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Background: Fishy Clouds, a 45-minute non-verbal touring puppet theatre show, was created with the objectives of (1) raising awareness of antimicrobial overuse and misuse (the fact that there simply is a problem), (2) raising awareness of the importance of research with children – including those involving antimicrobials, and (3) producing a science-themed performance of entertainment value and high artistic quality. The show used visual storytelling to bring the research and behaviour around antimicrobial resistance (AMR) to life for a broad range of audiences across different ages, locations, levels of education, and language. Methods: In order to understand the effectiveness of Fishy Clouds, we used a realist-informed evaluation approach. A combination of quantitative and qualitative approaches (semi-structured interviews, focus group discussions and field notes) were used for data collection. Results: We received a total of 880 quantitative feedback forms, conducted 22 semi-structured interviews and three focus group discussions. Our data showed that Fishy Clouds was an enjoyable performance to all audience groups and stakeholders and was generally viewed with artistic integrity. However, its effectiveness was primarily in raising existing awareness about medicine use and health more broadly, rather than specific health messaging concerning AMR and research with children. We found that those with limited background on AMR or research with children, such as school children and Karen ethnic migrants exhibited a wide range of interpretations. A science-themed theatre would function better if it is focussed on a single theme, embedded within a programme of activities and conducted at closed venues. Conclusions: Fishy Clouds showed that science theatre events have the potential to support public health programmes and engage local communities in science research.

Original publication




Journal article


Wellcome Open Research


F1000 Research Ltd

Publication Date





7 - 7