Exploring the Knowledge Gap of Asymptomatic Bacteriuria through Online Crowdsourcing

Objectives: Employ online crowdsourcing to explore public perceptions and knowledge of asymptomatic bacteriuria (ASB).

Methods: A cross-sectional online survey was administered to women aged 50 years or older via Qualtrics in December 2022. Participants were recruited through CloudResearch to complete the anonymous survey. Surveys were excluded from analysis if >2 of 3 attention check questions were answered incorrectly. Participants were provided a short description of ASB and asked a variety of demographic questions prior to completing a survey geared towards knowledge, concerns and treatment preferences surrounding ASB. Respondents were allowed to answer “Yes,” “No,” or “I don’t know.” Primary outcome was proportion of respondents answering “yes” to the question “Overall, would you be concerned with having ASB?” Secondary outcomes were proportion of respondents who would want ASB to be treated with antibiotics along with responses to all survey questions. We hypothesized that people with more education would be less concerned with ASB. Chi-square testing was utilized to look for variables associated with concern for ASB. The associations between education level and concern for ASB were estimated using logistic regression modeling. SPSS v26.0 (IBM statistics) was used for analysis and p< 0.05 was considered significant.

Results: There were a total of 526 participants of which 518 passed attention check qualifications. Most were 50-59 years of age (n=286, 55.2%), white race (n=455, 87.8%), and 71.3% (n=369) reported at least some college education (n=205, 39.6%). There was a wide range of locations with the largest percentage of respondents residing in the southeast (n=179, 34.6%). Overall only 45 (8.7%) had heard of ASB. For our primary outcome, 306 (59.1%) respondents would be concerned about having ASB, but only a minority definitely desired antibiotics (n=53, 10.2%). Many were concerned ASB would progress to a worsening infection like a urinary tract infection (n=387, 77.6%). (Table) In bivariate analysis there were no demographic variables associated with a higher proportion of concerned respondents including age (p=0.43) and education (p=0.15). When controlling for age and race categories, post-graduate education was not associated with less concern for ASB when compared to those with high school education or less (aOR 0.63, 95% CI 0.25-1.55; p=0.31).

Conclusions: Our national survey of women demonstrated a prevalent deficit in knowledge about ASB. Education level did not mitigate concern that ASB would progress to infection though most women indicated that more information in print or through discussion with their provider could help them understand ASB.