title: Investigating approaches to improving appropriate antibiotic use among higher risk ethnic groups.
abstract: A field study with follow up investigations sought to: 1. determine whether cold packs (over-the-counter symptomtic treatments), coupled with in-office education, improve antibiotic-related knowledge, attitudes and behaviors more than in-office education alone in patient populations with high percentages of Asian Americans and Hawaiian/Pacific Islanders; 2. identify possible reasons for intervention outcomes as described by physicians who participated in the field study; and 3. explore potential future directions based on a large sample survey of physicians in the field study's highly ethnic county. The intervention resulted in a pre- to post-consultation decrease in perceived need for and an increase in knowledge about antibiotic risks but had no impact on frequency of reported receipt of an antibiotic prescription. Unexpectedly, in-office education alone was more effective in increasing knowledge than in-office education plus the cold pack. In-depth interviews of field study physicians and a large scale physician survey suggest that cold pack interventions targeting patient populations with high percentages of Asian Americans and Hawaiian/Pacific Islanders may be more likely to succeed if accompanied by mass public education regarding risks and physician training regarding effective ways to talk to patients. Use of in-office education with cold packs alone may not achieve desired results.
authors.affiliation: University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA. dalden@hawaii.edu
authors.forename: Dana L
authors.initials: DL
authors.lastname: Alden
authors.forename: Alan D
authors.initials: AD
authors.lastname: Tice
authors.forename: John T
authors.initials: JT
authors.lastname: Berthiaume
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001213:Asian; D001291:Attitude of Health Personnel; D001424:Bacterial Infections / Q000188:drug therapy* / Q000208:ethnology; D002983:Clinical Competence; D006254:Hawaii; D006801:Humans; D044468:Native Hawaiian or Pacific Islander; D010818:Practice Patterns, Physicians'; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents