Development and evaluation of a culturally tailored animated educational video to improve antibiotic knowledge, attitudes, and practices among Jordanian adolescents: a quasi-experimental study

BACKGROUND: antimicrobial resistance (AMR) has emerged as a major global health concern, with antibiotic misuse and overuse being major contributing factors, particularly among adolescents. It has become essential to address this problem through educational interventions to foster responsible behavior during early life. OBJECTIVE: The primary objective of this study was to develop and assess the effectiveness of an educational video on antimicrobial resistance in enhancing knowledge, attitude, and practice (KAP) among secondary school students. METHODS: A quasi-experimental pretest-posttest study design was employed for this study. A sample of 133 secondary school students was selected from Jordan. A structured questionnaire was administered to assess knowledge, attitude, practice, preference for alternative medicine, and awareness/educational exposure. An educational video on antimicrobial resistance was developed and implemented as an intervention. To assess pre-post differences, a paired t-test was performed, and to control for confounding variables, a General Linear Model (GLM) analysis was conducted. To assess the associations among knowledge, attitude, and practice, correlation analysis was performed. RESULTS: Following implementation of the educational video, there were significant improvements in all knowledge, attitude, and practice domains. Knowledge improved significantly from a pretest mean of 3.56 (SD = 1.91) to a posttest mean of 6.59 (SD = 2.06) on a 9-point scale. The improvement was significant at p < 0.001, with a large effect size of 1.17. Attitude and practice also improved significantly, with large effect sizes. GLM analysis revealed that this improvement was significant even after adjustment for baseline confounders. Furthermore, correlation analysis revealed a positive correlation among knowledge, attitude, and practice, indicating a positive internal consistency for knowledge, attitude, and practice. DISCUSSION: The observed improvements suggest that culturally tailored animated educational interventions may be a useful approach for supporting adolescents' understanding, attitudes, and reported practices related to antibiotic use and antimicrobial resistance. CONCLUSION: Exposure to the culturally tailored video-based educational intervention with planned reinforcement was associated with significant improvements in antibiotic-related knowledge, attitudes, self-reported practices, and awareness among secondary school students. Given the single-group pretest-post-test design, these findings should be interpreted as improvements observed following the intervention rather than definitive evidence of causality.