Marco J. HaenssgenNutcha CharoenboonGiacomo ZanelloMayfong MayxayFelix Reed-TsochasCaroline O.H. JonesRomyen KosaikanontPollavat PraphattongPathompong ManohanYoel LubellPaul N. NewtonSommay KeomanyHeiman F.L. WertheimJeffrey LienertThipphaphone XayavongPenporn WarapikuptanunYuzana Khine ZawPatchapoom U-ThongPatipat BenjaroonNarinnira SangkhamKanokporn WibunjakPoowadon Chai-InSirirat ChailertPatthanan ThavethanutthanawinKrittanon PromsuttAmphayvone ThepkhamkongNicksan SithongdengMaipheth KeovilayvanhNid KhamsoukthavongPhaengnitta PhanthasomchitChanthasone PhanthavongSomsanith BoualaisengSouksakhone VongsavangRachel C. GreerThomas AlthausSupalert NedsuwanDaranee IntralawanTri WangrangsimakulDirek LimmathurotsakulProochista ArianaUniversity of Oxford, Saïd Business SchoolWellcome Trust Research Laboratories NairobiLondon School of Hygiene & Tropical MedicineGreen Templeton CollegeUniversity of OxfordMae Fah Luang UniversityNational Human Genome Research InstituteMahidol UniversityUniversity of ReadingNuffield Department of Clinical MedicineUniversity of Health SciencesMedical Microbiology DepartmentOxford University Clinical Research Unit (OUCRU)Salavan Provincial HospitalChiangrai Prachanukroh Hospital2019-08-282019-08-282018-03-01BMJ Global Health. Vol.3, No.2 (2018)205979082-s2.0-85056625843https://repository.li.mahidol.ac.th/handle/20.500.14594/46931© 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.Mahidol UniversityMedicineArticleSCOPUS10.1136/bmjgh-2017-000621