Existing Terminology Related to Antimicrobial Resistance Fails to Evoke Risk Perceptions and Be Remembered

Background

Antimicrobial resistance (AMR) is a global healthcare threat promoted by all use of antibiotics. Hence, reducing overuse of antibiotics is essential. The necessary behaviour change relies on effective public health communication, but previous information campaigns—while showing some successes—have fallen short in generating a lasting increase of public awareness. A potential reason for this is AMR-related terminology, which has been criticised as inconsistent, abstract and difficult to pronounce. We report the first empirical test of word memorability and risk association for the most frequent AMR-related health terms.

Methods

Across two surveys sampling 237 US and 924 UK participants, we test people’s memory for and the risk they associate with six AMR-related terms and thirty-four additional health risk terms (e.g., cancer). Participants also rate the terms on different linguistic dimensions including concreteness, familiarity, processing fluency and pronounceability.

Results

Our findings suggest that existing AMR-related health terms—particularly “AMR” and “Antimicrobial resistance”—are unsuitable for public health communication, because they score consistently low on both memorability and risk association. Out of the AMR terms, “Antibiotic resistance” and—to a lesser extent—“Drug-resistant infections” perform best. Regression analyses suggest that linguistic attributes (e.g., familiarity, processing fluency, pronounceability) are predictors of the terms’ risk association.

Conclusions

Our findings highlight an urgent need to rename AMR with a memorable term that effectively signals the existential threat of AMR and thereby motivates a change in antibiotic use. The success of the revised term is likely to depend, at least partially, on its linguistic attributes.

Plain language summary

Antimicrobial resistance (AMR) is a serious public health risk. It means that microorganisms, such as bacteria, change in a way that existing medicines, such as antibiotics, no longer kill them. As a result, it may be impossible to treat even common infections. Increasing the public’s understanding of AMR could help avoid its development, but to date, awareness campaigns have not been very successful in changing behaviour. Here, we aimed to understand why, by investigating the language used to communicate about AMR. Participants rated how much health risk they associated with different words (i.e., cancer, Ebola, AMR). People generally found it difficult to remember words associated with AMR and did not think they sounded risky compared to other health risk words. Future risk communication might benefit from renaming AMR to better signal the severity of the problem and motivate behaviour change.