The Role of Structural Factors in Antibiotic Use Among European Union Citizens: A Multilevel Analysis

Yvonnes Chen, Hong Tien Vu


Using the 2016 European Commission’s Eurobarometer survey, this study analyzed how a multitude of factors are associated with identification and intention of following proper antibiotic treatment. Multilevel analyses showed that knowledge and information from medical professionals and mass media (individual-level predictors), and advanced access to education (a structural-level factor) are associated with identification. For intention, structural factors (Access to Information & Communications, Health & Wellness, Nutrition & Basic Medical Care) contributed significant variances to the model, in addition to the individual-level effects (sources and trust in medical professionals and mass media). Results demonstrate a need to consider these structural-level influences to shed light on the process though which antibiotic resistance preventions and interventions might impact individuals’ health literacy and behavioral outcomes.


antibiotic resistance, multilevel analyses, health literacy, health information seeking, Eurobarometer survey

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