One Health policy communities' perspectives on zoonoses risk factors and management: A multiple qualitative methods approach.

Zoonoses emergence and endemicity are serious global public health problems that disproportionately affect low-resource settings. One Health (OH) serves as a framework to understand the interconnection of zoonoses risk factors and incentivizes collaboration, coordination, and communication among sectors. However, OH encounters barriers related to power imbalances, gaps in coordination, and conflicts of interest among diverse communities of practice, which are groups that share a problem and domain of interest and engage in collective learning. This research aims to elucidate the mental models of policy communities, which are representations of the environment, and how humans explain and predict their surroundings to describe their perspectives on zoonoses' risk factors and management. We used a multiple methods approach, including qualitative system dynamics and rapid qualitative methods (RQM), to describe the perspectives of policy communities regarding the drivers of zoonoses emergence and endemicity and the complexity of zoonoses management. Participants included national and sub-national policy makers and key informants integral to zoonoses programs in Peru, including representatives of human, animal, and environmental systems. We completed 77 semi-structured interviews from June 2023 to November 2023, and the final analytical sample included 75 interviews, excluding 2 incomplete interviews. Participants' mental models were represented with synthesized systems dynamics diagrams. Main themes and quotes from the RQM added context to the diagrams and described participants' perspectives regarding zoonoses management complexity. Representatives from animal, human, and environmental public organizations described a similar structural conceptualization of the risk factors related to pets, humans, wildlife, and livestock, identifying economic, social, and environmental risk factors linked to zoonoses emergence and endemicity. Central themes include: global structural economic and social forces; factors affecting biodiversity and natural reservoirs; environmental changes; medical and public health services; country economic factors; rural reliance on farming and limited funding; agricultural factors; and water, hygiene, and sanitation-responsive governance. The system dynamics diagrams illustrated interrelationships between pet, human, wildlife, and livestock populations. However, risk factors related to zoonoses affecting livestock were more prominently represented. Participants recognized the need to apply OH to address zoonoses; however, contextual factors, such as regional adaptation, were necessary in poor rural areas. The study's results inform about value systems that guide political action and decision making among the diverse OH communities of practice. A similar application in high-income settings could identify differences in zoonoses' risk factors that may not be related to rural vulnerability or poverty. Further research is needed to describe the interconnection of organizational factors associated with OH collaborations.