NCT07352371

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

Metaphors to Enhance Antibiotic Appropriate Use Knowledge and Behaviours to Reduce Educational Disparities Among Chinese Parents: A Survey-experimental Study

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 866 (actual)
• Sponsor: Bo Yan · Academic / Other
• Sex: All
• Age: 18 Years – 80 Years
• Healthy volunteers: Accepted

Summary

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.

Detailed 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.

Conditions

• Antimicrobial Resistance

Interventions

Type	Name	Description
BEHAVIORAL	metaphorical messages	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. All metaphorical messages were reviewed by a panel of experts in public health, clinical microbiology, health communication, and health education to ensure factual consistency and clarity.
BEHAVIORAL	conventional messages	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).

Timeline

• Start date: 2024-10-16
• Primary completion: 2024-11-10
• Completion: 2024-11-10
• First posted: 2026-01-20
• Last updated: 2026-01-22

Locations

1 site across 1 country: China