Transdisciplinary stakeholder understandings of antimicrobial resistance: An integrative approach in Aotearoa New Zealand

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health Pub Date : 2023-10-16 DOI:10.1016/j.anzjph.2023.100093

Sarah Mitchell, Alexandra Macmillan, Kate C Morgaine, Patricia Priest

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引用次数: 0

Abstract

Objective

Antimicrobial resistance (AMR) is a complex public health issue, with a range of influences across human, animal, and environmental health. Given the complexity of the problem, the diversity of stakeholders, and the failure of current policies to curb AMR worldwide, integrative approaches are needed to identify effective actions. Underpinned by systems thinking and One Health principles, this qualitative study explored how diverse AMR experts in Aotearoa New Zealand perceive the main drivers and effects of AMR.

Methods

Semi-structured interviews with clinical, academic, policy, community, and industry representatives were designed to elicit mental models of the causes and outcomes of AMR across dimensions.

Results

Thematic analysis revealed contrasting understandings of AMR causes across four domains: food-producing animals (livestock), healthcare, community, and environment. AMR was often framed as a problem of individual behaviour, despite many implicit references to underlying structural economic influences. The politics of collaboration was a further major underlying theme. The interviews highlighted fundamental connections between AMR and other complex issues, including poverty and environmental pollution.

Implications for public health

This study brings together the understandings of AMR of transdisciplinary stakeholders, providing some immediate insights for policy makers and setting the foundation for developing a collaborative system model of AMR as a basis for decision-making.

查看原文本刊更多论文

跨学科利益相关者对抗菌药物耐药性的理解：新西兰奥特亚的一种综合方法。

目的：抗微生物耐药性（AMR）是一个复杂的公共卫生问题，对人类、动物和环境健康有一系列影响。考虑到问题的复杂性、利益相关者的多样性以及当前全球遏制AMR的政策的失败，需要采取综合方法来确定有效的行动。在系统思维和“一个健康”原则的支持下，这项定性研究探讨了新西兰奥特亚不同的AMR专家如何感知AMR的主要驱动因素和影响。方法：设计对临床、学术、政策、社区和行业代表的半结构化访谈，以引出AMR原因和结果的跨维度心理模型。结果：专题分析揭示了四个领域对AMR病因的不同理解：食品生产动物（牲畜）、医疗保健、社区和环境。AMR通常被认为是一个个人行为的问题，尽管许多人隐含地提到了潜在的结构性经济影响。合作政治是另一个重要的基本主题。采访强调了AMR与其他复杂问题之间的根本联系，包括贫困和环境污染。对公共卫生的影响：这项研究汇集了跨学科利益相关者对AMR的理解，为决策者提供了一些即时的见解，并为开发AMR的合作系统模型奠定了基础，作为决策的基础。

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来源期刊

Australian and New Zealand Journal of Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.20

自引率

5.70%

发文量

121

审稿时长

6-12 weeks

期刊介绍： The Australian and New Zealand Journal of Public Health (ANZJPH) is concerned with public health issues. The research reported includes formal epidemiological inquiries into the correlates and causes of diseases and health-related behaviour, analyses of public policy affecting health and disease, and detailed studies of the cultures and social structures within which health and illness exist. The Journal is multidisciplinary and aims to publish methodologically sound research from any of the academic disciplines that constitute public health.