2022, Visschers, Vivianne, Feck, Vanessa, Herrmann, Anne

People should use antibiotics (AB) prudently to mitigate antibiotic resistance (ABR). Previous studies—and, subsequently, interventions—on ABR have focused mainly on improving public awareness and knowledge. We investigated a comprehensive theory-based explanatory model to understand the public's decision making regarding prudent AB use, based on, among others, the theory of planned behavior. In a cross-sectional online survey, the psychological determinants of people's decisions about prudent AB use were examined in a sample of 1,228 Swiss adults. The questionnaire assessed respondents’ demand for AB, willingness to adopt measures that prevent the need for AB, perceived risks of ABR, perceived benefits of AB, attitudes and social influences regarding AB, knowledge of AB and ABR, and cultural values. Mokken scale analysis revealed three types of knowledge: knowledge of the functioning of AB, of ABR, and of preventive measures. Structural equation modeling indicated that respondents’ demand for AB was mostly predicted by social influences, perceived benefits of AB, and knowledge of AB functioning. Willingness to prevent AB use was mainly related to conservative values, perceived risks of ABR, negative attitudes toward AB, and knowledge of preventive measures. Our study suggests that the provision of information about AB and preventive measures is a first step toward changing people's decisions related to prudent AB use. Future interventions that additionally utilize cultural values to convey important messages and target additional factors, such as social influences, the risks of ABR, and the benefits of cautious AB use, can be more successful in promoting prudent AB use.

2021, Freivogel, Claudia, Visschers, Vivianne

Objectives We aimed to identify the potential of behaviour change strategies to effectively increase consumers? risk awareness, behavioural intention, and preventive food-handling behaviour to reduce the transmission risk of antimicrobial-resistant bacteria through food. The applied strategies targeted knowledge and determinants of the health action process approach (HAPA). We tested techniques that are expected to increase knowledge, risk perception, and positive outcome expectancy (Study 1) as well as those that increase planning and coping self-efficacy (Study 2) in two randomised control trials.Methods In Study 1 (N?=?328), a 2x2 between-subject design was employed to investigate the effects of an educational video about the spread of antimicrobial-resistant bacteria and a personalised risk message on knowledge, risk perception, outcome expectancy and consequently on intention regarding safe food-handling behaviour. In Study 2 (N=129), we used a 2x2 design to examine to what extent goal setting (implemented vs. not implemented) and time (pre- vs. post-test) affected planning, coping self-efficacy, and preventive food-handling behaviour.Results In Study 1, we found that the video increased knowledge and the perceived susceptibility of risk compared to the control video. We found no increase on the dependent variables after receiving the personalised risk message. In Study 2, goal setting significantly improved safe food-handling behaviour compared to the control condition. Moreover, participants in the goal-setting condition showed more planning of safe food-handling measures and of dealing with emerging barriers than participants in the control condition.Conclusions These findings demonstrate that the delivery of an educational video on the spread of antimicrobial-resistant bacteria is a useful strategy to increase risk awareness, whereas goal setting presents a promising approach to improve food-handling behaviour. Following the HAPA, an additional effective behaviour change technique is required that decreases negative outcome expectancies and improves coping self-efficacy, thereby further improving intention and behaviour.

2020-04-08, Freivogel, Claudia, Visschers, Vivianne

In this study, we aimed to explore the psychosocial factors related to consumers’ safe food-handling behaviors to reduce the transmission risk of antimicrobial-resistant bacteria through food products. To this end, we investigated the extent to which the variables of the health action process approach (HAPA) and subjective norms can predict safe food handling by consumers. Data were collected from a representative sample of consumers belonging to the German-speaking part of Switzerland by administering a self-reporting questionnaire. The results showed that risk perception, self-efficacy, and positive outcome expectancy (i.e., the motivational phase of HAPA) were significant predictors of the intentions to handle food in a safe manner (see graphical abstract below). Additionally, in the volitional phase of HAPA, intention was found to be a significant predictor of safe food-handling behaviors. Contrary to expectations based on HAPA, action planning did not mediate the intention–behavior relationship. Only a small part of the variance in behavior was explained by coping planning and action control. The findings confirmed that the motivational phase of HAPA may be useful for determining safe food handling.

2020, Freivogel, Claudia, Visschers, Vivianne

Erklärungsvideo für Konsument*Innen über die Verbreitung antimikrobieller Resiztenzen durch den Kontakt mit Lebensmitteln und Haustieren. Das Video zeigt welche Massnahmen ergriffen werden können, um die Übertragung resistenter Keimen zu reduzieren. Das Video wurde zusammen mit Pascale Küng, Claudia Wirth, Vanessa Feck und Stefan Holaus entwickelt. Educational video for consumers about the transmission of antimicrobial-resistant bacteria through food handling and pet care. The video explains behavioral measures that prevent the spread of resistant bacteria. The video was developed together with Pascale Küng, Claudia Wirth, Vanessa Feck and Stefan Holaus.

2021-05-27, Visschers, Vivianne, Freivogel, Claudia, Lechner, Isabel, Schuppers, Manon

2021, Özçelik, Ranya, Remy-Wohlfender, Franziska, Küker, Susanne, Visschers, Vivianne, Hadorn, Daniela, Dürr, Salome

Animal owners' potential to observe and report clinical signs, as the persons with the closest contact to their animals, is an often neglected source of information in surveillance. Allowing community members other than health care professionals, such as animal owners, to report health events can contribute to close current surveillance gaps and enhance early detection. In the present study, we tested a community-based surveillance (CBS) approach in the equine community in Switzerland. We aimed at revealing the attitudes and intentions of equine owners toward reporting clinical signs by making use of an online questionnaire. We further set up and operated an online CBS tool, named Equi-Commun. Finally, we investigated potential reasons for the lack of its use by applying qualitative telephone interviews. The majority of the respondents of the online questionnaire (65.5%, 707/1,078) answered that they could see themselves reporting clinical observations of their equine. The multivariate logistic regression analysis indicated that French-speaking equine owners and those belonging to the positive attitude cluster are more likely to report to a CBS tool. Equi-Commun operated between October 2018 and December 2019 yet received only four reports. With the addition of qualitative interviews, we identified three critical, interlinked issues that may have led to the non-use of Equi-Commun within the Swiss equine community: (1) for successfully implementing CBS, the need for surveillance within the community of interest must be given; (2) the respective population under surveillance, here the equine, needs to show enough clinical cases for owners to be able to maintain the memory of an existing tool and its possible use; and (3) targeted and high effort communication of the system is key for its success. While CBS relying only on lay animal owners, complementary to existing surveillance systems, could potentially provide a good proxy of timely surveillance data, it is questionable whether the added value of generated surveillance knowledge is in balance with efforts necessary to implement a successful system. With this study, we showcased both the potential and challenges of CBS in animal health, as this may be of relevance and guidance for future initiatives.

2020, Laubereau, Birgit, Meyer, Lea, Kaufmann, Cornel, Visschers, Vivianne, Feck, Vanessa, Schaffner, Dorothea

Die seit 2016 umgesetzte Strategie Antibiotikaresistenzen (StAR) sieht in den Bereichen Mensch (StAR-M) und Tier (StAR-T) unter anderem vor, dass die Zielgruppen (d.h. Patienten/-innen, Kundschaft in Apotheken und Tierhalter/-innen) sensibilisiert und ihr Wissensstand erhöht werden soll. Zu diesem Zweck wurden unter Federführung des Bundesamts für Gesundheit (BAG) und des Bundesamts für Lebensmittelsicherheit und Veterinärwesen (BLV) zusammen mit Vertretern/-innen der Fachverbände verschiedene Informationsprodukte in den Bereichen Mensch («Antibiotika richtig einsetzen») und Tier («Antibiotika retten Leben – sind aber nicht immer nötig») entwickelt. Mittels einer Evaluation wird in den Bereichen Mensch und Tier die Verbreitung, die Akzeptanz sowie den Einsatz der Informationsprodukte durch die Mittler in den Arztpraxen (Grundversorger, Zahnärzte/-innen, Tierärzte/-innen) und Apotheken beurteilt. Zudem wird die Qualität im Sinne von Nutzerfreundlichkeit untersucht. Aufbauend auf den Ergebnissen werden realistische Empfehlungen zuhanden des BAG und des BLV formuliert als Grundlage für den Entscheid, welche Produkte weiterhin genutzt und verbreitet werden sollen und wie diese gegebenenfalls optimiert werden können.

2021-04, Visschers, Vivianne, Freivogel, Claudia, Lehmann, Sarah Heather, Lechner, Isabel

Konsumentinnen und Konsumenten sind über den Kontakt mit Tieren antimikrobiell resistenten Bakterien ausgesetzt (z. B. über den Lebensmittelkonsum und die Pflege von Haustieren). Es ist bisher unzureichend klar, welche Übertragungswege für Konsumentinnen und Konsumenten gefährlich sind und wie deren Umgang mit diesen Übertragungswegen verbessert werden kann. Es werden erprobte Interventionsstrategien benötigt, welche die Konsumentinnen und Konsumenten zu einem sicheren Umgang mit Tieren und Lebensmitteln, hinsichtlich der Übertragung resistenter Bakterien, bewegen. Der vorliegende Bericht ist das Ergebnis eines dreijährigen Forschungsprojekts. In welchem Interventionsstrategien entwickelt und getestet wurden, die Konsumentinnen und Konsumenten für einen sicheren Umgang mit Tieren und Lebensmitteln sensibilisieren und sie motivieren diese umzusetzen. Hierzu wurde aufgrund von Expertenmeinungen zunächst eine Risikokarte der Übertragungswege resistenter Bakterien in der Schweizer Lebensmittelkette und durch den Kontakt mit Haus- und Nutztieren erstellt. Anschliessend erhoben wir in Interviews, wie Konsumentinnen und Konsumenten, Tierärztinnen und -ärzte und Landwirtinnen und -wirte die jeweiligen Risiken wahrnehmen. Auf diese Weise wurden mögliche Anhaltspunkte für eine Intervention bei Konsumentinnen und Konsumenten identifiziert. Letztlich untersuchten wir, inwiefern verschiedene Interventionsstrategien Konsumentinnen und Konsumenten in ihrem Umgang hinsichtlich Lebensmittel beeinflussen. Es zeigte sich, dass eine Intervention, welche massgeschneiderte Strategien für den sicheren Umgang mit Lebensmitteln bietet, gleich gut funktioniert als eine allgemeine Intervention, die für alle Konsumentinnen und Konsumenten gleich ist. Dennoch ist eine massgeschneiderte Intervention imstande die Bereitschaft und Selbstwirksamkeit für den sicheren Umgang mit Lebensmitteln bei niedrig motivierten Personen zu verbessern. Die Erkenntnisse dieses Forschungsprojekts liefern eine Grundlage, um die Übertragungsrisiken resistenter Bakterien zwischen Tieren und Menschen zu bewerten. Darüber hinaus zeigen sie Entscheidungsträgern Interventionsstrategien (z. B. Erklärvideo, Zielsetzung), die wirksam und praktisch umsetzbar sind.

2020-12, Visschers, Vivianne, Freivogel, Claudia

Zusammenfassung der Aktivitäten und des Outputs des dritten Projektjahres.

2020, Lechner, Isabel, Freivogel, Claudia, Stärk, Katharina D. C., Visschers, Vivianne

Antimicrobial resistance (AMR) is an emerging global health concern, affecting both the animal and the human population. Transmission pathways of AMR are therefore abundant and complex, and ways to prevent or reduce transmission to consumers must be identified. The overall goal of this study was to define the content of an intervention study aimed at reducing the transmission of AMR from animal sources to humans. To identify the most relevant pathways, Swiss experts and consumers were interviewed about their opinions on the risks of transmission of AMR. Opinions of experts and consumers were then qualitatively compared and the main gaps identified. The results revealed that Swiss consumers had several misconceptions regarding the sources and transmission of AMR, and that they in particular underestimated the importance of poultry meat and pets as a potential source of AMR. Furthermore, high uncertainty was noted in experts regarding the prevalence of AMR in pets and the potential of transmission to their owners. Consequently, awareness of AMR transmission pathways should be increased among consumers to overcome common misconceptions, which will help reduce the risk of transmission. Further research is needed to better understand the pets' potential to harbor and transmit AMR to their owners, and to identify most effective methods to increase risk awareness in consumers as well as intervention strategies promoting consumer behaviors to mitigate AMR transmissions at the human-animal interface.