scholarly journals Reducing expectations for antibiotics in primary care: a randomised experiment to test the response to fear-based messages about antimicrobial resistance

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Laurence S. J. Roope ◽  
Sarah Tonkin-Crine ◽  
Natalie Herd ◽  
Susan Michie ◽  
Koen B. Pouwels ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Self Efficacy ◽  
Antibiotic Use ◽  
Self Management ◽  
Health Campaigns ◽  
Influenza Like Illness ◽  
Online Panel ◽  
Public Health Campaigns ◽  
Meta Analyses ◽  
To Receive

Abstract Background To reduce inappropriate antibiotic use, public health campaigns often provide fear-based information about antimicrobial resistance (AMR). Meta-analyses have found that fear-based campaigns in other contexts are likely to be ineffective unless respondents feel confident they can carry out the recommended behaviour (‘self-efficacy’). This study aimed to test the likely impact of fear-based messages, with and without empowering self-efficacy elements, on patient consultations/antibiotic requests for influenza-like illnesses, using a randomised design. Methods We hypothesised that fear-based messages containing empowering information about self-management without antibiotics would be more effective than fear alone, particularly in a pre-specified subgroup with low AMR awareness. Four thousand respondents from an online panel, representative of UK adults, were randomised to receive three different messages about antibiotic use and AMR, designed to induce fear about AMR to varying degrees. Two messages (one ‘strong-fear’, one ‘mild-fear’) also contained empowering information regarding influenza-like symptoms being easily self-managed without antibiotics. The main outcome measures were self-reported effect of information on likelihood of visiting a doctor and requesting antibiotics, for influenza-like illness, analysed separately according to whether or not the AMR information was ‘very/somewhat new’ to respondents, pre-specified based on a previous (non-randomised) survey. Results The ‘fear-only’ message was ‘very/somewhat new’ to 285/1000 (28.5%) respondents, ‘mild-fear-plus-empowerment’ to 336/1500 (22.4%), and ‘strong-fear-plus-empowerment’ to 388/1500 (25.9%) (p = 0.002). Of those for whom the respective information was ‘very/somewhat new’, only those given the ‘strong-fear-plus-empowerment’ message said they would be less likely to request antibiotics if they visited a doctor for an influenza-like illness (p < 0.0001; 182/388 (46.9%) ‘much less likely’/‘less likely’, versus 116/336 (34.5%) with ‘mild-fear-plus-empowerment’ versus 85/285 (29.8%) with ‘fear-alone’). Those for whom the respective information was not ‘very/somewhat new’ said they would be less likely to request antibiotics for influenza-like illness (p < 0.0001) across all messages (interaction p < 0.0001 versus ‘very/somewhat new’ subgroup). The three messages had analogous self-reported effects on likelihood of visiting a doctor and in subgroups defined by believing antibiotics would ‘definitely/probably’ help an influenza-like illness. Results were reproduced in an independent randomised survey (additional 4000 adults). Conclusions Fear could be effective in public campaigns to reduce inappropriate antibiotic use, but should be combined with messages empowering patients to self-manage symptoms effectively without antibiotics.

scholarly journals Trustworthiness of Doctors from Public Health Campaigns

2020 ◽  
Author(s):  
Jens Koed Madsen
Keyword(s):  
Public Health ◽  
Message Content ◽  
Health Campaigns ◽  
Four Dimensions ◽  
Exploratory Factor Analyses ◽  
Ethical Stance ◽  
Public Health Campaigns ◽  
The Uk ◽  
Meta Analyses ◽  
The Impact

Previous research concerning the effectiveness of public health campaigns have explored the impact of message design, message content, communication channel choice and other aspects of such campaigns. Meta analyses reported in the literature reveal, however, that the choice of endorsers in health campaigns remains unexplored. The present study addresses this gap in the literature by studying what makes doctors from public health campaigns appear trustworthy in the eyes of the receiver. The present research examines propensity for trust as well facets of trustworthiness of such expert doctors based on a survey carried out in the UK (155 respondents). Underlying factors of trustworthiness are explored to gain more insight into the understanding of how trust may affect the public’s belief updating and the formation of intentions. Exploratory factor analyses suggest four dimensions of trustworthiness. Multiple regression analyses demonstrate that these factors explain almost 70% of the variance in the participants’ expressed trust in doctors from public health campaigns. Doctors’ ethical stance and their care for the health of the general population appear to be more important for perceived trustworthiness than their actual professional background, although their abilities and competences are closely related to ethics and benevolence. For policy makers this has important implications when selecting endorsers for public health campaigns in order to design effective health related communication, for example to combat obesity.

scholarly journals Assessing National Antimicrobial Resistance Campaigns Using a Health Equity Assessment Tool (HEAT)

Antibiotics ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. 121 ◽  
Author(s):  
Hood ◽  
Toleikyte ◽  
Ashiru-Oredope
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Health Equity ◽  
Assessment Tool ◽  
Significant Proportion ◽  
Cost Effective ◽  
Health Campaigns ◽  
Quality Healthcare ◽  
Public Health Campaigns ◽  
Global Threat

It has been widely recognised that a significant proportion of the world’s population suffer inequalities in accessing high quality healthcare and wider services. Within healthcare, antimicrobial resistance (AMR) is a global threat to public health affecting all healthcare systems and growing at an alarming pace. To ensure that national AMR campaigns developed by Public Health England are inclusive of all populations within the target audience a health equity assessment tool (HEAT) was used. The project leads for each campaign completed the HEAT independently with a follow up meeting with the study team to discuss and clarify the responses. A trend analysis was carried out with common themes being used to provide recommendations. The campaigns have demonstrated equality and diversity based on the requirements of the Equality Act 2010, particularly age, sex, and race protected characteristics. Some notable results include the translation of website materials in over 30 languages and reaching individuals in 122 countries. It was however noted that several of the protected characteristics were not applicable. The continuous development of resources with collaboration from a variety of diverse user groups would be advantageous towards aiding future campaign reach. The use of the HEAT has demonstrated the ease and cost-effective way to assess any health inequalities and would be a useful addition to antimicrobial stewardship and public health campaigns.

scholarly journals Review on Drug Utilization Assessment of Cephalosporin

2021 ◽  
pp. 260-265
Author(s):  
Awais Ahmed Juno ◽  
Mirza Tasawer Baig ◽  
Aisha Jabeen ◽  
Shahzada Azam Khan ◽  
Saleem Ahmed Khoso ◽  
...  
Keyword(s):  
Observational Studies ◽  
Antimicrobial Agents ◽  
Standard Of Living ◽  
Health Campaigns ◽  
Microbial Resistance ◽  
High Rise ◽  
Public Health Campaigns ◽  
High Level ◽  
Meta Analyses ◽  
Primary Healthcare Centers

Pediatric is the field of medicine that is concerned with the health of infants, children and adolescents. Globally, many infectious diseases have been controlled in the 20th century by improving People’s standard of living through public health campaigns and the use of various antimicrobial agents. Evidence suggests that the manner in which Primary Healthcare centers prescribe drugs has contributed to the high rise in Anti-Microbial Resistance (AMR). The extent of the resistance is determined by the site of antibiotic application and in this study oral usage of antibiotics was found to be the highest contributor to Anti-Microbial Resistance.  A systematic review of the published literature on the conduct and reporting of meta-analyses in observational studies was done using databases searched included MEDLINE, Educational Resources Information Center, PsycLIT (http://www.wesleyan.edu/libr), Google Scholar, EMBASE, International Pharmaceutical Abstracts and the Current Index to Statistics. It was concluded that most of the articles reported that cephalosporin were widely used antibiotics and therefore its use must be rational; to avoid its abuse which may result to high level of resistance.

scholarly journals Australian Government attempts at regulatory and other control of antimicrobial resistance

2007 ◽  
Vol 28 (4) ◽  
pp. 198
Author(s):  
John Turnidge
Keyword(s):  
Antimicrobial Resistance ◽  
Research Council ◽  
Medical Research Council ◽  
Working Party ◽  
Antibiotic Use ◽  
Australian Government ◽  
The United Kingdom ◽  
The Government ◽  
To Receive ◽  
Species Being

Antimicrobial resistance has been on the government agenda in Australia since the early 1980s. At that time the National Health and Medical Research Council (NHMRC) established a working party composed of human and veterinary microbiologists to look at antibiotic use and, in particular, the risks of using them in stockfeed. This action was taken in response to continuing reports from overseas, particularly the United Kingdom, of resistant and multi-resistant Salmonella species being selected in food animals and spread to humans. The working party report made a number of regulatory recommendations in terms of resistance surveillance and scheduling. None of these recommendations were adopted directly, but the national regulators continued to call on NHMRC for advice and in various guises the NHMRC maintained a working group on antibiotics and resistance until 1997, when it was decided that antimicrobial resistance was no longer a priority issue. As the regulators still wished to receive advice, the Therapeutic Goods Administration (TGA) took temporary responsibility for maintaining the expertise or the working party.

Scope of Antibiotic Stewardship Programs in Pediatrics

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1291-1301 ◽  
Author(s):  
Leslie Grammatico-Guillon ◽  
Lukman Abdurrahim ◽  
Kimberley Shea ◽  
Pascal Astagneau ◽  
Stephen Pelton
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Antibiotic Prescribing ◽  
Large Variability ◽  
Search Terms ◽  
Inpatient Settings ◽  
Meta Analyses ◽  
The Impact

This review of pediatric antibiotic stewardship programs (ASPs) summarized the antibiotic prescribing interventions and their impact on antibiotic use and antimicrobial resistance. We reviewed studies of pediatric ASP, including the search terms “antimicrobial stewardship,” “antibiotic stewardship,” “children,” and “pediatric.” The articles’ selection and review were performed independently by 2 investigators, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Twenty-one studies were included, from the past 15 years, increasing after the 2007 IDSA (Infectious Diseases Society of America) guidelines for ASP with a large variability of the programs, and the virtual exclusive focus on inpatient settings (90%): 16 formalized ASP and 5 non-ASP actions. A reduction in antibiotic prescribing in ASP has been demonstrated in the studies reporting pediatric ASP, but only one ASP showed a significant impact on antimicrobial resistance. However, the impact on antibiotic consumption in pediatrics demonstrated the important contribution of these strategies to improve antibiotic use in children, without complications or negative issues.

scholarly journals The problem and the productivity of ignorance: Public health campaigns on antibiotic stewardship

2019 ◽  
Vol 68 (1) ◽  
pp. 55-76 ◽  
Author(s):  
Catherine M. Will
Keyword(s):  
Public Health ◽  
Social Action ◽  
Antibiotic Stewardship ◽  
Health Workers ◽  
Antibiotic Use ◽  
Behavioural Economics ◽  
Health Campaigns ◽  
Political Critique ◽  
Public Health Workers ◽  
Public Health Campaigns

This article offers a critical account of efforts to engage people with the issue of antimicrobial resistance (AMR). It analyses how public health workers encourage what they understand as responsible antibiotic use or antibiotic stewardship, and how their efforts are shaped by different theories of ‘behaviour’ or social action. Discourse analysis of all major UK campaigns and their evaluations over the last two decades reveals how different versions of the citizen jostle for attention in a public health that draws on sociology, psychology, and increasingly behavioural economics. Rejecting an explanation which focuses solely on the appeal of emotion in new forms of governance, I deploy theories of expert and lay ignorance to show how public health is pushed towards new approaches as it struggles with an apparently recalcitrant public in the case of AMR. Here ignorance is both problematic and productive, prompting a shift to campaigns based on unreflective action, that are accompanied by decisions to work with potential misunderstandings about antibiotics and their effects. I suggest the term ‘shrug’ as a provocative counterpart to the ‘nudge’ of behavioural economics, drawing attention to the ways in which behavioural interventions may be linked to strategic retreats from engagement, when policy makers feel unable to affect or predict the understanding and views of non-experts. The article thus contributes to sociological and political critique of narrow forms of behavioural thinking and their effects on relations between governments and their citizens.

scholarly journals Are Common Sense Model constructs and self-efficacy simultaneously correlated with self-management behaviors and health outcomes: A systematic review

2020 ◽  
Vol 7 (1) ◽  
pp. 205510291989884 ◽  
Author(s):  
Jessica Y Breland ◽  
Jessie J Wong ◽  
Lisa M McAndrew
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Statistical Model ◽  
Common Sense ◽  
Self Efficacy ◽  
Self Management ◽  
Common Sense Model ◽  
Meta Analyses ◽  
Management Behaviors ◽  
Sense Model

This systematic review answered two questions among adults with chronic conditions: When included in the same statistical model, are Common Sense Model constructs and self-efficacy both associated with (1) self-management behaviors and (2) health outcomes? We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included 29 articles. When included in the same statistical model, Common Sense Model constructs and self-efficacy were both correlated with outcomes. Self-efficacy was more consistently associated with self-management behaviors, and Common Sense Model constructs were more consistently associated with health outcomes. Findings support the continued inclusion and integration of both frameworks to understand and/or improve chronic illness self-management and outcomes.

Promoting Hearing Loss Prevention in Audiology Practice

2012 ◽  
Vol 13 (1) ◽  
pp. 3-19 ◽  
Author(s):  
David C. Byrne ◽  
Christa L. Themann ◽  
Deanna K. Meinke ◽  
Thais C. Morata ◽  
Mark R. Stephenson
Keyword(s):  
Hearing Loss ◽  
Sound Level ◽  
Health Campaigns ◽  
Loss Prevention ◽  
Hearing Conservation ◽  
Prevention Services ◽  
Occupational Programs ◽  
Strategic Position ◽  
Public Health Campaigns ◽  
Self Protection

An audiologist should be the principal provider and advocate for all hearing loss prevention activities. Many audiologists equate hearing loss prevention with industrial audiology and occupational hearing conservation programs. However, an audiologist’s involvement in hearing loss prevention should not be confined to that one particular practice setting. In addition to supervising occupational programs, audiologists are uniquely qualified to raise awareness of hearing risks, organize public health campaigns, promote healthy hearing, implement intervention programs, and monitor outcomes. For example, clinical audiologists can show clients how to use inexpensive sound level meters, noise dosimeters, or phone apps to measure noise levels, and recommend appropriate hearing protection. Audiologists should identify community events that may involve hazardous exposures and propose strategies to minimize risks to hearing. Audiologists can help shape the knowledge, beliefs, motivations, attitudes, and behaviors of individuals toward self-protection. An audiologist has the education, tools, opportunity, and strategic position to facilitate or promote hearing loss surveillance and prevention services and activities. This article highlights real-world examples of the various roles and substantial contributions audiologists can make toward hearing loss prevention goals.

Knowledge, Attitude, and Self-Efficacy in Asthma Self-Management and Quality of Life

2010 ◽  
pp. 1-6
Author(s):  
Carol A. Mancuso ◽  
Wendy Sayles ◽  
John P. Allegrante
Keyword(s):  
Quality Of Life ◽  
Self Efficacy ◽  
Self Management

Pulmonale Rehabilitation

2019 ◽  
Vol 76 (6) ◽  
pp. 323-327
Author(s):  
Martin Frey
Keyword(s):  
Körperliche Aktivität ◽  
Self Efficacy ◽  
Self Management

Zusammenfassung. Die pulmonale Rehabilitation ist eine komprehensive Behandlungsform, die bei fortgeschrittenen chronischen Lungenerkrankungen eine Abnahme der Dyspnoe, eine Verbesserung der Anstrengungstoleranz und eine Zunahme der Lebensqualität erreicht. Sie senkt im Weitern die Hospitalisationsfrequenzen und kann vor allem unter Einbezug einer Selbstmanagementschulung nachhaltig die körperliche Aktivität und damit die Prognose der Grunderkrankung verbessern. Die pulmonale Rehabilitation umfasst nach einem präzisen assessment eine individualisierte Trainingstherapie mit Fokus auf Ausdauer, Kraft und Beweglichkeit sowie im Weitern eine krankheitsspezifische Schulung, die nicht nur die «self efficacy» und das «self management» fördert, sondern auch das Ziel hat, den Lebensstil im Sinne einer Steigerung der körperlichen Aktivität zu ändern. Aufgrund der guten Evidenzlage sind akkreditierte Rehabilitationsprogramme eine Pflichtleistung der Kostenträger und können sowohl ambulant als auch stationär durchgeführt werden.

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