How we developed a multi-year campaign to address antibiotic misuse
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Service(s):
The Change
69%
average annual growth rate in website traffic over a 2 year period
58%
of survey respondents on average reported that they were “very likely” or “likely” to reduce their antibiotic use due to the campaign
186K%
average increase in Facebook account reach from 2022/23
Raising awareness of antibiotic resistance among older adults
Antibiotic Wise is an initiative of the BC Centre for Disease Control (BCCDC), providing the public with relevant and specific information about antibiotic stewardship and resistance. Antibiotic Wise aims to reduce unnecessary antibiotic prescribing in British Columbia, and prevent the spread of antibiotic-resistant bacteria.
The Challenge
The misuse of antibiotics and antimicrobial drugs has dire consequences for public health. It leads to bacterial strains that are resistant to existing medications, making illnesses caused by bacterial infections harder to treat and in some cases, untreatable.
The BCCDC Community Antimicrobial Stewardship (CAS) has taken the lead in addressing antimicrobial resistance (AMR) and antibiotic misuse in British Columbia (B.C.), Canada, making a significant impact in addressing antimicrobial resistance in B.C.
However, the CAS team recognized that more needed to be done, particularly in reaching B.C. residents over the age of 65. This age group is among the most at risk for AMR-related illnesses due to weakened immune systems from pre-existing conditions or prolonged antibiotic use. They are also prescribed antibiotics at a rate 60% higher than adults aged 15 to 59.
The CAS team sought a partner to launch a province-wide media campaign to raise awareness of the issue, targeting adults 65 and older, along with their loved ones. The campaign needed to highlight the dangers of antibiotic resistance, educate the public about antibiotic misuse, address misconceptions, and drive behaviour change toward appropriate use of these drugs.
The Solution
The CAS team partnered with Be the Change Group to develop a data-driven, multi-year, province-wide media campaign in B.C. to raise awareness of antibiotic resistance with practical, engaging facts that help people make informed health decisions. Featuring relatable, people-focused imagery, the campaign was both eye-catching and resonant with the target audience of over-65s. At its core was the clear, actionable tagline: “Don’t share. Don’t hoard. Don’t overuse.” which was adapted over time to incorporate audience feedback. Designed to adapt with new information, the campaign maintained its relevance and solution-focused approach during its two-year run, evolving with audience perceptions. It featured digital, print, and video assets across various channels, including online, TV, social media, and high-traffic physical locations like bus shelters.
Throughout its now three-year partnership with CAS, Be the Change Group has continually refined the campaign to improve outcomes. We have expanded the campaign’s assets to speak to diverse cultural groups in B.C., such as Chinese- and Punjabi-speaking communities. With each iteration, we evaluate the campaign’s performance and impact, testing at every stage and analyzing data to better engage and inform the audience.
Evolving the campaign through evidence-based strategies
Developing an evidence-based campaign strategy
In developing the first iteration of the campaign, our team carried out a cross-jurisdictional review of similar campaign efforts in antimicrobial stewardship across the world. We crafted multiple campaign concept options and worked with several focus groups composed of adults aged 65 and older, to refine the campaign’s messaging.
We then launched a small digital campaign in fall 2021 and used it to gain a deeper understanding of our target audience and inform the second iteration of the campaign the following year.
Introducing dynamic characters and taking a more inclusive approach
We developed a new media strategy and refined our content based on the previous campaign results and the feedback we received from the focus groups. For the spring of 2022, we introduced campaign characters who reflected our target audience and incorporated light humour to make the campaign more engaging.
The assets were created in two languages: English and Simplified Chinese. Working with a Chinese culture and language expert, we ensured that the messaging and campaign assets were appropriate and effectively captured the playful tone we established with English-speaking audiences.
Understanding that our regular online channels such as Facebook and other English-language platforms may not be as accessible to that audience due to language barriers, we worked with Canadian Chinese media platforms Sing Tao, Ming Pao, and Canadian City Post to reach this audience segment.
Centering community in strategy and expanding campaign reach
We evaluated the spring campaign’s impact through online surveys and in-person interviews with our target audience in B.C.’s Lower Mainland, as well as by tracking performance across all platforms. Using the insights gathered, we refined the messaging and tactics for the spring 2023 campaign. In this next evolution of the campaign, we shifted the tone from authoritative and urgent to empathetic and positive, boosting engagement.
For the spring 2023 campaign, we worked with a Punjabi culture and language expert and adapted the concept and messaging to engage Punjabi-speaking audiences, speaking more to B.C.’s diverse communities. The campaign then had assets translated in traditional and Simplified Chinese, Punjabi, and English. We expanded our tactics by partnering with an external vendor to leverage their programmatic network, to continue reaching cultural audiences who may not use traditional online platforms.
Maximizing campaign performance through data-driven insights
Our Research + Community Engagement team developed an evaluation framework and conducted a comprehensive analysis of the campaign’s impact, using both quantitative and qualitative methods. This included creating an online pop-up survey to gather in-depth responses from visitors to antibioticwise.ca and conducting in-person surveys at three high-traffic Vancouver locations featuring campaign assets. By targeting older adults who encountered the campaign, we were able to capture immediate feedback on the messaging and imagery, providing valuable qualitative insights into the campaign’s effectiveness.
Their work gave us more information about the effectiveness of the selected media channels, how target audiences perceived the campaign, if there were corresponding behavioural and mindset changes, and what target audiences would like to see from future campaigns.
Reaching our audience through tailored media and strategic placements
We cast actors representing our target audience and recruited voice-over talent to produce humorous, eye-catching videos tailored to our audience’s interests. The campaign was deployed through various channels, including TV commercials, bus shelters, digital ads, programmatic networks, and social media. In collaboration with the CAS team, we researched locations across the province with a high population of adults 65 and older, ensuring that media placements maximized reach to the target audience.
In the spring of 2024, we continued our work with the CAS team, testing and implementing new campaign concepts in order to launch a fulsome campaign in the fall.
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