Metaphors to Enhance Antibiotic Appropriate Use Knowledge and Behaviours to Reduce Educational Disparities

Bo Yan

Status: Completed

Conditions: Antimicrobial Resistance

Treatments: Behavioral: conventional messages; Behavioral: metaphorical messages

Study type: Interventional

Funder types: Other

Identifiers

NCT07352371

ZGL202403-3

72004194 (Other Grant/Funding Number)

Details and patient eligibility

About

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.

Full 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.

Enrollment: 866 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• adult child parent, willing to participate

Exclusion criteria

• declining to participate

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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866 participants in 2 patient groups, including a placebo group

metaphorical messages group

Experimental group

Description:

The metaphorical messages, by contrast, were crafted to be more accessible, drawing on familiar daily-life analogies derived from our prior qualitative research. 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.

Treatment:

Behavioral: metaphorical messages

conventional messages group

Placebo Comparator group

Description:

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).

Treatment:

Behavioral: conventional messages