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<p>Antimicrobial resistance (AMR) represents an escalating global public health threat with direct implications for food safety governance and consumer protection. Yet empirical evidence on the awareness, practices, and structural determinants of AMR-safe behavior among food service operators in lower-middle-income countries remains sparse. This study examined AMR awareness, food safety practices, perceived barriers, and adoption enablers among 189 restaurant owners and managers in Cebu, Philippines, and identified the determinants of AMR-safe practice adoption using a descriptive-correlational cross-sectional design. Data were collected via a validated bilingual survey instrument and analyzed using descriptive statistics, Spearman rank-order correlations, Kruskal-Wallis H tests, multiple linear regression, and bootstrapped mediation analysis (5,000 resamples). All four measurement scales demonstrated excellent reliability (AMR Awareness α = 0.982; Food Safety Practices α = 0.935; Perceived Barriers α = 0.970; Adoption Enablers α = 0.962). Respondents demonstrated moderate AMR awareness (M = 3.57, SD = 1.31) alongside moderate-to-high food safety practices (M = 3.94, SD = 0.94), confirming a bifurcation between general hygiene compliance (near-Always levels) and AMR-specific operational protocols (near-Sometimes levels). Food Safety Officer (FSO) certification was the strongest determinant of AMR-safe practices (β = 0.384, <i>p</i> &lt; .001) and was significantly associated with higher awareness, better practices, and lower perceived barriers. AMR awareness independently predicted practices (β = 0.161, <i>p</i> = .038), but bootstrapped mediation analysis revealed that enabler endorsement did not mediate this relationship (indirect effect: −0.022, 95% CI [− 0.086, 0.039]), indicating that structural interventions outperform awareness campaigns as levers for practice improvement. Economic barriers — specifically the cost and limited supply of AMR-safe ingredients — were the most pronounced deterrents. These findings provide, to our knowledge, among the first empirical evidence on AMR-safe practice determinants in Philippine food service, with direct transdisciplinary implications for Food Safety Officer training mandates, supply-chain AMR stewardship reform, One Health food safety policy design, and AMR awareness integration in hospitality education curricula.</p>

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Determinants of AMR-safe practice adoption among restaurant owners and managers in the Philippine food service sector

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月2日

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  • Anne Jere Bajarias,
  • Francis Dindo De Lara,
  • Marlou Godinez,
  • Michelle Trangia,
  • Adrian Ybañez

摘要

Antimicrobial resistance (AMR) represents an escalating global public health threat with direct implications for food safety governance and consumer protection. Yet empirical evidence on the awareness, practices, and structural determinants of AMR-safe behavior among food service operators in lower-middle-income countries remains sparse. This study examined AMR awareness, food safety practices, perceived barriers, and adoption enablers among 189 restaurant owners and managers in Cebu, Philippines, and identified the determinants of AMR-safe practice adoption using a descriptive-correlational cross-sectional design. Data were collected via a validated bilingual survey instrument and analyzed using descriptive statistics, Spearman rank-order correlations, Kruskal-Wallis H tests, multiple linear regression, and bootstrapped mediation analysis (5,000 resamples). All four measurement scales demonstrated excellent reliability (AMR Awareness α = 0.982; Food Safety Practices α = 0.935; Perceived Barriers α = 0.970; Adoption Enablers α = 0.962). Respondents demonstrated moderate AMR awareness (M = 3.57, SD = 1.31) alongside moderate-to-high food safety practices (M = 3.94, SD = 0.94), confirming a bifurcation between general hygiene compliance (near-Always levels) and AMR-specific operational protocols (near-Sometimes levels). Food Safety Officer (FSO) certification was the strongest determinant of AMR-safe practices (β = 0.384, p < .001) and was significantly associated with higher awareness, better practices, and lower perceived barriers. AMR awareness independently predicted practices (β = 0.161, p = .038), but bootstrapped mediation analysis revealed that enabler endorsement did not mediate this relationship (indirect effect: −0.022, 95% CI [− 0.086, 0.039]), indicating that structural interventions outperform awareness campaigns as levers for practice improvement. Economic barriers — specifically the cost and limited supply of AMR-safe ingredients — were the most pronounced deterrents. These findings provide, to our knowledge, among the first empirical evidence on AMR-safe practice determinants in Philippine food service, with direct transdisciplinary implications for Food Safety Officer training mandates, supply-chain AMR stewardship reform, One Health food safety policy design, and AMR awareness integration in hospitality education curricula.