Antimicrobial resistance (AMR) is an emerging global health concern, affecting both the animal and the human population. Transmission pathways of AMR are therefore abundant and complex, and ways to prevent or reduce transmission to consumers must be identified. The overall goal of this study was to define the content of an intervention study aimed at reducing the transmission of AMR from animal sources to humans. To identify the most relevant pathways, Swiss experts and consumers were interviewed about their opinions on the risks of transmission of AMR. Opinions of experts and consumers were then qualitatively compared and the main gaps identified. The results revealed that Swiss consumers had several misconceptions regarding the sources and transmission of AMR, and that they in particular underestimated the importance of poultry meat and pets as a potential source of AMR. Furthermore, high uncertainty was noted in experts regarding the prevalence of AMR in pets and the potential of transmission to their owners. Consequently, awareness of AMR transmission pathways should be increased among consumers to overcome common misconceptions, which will help reduce the risk of transmission. Further research is needed to better understand the pets' potential to harbor and transmit AMR to their owners, and to identify most effective methods to increase risk awareness in consumers as well as intervention strategies promoting consumer behaviors to mitigate AMR transmissions at the human-animal interface.
In this study, we aimed to explore the psychosocial factors related to consumers’ safe food-handling behaviors to reduce the transmission risk of antimicrobial-resistant bacteria through food products. To this end, we investigated the extent to which the variables of the health action process approach (HAPA) and subjective norms can predict safe food handling by consumers. Data were collected from a representative sample of consumers belonging to the German-speaking part of Switzerland by administering a self-reporting questionnaire. The results showed that risk perception, self-efficacy, and positive outcome expectancy (i.e., the motivational phase of HAPA) were significant predictors of the intentions to handle food in a safe manner (see graphical abstract below). Additionally, in the volitional phase of HAPA, intention was found to be a significant predictor of safe food-handling behaviors. Contrary to expectations based on HAPA, action planning did not mediate the intention–behavior relationship. Only a small part of the variance in behavior was explained by coping planning and action control. The findings confirmed that the motivational phase of HAPA may be useful for determining safe food handling.
Objectives: We aimed to identify the potential of behaviour change strategies to effectively increase consumers' risk awareness, behavioural intention, and preventive food-handling behaviour to reduce the transmission risk of antimicrobialresistant bacteria through food. The applied strategies targeted knowledge and determinants of the health action process approach (HAPA). We tested techniques that are expected to increase knowledge, risk perception, and positive outcome expectancy (Study 1) as well as those that increase planning and coping self-efficacy (Study 2) in two randomised control trials. Methods: In Study 1 (N = 328), a 2 × 2 between-subject design was employed to investigate the effects of an educational video about the spread of antimicrobial-resistant bacteria and a personalised risk message on knowledge, risk perception, outcome expectancy and consequently on intention regarding safe food-handling behaviour. In Study 2 (N = 129), we used a 2 × 2 design to examine to what extent goal setting (implemented vs. not implemented) and time (pre-vs. post-test) affected planning, coping self-efficacy, and preventive food-handling behaviour. Results: In Study 1, we found that the video increased knowledge and the perceived susceptibility of risk compared to the control video. We found no increase on the dependent variables after receiving the personalised risk message. In Study 2, goal setting significantly improved safe food-handling behaviour compared to the control condition. Moreover, participants in the goal-setting condition showed more planning of safe food-handling measures and of dealing with emerging barriers than participants in the control condition. Conclusions: These findings demonstrate that the delivery of an educational video on the spread of antimicrobial-resistant bacteria is a useful strategy to increase risk awareness, whereas goal setting presents a promising approach to improve foodhandling behaviour. Following the HAPA, an additional effective behaviour change technique is required that decreases negative outcome expectancies and improves coping self-efficacy, thereby further improving intention and behaviour.
antimicrobial-resistant (AMR) bacteria spread via food to humans and can seriously impair infection treatment. Hygienic food handling is an effective measure to avoid the transmission of bacteria. Therefore, we tested three types of interventions (tailored, generic, and no intervention) for their effectiveness in improving consumers’ hygienic food handling against the spread of antimicrobial-resistant bacteria through foods in a longitudinal randomized control trial. We based the determinants of hygienic food-handling behavior on the Health Action Process Approach (HAPA). The tailored intervention raised self-reported hygienic food handling, self-efficacy, and perceived likelihood of risk compared to no intervention. Moreover, interventions yielded different effects for participants with high vs. low intentions to improve their food-handling behavior. However, there were no differences between the tailored and generic interventions. More research is needed to find out whether including other behavior change techniques in the tailored intervention may increase the effect of tailoring.
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