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      ‘I don’t know if we can really, really change that’: a qualitative exploration of public perception towards antibiotic resistance in France

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          Abstract

          Background

          Since the 2000s, French authorities have put in place various national plans to make the general public aware of antibiotic stewardship. Twenty years later, France is still one of the countries with the highest use of antibiotics in Europe.

          Objectives

          Our study explored the general public’s perceptions of antibiotic resistance, their behaviour around antibiotic use and their expectations regarding awareness campaigns.

          Methods

          A qualitative study was performed from March 2018 to March 2019 in a French region using focus groups. Two types of public were targeted: parents of young children and retired people. The interview guide contained open-ended questions organized around three main themes: perceptions of antibiotic resistance; experience and use of antibiotics; and health information and campaigns.

          Results

          Nine focus groups were created, including 17 parents and 19 retirees. Participants did not link antibiotic overuse and antibiotic resistance. Antibiotic resistance was not perceived as a personal responsibility but as a suffered phenomenon on which the participants could not act. The blame was particularly put on the presence of antibiotics in the environment. Although participants expressed trust in their GPs, antibiotics remained perceived as the only solution for them to be cured quickly.

          Conclusions

          The study highlighted that the GPs were the preferred information source regarding the use of antibiotics. Actions targeting the public and health professionals will have little impact if, at the same time, efforts on work environment representation are not undertaken.

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          Most cited references36

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey

            Background Public trust in immunization is an increasingly important global health issue. Losses in confidence in vaccines and immunization programmes can lead to vaccine reluctance and refusal, risking disease outbreaks and challenging immunization goals in high- and low-income settings. National and international immunization stakeholders have called for better monitoring of vaccine confidence to identify emerging concerns before they evolve into vaccine confidence crises. Methods We perform a large-scale, data-driven study on worldwide attitudes to immunizations. This survey – which we believe represents the largest survey on confidence in immunization to date – examines perceptions of vaccine importance, safety, effectiveness, and religious compatibility among 65,819 individuals across 67 countries. Hierarchical models are employed to probe relationships between individual- and country-level socio-economic factors and vaccine attitudes obtained through the four-question, Likert-scale survey. Findings Overall sentiment towards vaccinations is positive across all 67 countries, however there is wide variability between countries and across world regions. Vaccine-safety related sentiment is particularly negative in the European region, which has seven of the ten least confident countries, with 41% of respondents in France and 36% of respondents in Bosnia & Herzegovina reporting that they disagree that vaccines are safe (compared to a global average of 13%). The oldest age group (65+) and Roman Catholics (amongst all faiths surveyed) are associated with positive views on vaccine sentiment, while the Western Pacific region reported the highest level of religious incompatibility with vaccines. Countries with high levels of schooling and good access to health services are associated with lower rates of positive sentiment, pointing to an emerging inverse relationship between vaccine sentiments and socio-economic status. Conclusions Regular monitoring of vaccine attitudes – coupled with monitoring of local immunization rates – at the national and sub-national levels can identify populations with declining confidence and acceptance. These populations should be prioritized to further investigate the drivers of negative sentiment and to inform appropriate interventions to prevent adverse public health outcomes.
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              Risk Society : Towards a New Modernity

              This panoramic analysis of the condition of Western societies has been hailed as a classic. This first English edition has taken its place as a core text of contemporary sociology alongside earlier typifications of society as postindustrial and current debates about the social dimensions of the postmodern.</p> <p></p> <p>Underpinning the analysis is the notion of the `risk society'. The changing nature of society's relation to production and distribution is related to the environmental impact as a totalizing, globalizing economy based on scientific and technical knowledge becomes more central to social organization and social conflict.

                Author and article information

                Journal
                JAC Antimicrob Resist
                JAC Antimicrob Resist
                jacamr
                JAC-Antimicrobial Resistance
                Oxford University Press
                2632-1823
                September 2020
                03 October 2020
                03 October 2020
                : 2
                : 3
                : dlaa073
                Affiliations
                [1 ] Université de Lorraine, APEMAC, équipe MICS , F-54000 Nancy, France
                [2 ] Université de Lorraine, CHRU-Nancy, Département Méthodologie , Promotion, Investigation, Nancy, France
                [3 ] Université de Lorraine, CHRU-Nancy, Département des Maladies Infectieuses , Nancy, France
                Author notes
                Corresponding author. E-mail: anais.essilini@ 123456univ-lorraine.fr
                [†]

                Joint first authors.

                Author information
                http://orcid.org/0000-0002-4123-7034
                Article
                dlaa073
                10.1093/jacamr/dlaa073
                8209967
                34223028
                2e3f1c10-08d2-4ebe-a362-ba427abd9789
                © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 May 2020
                : 10 August 2020
                Page count
                Pages: 7
                Categories
                Original Article
                AcademicSubjects/MED00740
                AcademicSubjects/MED00290
                AcademicSubjects/MED00230

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