Advancing health risk Literacy about Antimicrobial Resistance through the use of Metaphors (ALARM): An international comparative study

研究背景迫切需要社会科学方法来改进风险传播材料，提高对全球健康威胁的认识。风险沟通的一个重要背景是抗菌素耐药性的“无声大流行”。这指的是细菌等细菌，它们已经发展出更强大的基因，这意味着它们不再对抗生素等现有药物产生反应。抗菌素耐药性可能导致耐药感染，这是目前的药物无法治愈的疾病。耐药感染的增加是一个范围类似于气候变化的问题。据预测，到2050年，每年将有1000万人死于癌症--比所有类型癌症的总和还要多。所有抗生素的使用都会导致抗菌素耐药性的产生。换句话说，我们每次使用抗生素，它们就会失去一些治疗未来感染的有效性。为了保护现有的抗生素并确保它们更长时间地发挥作用，需要公众的共同努力。我们必须在不必要的时候减少抗生素的使用。不幸的是，许多公众对抗生素的作用方式知之甚少。他们也经常没有意识到与过度使用抗生素相关的风险。这种知识的缺乏可能导致他们无视医生的建议或从事不适当的行为，如囤积抗生素。目的和目标本项目旨在开发新的科学方法，以便有效地进行风险沟通。它将在抗菌素耐药性的背景下测试这些方法，并解决公众对抗生素使用的误解。该项目跨越两个不同的医疗保健背景--英国和南非--以获得国际洞察力，并比较疾病负担不同的国家。目标是开发新的全球信息材料，从根本上改变公众对抗菌素耐药性的看法。关于如何有效沟通风险的心理学知识是我们研究的基础。具体地说，我们侧重于隐喻的交流工具，即将诸如抗菌素耐药性等抽象概念与更好地了解和理解的其他主题进行比较的修辞手法。我们与来自英国、南非和国际上的医生、患者、医疗保健专家和创意写作促进者密切合作，旨在开发一套新的隐喻，向几乎没有医学知识的观众传达有关抗生素的信息。我们将在大型的跨文化实验中测试这些隐喻，这些实验将涉及向来自英国和南非的参与者展示新的隐喻，并检查它们是否提高了人们对抗生素耐药性的知识。潜在的应用和好处主要项目成果将是一套精心设计、试验和测试的隐喻，可供各国政府、卫生组织、慈善机构、媒体和医生使用，以提高对抗菌素耐药性的认识，告知患者抗生素是如何起作用的，并改变我们使用抗生素的方式。大量的利益相关者将从该项目中受益。卫生传播者将收到改进的公共卫生信息内容。医生在与患者进行咨询时将受益于更高效的沟通工具。公众将增加健康知识，并在用药方面做出更好的选择。所有这些都将有助于减少抗生素的过度使用，保存有效的药物，并与抗菌素耐药性作斗争。因此，该项目很可能造福于整个社会和未来几代患者。最后，尽管该项目侧重于关于抗菌素耐药性的传播，但新开发的隐喻设计的见解和方法将适用于许多其他风险传播领域，并可能有助于改变其他关于流行病或气候变化的信息运动。

Research contextThere is an urgent need for social science methods to improve risk communication materials and raise awareness about global health threats. An important context for risk communication is the 'silent pandemic' of antimicrobial resistance. This refers to germs such as bacteria, which have developed stronger genes that mean they no longer respond to existing drugs such as antibiotics. Antimicrobial resistance can result in drug-resistant infections, which are illnesses that cannot be cured with current medication. The rise of drug-resistant infections is a problem with a scope similar to climate change. It is predicted to cause 10 million annual deaths by 2050-more than all types of cancer combined. All use of antibiotics contributes to the development of antimicrobial resistance. In other words, each time we use antibiotics, they lose some of their effectiveness for treating future infections. To conserve existing antibiotics and ensure they keep working for longer, a united public effort is needed. We must reduce the use of antibiotics when they are not necessary. Unfortunately, many members of the public know little about the way antibiotics work. They are also often unaware of the risks associated with antibiotic overuse. This lack of knowledge may lead them to disregard doctors' advice or engage in inappropriate behaviours such as hoarding of antibiotics.Aims and objectivesThis project aims to develop new scientific methods for effective risk communication. It will test these methods in the context of antimicrobial resistance and address public misunderstandings about antibiotic use. The project spans two different healthcare contexts-the UK and South Africa-to gain international insights and compare countries with different disease burdens. The goal is to develop new, global information materials that radically change the way the public think about antimicrobial resistance. Psychological knowledge on how to communicate risks efficiently is the foundation of our research. Specifically, we focus on the communication tool of metaphors, i.e. figures of speech that compare abstract concepts such as antimicrobial resistance to other topics that are better known and understood. Working closely with doctors, patients, healthcare experts and creative writing facilitators from the UK, South Africa and internationally, we aim to develop a set of new metaphors that communicate information about antibiotics to audiences with little medical knowledge. We will test these metaphors in large, cross-cultural experiments, which will involve presenting participants from the UK and South Africa with the new metaphors and checking if they improve people's knowledge about antimicrobial resistance. Potential applications and benefitsThe main project outcome will be a carefully designed, tried and tested set of metaphors that can be used by governments, health organisations, charities, media and doctors internationally to raise awareness about antimicrobial resistance, inform patients how antibiotics work, and change the way we use antibiotics. A large range of stakeholders will benefit from the project. Health communicators will receive improved contents for their public health messages. Doctors will benefit from more efficient communication tools in their consultations with patients. The public will increase its health knowledge and make better choices relating to medication. All of this will help to reduce overuse of antibiotics, conserve effective drugs, and fight antimicrobial resistance. The project is therefore likely to benefit overall society and future generations of patients. Finally, even though this project focuses on communication about antimicrobial resistance, the newly developed insights and methods for metaphor design will be applicable to many other areas of risk communication and could help to transform other information campaigns about pandemics or climate change.