A Pilot Study on Understanding the Contextual Factors Impacting the Implementation of an Antibiotic Stewardship Program in a Single Health Center Serving Rural and Underserved Communities in the United States—A Mixed-Methods Approach

Arinze Nkemdirim Okere; Anthony Ryan Pinto; Sandra Suther

doi:10.3390/antibiotics14030263

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A Pilot Study on Understanding the Contextual Factors Impacting the Implementation of an Antibiotic Stewardship Program in a Single Health Center Serving Rural and Underserved Communities in the United States—A Mixed-Methods Approach

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A Pilot Study on Understanding the Contextual Factors Impacting the Implementation of an Antibiotic Stewardship Program in a Single Health Center Serving Rural and Underserved Communities in the United States—A Mixed-Methods Approach

Arinze Nkemdirim Okere, Anthony Ryan Pinto and Sandra Suther

Antibiotics (Basel), Vol.14(3), 263

03/05/2025

DOI: 10.3390/antibiotics14030263

PMCID: PMC11939229

PMID: 40149074

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Abstract

Objective : This study aimed to identify contextual factors influencing the implementation of an antibiotic stewardship program (ASP) in a rural primary care center serving underserved communities. Methods : A mixed-methods approach guided by the Consolidated Framework for Implementation Research (CFIR) was employed. Data were collected through semi-structured interviews, focus groups, and surveys with clinical staff and leadership at a Federally Qualified Health Center (FQHC). The CFIR framework was used to explore barriers and facilitators within the clinic’s inner and outer settings, focusing on staff perceptions, challenges, and readiness for ASP implementation. Results : Strong staff support for ASPs was identified, with participants emphasizing their potential to improve patient outcomes and antibiotic prescribing practices. Barriers included insufficient training, a high workload, and patient pressure to prescribe antibiotics. Leadership commitment, enhanced communication systems, and tailored educational materials were identified as critical facilitators for successful implementation. Participants highlighted the need for accessible educational tools and streamlined protocols to improve engagement and compliance. Conclusions : Implementing an ASP in rural and underserved settings is feasible but requires addressing site-specific challenges. The insights from this study underscore the importance of understanding contextual factors to inform evidence-based strategies for ASP adoption. The structured use of CFIR provided a comprehensive framework to guide implementation efforts, ultimately supporting better antibiotic use and public health outcomes in resource-constrained healthcare settings.

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Title: Subtitle: A Pilot Study on Understanding the Contextual Factors Impacting the Implementation of an Antibiotic Stewardship Program in a Single Health Center Serving Rural and Underserved Communities in the United States—A Mixed-Methods Approach
Creators: Arinze Nkemdirim Okere
Anthony Ryan Pinto - Florida Agricultural and Mechanical University
Sandra Suther - Florida Agricultural and Mechanical University
Resource Type: Journal article
Publication Details: Antibiotics (Basel), Vol.14(3), 263
DOI: 10.3390/antibiotics14030263
PMID: 40149074
PMCID: PMC11939229
NLM abbreviation: Antibiotics (Basel)
ISSN: 2079-6382
eISSN: 2079-6382
Publisher: MDPI
Grant note: American Association of Colleges of Pharmacy (AACP) Foundation American Society of Heath-System Pharmacist (ASHP) foundation
Language: English
Date published: 03/05/2025
Academic Unit: Pharmacy Practice and Science; Internal Medicine
Record Identifier: 9984845052502771

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