Leveraging Communication to Combat Antibiotic Resistance: A Longitudinal Test of a Video-Based Intervention to...

Background: Antibiotic resistance is a pressing public health concern, exacerbated by the prescribing of antibiotics in primary care settings when they are not clinically indicated. Research shows that providers often feel pressured to prescribe antibiotics in response to patients' expectations. To address this challenge, we developed a theory-informed video intervention to enhance antibiotic stewardship communication skills among current and future primary care providers, with emphasis on college health settings. The intervention consisted of five videos targeting core skills: explaining diagnosis and treatment, discussing antibiotic risks, advising on symptom management, offering patient support, and navigating visits with emerging adults. Program effectiveness was assessed immediately and three months post-intervention. Methods: Providers and medical students (N = 135) completed a three-wave study. At baseline, they reported demographics, perceived importance of the five skill sets, as well as self-efficacy, and completed closed- and open-ended skill assessment. Two weeks later, participants viewed the intervention videos, reassessed their skills, and rated their motivation to improve. Three months after video exposure, they completed the same skill assessments. Results: Participants showed improvements in all communication skills immediately post-intervention, except for supporting patients. While some skills showed sustained improvements at three months, the overall long-term effects were less pronounced. Perceived skill importance, baseline self-efficacy, and post-intervention motivation moderated these effects. Conclusions: A brief video-based intervention effectively enhanced current and future providers' antibiotic stewardship communication skills. Sustaining these gains, however, requires ongoing reinforcement. Notably, the intervention was especially beneficial for those with low motivation and self-efficacy, key targets for such programs.