Influencing parents’ awareness of antimicrobial resistance in Perth, Western Australia: A social marketing approach

Aaron L Alejandro

Antibiotics are commonly prescribed to children during illness, making them one of the largest groups of antibiotics consumers. In 2020, there were approximately 610,000 children aged 0–17 years in Western Australia. While most of the children (87.6%) in Western Australia were reported to have very good or excellent health, the incidence of acute respiratory tract infections (which often leads to inappropriate antibiotic prescriptions) in was higher compared with other high-income countries. Understanding parental attitudes and exploring their decisions on antibiotic use in Western Australia will play a vital role in informing interventions that aim to encourage its responsible use among children. Social marketing aims to bring about behavioural changes that benefit individuals and society utilising concepts from commercial marketing. However, the use of social marketing in the development antimicrobial awareness campaigns is under-explored. This PhD program utilised social marketing benchmark criteria to examine factors that promote or inhibit parents’ responsible use of antibiotics in their children. First, a systematic literature review was conducted to assess the use of social marketing benchmark criteria in previous antimicrobial awareness campaigns. This study found that social marketing is underutilised in antimicrobial awareness campaigns, therefore its use has potential to improve the effectiveness of future antimicrobial awareness campaigns. Second, a qualitative study design using focus group discussions, applied social marketing benchmarks of customer orientation and segmentation to understand the target audience. The findings showed parents agreed antimicrobial resistance (AMR) is a serious health problem but lacked awareness of AMR and did not consider their children at risk of developing AMR. Third, a quantitative examination of the relationships between parents’ exposure to antimicrobial awareness campaigns and their intention to demand antibiotic treatment were examined. Conducted on parents (N=250), this study found that parents who exhibited a low level of anxiety were less likely to express an intention to demand for antibiotic treatment compared to parents with a high level of anxiety (β -.450, p<.001). The fourth study, the final longitudinal sample comprised 50 participants from Victoria and 51 from Western Australia. Parental anxiety did not significantly change over time for either state. Intention to demand antibiotics was also stable over time within each state; however, participants from Victoria exhibited stronger intentions to demand antibiotics compared to those from Western Australia. Frequencies of parental preventative behaviours declined from Wave 1 to Wave 2 before increasing again in Wave 3, but only for Western Australia. Overall, this PhD research program demonstrated locally prevailing beliefs, misconceptions, and unhealthy behaviours regarding antibiotic use in children can be targeted more effectively by applying social marketing principles.

Influencing parents’ awareness of antimicrobial resistance in Perth, Western Australia: A social marketing approach

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