The Consequences of AMR Education and Awareness Raising: Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR.
The Consequences of AMR Education and Awareness Raising: Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR.
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DOI：
10.3390/antibiotics7040095
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发表时间：
2018-11-01
期刊：
影响因子：
--
通讯作者：
Khine Zaw Y
中科院分区：
文献类型：
--
作者：
Haenssgen MJ;Xayavong T;Charoenboon N;Warapikuptanun P;Khine Zaw Y
教育和提高认识是全球卫生政策改变公众行为和解决抗菌素耐药性问题的主要工具。考虑到提高认识议程的局限性，以及缺乏为替代方法提供信息的社会研究，我们的目标是就低收入国家背景下提高抗生素相关认识的后果产生新的经验证据。我们在两个老挝村庄开展了一项教育活动，以分享与抗生素有关的一般信息，并了解人们的观念和健康行为。两轮人口普查数据使我们能够评估活动的产出、知识成果以及在差异中差异设计中的直接行为影响。我们的小组数据涵盖了两轮1130名成年人，其中包括58名活动参与者和208名通过村庄对话间接接触的村民。我们发现，与活动相关的交流在更有特权的群体中传播，这限制了其间接影响。在参与者中，教育活动影响了对“耐药性”的认识和理解，而对态度的影响很小。关于行为影响的证据稀少且混杂，但可能的后果范围包括从正规医疗保健提供者处不成比例地摄取抗生素。我们的研究对提高认识作为解决抗生素耐药性的行为工具的持续主导地位提出了怀疑。
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.
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