BackgroundAntibiotic resistance (ABR) is a serious threat that requires coordinated global intervention to prevent its spread. There is limited data from the English-speaking Caribbean.MethodsAs part of a national programme to address antibiotic resistance in Jamaica, a survey of the knowledge, attitudes and antibiotic prescribing practices of Jamaican physicians was conducted using a 32-item self-administered questionnaire.ResultsOf the eight hundred physicians targeted, 87% responded. The majority thought the problem of resistance very important globally (82%), less nationally (73%) and even less (53%) in personal practices. Hospital physicians were more likely to consider antibiotic resistance important in their practice compared to those in outpatient practice or both (p < 0.001). Composite knowledge scores were generated and considered good if scored > 80%, average if 60–79% and poor if < 60%. Most had good knowledge of factors preventing resistance (83%) and resistance inducing potential of specific antibiotics (59%), but only average knowledge of factors contributing to resistance (57%). Knowledge of preventative factors was highest in females (p = 0.004), those with postgraduate training (p = 0.001) and those > four years post graduation (p = 0.03). Empiric therapy was often directed by international guidelines and cultures were not routinely done. Limited laboratory and human resources were identified as challenges.ConclusionPhysicians in this study were aware of the problem of ABR, but downplayed its significance nationally and personally. These results will guide a national antibiotic stewardship programme.

This article chronicles a brief history of social marketing practice in the Caribbean by reviewing the thinking that led to the introduction of social marketing in the region. The early years of social marketing in the Caribbean were characterized by donor-funded programs and projects that addressed social issues such as environmental protection, family planning, contraception and fertility control, and sexual and reproductive health matters. Various examples of Caribbean media campaigns and interventions that have utilized social marketing principles are presented. While these initiatives have made a contribution, perhaps the strongest impetus for sustaining social marketing practice in the region has been the introduction of education and training in social marketing in Caribbean academia. With the increasing institutionalization of social marketing, Caribbean researchers and practitioners of social marketing are now poised to make a further contribution to the field.

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Communication for Behavioral Impact (COMBI) is a communication planning model for social mobilization and strategic behavior change applied to social or health interventions. The guiding mantras of the approach are: doing nothing until precise behavioral objectives have been set, and doing nothing until a situational market analysis has been undertaken. COMBI adopts its communication planning processes from public relations, community mobilization, sustained appropriate advertising, interpersonal communication, and point‐of‐service promotion. The key steps in the COMBI planning process involve considering the goal, behavioral objective(s), situational market analysis, strategy for achieving the results, plan of action, management and implementation, monitoring, assessment of behavioral impact, and budget. The model is informed by marketing theory that speaks to audience, exchange theory and value, competition, and the four Cs of integrated marketing communication. COMBI also benefits from models used in health behavior change such as the health belief model, the theory of reasoned action or planned behavior, social cognitive theory, and the transtheoretical model. Despite its advantages, some downfalls of COMBI are that on its own it does not always generate development and programs using COMBI often require substantial resources. Nonetheless, COMBI programs aim at an integrated effort with a thoughtful amalgamation and selection of communication actions relevant to achieving desired behavioral outcomes.