title: Prevalence of Parental Misconceptions About Antibiotic Use.
abstract: BACKGROUND
  Differences in antibiotic knowledge and attitudes between parents of Medicaid-insured and commercially insured children have been previously reported. It is unknown whether understanding has improved and whether previously identified differences persist.
  
  
  METHODS
  A total of 1500 Massachusetts parents with a child <6 years old insured by a Medicaid managed care or commercial health plan were surveyed in spring 2013. We examined antibiotic-related knowledge and attitudes by using χ(2) tests. Multivariable modeling was used to assess current sociodemographic predictors of knowledge and evaluate changes in predictors from a similar survey in 2000.
  
  
  RESULTS
  Medicaid-insured parents in 2013 (n = 345) were younger, were less likely to be white, and had less education than those commercially insured (n = 353), P < .01. Fewer Medicaid-insured parents answered questions correctly except for one related to bronchitis, for which there was no difference (15% Medicaid vs 16% commercial, P < .66). More parents understood that green nasal discharge did not require antibiotics in 2013 compared with 2000, but this increase was smaller among Medicaid-insured (32% vs 22% P = .02) than commercially insured (49% vs 23%, P < .01) parents. Medicaid-insured parents were more likely to request unnecessary antibiotics in 2013 (P < .01). Multivariable models for predictors of knowledge or attitudes demonstrated complex relationships between insurance status and sociodemographic variables.
  
  
  CONCLUSIONS
  Misconceptions about antibiotic use persist and continue to be more prevalent among parents of Medicaid-insured children. Improvement in understanding has been more pronounced in more advantaged populations. Tailored efforts for socioeconomically disadvantaged populations remain warranted to decrease parental drivers of unnecessary antibiotic prescribing.
authors.affiliation: Division of Pediatric Infectious Diseases, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon; vaz@ohsu.edu.
authors.forename: Louise Elaine
authors.initials: LE
authors.lastname: Vaz
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts;
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Kleinman
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts;
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Lakoma
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts;
authors.forename: M Maya
authors.initials: MM
authors.lastname: Dutta-Linn
authors.affiliation: Johns Hopkins School of Nursing, Baltimore, Maryland;
authors.forename: Chelsea
authors.initials: C
authors.lastname: Nahill
authors.affiliation: Neighborhood Health Plan, Boston, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; and.
authors.forename: James
authors.initials: J
authors.lastname: Hellinger
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Finkelstein
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D014481:United States; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents