# Fostering behaviour change in farm veterinary practice: ‘champion’ goal-setting and implementation considerations for antimicrobial stewardship

## TL;DR

This study evaluates how a peer network of veterinary champions helped implement antimicrobial stewardship in Welsh veterinary practices from 2020 to 2024.

## Contribution

The study introduces a peer-based 'champion' model to drive antimicrobial stewardship behavior change in veterinary practice.

## Key findings

- 73% of practices reported at least one fully implemented antimicrobial stewardship change.
- AMS implementation faced challenges from cultural, practical, and inter-professional factors.
- The Arwain intervention achieved varying levels of success in implementing AMS changes.

## Abstract

The use of antimicrobials in human and animal health care settings is considered a major driving force behind the emergence of antimicrobial resistance, encouraging a focus on evidence-based interventions aimed at promoting behaviours aligned with antimicrobial stewardship (AMS) ideals within both sectors. The Arwain complex intervention within Wales established peer networks of ‘Veterinary Prescribing Champions’ (VPCs) within and between Welsh veterinary practices to facilitate AMS training, support and activity. This study evaluates AMS goal setting and implementation within continuously engaged Arwain veterinary practices (n = 34) between 2020 and 2024.

Descriptive quantitative analysis of Practice Action Plans (2020, 2024) and self-reported data on Action Plan implementation (2024), combined with qualitative analysis of participant interviews (2023) and participatory workshop feedback (2024) on challenges to implementing change, offer insight on the focus, achievements and implementation of AMS within the Arwain complex intervention.

VPCs focused on behaviour-led (practice team/farm client) and structural (farm/practice-focused) changes. All practices reported at least one change goal initiated, with the majority (73%) reporting at least one fully implemented change. AMS implementation challenges included practical and cultural considerations of veterinary practices, the complexities of delivering AMS within inter-professional teams, the situated complexity of AMS on farm and the geographic, economic, regulatory, epidemiological and attitudinal factors implicit in the practice ‘outer setting’.

The Arwain complex intervention led to successful implementation of AMS changes across participating practices, with varying complexity, abstractness and completeness. Further research into the impact on antimicrobial use is needed to evaluate and inform future policy.