and indicate the type of interventions which may be successful in reducing illegal dumping. These may include improved maintenance, better placement of bins and signage and collaborations with real estate agents.