Precise Persuasion: Investigating Incentive Appeals for the Promotion of Antibiotic Stewardship with Message-induced Transitions

Abstract

Two different lines of research-interpersonal resistance and public campaign design-lead us to consider the use of incentive appeals to motivate behavior change, with a call for greater attention to and use of positive incentives. This study tests the potential to promote antibiotic stewardship through microbiome benefits. In addition, multiple analyses were used: A causal analysis allowed us to identify what moved (e.g., which beliefs and intentions), a latent transition analysis allowed us to reveal who moved (targets, nontargets, or both), and a Markov model allowed us to estimate the stable state of these moves or, in other words, where and how the repetition of the messages would ultimately lead in terms of transitions from state to state. An experiment (N = 298), grounded in the context of antibiotic stewardship, showed that incentive appeals moved people with problematic patterns of past behavior (categorized as Persuaders, Stockers, and Dissenters) to positive patterns of behavioral intentions (categorized as Stewards). The causal analysis, latent class analysis, and equilibrium values for the separate transition matrices showed the relative benefit for a message that highlighted the health and wellness benefits of the microbiome. Implications for persuasion theory and practice are discussed.

Health Care Workers Online YouTube Content Compared to AUA Prevention of Recurrent Urinary Tract Infections in Women Guidelines: An Integrative Review of Quality and Comprehensiveness Analysis

“…17 Messaging on the topic of antibiotic use has been studied in the setting of UTI indicating that providing information about the microbiome is useful in antibiotic stewardship. 18 Accordingly, educational content on UTI should dedicate time to these topics.…”

“…estrogen as UTI prophylaxis in peri-/postmenopausal women with rUTI 6(13) Increase water/fluid intake in those consuming less than 1.5 L/d25 (56)Stop the use of spermicidal products, barrier contraceptives, or hormone-based IUD 8(18) …”

The public’s antibiotic use behavioural patterns and their determinants for upper respiratory tract infections: a latent class analysis based on consumer behaviour model in China

“…However, enhancing knowledge and attitude alone did not necessarily result in a reduction of irrational antibiotic use (25,26). On the other hand, several studies have explored people's different behavioural patterns of antibiotic use based on qualitative design (20,27) or by analysing several antibiotic use behaviours (19,21,28,29). This resulted in mixed findings due to the differences in research outcomes, settings, and populations (30).…”

“…Furthermore, these studies have often failed to establish connections with potential influencing factors, the underlying factors that can impact the individuals to form a specific antibiotic use behavioural pattern. Some studies have tried to link behavioural patterns with some influencing factors, such as perceived severity of having an antibiotic resistant infection (19, 21) and the perceived efficacy of antibiotics to treat non-bacterial illness (19,21,28). However, this still leaves the underlying causes of the diverse antibiotic use behaviours unclear.…”