Table 1.

ARI Antibiotic Prescribing Interview Sample Questions.

Question Category	Sample Questions
Current Practices	Tell me about the last time you as a primary care clinician prescribed an antibiotic for an acute respiratory infection such as a cold, otitis or sinusitis in the outpatient setting. Walk me through the decision and process – what you did and what you were thinking. Tell me about the clinicians in your clinic – how is their process similar to what you just described?
Knowledge	When are antibiotics indicated for acute respiratory infections in the outpatient setting? In what situations might you think about something differently (and prescribe something different) from what you described just now? Tell me about the knowledge that you (clinicians) in your practice or clinic have about prescribing. Can you give me an example where you realized a clinician had less knowledge than “average” about appropriate prescribing in the clinic?
Beliefs about Consequences	Describe a situation to me where you prescribed antibiotics when they were definitely indicated. Describe a situation where there was less certainty about whether antibiotics were indicated. What happens in these situations in your institution? What is your perception of clinician beliefs about the consequences? (e.g., what happens to you and what happens to others? What inherent risks might there be?)
Attitudes about Antibiotics Prescribing	If a clinician in your institution (and primary care clinic) “does the right thing” in terms of outpatient antibiotic prescribing for acute respiratory infections – what happens? How do others (patient, other clinicians, trainees, mentors) react? What do you think the attitudes about antibiotic prescribing, “doing the right thing” are for the patients you see in your institution? How many people at your institution – do the right thing in terms of antibiotic prescribing? For individuals (or times) when they do not, why not?
Subjective Norms	What do patients seen in your institution (ex. primary care clinic) think about antibiotics for treatment? Do clinicians discuss prescribing decisions with each other? Why or why not? Is there a process for providing feedback for antibiotic prescribing in outpatient environments at your institution? If yes, what is the process of feedback for antibiotic prescribing in outpatient environments at your institution? Have you ever received personal feedback relating to antibiotic prescribing in outpatient environment at your institution? How important are patients’ opinions in treatment decisions for antibiotic use in your institution? How important are clinicians’ opinions in treatment decisions for antibiotic use in your institution? Another way to think about this is how aware are other clinicians of your antibiotic prescribing decisions? Do they have opinions about them? How aware are you of others’ prescribing decisions? Do you have opinions about their prescribing?
Control Beliefs	How easy is it to make antibiotic prescribing decisions for ARI in outpatient (primary care clinic) environments? What makes it easy (or difficult)? How easy is it to change antibiotic prescribing decisions and/or behaviors for ARI in outpatient environments? What makes it easy (or difficult)? Are there things that might make it easy for you to “do the right thing” in antibiotic prescribing? How much control do you have over the prescribing decisions that you make?
Shared Decision Making	Are you familiar with the term shared decision making? Have you used shared decision making with patients when making antibiotic prescribing decisions for ARIs? In making other antibiotic prescribing decisions?
Future Planned Behaviors	Do you think there is room for improvement in how you prescribe antibiotics? Do you have any plans to promote the judicious use of antibiotics in your own practice? If so, what are your plans? If not, why not? What barriers do you (and others) face in developing potential plans? What are the solutions to promote appropriate antibiotic prescribing? If you were given some additional pointers on how to communicate with patients about antibiotic prescribing – what impact would that have on your approach? How do you think you would feel about that experience? If you were given feedback on how you were performing with antibiotic selection and feedback (e.g., how well your prescribing matched evidence based recommendations) -what impact would that have on your approach and subjective experience? If we were designing an intervention about patient communication and antibiotic prescribing – what would help you to have included? If you were getting feedback on your performance (how well you stack up compared to your peers in domains like making diagnoses or with CDC recommendations for treatment) – what kinds of things would you want feedback developers to know?