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Title: Antibiotics and activity spaces: Protocol of an exploratory study of behaviour, marginalisation and knowledge diffusion
Authors: Marco J. Haenssgen
Nutcha Charoenboon
Giacomo Zanello
Mayfong Mayxay
Felix Reed-Tsochas
Caroline O.H. Jones
Romyen Kosaikanont
Pollavat Praphattong
Pathompong Manohan
Yoel Lubell
Paul N. Newton
Sommay Keomany
Heiman F.L. Wertheim
Jeffrey Lienert
Thipphaphone Xayavong
Penporn Warapikuptanun
Yuzana Khine Zaw
Patchapoom U-Thong
Patipat Benjaroon
Narinnira Sangkham
Kanokporn Wibunjak
Poowadon Chai-In
Sirirat Chailert
Patthanan Thavethanutthanawin
Krittanon Promsutt
Amphayvone Thepkhamkong
Nicksan Sithongdeng
Maipheth Keovilayvanh
Nid Khamsoukthavong
Phaengnitta Phanthasomchit
Chanthasone Phanthavong
Somsanith Boualaiseng
Souksakhone Vongsavang
Rachel C. Greer
Thomas Althaus
Supalert Nedsuwan
Daranee Intralawan
Tri Wangrangsimakul
Direk Limmathurotsakul
Proochista Ariana
University of Oxford, Saïd Business School
Wellcome Trust Research Laboratories Nairobi
London School of Hygiene & Tropical Medicine
Green Templeton College
University of Oxford
Mae Fah Luang University
National Human Genome Research Institute
Mahidol University
University of Reading
Nuffield Department of Clinical Medicine
University of Health Sciences
Medical Microbiology Department
Oxford University Clinical Research Unit (OUCRU)
Salavan Provincial Hospital
Chiangrai Prachanukroh Hospital
Keywords: Medicine
Issue Date: 1-Mar-2018
Citation: BMJ Global Health. Vol.3, No.2 (2018)
Abstract: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. Background Antimicrobial resistance (AMR) is a global health priority. Leading UK and global strategy papers to fight AMR recognise its social and behavioural dimensions, but current policy responses to improve the popular use of antimicrobials (eg, antibiotics) are limited to education and awareness-raising campaigns. In response to conceptual, methodological and empirical weaknesses of this approach, we study people's antibiotic-related health behaviour through three research questions. RQ1: What are the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways? RQ2: Will people's exposure to antibiotic awareness activities entail changed behaviours that diffuse or dissipate within a network of competing healthcare practices? RQ3: Which proxy indicators facilitate the detection of problematic antibiotic behaviours across and within communities? Methods We apply an interdisciplinary analytical framework that draws on the public health, medical anthropology, sociology and development economics literature. Our research involves social surveys of treatment-seeking behaviour among rural dwellers in northern Thailand (Chiang Rai) and southern Lao PDR (Salavan). We sample approximately 4800 adults to produce district-level representative and social network data. Additional 60 cognitive interviews facilitate survey instrument development and data interpretation. Our survey data analysis techniques include event sequence analysis (RQ1), multilevel regression (RQ1-3), social network analysis (RQ2) and latent class analysis (RQ3). Discussion Social research in AMR is nascent, but our unprecedentedly detailed data on microlevel treatment-seeking behaviour can contribute an understanding of behaviour beyond awareness and free choice, highlighting, for example, decision-making constraints, problems of marginalisation and lacking access to healthcare and competing ideas about desirable behaviour. trial registration number NCT03241316; Pre-results.
ISSN: 20597908
Appears in Collections:Scopus 2018

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