Objective: This study aimed to compare pet owners’ knowledge of antibiotic use, understanding of antimicrobial resistance (AMR) and antibiotic practices for themselves and their pets to guide behavioral interventions to reduce AMR. Methods: A cross-sectional study conducted between March 2023 and December 2023 involved 1080 pet owners recruited from 16 veterinary clinics in Singapore. An anonymous self-administered survey assessed the participants’ knowledge of antibiotic use and AMR as well as their adherence to recommended antibiotic practices for themselves and their pets. McNemar’s Chi-square test was used to identify significant differences in the outcome variables between self and pets. The differences between the type of pet owned (dog owner/non-dog owner) were assessed using Pearson’s Chi-square test. Results: Among the 1080 pet owners surveyed, poorer knowledge of antibiotic use (46.3% vs. 33.2%; p < 0.001) and inappropriate antibiotic use (33.9% vs. 23.5%; p < 0.001) was more common for participants’ pets than for themselves. Compared to dog owners, non-dog owners had poorer knowledge of antibiotic use for their pets (poor knowledge, 55.2%; 42.4%; p < 0.001), but the knowledge of AMR occurrence and antibiotic practices did not differ between the dog owners and the non-dog owners. Conclusions: Pet owners have significantly poorer antibiotic use knowledge and antibiotic practices for their pets than for themselves. Compared to dog owners, non-dog owners have poorer knowledge of antibiotic use. Educational initiatives addressing pet owners’ knowledge deficits may improve their antibiotic practices for their pets and themselves, emphasizing the importance of cross-sectoral One Health planning.

Objectives: Inappropriate antibiotic prescribing for acute upper respiratory tract infections (URTIs) is a significant problem in emergency departments (EDs) worldwide. In this study, we separately evaluated the effectiveness of physician feedback and patient education in reducing antibiotic prescribing for URTIs in the ED setting. Methods: We conducted a quasi-experimental study across four large adult EDs in Singapore from January 2021 to December 2023. After a baseline period (18 months), two EDs were randomly assigned to either implement physician feedback or patient education for six months (intervention period 1), and all EDs subsequently implemented both interventions in the next six months (intervention period 2). Hierarchical segmented logistic regression was used to assess the effectiveness of the interventions in reducing weekly antibiotic prescribing for URTIs. Results: In the two EDs that implemented physician feedback first, there was a significant decrease in the trend of weekly antibiotics prescribed (AOR 0.981 [95% CI (0.964, 0.998)]) compared to the last 6 months of the pre-intervention period. Adding patient education in the next phase (intervention period 2) did not further reduce the trend of weekly antibiotics prescribed. For the second group of two EDs that implemented patient education first, there was no significant reduction in the weekly antibiotic prescribing trend during intervention period 1. With the addition of physician feedback, a significant decline in the trend of weekly antibiotics prescribed was observed in intervention period 2 (AOR 0.921 [95% CI (0.903,0.940)]). Conclusions: Physician feedback alone can reduce antibiotic prescribing for URTIs in EDs. Further research is warranted to assess the effectiveness of patient education involving multi-modal educational channels co-created with patients.

Background: Although health care providers are the most trusted sources of health information, service establishments within communities represent important, yet underused, sources of health information. Specifically, food and beauty establishments can act as alternative settings for health communication, facilitating broader engagement with the general population. Objective: This study examined factors associated with willingness to receive health information from these non–health care service establishments among community-dwelling adults in Singapore. Methods: A cross-sectional survey was conducted among residents in 2 neighborhoods in central Singapore between November 2024 and April 2025. Data on sociodemographic characteristics, trust in information from health care and non–health care services, and willingness to receive health information were collected anonymously. The primary outcome was willingness to receive health information from non–health care services (yes or no), assessed among respondents with no prior exposure to health information from such services. Multivariable logistic regression was used to identify factors independently associated with willingness to receive health information from non–health care services. Results: Among the 403 respondents, most were aged ≥50 years (n=223, 55.3%), female (n=219, 54.3%), Chinese (n=350, 86.9%), and highly educated (n=302, 74.9%). Of the 339 respondents without prior exposure to health information from non–health care services, approximately one-third (n=106, 31.3%) reported that they were willing to receive health information in the future. In adjusted analysis, greater trust in health information (adjusted odds ratio [AOR] 3.71, 95% CI 1.50-9.19) and high health information orientation (AOR 1.89, 95% CI 1.11-3.21) were associated with increased willingness to receive health information from non–health care services. Trust in health information was positively associated with willingness among those aged 21 to 34 years (AOR 4.96, 95% CI 1.35-18.30), those aged 35 to 49 years (AOR 8.02, 95% CI 2.62-24.59), and male respondents (AOR 6.22, 95% CI 2.79-13.89) to receive health information from these sources, but not among those aged ≥50 years (AOR 1.92, 95% CI 0.92-4.02) or female respondents (AOR 1.85, 95% CI 0.87-3.96). Conclusions: Nearly one-third of community-dwelling adults expressed willingness to receive health information from non–health care (food and beauty) services, highlighting the potential for leveraging these establishments as alternative health communication channels. Willingness was positively associated with higher health information orientation and greater trust. Additionally, trust in non–health care (food and beauty) services was associated with higher odds of willingness to receive health information among those aged 21 to 49 years and male respondents. This suggests the need for tailored trust-building strategies to strengthen engagement through such alternative channels.

BACKGROUND While healthcare providers are the most trusted sources of health information, service establishments within communities represent important yet underutilized sources of health information. Specifically, food and beauty establishments can act as alternative settings for health communication, facilitating broader engagement with the general population. OBJECTIVE This study examined factors associated with willingness to receive health information from these non-healthcare services among community-dwelling adults in Singapore. METHODS A cross-sectional survey was conducted among residents in two neighbourhoods in Central Singapore between November 2024 and April 2025. Data on socio-demographics, trust in information from healthcare and non-healthcare sources, and willingness to receive health information were collected anonymously. Multivariable logistic regression identified factors independently associated with willingness to receive health information from non-healthcare sources. RESULTS Most of the 403 respondents were aged ≥50 years (55.3%), female (54.3%), Chinese (82.6%), and higher educated (74.9%). Of the 339 respondents with no prior exposure to health information from non-healthcare services, nearly one-in-three (31.3%) reported that they were willing to receive health information from these sources. In adjusted analysis, those who trusted health information (AOR 3.71 [95% CI: 1.50, 9.19]) and those with high health information orientation (AOR1.89 [95% CI: 1.11, 3.21]) were more willing to receive health information from non-healthcare services in the future. Trust in health information increased willingness among those aged 21-34 years (AOR 4.98 [95% CI: 1.35, 18.30]), those aged 35-49 years (AOR 8.02 [95% CI: 2.62, 24.59]), and males (AOR 6.22 [95% CI: 2.79, 3.89]) to receive health information from these sources, but not among those aged ≥50 years (AOR 1.92 [95% CI: 0.92, 4.02]) or females (AOR 1.85 [95% CI: 0.87, 3.96]). CONCLUSIONS Nearly a third of community-dwelling adults expressed willingness to receive health information from non-healthcare services, highlighting the potential for leveraging these channels in health communication. Higher level of willingness was positively associated with higher health information orientation and greater trust. Additionally, trust in non-healthcare services enhanced the willingness among those aged 21-49 years and males. Building age- and gender-sensitive trust strategies could strengthen engagement through non-healthcare channels.