# Veterinarians' attitudes, knowledge, and practices about antibiotic use in animals: questionnaire design and reliability

## TL;DR

This study created and tested a questionnaire to assess veterinarians' knowledge and attitudes about antibiotic use and resistance in animals.

## Contribution

The study introduces a reliable questionnaire for evaluating veterinarians' perspectives on antimicrobial resistance and antibiotic use.

## Key findings

- The questionnaire showed good reliability, with Cronbach's alpha values of 0.81 and 0.78 for test and retest.
- ICC values ranged from 0.10 in the AMR section to 0.85 in the prescription and antibiotic use section.
- Based on feedback and ICC results, some questionnaire items were revised for clarity and reliability.

## Abstract

Antimicrobial resistance (AMR) is a global public health concern that requires a One Health approach. The role of veterinarians in promoting antimicrobial stewardship is essential for successful mitigation of AMR.

This study aimed to design a self-administered questionnaire and evaluate its reliability as a tool to assess veterinarians' knowledge, perceptions, and attitudes regarding AMR and antibiotic prescription and use in animals.

The questionnaire was developed based on a comprehensive review of relevant literature and by employing collective intelligence methodologies, including focus groups with veterinarians and pharmacists. For the pilot study, veterinarians working in the Northern region of Portugal were recruited. A test-retest was conducted with a 4-week interval. Reproducibility was determined with the intraclass correlation coefficient (ICC; 95% confidence interval) and internal consistency was calculated using Cronbach's alpha.

In total, 31 (out of 34) veterinarians completed the retest phase of the study. Four sections with scale-items were assessed for reliability, with ICC values ranging from 0.10 (p = 0.285) in Section 2 (AMR) to 0.85 (p < 0.001) in Section 4 (prescription and antibiotic use). The questionnaire achieved Cronbach's alpha coefficient values of 0.81 and 0.78 in test and retest, respectively. Based on ICC values and veterinarians' comments, some items were deleted or reformulated.

The developed questionnaire is a reliable instrument capable of capturing veterinarians' knowledge, perceptions, and attitudes on AMR and antibiotic use.