Kawamura Hitomi, Sakurai Hidehiko, Sakamoto Takuya, Arai Hiroto, Naoi Kazuyuki, Tsukui Rie, Iwamoto Sanju, Aizawa Madoka, Kishimoto Keiko
Department of Social Pharmacy, Graduate School of Pharmacy, Showa Medical University, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8555, Japan.
Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 15-4-1, Maeda 7-Jo, Teine-Ku, Sapporo-Shi, Hokkaido, 006-8585, Japan.
BMC Public Health. 2025 Jul 3;25(1):2360. doi: 10.1186/s12889-025-23577-4.
Appropriate antimicrobial use should be encouraged among parents to prevent the increase in antimicrobial resistance. In Japan, antibiotics are widely used in paediatrics. This study aimed to create educational animations to educate parents on the appropriate use of antibiotics and to examine the effects of different animation scenarios using message framing on the intention to use antibiotics appropriately (hereinafter referred to as 'intention').
In this intervention study, three educational animations were created: Animation A with a general message for Group A, Animation B with a gain-framing message for Group B, and Animation C with a loss-framing message for Group C. A questionnaire survey was conducted for parents of children who visited a medical facility before and after watching one of the animations. The primary questions focused on the intention to use antimicrobials appropriately and the assessment items based on the PMT that influence this intention (severity, vulnerability, response efficacy, self-efficacy, intrinsic rewards, and response costs).
Responses were obtained from 27, 29, and 31 participants in groups A, B, and C, respectively. Intention scores increased significantly in groups A (p = 0.001) and C (p < 0.001), whereas no significant difference was observed in group B (p = 0.237). Effect sizes were large in groups A (r = 0.62) and C (r = 0.64) and small in group B (r = 0.22). Regarding the PMT assessment items, severity significantly increased in groups A (p < 0.001) and C (p = 0.001), whereas no significant difference was observed in group B (p = 0.589). Effect sizes were large in groups A (r = 0.76) and C (r = 0.60).
The addition of loss-framing messages to general knowledge was found to be more effective than that of gain-framing messages in improving intention. Positive expressions might reduce awareness of the severity of the risk of antimicrobial resistance and not improve intention. The use of loss-framing animation may be an effective tool for educating parents on the appropriate use of antibiotics.
Japan Registry of Clinical Trials (Registration number: jRCT1030210605; Registration date: 10 February 2022).
应鼓励家长合理使用抗菌药物，以防止抗菌药物耐药性增加。在日本，抗生素在儿科中广泛使用。本研究旨在制作教育动画，以教育家长合理使用抗生素，并研究使用信息框架的不同动画场景对合理使用抗生素意愿（以下简称“意愿”）的影响。
在这项干预研究中，制作了三部教育动画：动画A向A组传达一般信息，动画B向B组传达获益框架信息，动画C向C组传达损失框架信息。对观看其中一部动画前后到医疗机构就诊的儿童的家长进行问卷调查。主要问题集中在合理使用抗菌药物的意愿以及基于预防动机理论（PMT）影响该意愿的评估项目（严重性、易感性、反应效能、自我效能、内在奖励和反应成本）。
A、B、C组分别有27、29和31名参与者给出了回复。A组（p = 0.001）和C组（p < 0.001）的意愿得分显著提高，而B组未观察到显著差异（p = 0.237）。A组（r = 0.62）和C组（r = 0.64）的效应量较大，B组（r = 0.22）的效应量较小。关于PMT评估项目，A组（p < 0.001）和C组（p = 0.001）的严重性显著增加，而B组未观察到显著差异（p = 0.589）。A组（r = 0.76）和C组（r = 0.60）的效应量较大。
在一般知识中添加损失框架信息在提高意愿方面比获益框架信息更有效。积极的表达可能会降低对抗菌药物耐药性风险严重性的认识，并且不会提高意愿。使用损失框架动画可能是教育家长合理使用抗生素的有效工具。
日本临床试验注册中心（注册号：jRCT1030210605；注册日期：2022年2月10日）。
