Peer-led learning of antimicrobial resistance improves knowledge and attitudes of primary school students in rural Indonesia

It is essential to promote awareness of antimicrobial resistance in youth so that they can lead responsible lives in the future. This study aimed to empower school-age cadres to disseminate their awareness of antimicrobial resistance to their peers. Five hundred and seventy-eight students in grades 4, 5, and 6 from five primary schools in rural Malang, Indonesia participated in this study. Our expert team trained five school-age cadres from each school using interactive pedagogical materials to encourage awareness of antimicrobial resistance. The peer-led learning process was conducted for 10 weeks. The same questionnaire was used to assess the pre- and post-peer learning intervention knowledge and attitudes of all participants. Our findings showed that the overall post-test knowledge and attitude scores were significantly better than pre-test scores (p < 0.0001). There was also a significant difference in the attitude score change among the five schools (p < 0.0001). The school with the lowest ratio of cadre to total number of participants showed the lowest change in attitude scores. An independent peer-led learning process in delivering awareness of antimicrobial resistance among primary school students is effective, providing that the ratio between the number of peer cadres and total students is adequate.