A Complex Intervention to Promote Appropriate Antibiotic Use Among Rural Residents Based on the Metaphor-Embedded Integrated Behavioral Model

Bo Yan

Status: Not yet enrolling

Conditions: Antimicrobial Drug Resistance

Treatments: Behavioral: health education based on the Metaphor-Embedded Integrated Behavioral Model

Study type: Interventional

Funder types: Other

Identifiers

NCT06967766

ZGL202504-10

Details and patient eligibility

About

The study aims to address the question of how to provide effective health education on health topics with high medical specialisation (e.g. bacterial drug resistance in this study), especially for rural or low-educated populations. In response to the high degree of correlation between irrational antimicrobial drug use behaviours, how to achieve the effectiveness of interventions on the complex health topic of rational use of antimicrobial drugs through synergistic interventions with multiple scenarios?

In this study, the investigators used an experimental-like research design to conduct a full-scenario intervention involving antimicrobial drug acquisition, use, and disposal in a township-based approach, so as to reduce the prevalence of irrational antimicrobial drug use behaviours among rural residents, and to significantly improve the governance of antimicrobial drug use in rural areas. After six months of intervention, the following specific objectives were achieved:

1. The incidence of self-treatment and use of antimicrobial drugs in the intervention group decreased by 30% compared with the control group;
2. Rational use of antimicrobial drugs and awareness of bacterial drug resistance among rural residents in the intervention group increased by 50% compared with the control group;
3. In the intervention group, the incidence of rural residents actively asking for antimicrobial drugs when seeking medical treatment, actively purchasing antimicrobial drugs without prescription at community pharmacies, stocking up on antimicrobial drugs at home, and improperly disposing of antimicrobial drugs decreased by 40%, 30%, 30%, and 50%, respectively, compared with that of the control group.

The study included the development and testing of metaphorical health materials and a multi-contextual metaphorical health education intervention. The implementation of the intervention included training in metaphorical health education and doctor-patient communication, a multi-situational intervention based on the theory of metaphorically embedded integrative behaviours, and the design of incentives for standardised antimicrobial drug discarding.

Enrollment: 1,500 estimated patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Residents aged 18 years and over who have lived in the survey township for more than 6 months

Exclusion criteria

• Residents with mental illness, severe mental health problems, and those unable to complete the questionnaire

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1,500 participants in 2 patient groups

Metaphor-based health education

Experimental group

Description:

In each intervention scenario, health education information is set to target key behaviors in the scenario. In the main scenarios for obtaining antibiotics, such as township health centers, village clinics, and community pharmacies, scenario-driven interventions are carried out for two key behaviors: patients actively asking for antibiotics (led by doctors in township health centers) and customers buying antibiotics without prescriptions (led by community pharmacy staff).

Treatment:

Behavioral: health education based on the Metaphor-Embedded Integrated Behavioral Model

Regular education

No Intervention group