Date Published: March 21, 2019
Publisher: Public Library of Science
Author(s): Aaron Martin, Timothy B. Gravelle, Erik Baekkeskov, Jenny Lewis, Yoshi Kashima, Maria Rosaria Gualano.
Antimicrobial resistance represents one of the world’s most pressing public health problems. Governments around the world have—and will continue to—develop policy proposals to deal with this problem. However, the capacity of government will be constrained by very low levels of trust in government. This stands in contrast to ‘medical scientists’ who are highly trusted by the public. This article tests to what extent trusted sources can alter attitudes towards a policy proposal to regulate the use of antibiotics. We find that respondents are much more likely to support a policy put forward by ‘medical scientists.’ This article provides some initial evidence that medical scientists could be used to gain support for policies to tackle pressing policy challenges such as AMR.
Antimicrobial resistance (AMR) is now recognized as one of the world’s most pressing public health problems [1,2]. Governments around the world have—and will continue to—develop policy proposals to deal with this problem. However, the capacity of government will be constrained by levels of trust in government. Trust in government has been declining around the world in recent years [3–6]. Kettl  argues that ‘the rising tide of distrust in government is surely one of the biggest challenges facing the world’s democracies in the twenty-first century.’ In such an environment, government may find it harder to secure support for policy proposals to deal with AMR. At a time when trust in government is declining and social problems (such as AMR) are becoming more complex, it is likely that government will have to enlist the support of trusted sources to secure support for policy reforms. This article tests to what extent trusted sources can alter attitudes toward a policy proposal to regulate the use of antibiotics.
To test these theoretical expectations, we designed an online survey experiment, which we administered to a demographically representative non-probability sample of the Australian public (n = 388) through Qualtrics, an online survey platform. The sample (derived from an online panel of respondents supplied by Qualtrics) was balanced on age, gender, educational attainment, and party identification (the latter was matched to 2016 Australian Election Study data). This study was approved by the Human Ethics Committee at the University of Melbourne, Australia.
Examining first the bivariate distributions for support for prescription monitoring by each treatment, it is clear that the proposal enjoys majority support regardless of how it is framed. Overall support (for the entire sample) is 91.8 percent (see Table 1). Still, the framing of the proposal does strengthen or weaken the level of support. Framing the proposal as coming from the government reduces aggregate support to 85.1 percent (versus 98.5 percent when the proposal is framed as coming from Australia’s leading medical scientists). The modal response also shifts from supporting the proposal ‘strongly’ when presented as originating with Australia’s leading medical scientists to weaker (‘somewhat’) support when presented as a government proposal. By contrast, the competence frame increases support to 94.8 percent (versus 88.7 percent when no competence frame is presented). The modal response similarly shifts from ‘somewhat’ to ‘strongly’ supporting the proposal with the competence frame.
Political trust is important because it has been shown to have numerous attitudinal and behavioural consequences [4,5,45]. In this article we have explored one such consequence: whether an AMR policy proposal put forward by scientists is more likely to be supported than one put forward by government. As we noted above, the experiment was in a lot of ways a ‘hard-test’ given that most people might recognise AMR as a pressing public health problem and be supportive of any attempt to curb it. This is borne out, with high aggregate levels of support for the policy. Even allowing for that, we find a significantly higher level of support for the policy proposal put forward by scientists, as opposed to government.