School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
School of Management, Hubei University of Chinese Medicine, Wuhan, Hubei, China.
BMC Public Health. 2023 Aug 31;23(1):1683. doi: 10.1186/s12889-023-16595-7.
This study aims to explore the impacts of knowledge and attitude on the behavior of antibiotic use during the treatment of the common cold based on the expanding KAP model, and then identify the critical behavioral stage.
A cross-sectional study was conducted on 815 public from 21 community health centers (CHCs) in Chongqing, China. Based on the expanding KAP model, a self-administered questionnaire was designed to measure knowledge, attitude, multi-stage behavior, and perceived threat, in which multi-stage behavior was divided into pre-use antibiotic behavior, during-use antibiotic behavior, and post-use antibiotic behavior. A structural equation model was used to examine the model fit and the direct, indirect, mediating effects, and moderating effect of the variables.
The expanding KAP showed good model fit indices with χ²/df = 0.537, RMSEA = 0.033, CFI = 0.973, GFI = 0.971, NFI = 0.934, TLI = 0.979. Knowledge had a positive effect on attitude (β = 0.503, p < 0.05), pre-use antibiotic behavior (β = 0.348, p < 0.05), during-use antibiotic behavior (β = 0.461, p < 0.001), and post-use antibiotic behavior (β = 0.547, p < 0.001). Attitude had a positive effect on during-use antibiotic behavior (β = 0.296, p < 0.001), and post-use antibiotic behavior (β = 0.747, p < 0.001). The mediating effect of attitude was positive among knowledge, during-use antibiotic behavior (β = 0.149, p < 0.05), and post-use antibiotic behavior (β = 0.376, p < 0.001). Perceived threat also had a positive moderating effect between knowledge and post-use antibiotic behavior (β = 0.021, p < 0.001).
Knowledge, attitude and perceived threat had different effects on different stages of antibiotic behavior. The critical behavioral stage prioritized the post-use antibiotic behavior and during-use antibiotic behavior over pre-use antibiotic behavior.
本研究旨在基于扩展 KAP 模型探讨知识和态度对普通感冒治疗中抗生素使用行为的影响，并确定关键行为阶段。
在中国重庆 21 个社区卫生服务中心（CHC）的 815 名公众中进行了一项横断面研究。基于扩展 KAP 模型，设计了一份自我管理问卷，以测量知识、态度、多阶段行为和感知威胁，其中多阶段行为分为使用前抗生素行为、使用中抗生素行为和使用后抗生素行为。使用结构方程模型检验模型拟合度以及变量的直接、间接、中介和调节效应。
扩展 KAP 显示出良好的模型拟合指数，χ²/df=0.537、RMSEA=0.033、CFI=0.973、GFI=0.971、NFI=0.934、TLI=0.979。知识对态度（β=0.503，p<0.05）、使用前抗生素行为（β=0.348，p<0.05）、使用中抗生素行为（β=0.461，p<0.001）和使用后抗生素行为（β=0.547，p<0.001）有正向影响。态度对使用中抗生素行为（β=0.296，p<0.001）和使用后抗生素行为（β=0.747，p<0.001）有正向影响。态度在知识、使用中抗生素行为（β=0.149，p<0.05）和使用后抗生素行为（β=0.376，p<0.001）之间的中介效应为正。感知威胁也对知识和使用后抗生素行为之间有正向调节作用（β=0.021，p<0.001）。
知识、态度和感知威胁对不同阶段的抗生素行为有不同的影响。关键行为阶段优先考虑使用后抗生素行为和使用中抗生素行为，而非使用前抗生素行为。
