“The Mould that Changed the World”: a quantitative and qualitative evaluation of knowledge and behavioural change in children in the UK following participation in a musical about antimicrobial resistance

Abstract Background A primary school musical—"The Mould that Changed the World"—was developed as a unique public engagement strategy to combat antimicrobial resistance (AMR) by engaging children in the story of the discovery of antibiotics, the risks of drug-resistant infections, and the importance of prudent antibiotic use. Methods The musical intervention was implemented in two UK primary schools. Parental consent was obtained for all participating children. All 182 participating children, aged 9–11 years, were given an online questionnaire in the classroom before rehearsals began and at 2 weeks after performance with a 6-month evaluation in one school. The effect of the musical was analysed using generalised linear models to control for confounding factors. For the qualitative evaluation, 15 participating children were selected randomly from each school to take part in semi-structured focus groups (n=5 per group) before rehearsals began and 2 weeks after performance. This study was approved by the University of Edinburgh research governance office as an evaluation of an intervention. Findings Consistent with other intervention studies, knowledge gain was shown with children being more likely to answer questions on key messages of the musical correctly 2 weeks after performance (n=161) compared with the pre-rehearsal questionnaire (n=180; odds ratio 4·63 [95% CI 2·46–9·31], p Interpretation Although only evaluated in two schools, this study shows that initiatives such as musical theatre can improve both short-term and long-term knowledge in children. It shows a hitherto infrequently reported change in attitude and intention to behaviour change in children at an influential age for health beliefs. This unique public health tool has the potential for national roll-out in primary schools across the UK. Funding British Society of Antimicrobial Chemotherapy.