{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T18:08:24Z","timestamp":1779127704870,"version":"3.51.4"},"reference-count":88,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Antibiotic resistance is a growing public health concern, particularly in low- and middle-income countries such as Bangladesh. This cross-sectional empirical study analyzed primary survey data collected from 254 respondents in Bangladesh using Structural Equation Modeling (SEM). Structural Equation Modeling (SEM) with Smart-PLS 4.0 was employed to analyze the relationships between key variables, ensuring accurate results despite non-normal data. The findings reveal that economic pressures, inadequate diagnostics, and cultural misconceptions are key contributors to antibiotic overuse and misuse. The study is grounded in the Health Belief Model and Ecological Systems Theory, offering a framework to understand these behaviors. It underscores the need for targeted policies, improved diagnostic resources, and heightened public awareness to address the growing problem of antimicrobial resistance. The findings indicate that economic incentives, diagnostic uncertainty, healthcare infrastructure, and sociocultural beliefs significantly influence antibiotic resistance within the surveyed population.<\/jats:p>","DOI":"10.1371\/journal.pone.0344449","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:25:07Z","timestamp":1779125107000},"page":"e0344449","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring factors contributing to antibiotic resistance: A cross-sectional empirical study in Bangladesh"],"prefix":"10.1371","volume":"21","author":[{"given":"Abdullah","family":"Al Rakib","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dr. Johaira","family":"Sultana Toma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dr. Mousumi","family":"Akhtar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. Abu","family":"Hasnat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. Sohel","family":"Rana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rezwan Ul","family":"Haque Aubhi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nur-A.-Alam","family":"Mishad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farzana","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9655-0941","authenticated-orcid":true,"given":"Shadia","family":"Sharmin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"issue":"2","key":"pone.0344449.ref001","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1093\/femsre\/fuaa001","article-title":"Antibiotic resistance: turning evolutionary principles into clinical reality","volume":"44","author":"DI Andersson","year":"2020","journal-title":"FEMS Microbiol Rev"},{"key":"pone.0344449.ref002","volume-title":"Global antimicrobial resistance and use surveillance system (GLASS) report 2022","author":"World Health Organization","year":"2022"},{"key":"pone.0344449.ref003","unstructured":"O\u2019Neill J. Tackling drug-resistant infections globally: Final report and recommendations. 2016. https:\/\/amr-review.org\/Publications"},{"key":"pone.0344449.ref004","article-title":"Drug-resistant infections could kill 10 million people annually by 2050","author":"Smithsonian","year":"2019","journal-title":"Smithsonian Magazine"},{"issue":"10014","key":"pone.0344449.ref005","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0140-6736(15)00474-2","article-title":"Access to effective antimicrobials: a worldwide challenge","volume":"387","author":"R Laxminarayan","year":"2016","journal-title":"The Lancet"},{"issue":"2","key":"pone.0344449.ref006","doi-asserted-by":"crossref","first-page":"192","DOI":"10.4161\/viru.23706","article-title":"How to educate prescribers in antimicrobial stewardship practices","volume":"4","author":"C Pulcini","year":"2013","journal-title":"Virulence"},{"issue":"11","key":"pone.0344449.ref007","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.cmi.2017.08.026","article-title":"What is antimicrobial stewardship?","volume":"23","author":"OJ Dyar","year":"2017","journal-title":"Clin Microbiol Infect"},{"issue":"10014","key":"pone.0344449.ref008","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/S0140-6736(15)00473-0","article-title":"Understanding the mechanisms and drivers of antimicrobial resistance","volume":"387","author":"AH Holmes","year":"2016","journal-title":"The Lancet"},{"issue":"4","key":"pone.0344449.ref009","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2016-000132","article-title":"Addressing the challenges of diagnostics demand and supply: insights from an online global health discussion platform","volume":"1","author":"N Engel","year":"2016","journal-title":"BMJ Global Health"},{"key":"pone.0344449.ref010","article-title":"Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines","volume":"364","author":"KB Pouwels","year":"2019","journal-title":"BMJ"},{"key":"pone.0344449.ref011","first-page":"1946","article-title":"Antimicrobial resistance: a growing serious threat for global public health","volume-title":"Healthcare","author":"MA Salam","year":"2023"},{"issue":"10443","key":"pone.0344449.ref012","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1016\/S0140-6736(24)00878-X","article-title":"Expanding antibiotic, vaccine, and diagnostics development and access to tackle antimicrobial resistance","volume":"403","author":"R Laxminarayan","year":"2024","journal-title":"The Lancet"},{"issue":"2","key":"pone.0344449.ref013","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The theory of planned behavior","volume":"50","author":"I Ajzen","year":"1991","journal-title":"Organizational Behavior and Human Decision Processes"},{"issue":"1","key":"pone.0344449.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/109019818401100101","article-title":"The Health Belief Model: a decade later","volume":"11","author":"NK Janz","year":"1984","journal-title":"Health Educ Q"},{"key":"pone.0344449.ref015","doi-asserted-by":"crossref","DOI":"10.4159\/9780674028845","volume-title":"The ecology of human development: experiments by nature and design","author":"U Bronfenbrenner","year":"1979"},{"issue":"5","key":"pone.0344449.ref016","first-page":"941","article-title":"Uncertainty and the welfare economics of medical care","volume":"53","author":"KJ Arrow","year":"1963","journal-title":"Am Econ Rev"},{"key":"pone.0344449.ref017","first-page":"1","volume-title":"Patient care related issues in the developing countries: Diagnosis. In: Handbook of Medical and Health Sciences in Developing Countries","author":"YM Al-Worafi","year":"2023"},{"key":"pone.0344449.ref018","unstructured":"T B S News. Parental lack of antibiotic knowledge imperils child health in Bangladesh: Study. The Business Standard. https:\/\/www.tbsnews.net. 2022. Accessed 2025 August 19."},{"issue":"2","key":"pone.0344449.ref019","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-076616","article-title":"Just as curry is needed to eat rice, antibiotics are needed to cure fever\u2014a qualitative study of individual, community and health system-level influences on community antibiotic practices in rural West Bengal, India","volume":"14","author":"M Gautham","year":"2024","journal-title":"BMJ Open"},{"key":"pone.0344449.ref020","doi-asserted-by":"crossref","first-page":"113813","DOI":"10.1016\/j.socscimed.2021.113813","article-title":"What are the challenges for antibiotic stewardship at the community level? An analysis of the drivers of antibiotic provision by informal healthcare providers in rural India","volume":"275","author":"M Gautham","year":"2021","journal-title":"Soc Sci Med"},{"issue":"11","key":"pone.0344449.ref021","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/j.cmi.2019.03.008","article-title":"Optimizing antibiotic prescribing: collective approaches to managing a common-pool resource","volume":"25","author":"C Tarrant","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"pone.0344449.ref022","first-page":"8213","article-title":"\u201cCaught in Each Other\u2019s Traps\u201d: Factors Perpetuating Incentive-Linked Prescribing Deals Between Physicians and the Pharmaceutical Industry","volume":"13","author":"MS Khan","year":"2024","journal-title":"Int J Health Policy Manag"},{"key":"pone.0344449.ref023","article-title":"Long-term effectiveness of financial incentives for not prescribing unnecessary antibiotics to children with acute respiratory and gastrointestinal infections: A Japan\u2019s nationwide quasi-experimental study","author":"Y Okubo","year":"2024","journal-title":"Clin Infect Dis"},{"issue":"5","key":"pone.0344449.ref024","doi-asserted-by":"crossref","first-page":"325","DOI":"10.7196\/SAMJ.9644","article-title":"The World Health Organization Global Action Plan for antimicrobial resistance","volume":"105","author":"M Mendelson","year":"2015","journal-title":"S Afr Med J"},{"issue":"2","key":"pone.0344449.ref025","doi-asserted-by":"crossref","first-page":"26","DOI":"10.30809\/solo.2.2019.9","article-title":"STUDY OF THE ROLE OF THE PHARMACISTS IN THE SYSTEM OF RATIONAL USE OF MEDICINES","volume":"6","author":"OM Kazmina","year":"2019","journal-title":"SOLO"},{"key":"pone.0344449.ref026","doi-asserted-by":"crossref","first-page":"1397096","DOI":"10.3389\/fpubh.2024.1397096","article-title":"C-reactive protein point-of-care testing in primary care-broader implementation needed to combat antimicrobial resistance","volume":"12","author":"C Llor","year":"2024","journal-title":"Front Public Health"},{"key":"pone.0344449.ref027","unstructured":"The Pew Charitable Trusts. Economic incentives needed to fix the broken antibiotic market. 2024. https:\/\/www.pewtrusts.org\/en\/research-and-analysis\/articles\/2019\/10\/04\/economic-incentives-needed-to-fix-the-broken-antibiotic-market"},{"key":"pone.0344449.ref028","volume-title":"Strengthening diagnostics capacity: Resolution WHA76.5","author":"World Health Organization","year":"2023"},{"issue":"10","key":"pone.0344449.ref029","article-title":"Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care","volume":"10","author":"SA Smedemark","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"issue":"12","key":"pone.0344449.ref030","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.3390\/antibiotics13121151","article-title":"Prevention and Modern Strategies for Managing Methicillin-Resistant Staphylococcal Infections in Prosthetic Joint Infections (PJIs)","volume":"13","author":"K Kraus","year":"2024","journal-title":"Antibiotics (Basel)"},{"issue":"12","key":"pone.0344449.ref031","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1080\/03007995.2024.2414893","article-title":"Managing drug therapy-related problems and assessment of chronic diabetic wounds","volume":"40","author":"MIMS Mahendran","year":"2024","journal-title":"Curr Med Res Opin"},{"issue":"3","key":"pone.0344449.ref032","doi-asserted-by":"crossref","first-page":"339","DOI":"10.3390\/ph17030339","article-title":"Shorter and Longer Antibiotic Durations for Respiratory Infections: To Fight Antimicrobial Resistance-A Retrospective Cross-Sectional Study in a Secondary Care Setting in the UK","volume":"17","author":"R Abdelsalam Elshenawy","year":"2024","journal-title":"Pharmaceuticals (Basel)"},{"issue":"6","key":"pone.0344449.ref033","doi-asserted-by":"crossref","first-page":"822","DOI":"10.7326\/M20-7355","article-title":"Appropriate use of short-course antibiotics in common infections: best practice advice from the American College of Physicians","volume":"174","author":"RA Lee","year":"2021","journal-title":"Ann Intern Med"},{"key":"pone.0344449.ref034","volume-title":"Global antimicrobial resistance and use surveillance system (GLASS) report: 2021","author":"World Health Organization","year":"2021"},{"key":"pone.0344449.ref035","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.17198","article-title":"Towards the development of cost-effective point-of-care diagnostic tools for poverty-related infectious diseases in sub-Saharan Africa","volume":"12","author":"B Ofori","year":"2024","journal-title":"PeerJ"},{"key":"pone.0344449.ref036","volume-title":"Antimicrobial resistance: Global report on surveillance","author":"World Health Organization","year":"2021"},{"issue":"3","key":"pone.0344449.ref037","doi-asserted-by":"crossref","DOI":"10.1128\/CMR.00048-19","article-title":"Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries","volume":"33","author":"S Gandra","year":"2020","journal-title":"Clin Microbiol Rev"},{"key":"pone.0344449.ref038","article-title":"Less than 2% of health budget finances diagnostics sector in Africa","author":"A Pamba","year":"2023","journal-title":"Ghana Business News"},{"issue":"10133","key":"pone.0344449.ref039","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1016\/S0140-6736(18)30459-8","article-title":"Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions","volume":"391","author":"S Sayed","year":"2018","journal-title":"The Lancet"},{"issue":"3","key":"pone.0344449.ref040","doi-asserted-by":"crossref","first-page":"510","DOI":"10.3390\/antibiotics12030510","article-title":"Antibiotic Culture: A History of Antibiotic Use in the Second Half of the 20th and Early 21st Century in the People\u2019s Republic of China","volume":"12","author":"X Zhou","year":"2023","journal-title":"Antibiotics (Basel)"},{"issue":"5","key":"pone.0344449.ref041","doi-asserted-by":"crossref","first-page":"669","DOI":"10.3390\/antibiotics11050669","article-title":"Public Health Interventions to Improve Antimicrobial Resistance Awareness and Behavioural Change Associated with Antimicrobial Use: A Systematic Review Exploring the Use of Social Media","volume":"11","author":"S Parveen","year":"2022","journal-title":"Antibiotics (Basel)"},{"issue":"1","key":"pone.0344449.ref042","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1038\/s41598-024-52313-y","article-title":"Factors contributing to antibiotic misuse among parents of school-going children in Dhaka City, Bangladesh","volume":"14","author":"MW Islam","year":"2024","journal-title":"Sci Rep"},{"issue":"3","key":"pone.0344449.ref043","doi-asserted-by":"crossref","first-page":"246","DOI":"10.25122\/jml-2023-0404","article-title":"The burden of antibiotic resistance of the main microorganisms causing infections in humans - review of the literature","volume":"17","author":"A-P Baciu","year":"2024","journal-title":"J Med Life"},{"key":"pone.0344449.ref044","volume-title":"Antibiotics most responsible for drug resistance are overused \u2013 WHO report","author":"World Health Organization","year":"2025"},{"key":"pone.0344449.ref045","article-title":"NHS launches \u2018subscription\u2019 scheme for antibiotics with pharma sector","author":"I Johnston","year":"2024","journal-title":"Financ Times"},{"issue":"6","key":"pone.0344449.ref046","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003139","article-title":"Antibiotic prescription practices in primary care in low- and middle-income countries: A systematic review and meta-analysis","volume":"17","author":"G Sulis","year":"2020","journal-title":"PLoS Med"},{"key":"pone.0344449.ref047","doi-asserted-by":"crossref","first-page":"741345","DOI":"10.3389\/fpubh.2021.741345","article-title":"Coping With Diagnostic Uncertainty in Antibiotic Prescribing: A Latent Class Study of Primary Care Physicians in Hubei China","volume":"9","author":"C Liu","year":"2021","journal-title":"Front Public Health"},{"key":"pone.0344449.ref048","unstructured":"World Health Organization. Control antibiotic misuse or the drugs won\u2019t work \u2013 warn WHO experts. https:\/\/www.who.int\/europe\/news\/item\/23-11-2023-control-antibiotic-misuse-or-the-drugs-won\u2019t-work--warn-who-experts. 2023."},{"issue":"5","key":"pone.0344449.ref049","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0285170","article-title":"The economic burden of antibiotic resistance: A systematic review and meta-analysis","volume":"18","author":"AN Poudel","year":"2023","journal-title":"PLoS One"},{"issue":"1","key":"pone.0344449.ref050","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12916-020-1507-2","article-title":"Quantifying the economic cost of antibiotic resistance and the impact of related interventions: rapid methodological review, conceptual framework and recommendations for future studies","volume":"18","author":"M Jit","year":"2020","journal-title":"BMC Med"},{"issue":"1","key":"pone.0344449.ref051","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s13561-021-00326-y","article-title":"Using point-of-care diagnostic testing for improved antibiotic prescription: an economic model","volume":"11","author":"F Anto\u00f1anzas","year":"2021","journal-title":"Health Econ Rev"},{"issue":"1","key":"pone.0344449.ref052","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12875-023-02223-1","article-title":"Factors contributing to the variation in antibiotic prescribing among primary health care physicians: a systematic review","volume":"25","author":"GE Kasse","year":"2024","journal-title":"BMC Prim Care"},{"key":"pone.0344449.ref053","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.39435","article-title":"The distribution of antibiotic use and its association with antibiotic resistance","volume":"7","author":"SW Olesen","year":"2018","journal-title":"eLife"},{"issue":"6","key":"pone.0344449.ref054","article-title":"Implications of reducing antibiotic treatment duration for antimicrobial resistance in hospital settings: A modelling study and meta-analysis","volume":"20","author":"Y Mo","year":"2023","journal-title":"PLoS Med"},{"issue":"1","key":"pone.0344449.ref055","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1186\/s12889-019-7258-3","article-title":"Communication interventions to promote the public\u2019s awareness of antibiotics: a systematic review","volume":"19","author":"VR Burstein","year":"2019","journal-title":"BMC Public Health"},{"issue":"5","key":"pone.0344449.ref056","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pbio.3000250","article-title":"Resistance diagnostics as a public health tool to combat antibiotic resistance: A model-based evaluation","volume":"17","author":"D McAdams","year":"2019","journal-title":"PLoS Biol"},{"issue":"12","key":"pone.0344449.ref057","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.3390\/antibiotics10121522","article-title":"How Socioeconomic, Health Seeking Behaviours, and Educational Factors Are Affecting the Knowledge and Use of Antibiotics in Four Different Cities in Asia","volume":"10","author":"SKY Chow","year":"2021","journal-title":"Antibiotics (Basel)"},{"issue":"1","key":"pone.0344449.ref058","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1186\/s12889-022-13855-w","article-title":"Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks\u2019 attitudes, perceptions and values","volume":"22","author":"D Papadimou","year":"2022","journal-title":"BMC Public Health"},{"key":"pone.0344449.ref059","doi-asserted-by":"crossref","first-page":"105923","DOI":"10.1016\/j.micpath.2022.105923","article-title":"Emergent crisis of antibiotic resistance: A silent pandemic threat to 21st century","volume":"174","author":"F Akram","year":"2023","journal-title":"Microb Pathog"},{"issue":"13","key":"pone.0344449.ref060","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1080\/10408398.2015.1077192","article-title":"Antimicrobial resistance: A global emerging threat to public health systems","volume":"57","author":"M Ferri","year":"2017","journal-title":"Crit Rev Food Sci Nutr"},{"issue":"11","key":"pone.0344449.ref061","doi-asserted-by":"crossref","DOI":"10.6007\/IJARBSS\/v12-i11\/15410","article-title":"The SEM SmartPLS Model Assessment: Mediating Influence of Technology Infrastructure Support on Human Capital Determinants in TVET Institutions","volume":"12","author":"FA Mat Nawi","year":"2022","journal-title":"IJARBSS"},{"key":"pone.0344449.ref062","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1108\/978-1-80455-063-220231002","article-title":"Which SEM to Use and What to Report? A Comparison of CB-SEM and PLS-SEM","volume-title":"Cutting Edge Research Methods in Hospitality and Tourism","author":"A Usakli","year":"2023"},{"issue":"1","key":"pone.0344449.ref063","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1108\/EBR-11-2018-0203","article-title":"When to use and how to report the results of PLS-SEM","volume":"31","author":"JF Hair","year":"2019","journal-title":"EBR"},{"key":"pone.0344449.ref064","article-title":"Cronbach\u2019s Alpha: A Cornerstone in Ensuring Reliability and Validity in Environmental Health Assessment","author":"SC Izah","year":"2023","journal-title":"ES Energy Environ"},{"issue":"4","key":"pone.0344449.ref065","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1177\/10944281221115374","article-title":"Construct Development and Validation in Three Practical Steps: Recommendations for Reviewers, Editors, and Authors","volume":"26","author":"LS Lambert","year":"2022","journal-title":"Organizational Research Methods"},{"issue":"3","key":"pone.0344449.ref066","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1108\/JTS-03-2024-0016","article-title":"A typology of validity: content, face, convergent, discriminant, nomological and predictive validity","volume":"12","author":"WM Lim","year":"2024","journal-title":"JTS"},{"issue":"1","key":"pone.0344449.ref067","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1037\/a0030767","article-title":"On the relationship between coefficient alpha and composite reliability","volume":"98","author":"RA Peterson","year":"2013","journal-title":"J Appl Psychol"},{"issue":"1","key":"pone.0344449.ref068","first-page":"27","article-title":"Statistical analysis: Internal-consistency reliability and construct validity","volume":"6","author":"ST Hajjar","year":"2018","journal-title":"Int J Quant Qual Res Methods"},{"issue":"5","key":"pone.0344449.ref069","first-page":"378","article-title":"Assessing reliability and validity of attitude construct using partial least squares structural equation modeling","volume":"12","author":"Y Haji-Othman","year":"2022","journal-title":"Int J Acad Res Bus Soc Sci"},{"key":"pone.0344449.ref070","first-page":"1","article-title":"Assessing convergent and discriminant validity in the ADHD-R IV rating scale: User-written commands for Average Variance Extracted (AVE), Composite Reliability (CR), and Heterotrait-Monotrait ratio of correlations (HTMT)","volume":"39","author":"D Alarc\u00f3n","year":"2015","journal-title":"Spanish STATA Meeting"},{"issue":"4","key":"pone.0344449.ref071","doi-asserted-by":"crossref","first-page":"042045","DOI":"10.1088\/1742-6596\/1529\/4\/042045","article-title":"Discriminant validity assessment of religious teacher acceptance: The use of HTMT criterion","volume":"1529","author":"ASM Yusoff","year":"2020","journal-title":"J Phys Conf Ser"},{"issue":"2","key":"pone.0344449.ref072","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1007\/s10490-023-09871-y","article-title":"Reporting reliability, convergent and discriminant validity with structural equation modeling: A review and best-practice recommendations","volume":"41","author":"GW Cheung","year":"2023","journal-title":"Asia Pac J Manag"},{"issue":"1","key":"pone.0344449.ref073","first-page":"7","article-title":"Modelling a high reliability and validity by using confirmatory factor analysis on five latent construct: Volunteerism program","volume":"1","author":"WMABW Afthanorhan","year":"2013","journal-title":"Int Res J Adv Eng Sci Technol"},{"issue":"2","key":"pone.0344449.ref074","first-page":"1","article-title":"Discriminant validity assessment in PLS-SEM: A comprehensive composite-based approach","volume":"3","author":"SM Rasoolimanesh","year":"2022","journal-title":"Data Anal Perspect J"},{"key":"pone.0344449.ref075","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/978-3-030-80519-7_4","article-title":"Evaluation of reflective measurement models","volume-title":"Partial Least Squares Structural Equation Modeling (PLS-SEM) Using R: A Workbook","author":"JFJ Hair","year":"2021"},{"issue":"1","key":"pone.0344449.ref076","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s11747-014-0403-8","article-title":"A new criterion for assessing discriminant validity in variance-based structural equation modeling","volume":"43","author":"J Henseler","year":"2015","journal-title":"J Acad Mark Sci"},{"key":"pone.0344449.ref077","unstructured":"Janadari MPN, Sri Ramalu S, Wei C. Evaluation of measurement and structural model of the reflective model constructs in PLS\u2013SEM. 2016."},{"issue":"4","key":"pone.0344449.ref078","first-page":"4","article-title":"PLS-based model selection: The role of alternative explanations in information systems research","volume":"20","author":"P Sharma","year":"2019","journal-title":"J Assoc Inf Syst"},{"issue":"4","key":"pone.0344449.ref079","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1111\/modl.12509","article-title":"Multiple Regression in L2 Research: A Methodological Synthesis and Guide to InterpretingR2Values","volume":"102","author":"L PLONSKY","year":"2018","journal-title":"The Modern Language Journal"},{"issue":"4","key":"pone.0344449.ref080","doi-asserted-by":"crossref","first-page":"729","DOI":"10.64534\/Commer.2023.061","article-title":"Top Management Green Commitment and Proenvironmental Behavior: Mediating Role of Environmental Knowledge Application and Moderating Role of Green Mindfulness","volume":"17","author":"M Alam","year":"2023","journal-title":"Pak J Commer Soc Sci"},{"key":"pone.0344449.ref081","volume-title":"Influence of emotional intelligence and classroom engagement on academic performance of university undergraduate students","author":"J Iqbal","year":"2022"},{"key":"pone.0344449.ref082","volume-title":"Global Action Plan on Antimicrobial Resistance","author":"World Health Organization","year":"2015"},{"issue":"4","key":"pone.0344449.ref083","doi-asserted-by":"crossref","first-page":"106411","DOI":"10.1016\/j.ijantimicag.2021.106411","article-title":"An insight into the implementation of the global action plan on antimicrobial resistance in the WHO African region: A roadmap for action","volume":"58","author":"CD Iwu","year":"2021","journal-title":"Int J Antimicrob Agents"},{"issue":"5","key":"pone.0344449.ref084","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1093\/jac\/dkac028","article-title":"Global consumption of antimicrobials: impact of the WHO Global Action Plan on Antimicrobial Resistance and 2019 coronavirus pandemic (COVID-19)","volume":"77","author":"T Khouja","year":"2022","journal-title":"J Antimicrob Chemother"},{"issue":"2","key":"pone.0344449.ref085","first-page":"141","article-title":"Uncertainty and the welfare economics of medical care. 1963","volume":"82","author":"KJ Arrow","year":"2004","journal-title":"Bull World Health Organ"},{"issue":"2","key":"pone.0344449.ref086","doi-asserted-by":"crossref","first-page":"117","DOI":"10.3109\/03009734.2014.902879","article-title":"The need to look at antibiotic resistance from a health systems perspective","volume":"119","author":"G Tomson","year":"2014","journal-title":"Ups J Med Sci"},{"issue":"1","key":"pone.0344449.ref087","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/ddr.21468","article-title":"Microbial esterases and ester prodrugs: An unlikely marriage for combating antibiotic resistance","volume":"80","author":"EM Larsen","year":"2019","journal-title":"Drug Dev Res"},{"issue":"4","key":"pone.0344449.ref088","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1177\/109019817400200405","article-title":"The Health Belief Model and Preventive Health Behavior","volume":"2","author":"IM Rosenstock","year":"1974","journal-title":"Health Education Monographs"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0344449","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:25:21Z","timestamp":1779125121000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0344449"}},"subtitle":[],"editor":[{"given":"Abdullah","family":"AlSaleh","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":88,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0344449","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]}}}