Research projects

The ESRC, in partnership with the National Institute for Health Research (NIHR), Arts and Humanities Research Council (AHRC), the Medical Research Council (MRC), the Department for Environment, Food and Rural Affairs (Defra) and the Veterinary Medicines Directorate (VMD) have supported the following Theme 4 research projects on the topic of behaviour relating to antimicrobial resistance (AMR).

Collaborative grants:

  • STEP-UP (Improving the uptake and SusTainability of Effective interventions to promote Prudent antibiotic Use in Primary care)
    Principal Investigator: Professor Ann Sarah Walker, University of Oxford

    STEP-UP aims to accelerate the uptake and maximise the sustainability of interventions to reduce antibiotic prescribing in primary care that previous research has already shown to be effective. The ultimate goal is achieving year-on-year overall reductions in unnecessary antibiotic prescribing in primary care in England over the next decade, and hence consequent reductions in antimicrobial resistance. We will do this by investigating two specific questions: “Why are we not using interventions we know to be effective in general clinical practice?” “How can we improve their uptake and sustainability?”. We will conduct studies in four exemplar areas, chosen to provide a diverse range of contexts with interventions targeted at organisational, inter-personal and individual levels, involving healthcare-commissioners, primary care clinicians, general practices and patients in England.

Pump-priming grants:

  • Antibiotics and Activity Spaces: An Exploratory Study of Behaviour, Marginalisation, and Knowledge Diffusion
    Principal Investigator: Dr Marco Haenssgen, University of Oxford

    Our study aims to improve the understanding of patients’ antibiotic-related behaviour to support creative thinking about targeted and unconventional antimicrobial resistance (AMR) interventions in low- and middle-income countries (LMICs). We thereby explore three research questions:

    1) What are the manifestations and determinants of problematic antibiotic use in patients’ healthcare-seeking pathways?

    2) Will people’s exposure to antibiotic awareness activities entail changed behaviours that diffuse or dissipate within a network of competing healthcare practices?

    3) Which proxy indicators facilitate the detection of problematic antibiotic behaviours across and within communities?

    By surveying 4,800 villagers in Thailand and Lao PDR, we will be able to generate innovative and unprecedentedly detailed open-access survey data on antibiotic-related behaviour and its social, economic, and spatial determinants. As part of our capacity-building activities, we are also hosting placement students from the MSc International Health and Tropical Medicine (University of Oxford) and offer research internships for local candidates from Southeast Asia.

  • Antimicrobial resistance as a social dilemma: Approaches to reducing broad-spectrum antibiotic use in acute medical patients internationally
    Principal Investigator: Dr Carolyn Tarrant, University of Leicester

    Adopting an international and interdisciplinary approach to tackling antimicrobial resistance, this 2-year project aims to investigate and compare antibiotic prescribing across the UK, Sri Lanka and South Africa. The project team comprises a diverse range of social scientists, microbiologists and medical doctors. Across all three project countries, we are planning to investigate barriers to appropriate antibiotic prescribing for acute medical patients in public and private hospitals. Semi-structured interviews with physicians will focus on the use of broad-spectrum antibiotics, which target a wide range of pathogens but are a strong driver of antimicrobial resistance, and narrow-spectrum antibiotics, which target a small range of pathogens but have a lesser effect on antimicrobial resistance. The results will be contextualised within a framework of social science theories (game theory; principal-agent theory) by comparing the medical decision context to a social dilemma situation. In such a situation, the interests of society—i.e., limited use of (broad-spectrum) antibiotics to maintain antibiotic effectiveness—are in conflict with those of the individual patient—i.e., generous use of (broad-spectrum) antibiotics to reduce the risk of treatment complications. Finally, the project aims to use agent-based modelling techniques to simulate the prescribing dilemma and make predictions about future developments as well as the likely effectiveness of targeted interventions.
  • Corporate food retailers, meat supply chains and the responsibilities of tackling antimicrobial resistance (AMR)
    Principal Investigator: Dr Alex Hughes, Newcastle University

    Our project on 'Corporate food retailers, meat supply chains and the responsibilities of tackling AMR' makes a contribution to the agenda for tackling antimicrobial resistance (AMR) by focusing scoping research and networking events on a link that has so far been missing from academic and policy debate - the pivotal role of corporate food retailers. The aim of the project is to address the responsibility of retailers in tackling the AMR challenge in the context of their chicken and pork supply chains, and to investigate this evolving role and how it might be shaped in the future, in the UK and at a global scale. It is becoming clearer that while antimicrobials are a necessary tool to maintain health and welfare on the farm, the key issue is their inappropriate and disproportionate use in animals thereby reducing availability for humans. Our current, UK-focused project is in the early stages. Future research might explore more global dimensions of retailers’ roles.

  • How do policymaker perceptions of antimicrobial resistance drive behaviour and policies for appropriate antimicrobial use? A case study of Pakistan
    Principal Investigator: Dr Johanna Hanefeld, London School of Hygiene and Tropical Medicine 
Edit this page