Perceptions of Responsibility for Antibiotic Resistance: Implications for Stewardship Campaigns

Abstract

Widespread public engagement with antibiotic stewardship is essential to stem the rising incidence of antibiotic-resistant infections; however, campaigns that focus on increasing knowledge have not been effective. Beliefs about who is responsible for causing and solving antibiotic resistance (AR) likely influences engagement in antibiotic stewardship behaviors. This study assesses the U.S. public’s AR causal and solution responsibility attributions and the capacity for changing these attributions to inform future antibiotic stewardship campaigns. U.S. participants (N= 1,014) diverse across race, education, and geographic region were surveyed on their beliefs about responsibility for AR for themselves, the general public, healthcare providers, scientists, and drug companies. Substantial percentages of participants held causal and solution beliefs about antibiotic resistance that likely inhibit antibiotic stewardship behaviors. Participants’ beliefs that they and the general public are responsible for causing and solving AR were lower than their beliefs that healthcare providers, scientists, and drug companies are responsible. Beliefs about causal responsibility for any given person or group were significantly and positively associated with beliefs about solution responsibility for that same person or group. Responsibility beliefs differed by age, education level, and racial/ethnic background. Results highlight the need for antibiotic stewardship campaigns to incorporate responsibility attribution messaging to motivate stewardship.

Disclosure Of Interest

No potential conflict of interest was reported by the authors.

Data Availability Statement

The data set can be found by contacting the corresponding author.

Notes

¹ Of note: (1) the denominator subtracts 1 because the response scales are anchored with 1 instead of 0; (2) the data are not dichotomous, so the concept of percentage is useful, but fictitious one; thus, improvement implies movement toward the high end of the scale; and (3) the RFII should be subtracted from 1 when the item is negatively worded.

Additional information

Funding

This research was supported by research funding awarded to the second author from the Department of Communication Arts and Sciences, Pennsylvania State University.