The impacts of knowledge and attitude on behavior of antibiotic use for the common cold among the public and identifying the critical behavioral stage: based on an expanding KAP model

Qianning Wang; Yuanyang Wu; Dan Wang; Xiaoquan Lai; Li Tan; Qian Zhou; Lixia Duan; Rujiao Lin; Xi Wang; Feiyang Zheng; Tiantian Yu; Lu Wang; Si Fan; Yanting Wang; Xinping Zhang; Chenxi Liu

doi:10.1186/s12889-023-16595-7

The impacts of knowledge and attitude on behavior of antibiotic use for the common cold among the public and identifying the critical behavioral stage: based on an expanding KAP model

BMC Public Health. 2023 Aug 31;23(1):1683. doi: 10.1186/s12889-023-16595-7.

Authors

Qianning Wang¹, Yuanyang Wu¹, Dan Wang², Xiaoquan Lai³, Li Tan³, Qian Zhou⁴, Lixia Duan¹, Rujiao Lin¹, Xi Wang¹, Feiyang Zheng¹, Tiantian Yu¹, Lu Wang¹, Si Fan¹, Yanting Wang¹, Xinping Zhang⁵, Chenxi Liu⁶

Affiliations

¹ School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
² School of Management, Hubei University of Chinese Medicine, Wuhan, Hubei, China.
³ Department of Nosocomial Infection, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
⁴ Department of Hospital Infection Management, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.
⁵ School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. xpzhang602@hust.edu.cn.
⁶ School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. liu_chenxi@hust.edu.cn.

Abstract

Background: This study aims to explore the impacts of knowledge and attitude on the behavior of antibiotic use during the treatment of the common cold based on the expanding KAP model, and then identify the critical behavioral stage.

Methods: A cross-sectional study was conducted on 815 public from 21 community health centers (CHCs) in Chongqing, China. Based on the expanding KAP model, a self-administered questionnaire was designed to measure knowledge, attitude, multi-stage behavior, and perceived threat, in which multi-stage behavior was divided into pre-use antibiotic behavior, during-use antibiotic behavior, and post-use antibiotic behavior. A structural equation model was used to examine the model fit and the direct, indirect, mediating effects, and moderating effect of the variables.

Results: The expanding KAP showed good model fit indices with χ²/df = 0.537, RMSEA = 0.033, CFI = 0.973, GFI = 0.971, NFI = 0.934, TLI = 0.979. Knowledge had a positive effect on attitude (β = 0.503, p < 0.05), pre-use antibiotic behavior (β = 0.348, p < 0.05), during-use antibiotic behavior (β = 0.461, p < 0.001), and post-use antibiotic behavior (β = 0.547, p < 0.001). Attitude had a positive effect on during-use antibiotic behavior (β = 0.296, p < 0.001), and post-use antibiotic behavior (β = 0.747, p < 0.001). The mediating effect of attitude was positive among knowledge, during-use antibiotic behavior (β = 0.149, p < 0.05), and post-use antibiotic behavior (β = 0.376, p < 0.001). Perceived threat also had a positive moderating effect between knowledge and post-use antibiotic behavior (β = 0.021, p < 0.001).

Conclusions: Knowledge, attitude and perceived threat had different effects on different stages of antibiotic behavior. The critical behavioral stage prioritized the post-use antibiotic behavior and during-use antibiotic behavior over pre-use antibiotic behavior.

Keywords: Antibiotic use5; Attitude2; Common cold6; KAP8; Knowledge1; Multi-stage behavior3; Perceived threat4; Public7.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / therapeutic use
China
Common Cold* / drug therapy
Cross-Sectional Studies
Humans
Knowledge

Substances

Anti-Bacterial Agents