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Antibiotics and activity spaces: protocol of an exploratory study of behaviour, marginalisation and knowledge diffusion.

ABSTRACT: 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?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).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.NCT03241316; Pre-results.

SUBMITTER: Haenssgen MJ

PROVIDER: S-EPMC5884330 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Antibiotics and activity spaces: protocol of an exploratory study of behaviour, marginalisation and knowledge diffusion.

Haenssgen Marco J MJ Charoenboon Nutcha N Zanello Giacomo G Mayxay Mayfong M Reed-Tsochas Felix F Jones Caroline O H COH Kosaikanont Romyen R Praphattong Pollavat P Manohan Pathompong P Lubell Yoel Y Newton Paul N PN Keomany Sommay S Wertheim Heiman F L HFL Lienert Jeffrey J Xayavong Thipphaphone T Warapikuptanun Penporn P Khine Zaw Yuzana Y U-Thong Patchapoom P Benjaroon Patipat P Sangkham Narinnira N Wibunjak Kanokporn K Chai-In Poowadon P Chailert Sirirat S Thavethanutthanawin Patthanan P Promsutt Krittanon K Thepkhamkong Amphayvone A Sithongdeng Nicksan N Keovilayvanh Maipheth M Khamsoukthavong Nid N Phanthasomchit Phaengnitta P Phanthavong Chanthasone C Boualaiseng Somsanith S Vongsavang Souksakhone S Greer Rachel C RC Althaus Thomas T Nedsuwan Supalert S Intralawan Daranee D Wangrangsimakul Tri T Limmathurotsakul Direk D Ariana Proochista P

BMJ global health 20180328 2

<h4>Background</h4>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 ...[more]

PMID: 29629190

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Project description:BackgroundThere is a persistent lack of understanding on the influence of the environment on behaviour and health. While the environment is considered an important modifiable determinant of health behaviour, past research assessing environments often relies on static, researcher-defined buffers of arbitrary distance. This likely leads to misrepresentation of true environmental exposures. This exploratory study aims to compare researcher-defined and self-drawn buffers in reflecting the spaces and time adolescents engage in physical activity (PA) and sedentary behaviour. It also investigates if adolescent's access the PA facility and greenspace nearest their home or school for PA, as well as examine how much time adolescents spent in PA at any PA facilities and greenspaces.MethodsAdolescents (aged 14-18 years; n = 34) were recruited from schools in West Yorkshire, England. Seven consecutive days of global positioning system (GPS) and accelerometer data were collected at 15 second intervals. Using ArcGIS, we compared 30 different researcher-defined buffers including: radial, network and ellipse buffers at 400m, 800m, 1000m, 1600m and 3000m and participant-defined self-drawn neighbourhoods to objectively measured PA and sedentary space and PA time. Location of PA was also compared to Points of Interest data to determine if adolescents use the nearest PA facility or greenspace to their home or school and to examine how much PA was undertaken within these locations.ResultsOur exploratory findings show the inadequacy of researcher-defined buffer size in assessing MVPA space or sedentary space. Furthermore, less than 35% of adolescents used the greenspaces or PA facilities nearest to their home or school. Approximately 50% of time spent in PA did not occur within the home, school, PA facility, or greenspace environments.ConclusionOur exploratory findings help to begin to quantify the inadequacy of researcher-defined, and self-drawn buffers in capturing adolescent MVPA and sedentary space, as well as time spent in PA. Adolescents often do not use PA facilities and greenspaces nearest their home and school and a large proportion of PA is achieved outside PA facilities and greenspaces. Further research with larger samples are needed to confirm the findings of this exploratory study.

Project description:IntroductionThe development of children's healthy and active lifestyles, including habit formation for optimal 24-hour movement behaviour, is associated with their family environment. A whole-family study collecting comprehensive data that can evaluate family lifestyle behaviours in different settings in depth has the potential to provide the evidence-based information needed for national guidelines, for designing interventions and for supporting policy-makers' decisions.Methods and analysisThe FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study is a nationally representative cross-sectional study that will recruit 500 families (with at least 1 child aged between 3 and 8 years) from the urban and rural parts of all three regions of the Czech Republic. To examine the relationship between family environment and children's healthy development (eg, healthy weight) and children's active lifestyle behaviour, anthropometric measures, parents' health-related behaviour (including dietary habits, alcohol and tobacco use, screen time and bedtime rules and 24-hour movement behaviour), socioeconomic data and data about the characteristics of the home and neighbourhood will be collected from parents and children. The 24-hour movement behaviour (eg, sleep, sedentary behaviour and physical activity) will be monitored using wGT3X-BT and GT9X Link ActiGraph accelerometers placed on the non-dominant wrist of the children and their parents for 7 consecutive days. The accelerometers will be set up for each family separately, using the group proximity mode, allowing proximity tagging between devices and establishing the time spent together and parent-child coactivities.Ethics and disseminationThe overarching methodological protocol of the FAMIPASS project was approved by the Ethics Committee of the Faculty of Physical Culture, Palacký University Olomouc, Czech Republic (reference number: 25/2021). The results and findings will be reported to: (1) the participating families and (2) school representatives and will be (3) presented at national and international conferences and (4) disseminated via peer-reviewed publications.

Dataset Information

Antibiotics and activity spaces: protocol of an exploratory study of behaviour, marginalisation and knowledge diffusion.

Publications

Antibiotics and activity spaces: protocol of an exploratory study of behaviour, marginalisation and knowledge diffusion.

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