Associations between multidimensional life satisfaction and antibiotic-related knowledge, attitudes, and practice: A cross-sectional study of three neighboring cities in China's Greater Bay Area
8 affiliations
- 1Department of Public and International Affairs, City University of Hong Kong, Hong Kong; Institute of Global Governance and Innovation for a Shared Future, City University of Hong Kong, Hong Kong
- 2Department of Anaesthesiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong
- 3School of Public Administration, Beihang University, Beijing, China
- 4School of Public Health, Sun Yat-sen University, Guangzhou, China; Institute for Global Health and Development, Peking University, Beijing, China
- 5Institute of Global Governance and Innovation for a Shared Future, City University of Hong Kong, Hong Kong; Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong
- 6Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Chinese University of Hong Kong, Hong Kong
- 7Vanke School of Public Health, Tsinghua University, China
- 8Department of Public and International Affairs, City University of Hong Kong, Hong Kong; Corresponding author.
Abstract
Background: Life satisfaction, as a measure of subjective wellbeing, has both positive and negative effects on health risks and social behavior. However, the associations between life satisfaction and knowledge, attitudes, and frequency of use related to antibiotic use and antimicrobial resistance are unclear. Methods: A cross-sectional study (n = 1230) was conducted in three neighboring cities in the Greater Bay Area (Hong Kong, Shenzhen, and Guangzhou). The Personal Wellbeing Index–Adult (PWI-A) was used to assess life satisfaction, which includes a measure of overall life satisfaction and additional measures for seven specific domains: standard of living, personal health, achievement in life, personal relationships, personal safety, community connectedness, and future security. Descriptive statistics were used to compare 1) knowledge, attitudes, and frequency of use related to antibiotic use and antimicrobial resistance and 2) life satisfaction among individuals from the three cities. Regression analyses were conducted to assess the associations between life satisfaction and antibiotic-related knowledge, attitudes, and frequency of use. Results: Personal health and personal safety were positively associated with knowledge of antibiotic use and antimicrobial resistance (β = 0.110 [0.028, 0.191] and 0.083 [0.001, 0.164]). Standard of living and achievement in life were negatively associated with knowledge (β = −0.097 [−0.188, −0.007] and −0.109 [−0.205, −0.012]) and attitudes (β = −0.107 [−0.190, −0.024] and −0.178 [−0.264, −0.093]). In addition, standard of living and achievement in life were positively associated with antibiotic use (ORs = 1.239 [1.127, 1.361] and 1.214 [1.108, 1.330]), whereas personal health was negatively associated with antibiotic use (OR = 0.848 [0.776, 0.927]). City contributed a fixed effect on knowledge independent of personal wellbeing, and differences in the associations between personal wellbeing and KAP across cities were mainly observed in the results for antibiotic use. Conclusion: Subjective socioeconomic status may negatively influence knowledge, attitudes, and practices regarding antibiotic use and antimicrobial resistance, which in turn affects medication decisions and risk perceptions among local residents.
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BibTeX
@article{ho2026associations,
title = {{Associations between multidimensional life satisfaction and antibiotic-related knowledge, attitudes, and practice: A cross-sectional study of three neighboring cities in China's Greater Bay Area}},
author = {Hung Chak Ho and Yuchang Bao and Shuang Zhong and Lianping Yang and Chi Wai Cheung and Wai Kit Ming and Chunlan Guo and Cunrui Huang and Nicholas Thomas},
journal = {Global Transitions},
year = {2026},
month = oct,
doi = {10.1016/j.glt.2026.09.008},
url = {https://doi.org/10.1016/j.glt.2026.09.008},
note = {CC BY},
}
RIS
TY - JOUR
TI - Associations between multidimensional life satisfaction and antibiotic-related knowledge, attitudes, and practice: A cross-sectional study of three neighboring cities in China's Greater Bay Area
AU - Hung Chak Ho
AU - Yuchang Bao
AU - Shuang Zhong
AU - Lianping Yang
AU - Chi Wai Cheung
AU - Wai Kit Ming
AU - Chunlan Guo
AU - Cunrui Huang
AU - Nicholas Thomas
PY - 2026
DA - 2026/10/25
JO - Global Transitions
DO - 10.1016/j.glt.2026.09.008
UR - https://doi.org/10.1016/j.glt.2026.09.008
AB - Background: Life satisfaction, as a measure of subjective wellbeing, has both positive and negative effects on health risks and social behavior. However, the associations between life satisfaction and knowledge, attitudes, and frequency of use related to antibiotic use and antimicrobial resistance are unclear. Methods: A cross-sectional study (n = 1230) was conducted in three neighboring cities in the Greater Bay Area (Hong Kong, Shenzhen, and Guangzhou). The Personal Wellbeing Index–Adult (PWI-A) was used to assess life satisfaction, which includes a measure of overall life satisfaction and additional measures for seven specific domains: standard of living, personal health, achievement in life, personal relationships, personal safety, community connectedness, and future security. Descriptive statistics were used to compare 1) knowledge, attitudes, and frequency of use related to antibiotic use and antimicrobial resistance and 2) life satisfaction among individuals from the three cities. Regression analyses were conducted to assess the associations between life satisfaction and antibiotic-related knowledge, attitudes, and frequency of use. Results: Personal health and personal safety were positively associated with knowledge of antibiotic use and antimicrobial resistance (β = 0.110 [0.028, 0.191] and 0.083 [0.001, 0.164]). Standard of living and achievement in life were negatively associated with knowledge (β = −0.097 [−0.188, −0.007] and −0.109 [−0.205, −0.012]) and attitudes (β = −0.107 [−0.190, −0.024] and −0.178 [−0.264, −0.093]). In addition, standard of living and achievement in life were positively associated with antibiotic use (ORs = 1.239 [1.127, 1.361] and 1.214 [1.108, 1.330]), whereas personal health was negatively associated with antibiotic use (OR = 0.848 [0.776, 0.927]). City contributed a fixed effect on knowledge independent of personal wellbeing, and differences in the associations between personal wellbeing and KAP across cities were mainly observed in the results for antibiotic use. Conclusion: Subjective socioeconomic status may negatively influence knowledge, attitudes, and practices regarding antibiotic use and antimicrobial resistance, which in turn affects medication decisions and risk perceptions among local residents.
SN - 2589-7918
ER -