Addressing related but competing risks: Effectiveness of an antibiotic stewardship intervention during COVID-19

Previous research on risk information behaviors has primarily focused on responses to a single target risk, without considering how related risks might influence information behaviors regarding the target risk. Guided by the Risk Information Seeking and Processing (RISP) model and drawing on theory and research taking a social context approach to risk communication, we developed a video-based intervention for promoting favorable antibiotic risk information behaviors that targets key predictors-including perceived risk, information insufficiency, and perceived information gathering capacity (PIGC)-theorized in RISP and addresses COVID-19 as a related risk factor. Experimentally testing the effectiveness of this video against a previously developed video that did not reference COVID-19 and a control group with no video exposure, we found that both videos increased perceived risk from antibiotics and PIGC. Relative to the original video, the extended, COVID-contextualized video led to greater knowledge about the ineffectiveness and harm of taking antibiotics for COVID-19. Results from structural equation modeling showed that knowledge about the ineffectiveness directly decreased information-avoidance intention. Knowledge about the harm, on the other hand, indirectly increased information seeking and reduced avoidance intention by heightening perceived risk, which led to negative affect and, in turn, elevated information insufficiency. In addition, information-seeking intention increased with greater PIGC. These relationships further varied by fear of COVID-19, with antibiotic risk information behaviors among high-fear individuals being more strongly influenced by COVID-related judgments than those with low fear. Implications of the findings for message designs in multirisk situations are discussed.