Bias and discrimination perceived by antimicrobial stewards: a mixed-methods study.

Area of Science:

• Healthcare Disparities
• Antimicrobial Stewardship
• Occupational Health

Background:

• Bias and discrimination significantly affect healthcare experiences, including those of antimicrobial stewardship providers.
• Understanding these perceptions is vital for improving the work environment within antimicrobial stewardship programs.

Purpose of the Study:

• To explore the perceptions and experiences of bias and discrimination among antimicrobial stewards.
• To identify the sources, impact, and potential mitigation strategies for bias experienced by stewards.

Main Methods:

• A mixed-methods approach combining a nationwide electronic survey and semi-structured interviews.
• Survey distributed to physicians, pharmacists, advanced practice providers, and trainees in antimicrobial stewardship roles.
• Interviews conducted to gain deeper insights into stewards' experiences with bias and discrimination.

Main Results:

• Of 204 participants, 50% of female stewards reported experiencing bias or discrimination compared to 26% of male stewards.
• Females were 2.8 times more likely to experience bias/discrimination when controlling for other factors (P < 0.01).
• Qualitative themes revealed sources of bias, its impact on stewards, and coping strategies.

Conclusions:

• Antimicrobial stewards, particularly women and junior members, face disproportionate bias and discrimination.
• These experiences negatively affect job satisfaction and perceived effectiveness.
• Institutions and professional societies must prioritize acknowledging these issues and equipping stewards with mitigation strategies.