The Antibiotic Use Questionnaire-Parent Version: a measure of the drivers of parental decisions about the use of antibiotics with their children

Abstract

The global increase in antimicrobial resistance is linked to the frequent use and misuse of antibiotics. The Antibiotic Use Questionnaire-Parent Version is informed by the principles of the Theory of Planned Behaviour and is designed to assess factors that are specific to the antibiotic use decisions of parents of children under the age of 12. The questionnaire was administered online between August and September 2024 to parents/caregivers aged ≥ 18 years living in metropolitan and rural areas across Australia as part of a cross-sectional study. Data analysis was conducted using orthogonal principal components analysis, Cronbach's alpha and general linear modelling to investigate variables that predict the intended antibiotic misuse behaviour of parents. The data of 509 participants were analysed, which showed four variables significantly predicted the intended antibiotic use behaviour of parents: attitudes/beliefs, social norms, perceived behavioural control and knowledge. Social norms had the strongest effect on the antibiotic use intentions of parents in both the rural and metropolitan cohorts. However, discrete differences were found between rural and metropolitan respondents in relation to socially desirable responding.

Conclusion: Interventions aimed at reducing self-initiated antibiotic use should target parents and address how social conformity influences their decision-making, while also being tailored to the specific community needs.

What is known: • Children are prolific users of antibiotics and may be given antibiotics by their parents without appropriate medical guidance, which can be influenced by parental knowledge, attitudes and beliefs.

What is new: • Social norms remain significant predictors of parental antibiotic use behaviours irrespective of demographic variables. • Geographical location influences the magnitude of effect of the predictors of antibiotic use behaviours in the Australian context. • Interventions seeking to reduce antibiotic misuse would benefit from analysis of both the drivers of antibiotic use and the location of the target population.

Keywords: Antibiotic Use Questionnaire; Antimicrobial resistance; Child health; Parents; Public health; Rural communities.