The values and principles underpinning community engagement approaches to tackling antimicrobial resistance (AMR)

Jessica Mitchell,Paul Cooke,Sushil Baral,Naomi Bull,Catherine Stones,Emmanuel Tsekleves,Nervo Verdezoto,Abriti Arjyal,Romi Giri,Ashim Shrestha,Rebecca King

doi:10.1080/16549716.2020.1837484

Abstract

ABSTRACT This paper presents seven values underpinning the application of Community Engagement (CE) approaches to the One Health challenge of antimicrobial resistance (AMR) developed during an international workshop in June 2019. We define a value as a quality or standard which a CE project is aiming for, whilst a principle is an objective which underpins the value and facilitates its achievement. The values of Clarity, Creativity, (being) Evidence-led, Equity, Interdisciplinarity, Sustainability and Flexibility were identified by a network of 40 researchers and practitioners who utilise CE approaches to tackle complex One Health challenges including, but not limited to, AMR. We present our understanding of these seven values and their underlying principles as a flexible tool designed to support stakeholders within CE for AMR projects. We include practical guidance on working toward each value, plus case studies of the values in action within existing AMR interventions. Finally, we consider the extent to which CE approaches are appropriate to tackle AMR challenges. We reflect on these in relation to the tool, and current literature for both CE and AMR research. Authors and co-producers anticipate this tool being used to scene-set, road map and trouble shoot the development, implementation, and evaluation of CE projects to address AMR and other One Health challenges. However, the tool is not prescriptive but responsive to the context and needs of the community, opening opportunity to build a truly collaborative and community-centred approach to AMR research.

Highlights

Introduction to our context and co-producersAntimicrobial resistance (AMR) is the process by which microbes change or evolve to survive the drugs used to destroy them
antimicrobial resistance (AMR) is a social issue driven by human behaviour, and others are attempting to tackle it via engaging with commu nities
We aim to present a flexible framework for applying community engagement (CE) projects to the field of AMR and One Health at all stages of the research process

Summary

Introduction

Introduction to our context and co-producersAntimicrobial resistance (AMR) is the process by which microbes (including bacteria, viruses, fungi, parasites) change or evolve to survive the drugs used to destroy them. It is considered a One Health issue because it impacts humans, animals and the environ ment and requires cross-sector collaboration to tackle [1] Without action this decade, AMR could cause economic damage on a similar scale to the 2008 financial crisis, leading to 300 million deaths by 2050 [2] and pushing 28.3 million people into pov erty, the bulk of which (26.2 million) will inevitably reside in low-middle income countries (LMICs) [3]. AMR is a social issue driven by human behaviour, and others are attempting to tackle it via engaging with commu nities Such bottom-up approaches can explore the local context of antimicrobial use which, in turn, can facilitate the co-development of bespoke solutions to minimise AMR in that community. The benefits of such community engagement (CE) appear particu larly meaningful when considering LMICs, as the local specificity of this approach can take into account many of the complex AMR-related inequal ities detailed above [8]

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Conclusion