Parental Digital Health Literacy and Appropriate Antibiotic-Seeking Behaviour for Childhood Illness in Bangladesh: The Mediating Role of Knowledge of Antimicrobial Resistance
DOI:
https://doi.org/10.54536/ajpehs.v4i2.8690Keywords:
Antibiotic-Seeking Behaviour, Antimicrobial Resistance, Bangladesh, Childhood Illness, Digital Health Literacy, ParentsAbstract
This research aims to understand the relationship between parental digital health literacy and adequate antibiotic seeking behaviour for childhood diseases in Bangladesh, focusing on the knowledge of antimicrobial resistance and confidence in seeking professional advice. A cross-sectional survey 560 complete observations. Appropriate antibiotic seeking behaviour, digital health literacy and confidence in seeking professional advice were modelled as reflective constructs and antimicrobial resistance knowledge was operationalised as a seven-item factual scale. 2,000 bootstrap samples were used to apply partial least squares structural equation modelling. The measurement model showed good test–retest reliability and presented good criterion-related and content-related validity. Digital health literacy was a positive predictor of antimicrobial resistance knowledge, confidence in seeking professionals’ advice and appropriate antibiotic seeking behaviour. There were positive associations between the levels of antimicrobial resistance knowledge and professional-advice confidence and antimicrobial resistance appropriate behaviour. Appropriate antibiotic seeking behaviour was most directly associated with confidence in seeking professional advice. The indirect effect via antimicrobial resistance knowledge was significant, demonstrating mediation. The model accounted for 35.8% of the variance in appropriate antibiotic seeking behaviour. The results suggest that enhancing parents’ skills in assessing digital health information could help them make safer choices about antibiotic use alongside increased knowledge about the facts of resistance and trust in seeking advice from trained healthcare providers during standard childhood infections.
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Ahmed, I., Rabbi, M. B., Rahman, M., Tanjin, R., Jahan, S., Khan, M. A. A., & Sultana, S. (2020). Knowledge of antibiotics and antibiotic usage behavior among the people of Dhaka, Bangladesh. Asian Journal of Medical and Biological Research, 6(3), 519–524. https://doi.org/10.3329/ajmbr.v6i3.49803
Aika, I. N., & Enato, E. (2023). Bridging the gap in knowledge and use of antibiotics among pediatric caregivers: comparing two educational interventions. Journal of Pharmaceutical Policy and Practice, 16(1), 76. https://doi.org/10.1186/s40545-023-00578-5
Akhtar, Z., Mah-E-Muneer, S., Rashid, Md. M., Ahmed, Md. S., Islam, Md. A., Chowdhury, S., Khan, Z., Hassan, Md. Z., Islam, K., Parveen, S., Debnath, N., Rahman, M., & Chowdhury, F. (2021). Antibiotics use and its knowledge in the community: a mobile phone survey during the COVID-19 pandemic in Bangladesh. Antibiotics, 10(9), 1052. https://doi.org/10.3390/antibiotics10091052
Akter, S., Banna, Md. H. A., Brazendale, K., Sultana, Mst. S., Kundu, S., Disu, T. R., Alshahrani, N. Z., Tareq, Md. A., Hassan, Md. N., & Islam Khan, Md. S. (2023). Determinants of health care seeking behavior for childhood infectious diseases and malnutrition: a slum-based survey from Bangladesh. Journal of Child Health Care, 27(3), 395–409. https://doi.org/10.1177/13674935211057714
Alima, F., Moon, K. J., Afrin, S., Noor, S. B., Amin, M. R., Afroz, R., Ferdouse, F., & Noor, S. F. (2023). Assessment ofknowledge and attitude toward antibiotic use and resistance among 4th year students of Shaheed Monsur Ali Medical College. Annals of International Medical and Dental Research, 9(2), 76–86. https://doi.org/10.53339/aimdr.2023.9.15
Applegate, J. A., Ahmed, S., Harrison, M., Callaghan-Koru, J., Mousumi, M., Begum, N., Moin, M. I., Joarder, T., Ahmed, S., George, J., Mitra, D. K., Ahmed, A. N. U., Shahidullah, M., & Baqui, A. H. (2020). Caregiver acceptability of the guidelines for managing young infants with possible serious bacterial infections (PSBI) in primary care facilities in rural Bangladesh. PLOS ONE, 15(4), e0231490. https://doi.org/10.1371/journal.pone.0231490
Bert, F., Previti, C., Calabrese, F., Scaioli, G., & Siliquini, R. (2022). Antibiotics self medication among children: a systematic review. Antibiotics, 11(11), 1583. https://doi.org/10.3390/antibiotics11111583
Bosley, H., Henshall, C., Appleton, J. V., & Jackson, D. (2022). Understanding antibiotic‐seeking behaviour: a qualitative case study of mothers of children aged 5 and under. Journal of Advanced Nursing, 78(11), 3772–3781. https://doi.org/10.1111/jan.15356
Dantuluri, K. L., Bonnet, K. R., Schlundt, D. G., Schulte, R. J., Griffith, H. G., Luu, A., Charnogursky, C., Perkins, J. M., Whitmore, C. C., Banerjee, R., Howard, L. M., & Grijalva, C. G. (2023). Antibiotic perceptions, adherence, and disposal practices among parents of pediatric patients. PLOS ONE, 18(2), e0281660. https://doi.org/10.1371/journal.pone.0281660
Earley, E. J. (2023). Methodology. https://doi.org/10.17605/OSF.IO/FN4J2
Hassan, M. Z., Monjur, M. R., Biswas, M. A. A. J., Chowdhury, F., Kafi, M. A. H., Braithwaite, J., Jaffe, A., & Homaira, N. (2021). Antibiotic use for acute respiratory infections among under-5 children in Bangladesh: a population-based survey. BMJ Global Health, 6(4), e004010. https://doi.org/10.1136/bmjgh-2020-004010
Hicks, J. P., Latham, S. M., Huque, R., Das, M., Newell, J., Abdullah, S. M., Al Azdi, Z., Jahan, I., Rassi, C., Hamade, P., Shafique, M., Islam, M. S., & King, R. (2021). Antibiotic practices among household members and their domestic animals within rural communities in Cumilla district, Bangladesh: a cross-sectional survey. BMC Public Health, 21(1), 406. https://doi.org/10.1186/s12889-021-10457-w
Kabir, H., Hasan, M. K., Akter, N., Tassdik, D. H., Islam, D. M. F., Jannat, D. H., Tutul, A. H., Akter, O., Ara, R., Islam, M. D., Mahmud, S., Akter, M., & Mitra, D. K. (2023). Antibiotics administration without prescription in Bangladesh. IJID Regions, 7, 11–17. https://doi.org/10.1016/j.ijregi.2023.02.001
Moura, M., & Neves, R. (2025). Methodology. In M. Moura & R. Neves, Using Fundamental Analysis and an Ensemble of Classifier Models Along with a Risk-Off Filter to Select Outperforming Companies (pp. 27–52). Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-62061-4_3
Nafei, Z., Karimi, M., & Najafi, Z. (2022). Evaluation of attitudes and practices of mothers on antibiotic use in children under five years old referred to Shahid Sadoughi Hospital in Yazd, 2019-2020. Journal of Shahid Sadoughi University of Medical Sciences. https://doi.org/10.18502/ssu.v30i2.9279
Noor, A. U. Z., Kabir, H., Chowdhury, Md. A. A., Ather, Md. F., & Kamrul Hasan, Md. (2023). An emerging route to antibiotic resistance in South Asia: a correspondence. Annals of Medicine & Surgery, 85(2), 335–336. https://doi.org/10.1097/MS9.0000000000000165
Parveen, M., Yeasmin, M., & Molla, Md. M. A. (2020). Antimicrobial Resistance, Evidences on Irrational Anti-microbial Prescribing and Consumption during COVID-19 Pandemic and Possible Mitigation Strategies: A Bangladesh Perspective. Infectious Diseases (except HIV/AIDS). https://doi.org/10.1101/2020.10.09.20210377
Paul, G. K., Swapon, Md. S., & Kaderi Kibria, K. M. (2022). Knowledge, awareness, and attitudes toward antibiotic resistance and practice of self-medication among university students in Bangladesh: a cross-sectional study. Journal of Education and Health Promotion, 11(1). https://doi.org/10.4103/jehp.jehp_602_21
Rahman, M. R., Islam, F., Rahman, M. A., Bashar, S. B., Rifat, R. H., Saha, B. C., & Paran, M. S. (2021). Antibiotic resistance situation in Dhaka, Bangladesh: a review. International Journal of Basic & Clinical Pharmacology, 10(5), 584. https://doi.org/10.18203/2319-2003.ijbcp20211659
Romandini, A., Pani, A., Schenardi, P. A., Pattarino, G. A. C., De Giacomo, C., & Scaglione, F. (2021). Antibiotic resistance in pediatric infections: global emerging threats, predicting the near future. Antibiotics, 10(4), 393. https://doi.org/10.3390/antibiotics10040393
Salam, A., Waseem, S., Akhtar, L., Manan, H. A., Abdul Malik, M. A. B., & Siddique, N. (2023). Parentalself-medication with antibiotics in Pakistan. Pakistan Journal of Medical and Health Sciences, 17(4), 228–231. https://doi.org/10.53350/pjmhs2023174228
Samir, N., Hassan, Md. Z., Biswas, Md. A. A. J., Chowdhury, F., Akhtar, Z., Lingam, R., Banu, S., & Homaira, N. (2021). Antibiotic use for febrile illness among under-5 children in Bangladesh: a nationally representative sample survey. Antibiotics, 10(10), 1153. https://doi.org/10.3390/antibiotics10101153
Shah, R. C., Pradhan, N., & Yadav, R. K. (2022). Knowledge, awareness and perception of antibiotics resistance among under graduates paramedical students of Bangladesh. Janaki Medical College Journal of Medical Science, 10(1), 33–38. https://doi.org/10.3126/jmcjms.v10i1.44631
Shamim, M. A., Padhi, B. K., Satapathy, P., Siddiq, A., Manna, S., Aggarwal, A. K., Al-Ahdal, T., Khubchandani, J., Henao-Martinez, A. F., & Sah, R. (2023). Parents’ expectation of antibiotic prescriptions for respiratory infections in children: a systematic review and meta-analysis. Therapeutic Advances in Infectious Disease, 10, 20499361231169429. https://doi.org/10.1177/20499361231169429
Unicomb, L. E., Nizame, F. A., Uddin, M. R., Nahar, P., Lucas, P. J., Khisa, N., Akter, S. M. S., Islam, M. A., Rahman, M., & Rousham, E. K. (2021). Motivating antibiotic stewardship in Bangladesh: identifying audiences and target behaviours using the behaviour change wheel. BMC Public Health, 21(1), 968. https://doi.org/10.1186/s12889-021-10973-9
Van Hecke, O., Lee, J., Butler, C., Moore, M., & Tonkin-Crine, S. (2022). P47 Infographics about antibiotics: making facts accessible. JAC-Antimicrobial Resistance, 4(Supplement_1), dlac004.046. https://doi.org/10.1093/jacamr/dlac004.046
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Copyright (c) 2026 Md Amjad Hossain Chowdhury, Samia Akter Bristy, Tamzid Hossain, Gazi nazmul Hossan
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