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Knowledge and Misconceptions Regarding Upper Respiratory Infections and Influenza Among Urban Hispanic Households: Need for Targeted Messaging

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Abstract

Background To characterize knowledge and misconceptions regarding viral upper respiratory infections (URI) among urban Hispanics and identify correlates of greater knowledge. Methods In-home interviews conducted by trained research coordinators in 453 primarily Hispanic households (2,386 members) in northern Manhattan. Results The majority of respondents attributed URI to weather-related conditions. While most agreed that colds and flu were caused by viruses, 88.1% also agreed that they were caused by bacteria, and a small proportion reported that URI may be caused by evil eye (‘mal de ojo’, 7.1%) or sudden fright (‘susto’, 3.3%). Only 29.8% agreed that colds and flu would improve without medication; 89.9% stated that antibiotics are needed to treat viral throat infections. Most were well versed about influenza vaccination and reported that a recommendation from a healthcare provider would definitely influence them to get vaccinated. Discussion Misconceptions about the role of antibiotics in the treatment of viral infections pose considerable risk in this population. Explicit, targeted recommendations from healthcare providers regarding vaccination and judicious antibiotic use as well as media campaigns targeted to Hispanics should be effective strategies for reducing misconceptions and improving health behaviors.

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References

  1. Heikkinen T, Jarvinen A. The common cold. Lancet. 2003;361(9351):51–9.

    Article  PubMed  Google Scholar 

  2. Gonzales R, Malone DC, Maselli JH, Sande MA. Excessive antibiotic use for acute respiratory infections in the United States. Clin Infect Dis. 2001;33(6):757–62.

    Article  PubMed  CAS  Google Scholar 

  3. Gonzales R, Camargo CA Jr, MacKenzie T, et al. Antibiotic treatment of acute respiratory infections in acute care settings. Acad Emerg Med. 2006;13(3):288–94.

    Article  PubMed  Google Scholar 

  4. Fendrick AM, Monto AS, Nightengale B, Sarnes M. The economic burden of non-influenza-related viral respiratory tract infection in the United States. Arch Intern Med. 2003;163(4):487–94.

    Article  PubMed  Google Scholar 

  5. Larson EL, Dilone J, Garcia M, Smolowitz J. Factors which influence Latino community members to self-prescribe antibiotics. Nurs Res. 2006;55(2):94–102.

    Article  PubMed  Google Scholar 

  6. Cimiotti JP, Marmur ES, Nesin M, Hamlin-Cook P, Larson EL. Adverse reactions associated with an alcohol-based hand antiseptic among nurses in a neonatal intensive care unit. Am J Infect Control. 2003;31(1):43–8.

    Article  PubMed  Google Scholar 

  7. Trepka MJ, Belongia EA, Chyou PH, Davis JP, Schwartz B. The effect of a community intervention trial on parental knowledge and awareness of antibiotic resistance and appropriate antibiotic use in children. Pediatrics. 2001;107(1):E6.

    Article  PubMed  CAS  Google Scholar 

  8. Larson EL, Lin SX, Gomez-Pichardo C, Della-Latta P. Effect of antibacterial home cleaning and handwashing products on infectious disease symptoms: a randomized, double-blind trial. Ann Intern Med. 2004;140(5):321–9.

    PubMed  Google Scholar 

  9. Lee GM, Friedman JF, Ross-Degnan D, Hibberd PL, Goldmann DA. Misconceptions about colds and predictors of health service utilization. Pediatrics. 2003;111(2):231–6.

    Article  PubMed  Google Scholar 

  10. Bureau USC. The Hispanic population in the United States: March 2002. http://www.census.gov/prod/2003pubs/p20-545.pdf. Accessed 9/1/07.

  11. Bureau USC. Hispanic population passes 40 million, Census Bureau reports. http://www.census.gov/Press-Release/www/releases/archives/population/005164.html. Accessed 9/1/07, 2007.

  12. Kuzujanakis M, Kleinman K, Rifas-Shiman S, Finkelstein JA. Correlates of parental antibiotic knowledge, demand, and reported use. Ambul Pediatr. 2003;3(4):203–10.

    Article  PubMed  Google Scholar 

  13. Huang SS, Rifas-Shiman SL, Kleinman K, et al. Parental knowledge about antibiotic use: results of a cluster-randomized, multicommunity intervention. Pediatrics. 2007;119(4):698–706.

    Article  PubMed  Google Scholar 

  14. Belongia EA, Naimi TS, Gale CM, Besser RE. Antibiotic use and upper respiratory infections: a survey of knowledge, attitudes, and experience in Wisconsin and Minnesota. Prev Med. 2002;34(3):346–52.

    Article  PubMed  Google Scholar 

  15. McKee MD, Mills L, Mainous AG III. Antibiotic use for the treatment of upper respiratory infections in a diverse community. J Fam Pract. 1999;48(12):993–6.

    PubMed  CAS  Google Scholar 

  16. Steinke D, Davey P. Association between antibiotic resistance and community prescribing: a critical review of bias and confounding in published studies. Clin Infect Dis. 2001;33 Suppl 3:S193–205.

    Article  PubMed  Google Scholar 

  17. Chung A, Perera R, Brueggemann AB, et al. Effect of antibiotic prescribing on antibiotic resistance in individual children in primary care: prospective cohort study. BMJ. 2007;335(7617):407–408.

    Article  CAS  Google Scholar 

  18. Levy SB, Marshall B. Antibacterial resistance worldwide: causes, challenges and responses. Nat Med. 2004;10 Suppl 12:S122–9.

    Article  PubMed  CAS  Google Scholar 

  19. Bronzwaer SL, Cars O, Buchholz U, et al. A European study on the relationship between antimicrobial use and antimicrobial resistance. Emerg Infect Dis. 2002;8(3):278–82.

    Article  PubMed  Google Scholar 

  20. Melander E, Ekdahl K, Jonsson G, Molstad S. Frequency of penicillin-resistant pneumococci in children is correlated to community utilization of antibiotics. Pediatr Infect Dis J. 2000;19(12):1172–7.

    Article  PubMed  CAS  Google Scholar 

  21. McCaig LF, Besser RE, Hughes JM. Trends in antimicrobial prescribing rates for children and adolescents. JAMA. 2002;287(23):3096–102.

    Article  PubMed  Google Scholar 

  22. McCaig LF, Besser RE, Hughes JM. Antimicrobial drug prescription in ambulatory care settings, United States, 1992–2000. Emerg Infect Dis. 2003;9(4):432–7.

    PubMed  Google Scholar 

  23. Suttajit S, Wagner AK, Tantipidoke R, Ross-Degnan D, Sitthi-amorn C. Patterns, appropriateness, and predictors of antimicrobial prescribing for adults with upper respiratory infections in urban slum communities of Bangkok. Southeast Asian J Trop Med Public Health. 2005;36(2):489–97.

    PubMed  Google Scholar 

  24. Ben-David D, Rubinstein E. Appropriate use of antibiotics for respiratory infections: review of recent statements and position papers. Curr Opin Infect Dis. 2002;15(2):151–6.

    PubMed  Google Scholar 

  25. Ochoa C, Inglada L, Eiros JM, Solis G, Vallano A, Guerra L. Appropriateness of antibiotic prescriptions in community-acquired acute pediatric respiratory infections in Spanish emergency rooms. Pediatr Infect Dis J. 2001;20(8):751–8.

    PubMed  CAS  Google Scholar 

  26. Ochoa C, Eiros JM, Inglada L, Vallano A, Guerra L. Assessment of antibiotic prescription in acute respiratory infections in adults. The Spanish Study Group on Antibiotic Treatments. J Infect. 2000;41(1):73–83.

    Article  PubMed  CAS  Google Scholar 

  27. Larson E, Grullon-Figueroa L. Availability of antibiotics without prescription in New York City. J Urban Health. 2004;81(3):498–504.

    PubMed  Google Scholar 

  28. Pichichero ME, Green JL, Francis AB, Marsocci SM, Murphy ML. Outcomes after judicious antibiotic use for respiratory tract infections seen in a private pediatric practice. Pediatrics. 2000;105(4 Pt 1):753–9.

    Article  PubMed  CAS  Google Scholar 

  29. Fakih MG, Hilu RC, Savoy-Moore RT, Saravolatz LD. Do resident physicians use antibiotics appropriately in treating upper respiratory infections? A survey of 11 programs. Clin Infect Dis. 2003;37(6):853–6.

    Article  PubMed  Google Scholar 

  30. McCoy SI, Zell ER, Besser RE. Antimicrobial prescribing for otitis externa in children. Pediatr Infect Dis J. 2004;23(2):181–3.

    Article  PubMed  Google Scholar 

  31. Ladd E. The use of antibiotics for viral upper respiratory tract infections: an analysis of nurse practitioner and physician prescribing practices in ambulatory care, 1997–2001. J Am Acad Nurse Pract. 2005;17(10):416–24.

    Article  PubMed  Google Scholar 

  32. Chamany S, Schulkin J, Rose CE Jr, Riley LE, Besser RE. Knowledge, attitudes, and reported practices among obstetrician-gynecologists in the USA regarding antibiotic prescribing for upper respiratory tract infections. Infect Dis Obstet Gynecol. 2005;13(1):17–24.

    PubMed  Google Scholar 

  33. Park SY, Gerber MA, Tanz RR, et al. Clinicians’ management of children and adolescents with acute pharyngitis. Pediatrics. 2006;117(6):1871–8.

    Article  PubMed  Google Scholar 

  34. Metlay JP, Shea JA, Crossette LB, Asch DA. Tensions in antibiotic prescribing: pitting social concerns against the interests of individual patients. J Gen Intern Med. 2002;17(2):87–94.

    Article  PubMed  Google Scholar 

  35. Metlay JP, Shea JA, Asch DA. Antibiotic prescribing decisions of generalists and infectious disease specialists: thresholds for adopting new drug therapies. Med Decis Making. 2002;22(6):498–505.

    Article  PubMed  Google Scholar 

  36. Richman PB, Garra G, Eskin B, Nashed AH, Cody R. Oral antibiotic use without consulting a physician: a survey of ED patients. Am J Emerg Med. 2001;19(1):57–60.

    Article  PubMed  CAS  Google Scholar 

  37. Friedman JF, Lee GM, Kleinman KP, Finkelstein JA. Acute care and antibiotic seeking for upper respiratory tract infections for children in day care: parental knowledge and day care center policies. Arch Pediatr Adolesc Med. 2003;157(4):369–74.

    Article  PubMed  Google Scholar 

  38. Vanden Eng J, Marcus R, Hadler JL, et al. Consumer attitudes and use of antibiotics. Emerg Infect Dis. 2003;9(9):1128–35.

    Google Scholar 

  39. Granados G, Puvvula J, Berman N, Dowling PT. Health care for Latino children: impact of child and parental birthplace on insurance status and access to health services. Am J Public Health. 2001;91(11):1806–7.

    Article  PubMed  CAS  Google Scholar 

  40. Wagner TH, Guendelman S. Healthcare utilization among Hispanics: findings from the 1994 Minority Health Survey. Am J Manag Care. 2000;6(3):355–64.

    PubMed  CAS  Google Scholar 

  41. Hampers LC, Cha S, Gutglass DJ, Binns HJ, Krug SE. Language barriers and resource utilization in a pediatric emergency department. Pediatrics. 1999;103(6 Pt 1):1253–6.

    Article  PubMed  CAS  Google Scholar 

  42. Pechere JC. Patients’ interviews and misuse of antibiotics. Clin Infect Dis. 2001;33 Suppl 3:S170–3.

    Article  PubMed  Google Scholar 

  43. Macias EP, Morales LS. Utilization of health care services among adults attending a health fair in South Los Angeles County. J Community Health. 2000;25(1):35–46.

    Article  PubMed  CAS  Google Scholar 

  44. Macias EP, Morales LS. Crossing the border for health care. J Health Care Poor Underserved. 2001;12(1):77–87.

    PubMed  CAS  Google Scholar 

  45. Larson E, Lin SX, Gomez-Duarte C. Antibiotic use in Hispanic households, New York city. Emerg Infect Dis. 2003;9(9):1096–102.

    PubMed  Google Scholar 

  46. Corbett KK, Gonzales R, Leeman-Castillo BA, Flores E, Maselli J, Kafadar K. Appropriate antibiotic use: variation in knowledge and awareness by Hispanic ethnicity and language. Prev Med. 2005;40(2):162–9.

    Article  PubMed  Google Scholar 

  47. Larson EL. Warned, but not well armed: preventing viral upper respiratory infections in households. Public Health Nurs. 2007;24(1):48–59.

    Article  PubMed  Google Scholar 

  48. Larson E. Community factors in the development of antibiotic resistance. Annu Rev Public Health. 2007;28:435–47.

    Article  PubMed  Google Scholar 

  49. Weissman J, Besser RE. Promoting appropriate antibiotic use for pediatric patients: a social ecological framework. Semin Pediatr Infect Dis. 2004;15(1):41–51.

    Article  PubMed  Google Scholar 

  50. Kiang KM, Kieke BA, Como-Sabetti K, Lynfield R, Besser RE, Belongia EA. Clinician knowledge and beliefs after statewide program to promote appropriate antimicrobial drug use. Emerg Infect Dis. 2005;11(6):904–11.

    PubMed  Google Scholar 

  51. Belongia EA, Knobloch MJ, Kieke BA, Davis JP, Janette C, Besser RE. Impact of statewide program to promote appropriate antimicrobial drug use. Emerg Infect Dis. 2005;11(6):912–20.

    PubMed  Google Scholar 

  52. Gonzales R, Sauaia A, Corbett KK, et al. Antibiotic treatment of acute respiratory tract infections in the elderly: effect of a multidimensional educational intervention. J Am Geriatr Soc. 2004;52(1):39–45.

    Article  PubMed  Google Scholar 

  53. Gonzales R, Corbett KK, Leeman-Castillo BA, et al. The “minimizing antibiotic resistance in Colorado” project: impact of patient education in improving antibiotic use in private office practices. Health Serv Res. 2005;40(1):101–16.

    Article  PubMed  Google Scholar 

  54. Belongia EA, Sullivan BJ, Chyou PH, Madagame E, Reed KD, Schwartz B. A community intervention trial to promote judicious antibiotic use and reduce penicillin-resistant Streptococcus pneumoniae carriage in children. Pediatrics. 2001;108(3):575–83.

    Article  PubMed  CAS  Google Scholar 

  55. Perz JF, Craig AS, Coffey CS, et al. Changes in antibiotic prescribing for children after a community-wide campaign. JAMA. 2002;287(23):3103–9.

    Article  PubMed  Google Scholar 

  56. Harris RH, MacKenzie TD, Leeman-Castillo B, et al. Optimizing antibiotic prescribing for acute respiratory tract infections in an urban urgent care clinic. J Gen Intern Med. 2003;18(5):326–34.

    Article  PubMed  Google Scholar 

  57. Croft DR, Knobloch MJ, Chyou PH, et al. Impact of a child care educational intervention on parent knowledge about appropriate antibiotic use. WMJ. 2007;106(2):78–84.

    PubMed  Google Scholar 

  58. Mangione-Smith R, McGlynn EA, Elliott MN, Krogstad P, Brook RH. The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior. Pediatrics. 1999;103(4 Pt 1):711–8.

    Article  PubMed  CAS  Google Scholar 

  59. Mangione-Smith R, Elliott MN, Stivers T, McDonald L, Heritage J, McGlynn EA. Racial/ethnic variation in parent expectations for antibiotics: implications for public health campaigns. Pediatrics. 2004;113(5):e385–94.

    Article  PubMed  Google Scholar 

  60. Weiss MC, Deave T, Peters TJ, Salisbury C. Perceptions of patient expectation for an antibiotic: a comparison of walk-in centre nurses and GPs. Fam Pract. 2004;21(5):492–9.

    Article  PubMed  CAS  Google Scholar 

  61. Akkerman AE, Kuyvenhoven MM, van der Wouden JC, Verheij TJ. Determinants of antibiotic overprescribing in respiratory tract infections in general practice. J Antimicrob Chemother. 2005;56(5):930–6.

    Article  PubMed  CAS  Google Scholar 

  62. Ong S, Nakase J, Moran GJ, Karras DJ, Kuehnert MJ, Talan DA. Antibiotic use for emergency department patients with upper respiratory infections: prescribing practices, patient expectations, and patient satisfaction. Ann Emerg Med. 2007;50(3):213–20.

    Article  PubMed  Google Scholar 

  63. Hare ME, Gaur AH, Somes GW, Arnold SR, Shorr RI. Does it really take longer not to prescribe antibiotics for viral respiratory tract infections in children? Ambul Pediatr. 2006;6(3):152–6.

    Article  PubMed  Google Scholar 

  64. Leeman-Castillo BA, Corbett KK, Aagaard EM, Maselli JH, Gonzales R, Mackenzie TD. Acceptability of a bilingual interactive computerized educational module in a poor, medically underserved patient population. J Health Commun. 2007;12(1):77–94.

    Article  PubMed  Google Scholar 

  65. Chang BL, Bakken S, Brown SS, et al. Bridging the digital divide: reaching vulnerable populations. J Am Med Inform Assoc. 2004;11(6):448–57.

    Article  PubMed  Google Scholar 

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Larson, E., Ferng, YH., Wong, J. et al. Knowledge and Misconceptions Regarding Upper Respiratory Infections and Influenza Among Urban Hispanic Households: Need for Targeted Messaging. J Immigrant Minority Health 11, 71–82 (2009). https://doi.org/10.1007/s10903-008-9154-2

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