Antibiotic Smart Sweden: A society where everyone helps ensure antibiotics remain effective and continue to save lives

Title or slogan

Publication Year

2019

Leading Institution

Folkhälsomyndighetens (The Public Health Agency of Sweden)

Source

-Antibiotic-smart Sweden: A society where everyone contributes to ensuring that antibiotics work and continue to save lives: https://www.folkhalsomyndigheten.se/antibiotikasmart-sverige/bli-antibiotikasmart/
-Towards an Antibiotic Smart Sweden: http

Country/Countries

Sweden

Original language

Swedish

Available Language(s)

Swedish

English

Contact e-mail

info@folkhalsomyndigheten.se

Campaign link

https://www.folkhalsomyndigheten.se/antibiotikasmart-sverige/

Objectives and Target Audience

Objective(s)

Antibiotic Smart Sweden is a nationwide initiative aiming to create a society where everyone safeguards antibiotics. Led by the Swedish Public Health Agency and Research Institutes of Sweden (RISE), in collaboration with ReAct Europe and Strama, the project promotes antibiotic resistance as a broader public health issue. It sets up criteria in various sectors, demonstrating how different parts of society can be "antibiotic smart," including schools, wastewater treatment, pre-schools, long-term care facilities, and food procurement. Antibiotikasmart Sverige employs a multi-channel approach to spread awareness, engagement, and practical action:
-A central website with resources and multi-language support.
-Interactive webinars, workshops, and networking for stakeholder collaboration.
-Digital e-learning for professional development.
-Press releases and reports to maintain public transparency.
-Sector-specific campaigns, including certification and local storytelling.
-Engagement in international forums to promote Sweden’s antibiotic stewardship model globally.

Target audience

General public

School Students

Primary care professionals such as GPs or pharmacists

Hospitals

Elderly people

Public agencies

Research institutes

Global partners

Municipalities

Campaign Scope

National

Collaborations

Partners or Allies

Research Institutes of Sweden (RISE)

Communication Strategy

Communication Channels Used

websites/blogs

Community events

Web-based training modules

Local press

Public reports

Sector-specific diploma campaign

Campaign Material(s)

Word/PowerPoint/email templates

Logo downloads

Email signature

Stories

Diploma

Website content

Videos

Self-monitoring tools

Documents

Key messages

Outlined in the “Our messages” section of campaign communications (https://www.folkhalsomyndigheten.se/antibiotikasmart-sverige/kommunikationsstod/vara-budskap/) :
Background
-Antibiotics save lives every day and are a prerequisite for human and animal health, for our modern healthcare and for a sustainable society.
-If we all help prevent infections, prevent the spread of infection and use antibiotics responsibly, we will help ensure that antibiotics continue to work.
-Incorrect and excessive use of antibiotics is causing bacteria to become resistant at an ever faster rate, which means that more infections are becoming difficult to treat. Every year, around 35,000 people in Europe die from antibiotic-resistant infections.

This makes Antibioticsmart Sweden unique – our USP (unique selling point)
-We want to bring together and engage the entire community in helping antibiotics work and continue to save lives.
-We offer target group-specific knowledge and support for residents to understand the problem and how they can contribute by acting antibiotic-smart every day.
-With antibiotic-smart criteria, we want to stimulate regions, municipalities and their operations to work in a structured way on antibiotic and healthcare hygiene issues.
-To increase national collaborations, we offer a meeting place for academia, the private sector, authorities and civil society.
-We work actively with international exchange to spread knowledge about our model and gain inspiration from other countries in our work.
-We see civil society as a force and important partner in creating an antibiotic-smart society.

Campaign Focus

Human health

Campaign Setting

Online

Design and Content

Use of Scientific Evidence

Yes

Visual and Symbolic Elements

Distinct logo

Color scheme

Photos

Sector-specific icons

Pedagogical Approach

Educational model applied

Transmissive

Participatory

Constructivist

Content Complexity Level

Intermediate

Diversity and Inclusion

Content accessibility

Yes

Content accessibility

Plain language

Transcription

Listen button

Diversity and Inclusion

Yes

Diversity and Inclusion

Diverse visuals

Listen button

Involvement of Vulnerable Groups

Yes

Vulnerable Groups

Targeted materials

Cultural Sensitivity and Contextualization

Yes

Cultural Sensitivity and Contextualization

Relevant examples

Neutral language

Sector adaptation

Multilingual support

Dissemination and Sustainability

Implementation/Dissemination Period(s)

Campaign Start Month

Campaign Start Year

2019

Campaign End Month

Campaign End Year

2025

Replicability

Yes

Content usage license

Free

Campaign Status

Active

Funding

Estimated budget

2 262 000 €

Lessons and Observations

Identified gaps

Partial translation for multilingual target audience

Accessible formats for visually impaired users not provided

Frequently Asked Questions (FAQs) section not included

Interactive features not included

Feedback or audience involvement not visible

Reporting on results or impact not found

Lessons learned

Consistency in tone, slogans, and design may strengthen campaign recognition.

Tailoring content to specific groups (e.g., parents, seniors, teens) may enhance impact.

Involving youth and students can help amplify campaign reach.

"Listen" button available improves accessibility for different audience

Cross-sector collaboration (e.g., health, education, environment) may support integrated approaches like One Health.

Partnering with schools, municipalities, and local groups may enhance credibility and distribution.

A central campaign hub or website can improve discoverability and consistency.

1. Whole-of-Society engagement works by targeting all sectors—citizens, schools, healthcare, municipalities, water services—the campaign emphasizes that everyone has a role in combating antibiotic resistance. This inclusive approach builds shared responsibility and ensures no group is left behind.

2. Sector-specific criteria enable practical change: Creating tailored checklists and certification tools for different environments (e.g., preschools vs. hospitals) facilitates structured, relevant action. This increases ownership and motivation among institutions to implement antibiotic-smart practices.

3. Visual identity and clear branding enhance recognition: The use of a unified logo, templates, and consistent messaging helps reinforce campaign identity across sectors and materials. A strong visual brand improves trust, clarity, and recognition.
4. Collaboration increases legitimacy and reach: Led by the Public Health Agency of Sweden, RISE, Strama, and ReAct, with support from Vinnova, the campaign benefits from cross-sector collaboration. Multi-stakeholder coordination ensures both scientific credibility and practical insight.

5. Communication must be multi-modal: The campaign successfully uses traditional communication (fact sheets, posters) alongside digital tools (e-learning, webinars, social media). This multi-modal strategy increases reach across literacy levels, age groups, and professions.

6. Adaptability across levels is essential: The campaign shows that local actions (e.g., water services, schools) are just as critical as national policy. This bottom-up empowerment promotes systemic change from all levels.

7. Behavioral insights add value: The campaign incorporates elements from implementation science and behavioral research, recognizing that changing habits (not just knowledge) is key to long-term antibiotic stewardship.

8. Recognition drives motivation: The certification model ("diplomering") motivates organizations by providing public recognition, which enhances prestige and encourages continued effort.

9. Global framing supports local action: Using the One Health framework helps participants see their role in a larger, interconnected system—making even small contributions feel meaningful.

Identified biases

Digital Access Bias

Digital Literacy Bias

Evaluation Absence Bias

Inclusivity Bias

Vulnerable Groups Bias

Identified Weaknesses

No Measurable Outcomes or Evaluation Plan

1. Complex navigation and dense content: The website is content-heavy, and some materials (e.g., criteria documents, templates) may be overwhelming for lay users or small organizations unfamiliar with public health terminology. Some key resources (e.g., criteria, templates) are buried in multi-level navigation, making them hard to locate for casual users.

2. Lack of real-time progress indicators: There’s no dashboard or progress tracker showing how many schools, municipalities, or organizations are certified or active in the campaign.This reduces transparency and makes it harder for users to understand the collective impact.

5. Limited youth specific outreach: Although schools are targeted, there is no clearly visible effort to directly engage children, teens, or young adults using age-appropriate platforms or formats (e.g., TikTok, youth ambassadors, animated explainers).

6. Low visibility of testimonials or case stories: Few first-person narratives or videos show the human side of antibiotic resistance or highlight how participation has changed practices at the local level.

7. No clear feedback mechanism: Users have no interactive space to ask questions, share practices, or request help—missing an opportunity for peer learning or iterative improvement.

8. Limited general public visibility: The initiative is highly structured and institutional, but lacks broad public awareness. It appears more prominent among healthcare professionals, municipalities, and educational institutions than among ordinary citizens.

9. Lack of gamification or interactive learning: No visible use of gamification (e.g., quizzes, badges, levels), which could enhance learning and engagement, particularly for non-professionals.

Identified Strengths

Clear messaging

Culturally appropriate content

Dedicated website or online portal

Engagement with stakeholders

Use of visuals and infographics

Accessibility

Call to Action

Endorsements by Trusted Institutions

1. Provides "Listen" button": When clicked, it reads aloud the webpage content (usually using text-to-speech technology). This feature is designed to improve accessibility for: 1. People with visual impairments. 2. Users with reading difficulties (e.g., dyslexia). 3. Those who prefer auditory learning. 4. People navigating in multilingual contexts.

2. The Antibiotikasmart Sverige campaign demonstrates a strong degree of cultural sensitivity and contextualization, particularly in how it engages various sectors of Swedish society while acknowledging global interconnectedness. Concerning cultural sensitivity: 1. Inclusive language and imagery: The website and materials use neutral, inclusive language that avoids stigma or blame. Visuals reflect everyday Swedish life—schools, healthcare settings, and local communities—making the message relatable. 2. Recognition of societal roles: Messaging emphasizes that everyone has a role, from individual citizens to municipalities and healthcare institutions. Campaign materials are tailored to various sectors (e.g., schools, preschools, water services), showing respect for professional cultures and their unique contributions. 3. Multilingual awareness (Swedish and english): Patient-facing materials and information (especially on antibiotic use and infections) are available in multiple languages, supporting immigrants and diverse populations within Sweden. 4. Careful framing of resistance: Antibiotic resistance is framed as a shared societal and global issue, not a fault of any group, region, or profession.
Concerning contextualization: a. One Health framework: Adopts an internationally relevant but locally contextualized model—One Health—linking human, animal, and environmental health in ways meaningful to Swedish policy and farming culture. b. Localized implementation: Offers sector-specific criteria developed with Swedish municipalities, clinics, and schools. This ensures the campaign respects regional autonomy and local decision-making structures.

3. Language & terminology: -Plain language is used in public-facing sections (e.g., key messages, calls to action).
-However, many terms—such as “antibiotic stewardship,” “resistance,” and “criteria-based certification”—require some health literacy or prior familiarity.
-Sections aimed at institutions (municipalities, clinics, water services) use technical vocabulary and refer to public health frameworks, requiring professional or organizational knowledge.

4. Requires some navigational skill to access tailored materials and understand how different components (criteria, support tools, certifications) connect.

5. Integrates multiple communication approaches, including: 5.1. Transmissive: The campaign uses centralized messages and informational materials to raise awareness and promote behavioral change. Examples: Fact sheets, criteria documents, and press releases are designed to transmit information from experts to the public.Templates and posters reflect top-down, one-way communication. 5.2. Participatory: The campaign actively invites participation from citizens, schools, municipalities, healthcare providers, and organizations. Examples:The “Become Antibiotic Smart” certification program encourages organizations to apply structured changes and share their progress. Social media engagement encourages individuals to share, tag, and promote antibiotic-smart actions. 5.3. Partially constructivist: The initiative supports learning through experience, particularly via:Self-assessment tools and local implementation of antibiotic-smart criteria.Sharing of case studies and good examples—e.g., how specific municipalities or clinics met the standards.Webinars and knowledge exchange promote learning from peers. However, while constructivist elements exist, they are less emphasized than transmissive and participatory modes.

Documents