Identifying factors improving the intention to use antibiotics appropriately in children and adults using protection motivation theory

Abstract

ObjectiveThis study aimed to employ hypothetical models based on the protection motivation theory (PMT) to identify factors that improve the intention to use antibiotics appropriately (intention) among individuals who take antibiotics or administer them to their children. MethodsAdult Japanese participants, including 600 parents who administer antibiotics to children aged <14 years and 600 adults who take them, completed an online survey. Structural equation modeling (SEM) was conducted on hypothetical models representing intention using 19 questions based on PMT. If the hypothesized model did not fit, SEM was repeated to search for a new model. ResultsThe hypothesized models did not fit. Two factors were extracted from SEM: “understanding the risk of antimicrobial resistance” and “excessive expectation of antibiotics.” In adults, SEM revealed that “excessive expectation of antibiotics” (β = −0.50, p < 0.001) negatively influenced intention; in children, “excessive expectation of antibiotics” (β = −0.52, p < 0.001) negatively influenced intention, while “understanding the risk of antimicrobial resistance” (β = 0.22, p < 0.001) positively influenced intention. ConclusionFactors influencing intention varied between adult and pediatric antibiotic use. InnovationAwareness activities for appropriate antibiotic use should be tailored to population characteristics.