Antibiotics and Activity Spaces: An Exploratory Study of Behaviour, Marginalisation, and Knowledge Diffusion
- Conditions
- Antibiotic UseRural Healthcare-seeking BehaviourMarginalisation (Economic, Social, Spatial)
- Interventions
- Behavioral: Observational study of behaviour
- Registration Number
- NCT03241316
- Lead Sponsor
- University of Oxford
- Brief Summary
The investigators will conduct two rural surveys in Thailand and Lao PDR to improve the understanding of antibiotic-related health behaviour among the general population. One survey will capture a cross-section of health behaviours that is representative for the rural population in Chiang Rai (Thailand) and Salavan (Lao PDR), the other survey will create a two round village-level panel data set to study the evolution of health behaviours in the context of public engagement activities. The investigators will also collect complementary data about village-level infrastructure through observational check-lists, and collect secondary data on patient load from primary care units catering to their survey villages. As part of the questionnaire testing process, the investigators will conduct (and collect as primary data) cognitive interviews to improve the survey tool, to interpret their data, and to justify their methodological choices.
- Detailed Description
The investigators will collect two data sets each in Lao PDR and Thailand: the first contains district-level representative health behaviour of approx. 2,400 adults across 30 rural communities per country (4,800 in total; representing rural populations of approx. 1-2 million adults); the second is a complete social network census of approx. 1600 adults each in three rural communities per country (approx. 4,800 in total). Within the sampled villages, the investigators will complete checklists about existing formal and informal healthcare facilities and gather patient load data from primary care units catering to the respective villages. As part of the questionnaire testing process, the investigators will conduct (and collect as primary data) cognitive interviews to improve the survey tool, to interpret our data, and to justify our methodological choices. The investigators will carry out the district-level village survey in one round, and the village-level social network censuses in two rounds. Between the two village social network censuses, the investigators will engage in public engagement activities in the selected villages (focused on antibiotic use) and re-survey all adults in the three villages per country two to three months later.
Objectives:
The primary objective is to improve the understanding of patients' antibiotic-related behaviour to support creative thinking about targeted and unconventional antimicrobial resistance (AMR) interventions in low- and middle-income countries (LMICs).
The investigators strive to achieve this primary objective by informing three research questions in Chiang Rai (Thailand) and Salavan (Lao PDR):
1. What are the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways?
2. Will people's exposure to antibiotic awareness activities entail changed behaviours that diffuse or dissipate within a network of competing healthcare practices?
3. Which proxy indicators facilitate the detection of problematic antibiotic behaviours across and within communities?
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 5885
- Any villager in rural Chiang Rai (Thailand) or Salavan (Lao PDR) who had been sampled to participate in the survey
- Is willing and able to give informed consent for participation in the study
- Is aged 18 years and above
- Respondent is not available or able to participate in interview after two attempts to arrange for appointment
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description district-level representative rural survey Observational study of behaviour Approximately 4,800 adults in 60 villages across Thailand and Lao PDR to study health and antimicrobial resistance (AMR)-related behaviour in breadth. village-level social network census Observational study of behaviour Approximately 4,800 adults across 6 villages in rural Thailand and Lao PDR that are exposed to AMR awareness activities to study health behaviour within social networks.
- Primary Outcome Measures
Name Time Method General population and villagelevel data on antibiotic access and use within individuals' healthcare-seeking pathways The study is expected to take place from January 2017 to October 2018, with data collection scheduled for November 2017 to April 2018 To improve the understanding of patients' antibiotic-related behaviour to support creative thinking about targeted and unconventional antimicrobial resistance (AMR) interventions in low- and middle-income countries (LMICs).
- Secondary Outcome Measures
Name Time Method Proxy indicators that predict problematic antibiotic use in the general population The study is expected to take place from January 2017 to October 2018, with data collection scheduled for April 2018. To identify less data-intensive indicators to detect problematic contexts of antibiotic use
Indicators of economic, social, and spatial marginalisation The study is expected to take place from January 2017 to October 2018, with data collection scheduled for November 2017 to April 2018 To understand the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways.
Degree of technology use during the healthcare seeking process The study is expected to take place from January 2017 to October 2018, with data collection scheduled for April 2018. To understand the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways.
Demand fluctuations for healthcare services over time within rural communities The study is expected to take place from January 2017 to October 2018, with data collection scheduled for April 2018. To understand whether people's exposure to antibiotic awareness activities entail changed behaviours that diffuse or dissipate within a network of competing healthcare practices.
Access to formal and informal medical treatment The study is expected to take place from January 2017 to October 2018, with data collection scheduled for April 2018. To understand the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways.
Access to prescription and over-the-counter medicines including antibiotics The study is expected to take place from January 2017 to October 2018, with data collection scheduled for April 2018. To understand the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways.
Awareness about "rational" antibiotic use The study is expected to take place from January 2017 to October 2018, with data collection scheduled for April 2018. To understand the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways.
Social network structures in rural communities The study is expected to take place from January 2017 to October 2018, with data collection scheduled for April 2018. To understand whether people's exposure to antibiotic awareness activities entail changed behaviours that diffuse or dissipate within a network of competing healthcare practices.
Typologies of desirable and undesirable healthcare practices with respect to antibiotic use The study is expected to take place from January 2017 to October 2018, with data collection scheduled for April 2018. To understand whether people's exposure to antibiotic awareness activities entail changed behaviours that diffuse or dissipate within a network of competing healthcare practices.
Trial Locations
- Locations (2)
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit
🇱🇦Vientiane, Lao People's Democratic Republic
Chiangrai Clinical research Unit
🇹ðŸ‡Chiang Rai, Chiangrai, Thailand