This were part of the process. The questions included

This is a
randomized control trial by Bekkers et al (2010) an intervention utilizing Theory
of Planned Behavior (TPB) which included 244 General Physicians (GPs) and Nurse
practitioners and 68 practices participated. TPB is a theory which links ones “behavior
and beliefs”4.
The concept proposed by Icek Ajzen was to predict one’s intentions while
engaging in a behavior at a specific time and place4. The goal of STAR which stands for
Stemming the Tide of Antibiotic Resistance Educational Program is to improve
the quality of antibiotic prescribing as well as increase awareness about
antibiotic resistance GPs6. The program comprises of seven parts and
is a “theory-based learning program which involves reflection on physicians own
practice, presentation of research evidence and guidelines, a practice based
seminar which concentrated on the participants’ own prescribing and resistance
rates in samples obtained from their practice.6” They also used videos
on communication skills and training of patients in routine surgeries and a web

             Semi-structured, digitally
recorded, and telephone interviews with the 31 practices who participated since
2 practices withdrew. Thematic content was used for analysis. The participants
were first contacted by letter to notify them that interviews were part of the
process. The questions included 3 main areas: 1). General information about
where the practice was located, how long they have worked there and how much
importance was given to antibiotic resistance6. 2). Effects of the
program after completion6 and 3). Detailed evaluation of everything.
The overview of the interviewee sampling included gender, experience,
prescribing and training completion.6

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             Most of the participants reported
that this increase in awareness on AMR allowed them to build greater
self-confidence in decreasing antibiotic prescribing and some change in
consultation and antibiotic prescribing behavior6. They also
reported making practical changes which included “adopting a practice-wide
policy of antibiotic prescription reduction.6” Most physicians also
mentioned improving doctor-patient relationship to increase awareness of
patient expectations.6 The intervention had great influence on
changing providers’ behavior and making sure they were caught up with research
and resources. Providers were presented with simple online videos on effective
communication as well as their own prescribing levels and data of their local
resistance. Providers thought this intervention was acceptable and possible
which resulted in positive changes in attitudes and practice.

             Some of the strengths of this study
were that the online training was convenient since providers already have a
heavy workload/busy schedule but users did face some technical difficulties6.
The providers could access the information on their own time. Another strength which
the study allowed participants to discuss their experiences with STAR, not only
what providers considered the most successful portion of the learning program
but also to discuss areas where improvement was necessary. Some limitations
this study included were when using an interview process, there are more
individual comments which may prevent topics that can add to greater insight on
how efficient the learning programs can be. Additional limitation were that not
all interviewees could be interviewed due to the intervention and timing.

             This randomized control trial
offers support to the idea that Theory of Planned Behavior is effective in
educational programs which increase awareness of antibiotic prescribing. The
theory motivating behavior and beliefs proved validating results. The theory
relies on the foundation of intent; behavioral intentions are persuaded by the
attitude about the probability that a behavior will have the projected outcome.