Health communication for AMR behaviour change: Zimbabwean students' relationships with the microbial world.

Background: Microbes have a global impact on health; microbial relationships benefit and impair quality of life. Negative health impacts of antimicrobial resistance (AMR) in our relationships with the microbial world are primarily borne by the Global South. Objectives: To study experiences, understandings and practices of Zimbabwean students regarding health, food and microbes. Methods: Using purposive sampling, Zimbabwean school students were recruited as participants in group interviews supported by participant observation, exploring the relationships between health, food and microbes. Results: The study included 120 students from six upper secondary schools in the Midland Region and Gweru District. Findings identify two categories: microbial relationships and microbial encounters, each with three subcategories. Food emerged as both mediating artefacts and mediating experiences, enabling the students to link biomedical explanations of AMR and their everyday lives with friends and family. The necessity for health communication to explore and engage with participants' contextual preferences and motivations is highlighted. When discussing food choices and practices, students considered the beneficial relationships with the microbial world. Conclusions: A contextually relevant approach is outlined, where food mediates the relationship between student health and the microbial world, supporting health communication for AMR behaviour change. Expanding AMR education to include the everyday experiences of food enables students to link the pressing sustainability challenge of AMR to their health goals. The study showcases how the exploration of microbial relationships and food practices as a ubiquitous feature of community life can form a basis for AMR prevention and control.