Antimicrobial Resistance
Conditions
Keywords
metaphor, antimicrobial resistance, antibiotic use behaviour, equity
Brief summary
A randomized controlled survey experiment was conducted from October to November 2024 to assess the effectiveness of metaphor-based health education in improving Chinese parents' knowledge and behavioural intentions regarding appropriate antibiotic use. A total of 866 parents from two Chinese provinces were randomly assigned to either a metaphorical message group (n = 432) or a conventional message group (n = 434). Metaphors included comparing antimicrobial resistance (AMR) to insect resistance to pesticides, improper antibiotic disposal to mercury battery pollution, and antibiotic-free foods to organic foods. Outcomes measured were AMR knowledge, willingness to pay (WTP) for antibiotic-free foods, and proper antibiotic disposal intention.
Detailed description
To assess the influence of metaphorical and conventional health education messages on the AMR-related knowledge and behavioural intentions of rural and urban residents, the investigators conducted a survey experimental study across two provinces in China. Prior to receiving any health education message, the respondents completed questions on AMR-related knowledge, behaviours, and behavioural intentions. Subsequently, participants were randomly assigned to read either metaphorical or conventional health education messages. Following the reading of assigned message, the respondents once again completed the questions on AMR-related knowledge and behavioural intentions.
Interventions
BEHAVIORALmetaphorical messages
We created three specific pairs: the first explained mechanisms of AMR, comparing resistant bacteria to pesticide-resistant insects. The second addressed environmental contamination by likening antibiotics to mercury batteries. The third used the analogy of "organic" food to convey the concept of antibiotic-free animal foods. All metaphorical messages were reviewed by a panel of experts in public health, clinical microbiology, health communication, and health education to ensure factual consistency and clarity.
BEHAVIORALconventional messages
The conventional messages were adapted from formal health communication sources, such as the World Health Organization and the Chinese National Health Commission, and retained the technical tone typical of official health education materials (China NHC, 2010; He, 2018; WHO, 2022).
Sponsors
Bo Yan
Hangzhou Normal University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Masking description
The study is double-blinded, meaning that both the subjects and the researchers are unaware of the group assignments. The randomization of groups is conducted using Wenjuanxing (a survey tool). However, blinding is not implemented during data analysis.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* adult child parent, willing to participate
Exclusion criteria
* declining to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| knowledge | Immediately after the 30-second message exposure. | Three items were summed to form the AMR-related knowledge scale. This scale was assessed by asking respondents to judge the correctness of the following statements before and after their first exposure to health education message: (1) Does antimicrobial resistance imply that bacteria are becoming increasingly difficult to kill with antibiotics? (2) Dose overuse of antibiotics lead to antimicrobial resistance? (3) Can antimicrobial resistant be transmitted between people? |
| Willingness to pay for antibiotic-free animal food | Immediately after the 30-second message exposure. | Respondents were asked whether they were willing to pay a higher price for antibiotic-free animal foods compared to regular animal- foods. Their answers were dichotomized into "Yes" and "No/Not Sure". |
| antibiotic disposal intention | Immediately after the 30-second message exposure. | To evaluate antibiotic disposal practices, participants were asked to recall how they had handled expired or unused antibiotic prior to receiving a third exposure to health education message. |
Countries
China
Outcome results
None listed