Introduction: Psychology plays a pivotal role in understanding and changing health behaviours. In antimicrobial resistance (AMR), inappropriate consumption and non-adherence are key behavioural drivers. To address AMR it therefore is essential to investigate psychological factors that shape antibiotic-related behaviours.
Purpose: This study applies the COM-B model (Capability, Opportunity, Motivation - Behaviour) to explore psychological factors influencing antibiotic-related behaviours among Italian citizens.
Method: A web-based survey was administered to a representative sample (n=500). The questionnaire included ad hoc items and validated scales. After testing the reliability and factorial structure, linear regression models were performed to examine the associations between COM-B components and self-reported behaviours of antibiotic consumption.
Results: The EFA identified two behavioural domains: adherence to treatment and inappropriate consumption. The regression model for adherence was significant (F (9,487) = 48.63, p <.001, R2=.47). Adherence was positively associated with perceived capability (β = .33, p < .001) and knowledge (β = .23, p < .001), and negatively associated with memory, attention and decision processes (β = -.40, p < .001). The model for inappropriate consumption was also significant (F(9,487) = 28.11, p < .001; R² = .34). Inappropriate use was positively associated with social pressure (β = .24, p < .001) and misconceptions (β = .32, p < .001) and negatively associated with knowledge (β = -.09, p = .038) and risk perception (β = -.09, p = .019).
Conclusions: Findings show that antibiotic consumption is not only a matter of knowledge but also of cognitive resources, risk appraisal, and social influence. By mapping these determinants, the COM-B model provides actionable insights for designing interventions that go beyond information campaigns, addressing misconceptions, reducing social pressure, and supporting citizens' capacity to adhere to treatment. Such evidence is critical to inform public health strategies aimed at tackling AMR.