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Improving Health Outcomes: Program Theory for Antimicrobial Resistance and Telehealth Policies

Lookup NU author(s): Dr Josephine Go JefferiesORCiD


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Two ‘wicked’ problems currently threaten public health globally: the growing incidence of antimicrobial resistance (AMR) and increased demand for healthcare due to rising levels of chronic disease. Policies generated by the World Health Organization focus on the use of technical-rational solutions to counter these threats. In order to study the prospects for AMR stewardship, we conducted a policy analysis and considered its application to the UK healthcare context which is prioritising the use of telehealth (TH) to remotely monitor chronic disease patients. This paper examines the intersection of two health policies that favour technological solutions in order to change healthcare behaviours via new socio-technical regimes. In order to develop health policy analysis theory, we apply an analytical framework from Science and Technology Studies, the socio-technical imaginary (Jasanoff et al., 2009) to identify underpinning generative mechanisms in the problem definition and agenda setting stages of the AMR policy process, and develop a synthesised program theory (Leeuw, 2003; Rogers et al., 2000a; 2000b) to explain how and why AMR policy may succeed or fail. As AMR stewardship is entwined around technological developments to reduce antibiotic use, we analyse AMR policy in conjunction with the WHO’s TH policy and practice in the UK because the use of TH to remotely monitor patients has been found to increase levels of antibiotic prescriptions (Fairbrother et al., 2012). We argue that although both policies are rooted in ‘rational use’ as a socio-technical imaginary at the supranational level, potential for synergies are compromised by conflicting articulations in context.

Publication metadata

Author(s): Go-Jefferies J, Helliwell R

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Academy of Management 75th Annual Meeting

Year of Conference: 2015

Acceptance date: 25/01/2015