Efficacy of priming and commitment posters on urgent care patients' antibiotic expectations and knowledge: a cluster randomized trial.

Michael J Cziner, Daniel E Park, Rana F Hamdy, Laura Rogers, Monique M Turner, Cindy M Liu
Author Information
  1. Michael J Cziner: Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. ORCID
  2. Daniel E Park: Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. ORCID
  3. Rana F Hamdy: Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
  4. Laura Rogers: Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. ORCID
  5. Monique M Turner: Department of Communication, Michigan State University, East Lansing, MI, USA. ORCID
  6. Cindy M Liu: Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. ORCID

Abstract

Objective: Successfully educating urgent care patients on appropriate use and risks of antibiotics can be challenging. We assessed the conscious and subconscious impact various educational materials (informational handout, priming poster, and commitment poster) had on urgent care patients' knowledge and expectations regarding antibiotics.
Design: Stratified Block Randomized Control Trial.
Setting: Urgent care centers (UCCs) in Colorado, Florida, Georgia, and New Jersey.
Participants: Urgent care patients.
Methods: We randomized 29 UCCs across six study arms to display specific educational materials (informational handout, priming poster, and commitment poster). The primary intention-to-treat (ITT) analysis evaluated whether the materials impacted patient knowledge or expectations of antibiotic prescribing by assigned study arm. The secondary as-treated analysis evaluated the same outcome comparing patients who recalled seeing the assigned educational material and patients who either did not recall seeing an assigned material or were in the control arm.
Results: Twenty-seven centers returned 2,919 questionnaires across six study arms. Only 27.2% of participants in the intervention arms recalled seeing any educational materials. In our primary ITT analysis, no difference in knowledge or expectations of antibiotic prescribing was noted between groups. However, in the as-treated analysis, the handout and commitment poster were associated with higher antibiotic knowledge scores.
Conclusions: Educational materials in UCCs are associated with increased antibiotic-related knowledge among patients when they are seen and recalled; however, most patients do not recall passively displayed materials. More emphasis should be placed on creating and drawing attention to memorable patient educational materials.

References

  1. Health Psychol. 2017 Apr;36(4):402-409 [PMID: 28206788]
  2. Cochrane Database Syst Rev. 2016 Nov 25;11:CD011360 [PMID: 27886368]
  3. Fam Pract. 2020 Mar 25;37(2):276-282 [PMID: 31690948]
  4. JAMA Intern Med. 2014 Mar;174(3):425-31 [PMID: 24474434]
  5. Pediatrics. 1999 Apr;103(4 Pt 1):711-8 [PMID: 10103291]
  6. J Antimicrob Chemother. 2010 Jul;65(7):1526-33 [PMID: 20488985]
  7. Int J Epidemiol. 2018 Feb 1;47(1):321-331 [PMID: 29025158]
  8. Fam Pract. 2022 Jan 19;39(1):1-5 [PMID: 34173645]
  9. Pharmacotherapy. 2020 Oct;40(10):1012-1021 [PMID: 32867003]
  10. Zhong Xi Yi Jie He Xue Bao. 2010 Jul;8(7):604-12 [PMID: 20619135]
  11. J Healthc Qual. 2019 May/Jun;41(3):e13-e20 [PMID: 31094953]
  12. Eur J Clin Microbiol Infect Dis. 2019 Aug;38(8):1463-1469 [PMID: 31102079]
  13. Lancet. 2022 Feb 12;399(10325):629-655 [PMID: 35065702]
  14. Br J Psychol. 2021 Aug;112(3):804-827 [PMID: 33543779]
  15. J Telemed Telecare. 2024 Jan 18;:1357633X231221586 [PMID: 38239048]
  16. Infect Control Hosp Epidemiol. 2023 May;44(5):736-745 [PMID: 35822429]
  17. Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S69-78 [PMID: 25222901]
  18. JAMA. 2016 May 3;315(17):1864-73 [PMID: 27139059]
  19. JAMA Netw Open. 2022 May 2;5(5):e2214153 [PMID: 35616940]
  20. Jt Comm J Qual Patient Saf. 2020 Dec;46(12):682-690 [PMID: 32994132]
  21. Antibiotics (Basel). 2022 Dec 28;12(1): [PMID: 36671252]

Word Cloud

Created with Highcharts 10.0.0materialspatientscareeducationalposterknowledgecommitmentexpectationsanalysisantibioticurgenthandoutprimingUCCsstudyarmsassignedrecalledseeingantibioticsinformationalpatients'UrgentcentersrandomizedacrosssixprimaryITTevaluatedpatientprescribingarmas-treatedmaterialrecallassociatedObjective:SuccessfullyeducatingappropriateuseriskscanchallengingassessedconscioussubconsciousimpactvariousregardingDesign:StratifiedBlockRandomizedControlTrialSetting:ColoradoFloridaGeorgiaNewJerseyParticipants:Methods:29displayspecificintention-to-treatwhetherimpactedsecondaryoutcomecomparingeithercontrolResults:Twenty-sevenreturned2919questionnaires272%participantsinterventiondifferencenotedgroupsHoweverhigherscoresConclusions:Educationalincreasedantibiotic-relatedamongseenhoweverpassivelydisplayedemphasisplacedcreatingdrawingattentionmemorableEfficacypostersknowledge:clustertrial

Similar Articles

Cited By