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Lin R, Duan L, Liu C, Wang D, Zhang X, Wang X, Zhang X, Wang Q, Zheng S, Liu C. The public's antibiotic use behavioural patterns and their determinants for upper respiratory tract infections: a latent class analysis based on consumer behaviour model in China. Front Public Health 2023; 11:1231370. [PMID: 38162628 PMCID: PMC10754980 DOI: 10.3389/fpubh.2023.1231370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Background The irrational use of antibiotics among the public is a major contributor to antimicrobial resistance (AMR), which is a serious global threat. Prior studies have demonstrated that there are different behavioural patterns regarding antibiotic use among the public, and targeted interventions for subgroups with different behavioural patterns may be more effective. Thus, this study aimed to identify the public's behavioural patterns of antibiotic use for upper respiratory tract infections (URTIs) and their influencing factors. Methods A cross-sectional survey was conducted among the general population in Chongqing, China. Consumer decision-making (Consumer Behaviour Model, CBM) was used to assess the public's behaviours regarding antibiotic use, including need recognition, information searching, alternative evaluation, obtaining antibiotics, antibiotic consumption, and postuse evaluation. Furthermore, a latent class analysis was used to identify the underlying behavioural patterns among the public. The identified behavioural patterns of antibiotic use were further linked with individuals' capacity, opportunity, and motivation factors of antibiotic use based on a multinominal logistic regression to explore possible determinants. Results A total of 815 respondents were enrolled in the study. The public's irrational use of antibiotics was prevalent, including antibiotic self-medication (39.63%), nonprescription antibiotic purchasing (59.02%), and early stopping of antibiotic prescriptions (76.56%). Participants had inadequate knowledge of antibiotics (Mean = 2.33, SD = 1.71), reported high availability to antibiotics (Mean = 7.13, SD = 2.41), held strong belief in antibiotic effectiveness (Mean = 10.29, SD = 2.71), and demonstrated a high perceived threat of AMR (Mean = 12.30, SD = 3.20). Four behavioural patterns regarding antibiotic use for URTIs were identified, namely, "antibiotic self-medicators" (n = 165, 20.25%), "formal health care seekers" (n = 216, 26.50%), "various treatment users" (n = 198, 24.20%), and "self-medication without antibiotics" (n = 236, 28.96%). Individuals' self-efficacy of antibiotic use, belief in antibiotic effectiveness, awareness of antibiotic side effects, perceived antibiotic availability, social influence, and demographics (age, education, medical insurance, and having a medical background) were significantly associated with the public's different behavioural patterns of antibiotic use for URTIs. Conclusion This study calls for collaborative efforts among the public, physicians, policy makers, and the implementation of precise and multifaceted interventions to effectively reduce irrational use of antibiotics in the public. Such interventions include identifying subgroups within the public to provide more targeted education about antibiotics and the management of URTIs, reinforcing the regulation of antibiotic dispensing, and improving physicians' rational antibiotic prescriptions.
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Affiliation(s)
- Rujiao Lin
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lixia Duan
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Dan Wang
- School of Management, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xi Wang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinyi Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qianning Wang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuangjiang Zheng
- Department of Medical Affairs, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chenxi Liu
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Worthington AK, MacGeorge EL, Foley KA. Perceptions of Responsibility for Antibiotic Resistance: Implications for Stewardship Campaigns. JOURNAL OF HEALTH COMMUNICATION 2020; 25:703-711. [PMID: 33232217 DOI: 10.1080/10810730.2020.1838672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Widespread public engagement with antibiotic stewardship is essential to stem the rising incidence of antibiotic-resistant infections; however, campaigns that focus on increasing knowledge have not been effective. Beliefs about who is responsible for causing and solving antibiotic resistance (AR) likely influences engagement in antibiotic stewardship behaviors. This study assesses the U.S. public's AR causal and solution responsibility attributions and the capacity for changing these attributions to inform future antibiotic stewardship campaigns. U.S. participants (N= 1,014) diverse across race, education, and geographic region were surveyed on their beliefs about responsibility for AR for themselves, the general public, healthcare providers, scientists, and drug companies. Substantial percentages of participants held causal and solution beliefs about antibiotic resistance that likely inhibit antibiotic stewardship behaviors. Participants' beliefs that they and the general public are responsible for causing and solving AR were lower than their beliefs that healthcare providers, scientists, and drug companies are responsible. Beliefs about causal responsibility for any given person or group were significantly and positively associated with beliefs about solution responsibility for that same person or group. Responsibility beliefs differed by age, education level, and racial/ethnic background. Results highlight the need for antibiotic stewardship campaigns to incorporate responsibility attribution messaging to motivate stewardship.
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Affiliation(s)
- A K Worthington
- Department of Communication, University of Alaska Anchorage , Anchorage, Alaska, USA
| | - E L MacGeorge
- Department of Communication Arts and Sciences, Pennsylvania State University, University Park , State College, Pennsylvania, USA
| | - K A Foley
- Department of Communication Arts and Sciences, Pennsylvania State University, University Park , State College, Pennsylvania, USA
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Duan Z, Liu C, Han M, Wang D, Zhang X, Liu C. Understanding consumer behavior patterns in antibiotic usage for upper respiratory tract infections: A study protocol based on the COM-B framework. Res Social Adm Pharm 2020; 17:978-985. [PMID: 32830072 DOI: 10.1016/j.sapharm.2020.07.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Irrational use of antibiotics is prevalent worldwide. But our understanding on consumer behaviors in the use of antibiotics is very limited. This study aims to identify consumer behavior patterns in the use of antibiotics for upper respiratory tract infections (URTIs). METHODS The study will employ a mixed methods approach based on the "Capacity & Opportunity & Motivation - Behavior" (COM-B) framework. The COM-B attributes of consumers in relation to the use of antibiotics will be extracted from a systematic literature review. Semi-structured in-depth interviews will be conducted on 20-25 community residents with URTI symptoms over the past three months to illustrate the meaning and implications of the thematic categories of COM-B attributes for the purpose of measurement development. The measurement instruments will be modified and validated through Delphi consultations with 15 experts and a survey of 300 adult residents in Wuhan. A cross-sectional survey using the finalised measurement instruments will be conducted on 2700 adult residents randomly selected from 18 residential communities across 9 municipalities in 3 provinces in China. Multi-level latent class analyses will be performed to categeorise the respondents based on the indicators measuring the behavioral features (need recognition, information searching, alternative assessment, purchase, use, and post-use evaluation) of consumers in purchasing, consuming and disposing antibiotics for URTIs. Multi-nominal regression analyses will be performed to determine the predictors of different behavior patterns. DISCUSSION This study aims to classify consumers into distinguished categories of behavior patterns toward the use of antibiotics for URTIs. Such a classification system categories the consumers with similar behavior features into the same group so that better targeted interventions can be developed. The COM-B model adopted in this study can also help us better understand the underlying mechanisms of different behavior patterns of consumers.
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Affiliation(s)
- Zhonghong Duan
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
| | - Meng Han
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Dan Wang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Chenxi Liu
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Smith RA, Fink EL, Romano A, M'ikanatha NM. Precise Persuasion: Investigating Incentive Appeals for the Promotion of Antibiotic Stewardship with Message-induced Transitions. JOURNAL OF HEALTH COMMUNICATION 2020; 25:430-443. [PMID: 32552562 DOI: 10.1080/10810730.2020.1778821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Two different lines of research-interpersonal resistance and public campaign design-lead us to consider the use of incentive appeals to motivate behavior change, with a call for greater attention to and use of positive incentives. This study tests the potential to promote antibiotic stewardship through microbiome benefits. In addition, multiple analyses were used: A causal analysis allowed us to identify what moved (e.g., which beliefs and intentions), a latent transition analysis allowed us to reveal who moved (targets, nontargets, or both), and a Markov model allowed us to estimate the stable state of these moves or, in other words, where and how the repetition of the messages would ultimately lead in terms of transitions from state to state. An experiment (N = 298), grounded in the context of antibiotic stewardship, showed that incentive appeals moved people with problematic patterns of past behavior (categorized as Persuaders, Stockers, and Dissenters) to positive patterns of behavioral intentions (categorized as Stewards). The causal analysis, latent class analysis, and equilibrium values for the separate transition matrices showed the relative benefit for a message that highlighted the health and wellness benefits of the microbiome. Implications for persuasion theory and practice are discussed.
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Affiliation(s)
- Rachel A Smith
- Department of Communication Arts and Sciences, The Pennsylvania State University , State College, Pennsylvania, USA
| | - Edward L Fink
- Department of Communication and Social Influence, Temple University , Philadelphia, Pennsylvania, USA
| | - Adriana Romano
- Department of Communication Arts and Sciences, The Pennsylvania State University , State College, Pennsylvania, USA
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Tamhankar AJ, Nachimuthu R, Singh R, Harindran J, Meghwanshi GK, Kannan R, Senthil Kumar N, Negi V, Jacob L, Bhattacharyya S, Sahoo KC, Mahadik VK, Diwan V, Sharma M, Pathak A, Khedkar SU, Avhad D, Saxena S, Nerkar S, Venu V, Kumar S, Shandeepan G, Ranjit Singh K, Gashnga R, Kumar A. Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245141. [PMID: 31888272 PMCID: PMC6950494 DOI: 10.3390/ijerph16245141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 11/24/2022]
Abstract
Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries.
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Affiliation(s)
- Ashok J. Tamhankar
- Indian Initiative for Management of Antibiotic Resistance, 302, Aryans, Deonar, Mumbai 400088, India
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (M.S.); (A.P.)
- Correspondence: or ; Tel.: +91-2225573179 or +91-9892465195
| | - Ramesh Nachimuthu
- Indian Initiative for Management of Antibiotic Resistance, Antibiotic Resistance and Phage Laboratory, Vellore Institute of Technology, Vellore 632014, India;
| | - Ravikant Singh
- Chief Functionary’s Office, Doctors For You, Lallubhai Compound, Mankhurd, Mumbai 400 043, India;
| | - Jyoti Harindran
- Departmentof Pharmaceutical Sciences, Centre for Professional and Advanced Studies, Cheruvandoor Campus, Ettumanoor, Kottayam, Kerala 686631, India;
| | - Gautam Kumar Meghwanshi
- Department of Microbiology, Maharaja Ganga Singh University, NH-15, Jaisalmer Road, Bikaner, Rajasthan 334 001, India;
| | - Rajesh Kannan
- Department of Microbiology, Bharathidhasan University, Thiruchirapalli, Tamilnadu 620024, India;
| | | | - Vikrant Negi
- Department of Microbiology, Dr. S.N. Medical College, Jodhpur, Rajasthan 342 001, India;
| | - Lijy Jacob
- Department of Biotechnology, St. Berchmans College, Changanassery, Kerala 686101, India;
| | - Sayan Bhattacharyya
- Department of Microbiology, All India Institute of Medical Sciences, Patna, Bihar 801507, India;
| | - Krushna Chandra Sahoo
- Department of Health Research, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha 751023, India;
| | - Vijay Kumar Mahadik
- Department of Public Health and Environment, R.D Gardi Medical College, Ujjain, Madhya Preadesh 456006, India;
| | - Vishal Diwan
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (M.S.); (A.P.)
- Medical Director’s office, Department of Public Health and Environment, R.D Gardi Medical College, Ujjain, Madhya Preadesh 456006, India
| | - Megha Sharma
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (M.S.); (A.P.)
- Department of Pharmacology, R.D Gardi Medical College, Ujjain, Madhya Preadesh 456006, India
| | - Ashish Pathak
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (M.S.); (A.P.)
- Department of Paediatrics, R.D Gardi Medical College, Ujjain, Madhya Preadesh 456006, India
| | - Smita U. Khedkar
- Bactest Laboratory and Dental College, Nashik, Maharashtra 422 005, India;
| | - Dnyaneshwar Avhad
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai 400088, India;
| | - Sonal Saxena
- Department of Microbiology, Lady Hardinge Medical College, Delhi 110 001, India;
| | - Sandeep Nerkar
- Chetana Laboratories, Nashik, Maharashtra 422009, India;
| | - Vaishali Venu
- Director-Health services’ offce, Doctors For You, Lallubhai Compound, Mankhurd, Mumbai, Maharashtra 400043, India;
| | | | - G. Shandeepan
- Doctors For You, Bandipore, Jammu and Kashmir 193502, India;
| | | | - Ridiamma Gashnga
- Doctors For You, Laitumkhrah Nongrim Road, Shillong, Meghalaya 793003, India;
| | - Arvind Kumar
- Doctors For You, A-58, Plot no. 7, Block A extension, Budh Vihar, Delhi, Budh Vihar, Delhi 110086, India;
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Huttner B, Saam M, Moja L, Mah K, Sprenger M, Harbarth S, Magrini N. How to improve antibiotic awareness campaigns: findings of a WHO global survey. BMJ Glob Health 2019; 4:e001239. [PMID: 31179029 PMCID: PMC6528771 DOI: 10.1136/bmjgh-2018-001239] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/15/2019] [Accepted: 01/19/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION We aimed to examine the characteristics of antibiotic awareness campaigns (AAC) conducted on a national or regional level since 2010. METHODS In October 2016, the WHO invited stakeholders involved in the planning or conduct of AACs to answer a web questionnaire. We solicited general information about the characteristics of the AAC, with a particular focus on key messages supporting optimal use of antibiotics. RESULTS Stakeholders in 93 countries were contacted and 55 countries responded. Overall, 60 AACs from 16 low/middle-income countries (LMIC) and 31 high-income countries were identified. Forty-five campaigns (75%) were conducted on a national level and most of them (47/60; 78%) were organised by public health authorities and publicly funded. There were no major differences between LMICs and high-income countries in the types of key messages. The scientifically questionable 'Finish your prescription' slogan was used by 31 AACs (52%). A One Health approach was mentioned in 13/60 AACs (22%). Most messages were universally applicable; adaptation to locally prevalent public misconceptions was not systematic. The evaluation of the impact of campaigns was still incomplete, as only 18 AACs (30%) assessed their impact on antibiotic use. CONCLUSION For future AACs, it seems essential to base messages more rigorously on scientific evidence, context specificities and behavioural change theory. A new generation of messages that encourage first-choice use of narrow spectrum antibiotics is needed, reflecting international efforts to preserve broad spectrum antibiotic classes. Evaluation of the impact of AACs remains suboptimal.
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Affiliation(s)
- Benedikt Huttner
- Infection Control Program and Division of Infectious Diseases, World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- World Health Organization, Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
| | - Mirko Saam
- Communications in Science, Geneva, Switzerland
| | - Lorenzo Moja
- World Health Organization, Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
| | - Karen Mah
- World Health Organization, Antimicrobial Resistance Secretariat, Geneva, Switzerland
| | - Marc Sprenger
- World Health Organization, Antimicrobial Resistance Secretariat, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program and Division of Infectious Diseases, World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nicola Magrini
- World Health Organization, Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
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Mathew P, Sivaraman S, Chandy S. Communication strategies for improving public awareness on appropriate antibiotic use: Bridging a vital gap for action on antibiotic resistance. J Family Med Prim Care 2019; 8:1867-1871. [PMID: 31334147 PMCID: PMC6618197 DOI: 10.4103/jfmpc.jfmpc_263_19] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Antimicrobial resistance (AMR) is now a global public health issue and is projected to affect the longevity of people and increase health expenditure of countries. Its impact is going to be higher in low-middle income countries as the healthcare systems are suboptimal and ill-equipped to deal with the issue. As antibiotic misuse is the primary driver for AMR, there is an acute need to create awareness among general public regarding antibiotic misuse. This calls for a comprehensive communication strategy, which takes into account the various drivers of AMR and the solutions associated with it. In the short term, the focus of communication strategies can be on raising awareness in specific interest groups. It can help in channeling limited resources to achieve specific objectives for raising awareness among these groups, thereby improving the chances of behavior change. The general public can be targeted at a later stage or as a second phase with definite strategies and messages. But, it is erroneous to assume that a higher level of awareness will translate into a positive change in behavior. We propose that behavior change is the final fruit of a long and dynamic process. This process should rest on four pillars: adequate awareness, robust regulatory environment, emotional or material incentives, and an enabling social structure. Unless all these domains are satisfactorily addressed, the communication strategy will not be able to bring about a discernible change in behavior in terms of antibiotic use.
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Affiliation(s)
- Philip Mathew
- ReAct Asia Pacific and Department of Community Medicine, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India
| | - Satya Sivaraman
- ReAct Asia Pacific, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sujith Chandy
- ReAct Asia Pacific and Department of Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
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Smith RA, MacGeorge EL, Hackman NM, M'ikanatha NM. Campaign Preparation for Complex Initiatives: A Person-Centered Approach to Audience Segmentation of Parents' Antibiotic Stewardship. HEALTH COMMUNICATION 2018; 33:1539-1548. [PMID: 29068705 PMCID: PMC6085158 DOI: 10.1080/10410236.2017.1384345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The evolution of antibiotic resistance is outpacing the speed at which new antibiotics will reach the marketplace. To slow the rate of resistance, people need to engage in antibiotic stewardship, which includes acts to prevent the spread of bacteria and judicious use of antibiotics to treat infections. This study identified the patterns and predictors of antibiotic stewardship behaviors of parents (N = 516) related to their children. The latent class analysis revealed three profiles of parental stewardship, labeled Stewards, Requesters, and Non-Stewards. The findings implied different campaign goals: to encourage Stewards to follow through on their intentions, to encourage Requesters to stop asking providers for antibiotics when their children have ear infections, and to influence Non-Stewards to accept medical advice when an antibiotic is not indicated and to dispose of leftover antibiotics. The covariate analysis provided theoretical insight into the strategies to pursue in campaigns targeting these three groups. For example, parents who perceived antibiotic-resistant infections as less serious health conditions, felt less worry when thinking about their child getting an antibiotic-resistant infection, and had stronger misattributions of antibiotics' efficacy to treat multiple symptoms were more likely to be Requesters and Non-Stewards, instead of Stewards.
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Affiliation(s)
- Rachel A Smith
- a Department of Communication Arts & Sciences , The Pennsylvania State University
| | - Erina L MacGeorge
- a Department of Communication Arts & Sciences , The Pennsylvania State University
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Smith RA, Zhu X, Shartle K, Glick L, M'ikanatha NM. Understanding the Public's Intentions to Purchase and to Persuade Others to Purchase Antibiotic-Free Meat. HEALTH COMMUNICATION 2017; 32:945-953. [PMID: 27436180 PMCID: PMC5296377 DOI: 10.1080/10410236.2016.1196415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Extending the effectiveness of media-based campaigns into interpersonal networks has been a long concern for studies on persuasive messages, yet there is much to understand about why people attempt to persuade others to engage in health-related behaviors. This study investigated two alternative predictors of interpersonal persuasion: psychosocial determinants of behavior and homophily. We used the integrated model of behavior (IMB) to predict consumers' intentions to purchase antibiotic-free meat, and extended the model to predict consumers' intentions to encourage important others to do so. IMB variables predicted 44% of future purchasing intentions and 40% of future persuasion intentions. The findings support a homophily explanation for persuasion: people intend to persuade important others to do what they do. In addition, a person-centered analysis identified three audience segments based on antibiotic-resistance-related behaviors, cognitions, and experiences: Purchasers, Resisters, and New Adopters. The covariate analysis revealed that people who had more topic awareness of antibiotic use in animal husbandry, knowledge of someone with an antibiotic-resistant infection, and health mavenism were more likely to be Purchasers than Resisters or New Adopters. Anxiety, however, was highest among New Adopters and lowest among Resisters. Implications for theory and practice are discussed.
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Affiliation(s)
- Rachel A Smith
- a Department of Communication Arts & Sciences , The Pennsylvania State University
| | - Xun Zhu
- a Department of Communication Arts & Sciences , The Pennsylvania State University
| | - Kaitlin Shartle
- a Department of Communication Arts & Sciences , The Pennsylvania State University
| | - Lydia Glick
- a Department of Communication Arts & Sciences , The Pennsylvania State University
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Castro-Sánchez E, Moore LSP, Husson F, Holmes AH. What are the factors driving antimicrobial resistance? Perspectives from a public event in London, England. BMC Infect Dis 2016; 16:465. [PMID: 27590053 PMCID: PMC5010725 DOI: 10.1186/s12879-016-1810-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 08/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antimicrobial resistance is driven by multiple factors. Resolving the threat to human and animal health presented by drug-resistant infections remains a societal challenge that demands close collaboration between scientists and citizens. We compared current public views about key contributing factors to antimicrobial resistance with those expressed by experts. METHODS Overarching factors contributing to antimicrobial resistance were identified following a review of literature. The factors were then described in plain language and attached to ballot boxes at a public engagement event organised by a university. Responses to each factor were counted at the end of the event. RESULTS Four hundred five responses were received from 3750 visitors (11 % response rate). Nearly half of responses (192/405, 47 · 4 %) considered the misuse/overuse of antibiotics in humans as the main determinant of antimicrobial resistance. The misuse of antibiotics in animal health obtained 16 · 3 % (66/405) responses. However, the lack of quick tests to diagnose infections received 10/405 votes (2 · 47 %), and the lack of effective vaccines received one vote (0 · 25 %). CONCLUSIONS The majority of responses ascribed the emergence of drug-resistant infections to the misuse of antibiotics in human and animals. Suboptimal dosing, availability of diagnostics and environmental contamination were considered less influential on the development of antimicrobial resistance. The growing recognition of broader multifaceted drivers of drug resistance by experts is not yet echoed in the public mind.
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Affiliation(s)
- Enrique Castro-Sánchez
- National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, London, W12 0NN UK
| | - Luke S. P. Moore
- National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, London, W12 0NN UK
- Department of Infectious Diseases, Imperial College London, London, UK
| | - Fran Husson
- Imperial College Healthcare NHS Trust, London, UK
| | - Alison H. Holmes
- National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, London, W12 0NN UK
- Department of Infectious Diseases, Imperial College London, London, UK
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