Breed-specific Health Strategies – my presentation at IDHW4

When I spoke at the 3rd International Dog Health Workshop in Paris in 2017, I started by saying that breed health improvement is not a conformation problem, a genetics problem, or a veterinary problem. It’s a change management and a continuous improvement problem.

For IDHW4 held in the UK recently, I said the challenge is not “are you improving?” but (a) “how fast are you improving?” and (b) “can you prove it?”.

We now know what a Breed-specific Health Strategy looks like. There are examples from the Nordic countries (RAS & JTO) and the UK now has its Breed Health and Conservation Plans. All these are based on the principle that a strategy is an action plan with a rationale.

Of course, we need to ask what is driving the development of breed strategies and I think there are 2 forces at work. Firstly, there is pressure for change and secondly, there is vision for change. Breeds will end up with strategies either because they are told to do it or because they want to do it; reactive or proactive. It’s a choice.

We also have to understand the landscape of breed strategy drivers. Both pressure and vision for change can come from one or more of:

  • Governments/Legislators
  • Kennel Clubs
  • Breed Clubs
  • Veterinary Surgeons
  • Scientists & Researchers
  • Breeders
  • Owners & Buyers
  • Campaigners
  • Media

Brenda Bonnett, CEO of the International Partnership for Dogs said:

“For many years, lecturing about breed-specific issues in dogs, even before the existence of IPFD, in discussions with the breeding community, veterinarians and others, it was becoming self-evident that if concerns were not addressed by the dog community, society would likely impose ‘solutions’ on them.  This is coming to fruition in many areas, and society and the media wants to move at a much faster pace than many in the pedigreed dog world.

A couple of my favourite quotes on planning come from General Eisenhower and the management guru Peter Drucker. Eisenhower said: “Plans are nothing, planning is everything”. He meant that the thought process and engagement of the right people in producing plans is more important than the document that pops out at the end. Drucker said, “Eventually, plans must degenerate into hard work”. If Breed Strategies sit on a shelf (or website) and nobody does anything different, we shouldn’t be surprised if canine health doesn’t improve.

Spray and pray!

One of the models I use when working with my clients to plan and implement projects and programmes makes the connection between the work that needs to be done and how benefits will be achieved. For dogs to benefit, i.e. become healthier, we need to establish new behaviours. Plenty of organisations are defining projects and processes and creating outputs such as breed strategies, legislation, toolkits, websites and so on. However, if there is no support for them because of the way plans have been developed, people’s behaviour is unlikely to change. All too often, the groups designing the projects, processes and outputs are not the same ones as will have to change their behaviour for dogs to benefit. Outputs get “lobbed over the wall” in the hope that breeders/owners/judges/buyers will change their behaviour. If the people who have to change their behaviours are involved in the design of the solutions, they are far more likely to support them. Otherwise, it’s just “spray and pray”.

It might be a bit of an exaggeration to say that the people designing the solutions aren’t involving the people who have to implement them because there are some excellent examples of very collaborative approaches. Those are the models we should follow; for example the Brachycephalic Working Group in the UK.

At the heart of breed improvement is human behaviour change. When it comes to behaviour change, we need to answer 2 questions: Can people change and will people change?

Canine health and welfare improvement are not unique in having to achieve human behaviour change and, surprise surprise, there is plenty of peer-reviewed evidence of what works in other fields. Complex problems such as Adult Social Care, Criminal Justice, Obesity and Smoking are all being tackled with interventions requiring behaviour change.

Behaviour change techniques

One of my favourite frameworks is the COM-B Model developed by Susan Michie and colleagues at University College London. In her 2011 paper which reviewed 19 behaviour change models from other studies, she identified Capability, Opportunity and Motivation as the 3 sources of behaviour. The Behaviour Change Wheel that she produced summarises a range of interventions and policy tools that can be used to influence Capability, Opportunity and Motivation. There is even a Taxonomy of 83 Behaviour Change Techniques available as an online toolkit. We don’t need to be starting from a blank sheet of paper. In a recent paper, Michie also reported on which interventions were most successful in changing behaviours for human health problems. Significantly, coercion and threat were the least likely to work; beating people up and telling them they have to change is of little value. She also reported that, for many of the health problems, around 9 or 10 different intervention types were required to implement successful change. In other words, a single, one-size-fits-all solution will be unlikely to achieve sustainable behavioural changes.

I reflected on an example from my breed, Dachshunds. Over the past 7 years, we have achieved an important improvement in the health of Mini Wire Dachshunds by tackling Lafora Disease, which is a form of epilepsy. A DNA test is available and we have moved from 55% of litters being bred with “at risk” puppies in 2012 to the position now where only around 5% are affected. That has been achieved by adopting techniques from 8 of the 9 COM-B intervention categories and 6 of the 7 policy categories. Our work has involved breeders, buyers, owners, vets and our clubs and breed council.

In Dachshunds, our approach to Lafora Disease has been part of our wider breed health strategy and the process we follow is based on a guide developed by our Kennel Club. It has 4 stages: Lead, Plan, Engage and Improve. All 4 stages are required for a breed health strategy to become sustainable and I prepared a poster that was on display at IDHW4 to illustrate some of the work we have been doing.

In my opinion, breed health strategies need more focus and effort on leadership and engagement in order to get better and quicker improvement results. There are lots of plans in many forms but, without leadership and engagement, dog health will not improve.

I ended my presentation with 3 quotes:

“The ‘tell, sell, yell’ strategy for Change Management never works.”

“Culture change happens in units of 1.”

“And that is how change happens. One gesture. One person. One moment at a time.”

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