Edgar Timothy, Boyd Stephanie D, Palamé Megan J
Department of Communication Sciences and Disorders, Emerson College, 120 Boylston Street, Boston, MA 02116, USA.
J Antimicrob Chemother. 2009 Feb;63(2):230-7. doi: 10.1093/jac/dkn508. Epub 2008 Dec 18.
Antibiotic resistance is one of today's most urgent public health problems, threatening to undermine the effectiveness of infectious disease treatment in every country of the world. Specific individual behaviours such as not taking the entire antibiotic regimen and skipping doses contribute to resistance development as does the taking of antibiotics for colds and other illnesses that antibiotics cannot treat. Antibiotic resistance is as much a societal problem as it is an individual one; if mass behaviour change across the population does not occur, the problem of resistance cannot be mitigated at community levels. The problem is one that potentially can be solved if both providers and patients become sufficiently aware of the issue and if they engage in appropriate behaviours. Although a number of initiatives have been implemented in various parts of the world to elicit behaviour change, results have been mixed, and there is little evidence that trial programmes with positive outcomes serve as models of sustainability. In recent years, several scholars have suggested social marketing as the framework for behaviour change that has the greatest chance of sustained success, but the antibiotic resistance literature provides no specifics for how the principles of social marketing should be applied. This paper provides an overview of previous communication-based initiatives and offers a detailed approach to social marketing to guide future efforts.
抗生素耐药性是当今最紧迫的公共卫生问题之一,有可能破坏世界各国传染病治疗的有效性。不服用完整疗程抗生素以及漏服等特定个人行为会导致耐药性的产生,将抗生素用于治疗感冒及其他抗生素无法治疗的疾病也会如此。抗生素耐药性既是个人问题,也是社会问题;如果全体民众不改变行为,社区层面的耐药性问题就无法得到缓解。如果医疗服务提供者和患者都能充分认识到这一问题并采取适当行为,这个问题是有可能解决的。尽管世界各地区已实施多项举措来促使行为改变,但结果参差不齐,几乎没有证据表明取得积极成果的试验项目可作为可持续发展的典范。近年来,几位学者建议将社会营销作为最有可能取得持续成功的行为改变框架,但抗生素耐药性相关文献并未具体说明应如何应用社会营销原则。本文概述了以往基于沟通的举措,并提供了社会营销的详细方法,以指导未来的工作。