Reducing primary care attendance intentions for pediatric respiratory tract infections

Annegret Schneider*, Christie Cabral, Natalie Herd, Alastair Hay, Joanna May Kesten, Emma Anderson, Isabel Lane, Charles Beck, Susan Michie

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


PURPOSE The aim of this study was to evaluate a theory and evidence-based, parent-targeted online intervention, combining microbiological local syndromic surveillance data, symptom information, and home-care advice, to reduce primary care attendance for self-limiting, low-risk pediatric respiratory tract infections (RTIs). METHODS The effect of this novel intervention on primary care attendance intentions was evaluated in an online experimental study. A representative sample of mothers (n = 806) was randomly assigned to receive the intervention material before (intervention) or after (control) answering questions concerning attendance intentions for an RTI illness scenario and mediating factors. Both groups provided feedback on the material. Group comparisons, linear regression, and path analyses were conducted. RESULTS Intervention participants reported lower attendance intentions compared with control participants (d = 0.69, 95% CI, 0.55-0.83), an effect that remained when controlling for demographic and clinical characteristics (B = -1.62, 95% CI, -1.97 to -1.30). The path model highlighted that the intervention effect (B = -0.33, 95% CI, -0.40 to -0.26) was mostly indirect and mediated by infection and antibiotic knowledge, symptom severity concerns, and social norm perceptions concerning attendance. Information on when to attend was rated as the most important intervention component 227 times, followed by symptoms rated 186 times. Information on circulating viruses was rated as least important 274 times. CONCLUSIONS The intervention was effective in reducing primary care attendance intentions by increasing knowledge, lowering attendance motivation, and reducing the need for additional resources. The contribution of individual intervention components and effects on behavioral outcomes requires further testing.

Original languageEnglish
Pages (from-to)239-249
Number of pages11
JournalAnnals of Family Medicine
Issue number3
Publication statusPublished - 1 May 2019

Bibliographical note

Funding Information:
Funding support: This research is supported by the National Institute for Health Research, Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health and Social Care or Public Health England. Joanna Kesten is partly funded by NIHR HPRU in Evaluation of Interventions at the University of Bristol in partnership with Public Health England and NIHR Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS Foundation Trust.

Publisher Copyright:
© 2019, Annals of Family Medicine, Inc. All rights reserved.


  • Antimicrobial resistance
  • Behavioral medicine
  • Child health
  • Ehealth
  • Primary care


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