{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:02:23Z","timestamp":1787320943712,"version":"build-2736575974"},"reference-count":48,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Antimicrobial-resistant (AMR) bacteria are prevalent in household and environmental settings in low-income locations. However, there are limited data on individuals\u2019 understanding of AMR bacteria exposure risks in these settings. A cross-sectional study was conducted to identify individual risk perception of AMR bacteria and its associated behavioral determinants at the household level in urban, peri-urban, and rural Malawi. We conducted interviews with 529 participants from 300 households (\n                    <jats:italic>n<\/jats:italic>\n                    = 100 households\/site). The risk, attitude, norms, ability, and self-regulation model was used to assess psychosocial factors underlying AMR bacteria exposure through animal feces, river water, and drain water. Analysis of variance was used to assess the difference between doers and non-doers of the three targeted behaviors: use and contact with river water, contact with drain water, and contact with animal feces. There was limited understanding regarding human\u2013environmental interactions facilitating AMR bacteria transmission across all sites, and as such, the perceived risk of contracting AMR infection was low (41%;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.189). Human contact with animal feces was seen as risky (64%) compared with contact with river and drain water (17%). Urban participants perceived that they were at greater risk of AMR bacteria exposure than their rural counterparts (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.001). The perception of social norms was favorable for the targeted behaviors (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.001), as well as self-reported attitude and ability estimates (self-efficacy;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.023), thus indicating the role of psychosocial factors influencing the human\u2013environment interaction in AMR bacteria transmission. Our findings underscore the need for combined infrastructural improvements and behavior-centered AMR bacteria education to drive behavioral changes, benefiting both AMR infection mitigation and broader One Health initiatives.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.24-0253","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T15:35:14Z","timestamp":1733240114000},"page":"355-363","source":"Crossref","is-referenced-by-count":4,"title":["Risk Perception and Psychosocial Factors Influencing Exposure to Antimicrobial Resistance through Environmental Pathways in Malawi"],"prefix":"10.4269","volume":"112","author":[{"given":"Kondwani","family":"Chidziwisano","sequence":"first","affiliation":[{"name":"Centre for Water, Sanitation, Health and Appropriate Technology Development, Malawi University of Business and Applied Sciences, Chichiri, Malawi;"},{"name":"Department of Environmental Health, Malawi University of Business and Applied Sciences, Chichiri, Malawi;"},{"name":"Department of Civil and Environmental Engineering, University of Strathclyde, Glasgow, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Cocker","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi;"},{"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taonga","family":"Mwapasa Kumwenda","sequence":"additional","affiliation":[{"name":"Centre for Water, Sanitation, Health and Appropriate Technology Development, Malawi University of Business and Applied Sciences, Chichiri, Malawi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Amos","sequence":"additional","affiliation":[{"name":"Centre for Water, Sanitation, Health and Appropriate Technology Development, Malawi University of Business and Applied Sciences, Chichiri, Malawi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Feasey","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi;"},{"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Morse","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, University of Strathclyde, Glasgow, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Am J Infect Control","first-page":"1090","article-title":"Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A position 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