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There are a number of national interventions which support health professionals to deliver the best care to patients. This study looks at national interventions aimed at: 1) reducing catheter-associated urinary tract infections (CAUTI), and 2) reducing antibiotic prescribing for respiratory tract infections (AMS). The aim of this study was to explore how national interventions in each of these areas could be improved.

why this is important

Preventing infections (from use of catheters) and the prudent use of antibiotics are both public health priorities. It is important that national interventions support health professionals to use catheters and antibiotics in the best way. Many interventions exist that try to change the behaviours of healthcare professionals. We want to identify ways interventions can be improved so that they can have a more positive impact. This would help reduce infections and the use of antibiotics, and improve patient care.


In both parts of the study we use similar methods, including:

  • Literature review – we identified interventions which were either effective at reducing catheter associated infections or the use of antibiotics.
  • Behavioural analysis – we looked at the content of interventions that were effective and compared this to the content of national interventions. We used behavioural science theory to identify ways in which interventions could be improved.
  • Expert opinion – we asked experts in the field about their views on how interventions could be improved using a focus group and a questionnaire.
  • Making recommendations – we developed a list of potential improvements for national interventions (for CAUTI and AMS).


Results related to reducing catheter-associated urinary tract infections (CAUTI) are available here:

 Exploring the implementation of interventions to reduce catheter-associated urinary tract infections (ENACT): main report -

Optimising interventions for catheter-associated urinary tract infections (CAUTI) in primary, secondary and care home settings


Results related to reducing antibiotic prescribing for respiratory tract infections are available here:

Exploring the implementation of interventions to reduce antibiotic use (ENACT study) -

Optimising antimicrobial stewardship interventions in English primary care: a behavioural analysis of qualitative and intervention studies

How can national antimicrobial stewardship interventions in primary care be improved? A stakeholder consultation

research team

Dr Sarah Tonkin-Crine, Dr Aleksandra Borek, Dr Marta Wanat, Professor Chris Butler, Nuffield Department of Primary Care Health Sciences, University of Oxford.

Dr Lou Atkins, Centre for Behaviour Change, University College London.

Anna Sallis, Dr Tim Chadborn, Behavioural Insights Unit, Public Health England.

Funder: Public Health England.