Marco J. HaenssgenThipphaphone XayavongNutcha CharoenboonPenporn WarapikuptanunYuzana Khine ZawUniversity of Oxford, Saïd Business SchoolAteneo de Manila UniversityLondon School of Hygiene & Tropical MedicineGreen Templeton CollegeMahidol UniversityNuffield Department of Clinical MedicineUniversity for Peace2019-08-232019-08-232018-12-01Antibiotics. Vol.7, No.4 (2018)207963822-s2.0-85056655506https://repository.li.mahidol.ac.th/handle/20.500.14594/44981© 2018 by the authors. Licensee MDPI, Basel, Switzerland. Education and awareness raising are the primary tools of global health policy to change public behaviour and tackle antimicrobial resistance. Considering the limitations of an awareness agenda, and the lack of social research to inform alternative approaches, our objective was to generate new empirical evidence on the consequences of antibiotic-related awareness raising in a low-income country context. We implemented an educational activity in two Lao villages to share general antibiotic-related messages and also to learn about people’s conceptions and health behaviours. Two rounds of census survey data enabled us to assess the activity’s outputs, its knowledge outcomes, and its immediate behavioural impacts in a difference-in-difference design. Our panel data covered 1130 adults over two rounds, including 58 activity participants and 208 villagers exposed indirectly via conversations in the village. We found that activity-related communication circulated among more privileged groups, which limited its indirect effects. Among participants, the educational activity influenced the awareness and understanding of “drug resistance”, whereas the effects on attitudes were minor. The evidence on the behavioural impacts was sparse and mixed, but the range of possible consequences included a disproportionate uptake of antibiotics from formal healthcare providers. Our study casts doubt on the continued dominance of awareness raising as a behavioural tool to address antibiotic resistance.Mahidol UniversityBiochemistry, Genetics and Molecular BiologyImmunology and MicrobiologyMedicinePharmacology, Toxicology and PharmaceuticsArticleSCOPUS10.3390/antibiotics7040095