ArticleBMC global and public health2024
"It's easier to take a pill than fix a problem:" qualitative analysis of barriers and facilitators to antimicrobial stewardship program implementation in carceral settings.
Article in BMC global and public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Antimicrobial Resistance in Refugee Camps and Prisons: A Global Scoping Review of Primary Studies on Burden, Risk Factors, Surveillance, and Mitigation Strategies.Infection and drug resistance · 2026Review
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Authors and funding
9 authors.
Funding
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Abstract
backgroundWidespread antibiotic prescribing contributes to globally emerging antimicrobial resistance (AMR). Despite stewardship recommendations by the Infectious Diseases Society of America, there is a lack of literature identifying barriers and facilitators to antimicrobial stewardship programs (ASPs) in United States (U.S.) carceral settings.
methodsGuided by the Theoretic Domains Framework, we performed in-depth interviews with 68 key stakeholders in Massachusetts carceral settings to contextualize barriers and facilitators to ASP implementation. We recruited 32 people incarcerated in Massachusetts jails and 36 carceral clinicians, correctional officers/administrators in Massachusetts and other U.S. states, and Massachusetts community clinicians for interviews.
resultsFrom the completed semi-structured in-depth interviews, we identified seven salient themes-four barriers and three facilitators-both specific to and across stakeholder groups. Barriers included the following: (1) jail being viewed as a "dirty place" that increases the risk of infections; (2) variable awareness and knowledge of AMR and ASPs; (3) clinicians' opposition to change and oversight of their antibiotic prescribing; (4) competing priorities taking precedence over ASP implementation. Facilitators included (5) interest in changing the narrative about carceral healthcare through ASP implementation; (6) opportunities for education about ASP and AMR; and (7) the development of systems, policies, and regulations to improve antibiotic prescribing.
conclusionsTo our knowledge, this is the first qualitative study to leverage broad criminal-legal stakeholder groups to inform the next steps in developing and implementing ASPs in carceral settings in the U.S.
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