An Effort Worth Making: A Qualitative Study of How Swedes Respond to Antibiotic Resistance

Ancillotti, Mirko; Eriksson, Stefan; Godskesen, Tove; Andersson, Dan I.; Fahlquist, Jessica Nihlén

doi:10.1093/phe/phaa033

Cited by 3 publications

(7 citation statements)

References 49 publications

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“…This study reinforces the growing recognition of the importance of norms and values for antibiotic use and related mitigation strategies [14,15] and of the need to consider contextual variation in this regard [16]. Recent literature has stressed that, amongst other challenges, ABR raises serious ethical ones, which require justifiable ethical principles to be formulated and applied [37,53,54].…”

Section: Discussionsupporting

confidence: 78%

“…In comparison to previous studies performed in Sweden (the interview guide used in this study was adapted from the Swedish research) [15,32], some commonalities and differences stand out, especially about the notion of responsibility. Both Swedish and Greek participants expressed the belief that there is a personal responsibility for ABR.…”

Section: Discussionmentioning

confidence: 99%

“…Where they clearly diverged was in their consideration of the collective dimension of responsibility. While the Swedish participants considered the decreasing availability of effective antibiotics a problem of justice prompting both individual and collective responsibility for ABR [15], the notion of collective responsibility was a vague concept for most of the Greek participants, who tended to see as unrealistic a scenario in which society would share and act on the idea of a common purpose. Moreover, in contrast to the Greek participants, the Swedish participants expressed high levels of trust in institutions and in their individual self-efficacy to engage in judicious behaviours in relation to ABR [32].…”

Section: Discussionmentioning

confidence: 99%

“…The original interview guide was constructed using the Health Belief Model as methodological framework [32]. However, the interview guide proved to be useful also in generating contents connected to the value and social dimensions of ABR, worth being investigated in a secondary analysis [15]. The interview guide was translated and adjusted so that meetings would not exceed one-hour duration.…”

Section: Designmentioning

confidence: 99%

“…Such complexity has been acknowledged for decades [12], while at the same time social scientists have increasingly contributed to addressing this global challenge [13]. Recent research has also highlighted the role that the norms and values shared by a population can play for addressing ABR [14,15]. One of the main lessons learned is that the design and feasibility of effective stewardship programs largely depends on the contexts to which they are applied [16].…”

Section: Introductionmentioning

confidence: 99%

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Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values

2022

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Background Antibiotic resistance is a complex phenomenon heavily influenced by social, cultural, behavioural, and economic factors that lead to the misuse, overuse and abuse of antibiotics. Recent research has highlighted the role that norms and values can play for behaviours that contribute to resistance development, and for addressing such behaviours. Despite comparatively high antibiotic consumption in Greece, both at the community and healthcare level, Greeks have been shown to be relatively aware of the connection between antibiotic overuse and antibiotic resistance. This suggests that Greeks’ non-judicious use cannot simply be explained by lack of awareness but may relate to other factors specific to Greek society. The present study aimed to explore attitudes, perceived norms, and values in relation to antibiotics, in order to improve understanding of socio-cultural determinants of antibiotic resistance in Greece. Methods Data were collected through online focus group discussions in 2021. Twenty Greeks were recruited through purposive sampling, aiming for as heterogeneous groups as possible regarding gender (12 women, 8 men), age (range 21–55, mean 33), and education level. Interview transcripts were analysed inductively using thematic content analysis. Results Participants considered antibiotic overconsumption as a consolidated habit influenced by ease of access, social expectations and, more generally, cultural practices. While critical of such norms and practices, participants opposed stewardship measures that would prioritize the societal interest in maintaining antibiotic effectiveness over individual needs. Participants considered responsibility for antibiotic resistance to be shared by the whole society, but the role of government actors and health professionals as well as of food producers was emphasized. Notably, scepticism about the prospect of effectively managing antibiotic resistance in Greece was commonly expressed. Conclusions The study makes explicit attitudes, perceived norms and values that, besides limited awareness, may contribute to non-judicious antibiotic use in Greece. These socio-cultural determinants of antibiotic resistance warrant further research and should be considered when designing measures aimed to mitigate this problem.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values

2022

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Prosocial Behaviour and Antibiotic Resistance: Evidence from a Discrete Choice Experiment

Ancillotti,

Huls,

Krockow

et al. 2023

Patient

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Introduction The health of a community depends on the health of its individuals; therefore, individual health behaviour can implicitly affect the health of the entire community. This is particularly evident in the case of infectious diseases. Because the level of prosociality in a community might determine the effectiveness of health programmes, prosocial behaviour may be a crucial disease-control resource. This study aimed to extend the literature on prosociality and investigate the role of altruism in antibiotic decision making. Methods A discrete choice experiment was conducted to assess the influence of altruism on the general public’s preferences regarding antibiotic treatment options. The survey was completed by 378 Swedes. Latent class analysis models were used to estimate antibiotic treatment characteristics and preference heterogeneity. A three-class model resulted in the best model fit, and altruism significantly impacted preference heterogeneity. Results Our findings suggest that people with higher altruism levels had more pronounced preferences for treatment options with lower contributions to antibiotic resistance and a lower likelihood of treatment failure. Furthermore, altruism was statistically significantly associated with sex, education, and health literacy. Conclusions Antibiotic awareness, trust in healthcare systems, and non-discriminatory priority setting appear to be structural elements conducive to judicious and prosocial antibiotic behaviour. This study suggests that prosocial messages could help to decrease the demand for antibiotic treatments. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-023-00666-3.

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Patient and public understanding of antimicrobial resistance: a systematic review and meta-ethnography

Wojcik,

Afseth,

Fagan

et al. 2024

JAC-Antimicrobial Resistance

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Objectives To further develop an understanding of laypeople’s (adult patients and public) beliefs and attitudes toward antimicrobial resistance (AMR) by developing a conceptual model derived from identifying and synthesizing primary qualitative research. Methods A systematic search of 12 electronic databases, including CINAHL, MEDLINE, PsycINFO, PubMed and Web of Science to identify qualitative primary studies exploring patient and public understanding of AMR published between 2012 and 2022. Included studies were quality appraised and synthesized using Noblit and Hare’s meta-ethnographic approach and reported using eMERGe guidance. Results Thirteen papers reporting 12 qualitative studies were synthesized. Studies reported data from 466 participants aged 18–90 years. Five themes were identified from these original studies: the responsible patient; when words become meaningless; patient–prescriber relationship; past experience drives antibiotic use; and reframing public perception. These themes supported the development of a conceptual model that illustrates the tension between two different assumptions, that is, how can antibiotics be used for the collective good whilst balancing the immediate needs of individual patients. Conclusions Findings suggest that AMR is a distinct ethical issue and should not be viewed purely as a prescribing problem. The meta-ethnography-generated conceptual model illustrates many factors affecting the public’s perception of AMR. These include laypeople’s own knowledge, beliefs and attitudes around antibiotic use, the relationship with the healthcare provider and the wider context, including the overwhelming influence of the media and public health campaigns. Future research is needed to explore effective health messaging strategies to increase laypeople’s baseline awareness of AMR as a public threat.

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An Effort Worth Making: A Qualitative Study of How Swedes Respond to Antibiotic Resistance

Cited by 3 publications

References 49 publications

Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values

Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values

Prosocial Behaviour and Antibiotic Resistance: Evidence from a Discrete Choice Experiment

Patient and public understanding of antimicrobial resistance: a systematic review and meta-ethnography

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