Increasing Information Seeking About Antibiotic Risks: Testing a Clinical Intervention Message Using the Risk Information Seeking and Processing Model

Abstract

We employed the risk information seeking and processing (RISP) model to inform the design of antibiotic stewardship messages aiming at influencing intentions to seek or avoid antibiotic risk information. College-age respondents (N = 400) from a national sample viewed one of three versions of a RISP-informed message or no message (control group). Relative to the control group, all RISP-informed messages increased perceptions of information insufficiency. The most complete version of the RISP-informed message increased severity perceptions and information seeking intention and decreased information avoidance intention. Approaches to designing antibiotic stewardship messages are recommended accordingly.

Keywords

information insufficiency information seeking RISP model antibiotic stewardship risk communication

Get full access to this article

View all access options for this article.

References

Ajzen

(1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-T

Alanis

A. J.

(2005). Resistance to antibiotics: Are we in the post-antibiotic era. Archives of Medical Research, 36, 697-705. https://doi.org/10.1016/j.arcmed.2005.06.009

Alder

Wuthrich

Haddadin

Donnelly

Hannah

E. L.

Stoddard

Benuzillo

Bateman

Samore

(2010). Community intervention model to reduce inappropriate antibiotic use. American Journal of Health Education, 41(1), 20-28. https://doi.org/10.1080/19325037.2010.10599123

Almeida Santimano

N. M.

Foxcroft

D. R

. (2017). Poor health knowledge and behaviour is a risk for the spread of antibiotic resistance: Survey of higher secondary school students in Goa, India. Perspectives in Public Health, 137(2), 109-113. https://doi.org/10.1177/1757913916650917

Avorn

Solomon

D. H.

(2000). Cultural and economic factors that (mis)shape antibiotic use: The nonpharmacologic basis of therapeutics. Annals of Internal Medicine, 133(2), 128-135. https://doi.org/10.7326/0003-4819-133-2-200007180-00012

Barbour

J. B.

Rintamaki

L. S.

Ramsey

J. A.

Brashers

D. E.

(2012). Avoiding health information. Journal of Health Communication, 17(2), 212-229. https://doi.org/10.1080/10810730.2011.585691

Belongia

E. A.

Naimi

T. S.

Gale

C. M.

Besser

R. E.

(2002). Antibiotic use and upper respiratory infections: A survey of knowledge, attitudes, and experience in Wisconsin and Minnesota. Preventive Medicine, 34(3), 346-352. https://doi.org/10.1006/pmed.2001.0992

Bramesfeld

K. D.

Gasper

(2008). Happily putting the pieces together: A test of two explanations for the effects of mood on group-level information processing. British Journal of Social Psychology, 47(2), 285-309. https://doi.org/10.1348/000712607X218295

Brashers

D. E.

Goldsmith

D. J.

Hsieh

(2002). Information seeking and avoiding in health contexts. Human communication research, 28(2), 258-271. https://doi.org/10.1111/j.1468-2958.2002.tb00807.x

10.

Case

D. O.

Andrews

J. E.

Johnson

J. D.

Allard

S. L.

(2005). Avoiding versus seeking: The relationship of information seeking to avoidance, blunting, coping, dissonance, and related concepts. Journal of the Medical Library Association, 93(3), 353-362.

11.

Centers for Disease Control and Prevention. (2019). Antibiotic resistance threats in the United States, 2019. Retrieved from https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf

12.

Céspedes

Larson

(2006). Knowledge, attitudes, and practices regarding antibiotic use among Latinos in the United States: Review and recommendations. American Journal of Infection Control, 34(8), 495-502. https://doi.org/10.1016/j.ajic.2006.01.005

13.

Clarke

C. E.

McComas

(2012). Seeking and processing influenza vaccine information: A study of health care workers at a large urban hospital. Health Communication, 27(3), 244-256. https://doi.org/10.1080/10410236.2011.578332

14.

Dal Cin

Zanna

M. P.

Fong

G. T

. (2004). Narrative persuasion and overcoming resistance. In Knowles

E. S.

Linn

J. A.

(Eds.), Resistance and persuasion (pp. 175-191). Lawrence Erlbaum. https://doi.org/10.1037/e633872013-232

15.

Davey

Brown

Charani

Fenelon

Gould

I. M.

Holmes

Ramsay

C. R.

Wiffen

P. J.

Wilcox

(2013). Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews, 4, CD003543. https://doi.org/10.1002/14651858.CD003543.pub3

16.

Deline

M. B.

Kahlor

L. A.

(2019). Planned risk information avoidance: A proposed theoretical model. Communication Theory, 29(3), 360-382. https://doi.org/10.1093/ct/qty035

17.

Demore

Mangin

Tebano

Pulcini

Thilly

(2017). Public knowledge and behaviours concerning antibiotic use and resistance in France: A cross-sectional survey. Infection, 45(4), 513-520. https://doi.org/10.1007/s15010-017-1015-2

18.

Dunwoody

Griffin

R. J.

(2014). The role of channel beliefs in risk information seeking. In Arvai

Rivers

(Eds.), Effective risk communication (pp. 220-233). Routledge.

19.

Dunwoody

Griffin

R. J.

(2015). Risk information seeking and processing model. In Cho

Reimer

McComas

K. A.

(Eds.), The SAGE handbook of risk communication (pp. 102-116). Sage. https://doi.org/10.4135/9781483387918.n14

20.

Fagerlin

Zikmund-Fisher

B. J.

Ubel

P. A.

(2005). Cure me even if it kills me: Preferences for invasive cancer treatment. Medical Decision Making, 25(6), 614-619. https://doi.org/10.1177/0272989X05282639

21.

Fleming-Dutra

K. E.

Hersh

A. L.

Shapiro

D. J.

Bartoces

Enns

E. A.

File

T. M.

Finkelstein

J. A.

Gerber

J. S.

Hyun

D. Y.

Linder

J. A.

Lynfield

Margolis

D. J.

May

L. S.

Merenstein

Metlay

J. P.

Newland

J. G.

Piccirillo

J. F.

Roberts

R. M.

Sanchez

G. V.

. . . Hicks

L. A.

(2016). Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA Journal of the American Medical Association, 315(17), 1864-1873. https://doi.org/10.1001/jama.2016.4151

22.

Flores

(2000). Culture and the patient-physician relationship: Achieving cultural competency in health care. Journal of Pediatrics, 136(1), 14-23. https://doi.org/10.1016/S0022-3476(00)90043-X

23.

Frank

L. B.

Murphy

S. T.

Chatterjee

J. S.

Moran

M. B.

Baezconde-Garbanati

(2015). Telling stories, saving lives: Creating narrative health messages. Health communication, 30(2), 154-163. https://doi.org/10.1080/10410236.2014.974126

24.

Griffin

R. J.

Dunwoody

Neuwirth

(1999). Proposed model of the relationship of risk information seeking and processing to the development of preventive behaviors. Environmental Research, 80(2), S230-S245. https://doi.org/10.1006/enrs.1998.3940

25.

Griffin

R. J.

Dunwoody

Yang

Z. J.

(2013). Linking risk messages to information seeking and processing. Annals of the International Communication Association, 36(1), 323-362. https://doi.org/10.1006/enrs.1998.3940

26.

Griffin

R. J.

Neuwirth

Dunwoody

Giese

(2004). Information sufficiency and risk communication. Media Psychology, 6(1), 23-61. https://doi.org/10.1207/s1532785xmep0601_2

27.

Griffin

R. J.

Yang

ter Huurne

Boerner

Ortiz

Dunwoody

(2008). After the flood: Anger, attribution, and the seeking of information. Science Communication, 29(3), 285-315. https://doi.org/10.1177/1075547007312309

28.

Gualano

M. R.

Gili

Scaioli

Bert

Siliquini

(2015). General population’s knowledge and attitudes about antibiotics: A systematic review and meta-analysis. Pharmacoepidemiology & Drug Safety, 24(1), 2-10. https://doi.org/10.1002/pds.3716

29.

Hamour

S. M.

O’Bichere

Peters

J. L.

McDonald

P. J.

(2003). Patient perceptions of MRSA. Annals of the Royal College of Surgeons of England, 85(2), 123-125. https://doi.org/10.1308/003588403321219939

30.

Hart

Albarracín

Eagly

A. H.

Brechan

Lindberg

M. J.

Merrill

(2009). Feeling validated versus being correct: A meta-analysis of selective exposure to information. Psychological Bulletin, 135(4), 555-588. https://doi.org/10.1037/a0015701

31.

Hovick

S. R.

Kahlor

Liang

M. C.

(2014). Personal cancer knowledge and information seeking through PRISM: The planned risk information seeking model. Journal of Health Communication, 19(4), 511-527. https://doi.org/10.1080/10810730.2013.821556

32.

Bentler

P. M.

(1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118

33.

Huttner

Goossens

Verheij

Harbarth

(2010). Characteristics and outcomes of public campaigns aimed at improving the use of antibiotics in outpatients in high-income countries. The Lancet Infectious Diseases, 10(1), 17-31. https://doi.org/10.1016/S1473-3099(09)70305-6

34.

Hwang

T. J.

Gibbs

K. A.

Podolsky

S. H.

Linder

J. A.

(2015). Antimicrobial stewardship and public knowledge of antibiotics. The Lancet Infectious Diseases, 15(9), 1000-1001. https://doi.org/10.1016/S1473-3099(15)00235-2

35.

Hwang

Jeong

S. H.

(2016). Information insufficiency and information seeking: An experiment. Science Communication, 38(6), 679-698. https://doi.org/10.1177/1075547016673200

36.

Iriyama

Nakahara

Jimba

Ichikawa

Wakai

(2007). AIDS health beliefs and intention for sexual abstinence among male adolescent students in Kathmandu, Nepal: A test of perceived severity and susceptibility. Public Health, 121(1), 64-72. https://doi.org/10.1016/j.puhe.2006.08.016

37.

Johnson

B. B.

(2005). Testing and expanding a model of cognitive processing of risk information. Risk Analysis: An International Journal, 25(3), 631-650. https://doi.org/10.1111/j.1539-6924.2005.00609.x

38.

Jorgensen

T. D.

Pornprasertmanit

Schoemann

A. M.

Rosseel

(2018). semTools: Useful tools for structural equation modeling. R Package Version 0.5-1.

39.

Kahlor

L. A.

(2007). An augmented risk information seeking model: The case of global warming. Media Psychology, 10(3), 414-435. https://doi.org/10.1080/15213260701532971

40.

Kahlor

Dunwoody

Griffin

R. J.

Neuwirth

Giese

(2003). Studying heuristic-systematic processing of risk communication. Risk Analysis, 23(2), 355-368. https://doi.org/10.1111/1539-6924.00314

41.

Kahlor

L. A.

Olson

H. C.

Markman

A. B.

Wang

(2018). Avoiding trouble: Exploring environmental risk information avoidance intentions. Environment and Behavior, 52(2), 187-218. https://doi.org/10.1177/0013916518799149

42.

Kahlor

Rosenthal

(2009). If we seek, do we learn? Predicting knowledge of global warming. Science Communication, 30(3), 380-414. https://doi.org/10.1177/1075547008328798

43.

Kahlor

L. A.

Yang

Z. J.

Liang

M. C.

(2018). Risky politics: Applying the planned risk information seeking model to the 2016 US Presidential Election. Mass Communication and Society, 21(6), 697-719. https://doi.org/10.1080/15205436.2018.1498900

44.

Klessig

(1992). Cross-cultural medicine a decade later: The effects of values and culture on life-support decisions. Western Journal of Medicine, 157(3), 316-322.

45.

Kline

R. B.

(2016). Principles and practice of structural equation modeling (4rd ed.). Guilford Press.

46.

Kuzujanakis

Kleinman

Rifas-Shiman

Finkelstein

J. A.

(2003). Correlates of parental antibiotic knowledge, demand, and reported use. Ambulatory Pediatrics, 3(4), 203-210. https://doi.org/10.1367/1539-4409(2003)003<0203:COPAKD>2.0.CO;2

47.

(2015). Burgers or tofu? Eating between two worlds: Risk information seeking and processing during dietary acculturation. Health Communication, 30(8), 758-771. https://doi.org/10.1080/10410236.2014.899658

48.

Mangione-Smith

McGlynn

E. A.

Elliott

M. N.

McDonald

Franz

C. E.

Kravitz

R. L.

(2001). Parent expectations for antibiotics, physician-parent communication, and satisfaction. Archives of Pediatrics & Adolescent Medicine, 155(7), 800-806. https://doi.org/10.1001/archpedi.155.7.800

49.

McClendon

(2011). Perceived susceptibility of cardiovascular disease as a moderator of relationships between perceived severity and cardiovascular health promoting behaviors among female registered nurses [Unublished doctoral dissertation]. Georgia State University.

50.

McKee

Mills

Mainous

A. G.

(1999). Antibiotic use for the treatment of upper respiratory infections in a diverse community. Journal of Family Practice, 48(12), 993-996.

51.

McNulty

C. A.

Nichols

French

D. P.

Joshi

Butler

C. C.

(2013). Expectations for consultations and antibiotics for respiratory tract infection in primary care: The RTI clinical iceberg. The British Journal of General Practice, 63(612), e429-e436. https://doi.org/10.3399/bjgp13X669149

52.

Moyer

Griffin

R. J.

Pokrywczynski

(2019). Take me out to the Facebook page. Journal of Digital & Social Media Marketing, 6(4), 357-370. https://doi.org/10.1002/meet.2011.14504801085

53.

Narayan

Case

D. O.

Edwards

S. L.

(2011). The role of information avoidance in everyday-life information behaviors. Proceedings of the ASIST Annual Meeting, 48, 1-7. https://doi.org/10.1002/meet.2011.14504801085

54.

Nichol

K. L.

D’Heilly

Ehlinger

(2006). Burden of upper respiratory illnesses among college and university students: 2002–2003 and 2003–2004 cohorts. Vaccine, 24, 6724-6725. https://doi.org/10.1016/j.vaccine.2006.05.033

55.

Ong

Nakase

Moran

Karras

D. J.

Kuehnert

M. J.

Talan

D. A.

(2007). Antibiotic use for emergency department patients with upper respiratory infections: Prescribing practices, patient expectations, and patient satisfaction. Annals of Emergency Medicine, 50(3), 213-220. https://doi.org/10.1016/j.annemergmed.2007.03.026

56.

Petty

R. E.

Cacioppo

J. T.

(1984). Source factors and the elaboration likelihood model of persuasion. Advances in Consumer Research, 11, 668-672.

57.

Pokrywczynski

Griffin

R. J.

Calhoun

G. J.

(2019). Information seeking among women aged 18 to 25 about the risk of sexual aggression. Journalism & Mass Communication Quarterly, 96(1), 239-263. https://doi.org/10.1177/1077699018801315

58.

R Core Team. (2018). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org/

59.

Roberts

R. M.

Albert

A. P.

Johnson

D. D.

Hicks

L. A.

(2015). Can improving knowledge of antibiotic-associated adverse drug events reduce parent and patient demand for antibiotics? Health Services Research and Managerial Epidemiology, 2, 2333392814568345. https://doi.org/10.1177/2333392814568345

60.

Roeland

Cain

Onderdonck

Kerr

Michell

Thornberry

(2014). When open-ended questions don’t work: The role of palliative paternalism in difficult medical decisions. Journal of Palliative Medicine, 17(4), 415-420. https://doi.org/10.1177/2333392814568345

61.

Rosenstock

I. M.

(1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328-335. https://doi.org/10.1177/2333392814568345

62.

Rosseel

(2012). Lavaan: An R package for structural equation modeling and more. Version 0.5-12 (BETA). Journal of Statistical Software, 48(2), 1-36. https://doi.org/10.18637/jss.v048.i02

63.

Slater

M. D.

Rouner

(2002). Entertainment—education and elaboration likelihood: Understanding the processing of narrative persuasion. Communication Theory, 12(2), 173-191. https://doi.org/10.1111/j.1468-2885.2002.tb00265.x

64.

Smith

R. A.

M’ikanatha

N. M.

Read

A. F.

(2015). Antibiotic resistance: A primer and call to action. Health Communication, 30(3), 309-314. https://doi.org/10.1080/10410236.2014.943634

65.

Tedijanto

Olesen

Grad

Lipsitch

(2018). Estimating the proportion of bystander selection for antibiotic resistance among potentially pathogenic bacterial flora. Proceedings of the National Academy of Sciences of the U S A, 115(51), E11988-E11995. doi:10.1073/pnas.1810840115

66.

ter Huurne

E. F.

Griffin

R. J.

Gutteling

J. M

. (2009). Risk information seeking among US and Dutch residents: An application of the model of risk information seeking and processing. Science Communication, 31(2), 215-237. https://doi.org/10.1177/1075547009332653

67.

Witte

(1992). Putting the fear back into fear appeals: The extended parallel process model. Communications Monographs, 59(4), 329-349. https://doi.org/10.1080/03637759209376276

68.

Yang

Z. J.

(2012). Too scared or too capable? Why do college students stay away from the H1N1 vaccine? Risk Analysis, 32(10), 1703-1716. https://doi.org/10.1111/j.1539-6924.2012.01799.x

69.

Yang

Z. J.

Aloe

A. M.

Feeley

T. H.

(2014). Risk information seeking and processing model: A meta-analysis. Journal of Communication, 64(1), 20-41. https://doi.org/10.1111/jcom.12071

70.

Yang

Z. J.

Kahlor

(2013). What, me worry? The role of affect in information seeking and avoidance. Science Communication, 35(2), 189-212. https://doi.org/10.1177/1075547012441873

71.

Yang

Z. J.

McComas

Gay

Leonard

J. P.

Dannenberg

A. J.

Dillon

(2010). Motivation for health information seeking and processing about clinical trial enrollment. Health Communication, 25(5), 423-436. https://doi.org/10.1080/10410236.2010.483338

72.

Yang

Z. J.

Rickard

L. N.

Harrison

T. M.

Seo

(2014). Applying the risk information seeking and processing model to examine support for climate change mitigation policy. Science Communication, 36(3), 296-324. https://doi.org/10.1177/1075547014525350