Stage 2: Defining a target behavior

STAGE 2: DEFINING A TARGET BEHAVIOUR


Boehringer Ingelheim Animal Health and Innovia Technology have been exploring the concept of “gold-standard” behaviours in relation to detection and management of pain in cattle, with a focus on pain caused by mastitis, respiratory disease and assisted calving. The team carried out in depth research to see how much discrepancy there was between what is recommended and what is usually done on farm.

Defining the who and the what that needs to be done differently is key to achieving the desired outcome. In stage 2 of the project, we defined ideal – or gold-standard – vet and farmer behaviours relating to pain management. These gold-standard behaviours are what we could expect farmers and vets to be doing and were constructed through reviewing literature, conducting a relatively small number of farmer and vet interviews.

An iterative process followed, that involved carrying out additional interviews with vets and farmers, as well as desk-based research to help identify and define “gold-standard” and “usual” vet and farmer behaviours relating to the target factor.

 

Two rounds of interviews were conducted

1. The first round was exploratory and designed to allow participants to reflect on what they considered to be the ideal – or “gold-standard” – when it came to farmer and vet behaviour, with respect to the detection and treatment of pain associated with mastitis, respiratory disease and assisted calving.

These interviews consisted of two broad open-ended questions (about “ideal” behaviours and “usual behaviours”) in relation to each of the three target causes of pain. Interviews were conducted over the telephone and lasted between 30 and 60 minutes.

2. In the second round of interviews, Innovia emailed the participants a copy of the draft gold-standard vet and farmer behaviours for them to review ahead of the call. With these participants Innovia conducted a semi-structured interview – lasting between 45 and 60 minutes – to review each of the draft gold-standard behaviours, and to solicit feedback on their accuracy as well as the headroom for improvement between usual farmer and vet behaviours and the gold-standard behaviours.

 

The findings were analysed by the Innovia team and brought to discussions with the core project team, where the evidence was used to influence a decision as to exactly what the most relevant target behaviour for the project should be.

The diagrams below highlight the discrepancies between the “gold-standard” and usual farmer behaviours.

Gold standard farmer behaviour
Usual farmer behaviour

 

In the case of mastitis, in general, the farmers and vets interviewed all believed there was significant headroom for improving the detection and treatment of pain associated with mastitis, explains Dr Morton:

“In particular, our interviewees identified intervening with NSAIDs more promptly and in earlier grades of mastitis as an opportunity for improving pain management in mastitis.”

 

Interviewees also identified intervening with NSAIDs in both cow and calf as an opportunity for improving pain management in assisted calving.

“ We heard that farmers are often not using the correct techniques when assisting calving. This can lead to unnecessary pain due to greater force application and increased complication rates.”

 

 

At the end of stage 2, the core BI-Innovia team selected a target behaviour for the rest of the project from the shortlist of three areas. This decision making process was done through individual polling, reviewing and discussing the findings and re-prioritising as a group. This approach is based on the Delphi technique - a group communication method where a panel of experts arrive at a consensus over a series of questions and subsequent discussions. The benefits of this approach is that it enables all participants’ voices to be heard and the group to reach consensus through discussion.

 

The core team eventually decided to refine the target factor (the ultimate goal of the Behaviour Change Programme) as follows:

“To reduce pain and discomfort associated with assisted calving”

 

 

The team subsequently defined the associated target behaviour (who we want to do what in order to achieve the target factor) as:

“Farmer complies with best practice for minimising pain and discomfort associated with assisted calving”

 

Gold standards for assisted calving

Based on the evidence collated by the Innovia team through research and interviews, the “gold standards” for farmers dealing with dystocia – or assisting with calving – were defined as:

  • Proactively monitor dams expected to calve
  • Assess dam
  • Avoid intervention unless dystocia is apparent
  • Use correct technique when assisting (call vet early if no success)
  • Assess calf, recognise assisted calving may be painful or distressing for calf
  • Manage calf appropriately
  • Assess dam, recognise assisted calving is painful, provide analgesia to all dams
  • Treat dam injuries appropriate
  • Give dam appropriate water and feed
  • Allow dam to lick calf clean, if possible
  • Move dam and calf to appropriate housing
  • Monitor dam and calf
  • Maintain analgesia and supportive therapy until overt causes of pain have healed
  • Evaluate why dystocia and secondary injuries occurred
  • Identify and implement practices to reduce future incidences of dystocia and injuries from dystocia

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