At the end of the 4th International Dog Health Workshop, Dr Dan O’Neill said something along the lines of; “This is no longer about the dogs, it’s about the people”. Readers of this column will probably be tired of me getting on my Human Behaviour Change hobby-horse but that’s what Dan was alluding to; unless people change their behaviour, dog health won’t be improved.
The point I want to make about data is that it’s necessary but not sufficient. I suspect that presenting data to owners, breeders and judges might persuade 5-10% of them to do something different. Presenting data just doesn’t motivate many people to change their behaviour. Why is that?
Fear of Maths
Many breeds are overwhelmed by data from research papers, surveys and insurance companies, some of which gets analysed and turned into reports, but all too often breed clubs and breeders simply don’t have the skills to get real insight from the data.
Perhaps some people are “scared of maths”; others may not have the time and yet others may not see data analysis and interpretation as important for breed health improvement. Plus, some people think that “numbers speak for themselves” and don’t bother to present data in a way that might be helpful to others.
Add to that the manipulation of data by the media and the political spin put on “official statistics” and it’s no wonder that health data can get a bad press.
Breed Health Coordinators, in particular, are grappling with ever more complex data to understand how to improve their breed’s health. We have EBVs, COIs, Medians, Means, Odds Ratios and Confidence Limits, to name just a few terms that litter our breed health reading material. Who can we turn to to make sense of the numbers, provide insight and guidance?
People just don’t “get risk”
We have seen clearly over the past few months of the Covid19 pandemic that the majority of the public simply do not understand risk. At the time of writing (July), the median Infection Fatality Rate for England was 1.3%. That figure, however, masks a huge range of risks, depending on how old you are. Nearly 1 in 5 infected over the age of 75 had died. Under the age of 25, fewer than 50 infected people had died. People in that younger age group have more chance of being killed in a car accident than from Covid19.
When it comes to risk in canine health, some people struggle to understand risk-based screening programmes such as those available for hips and elbows. These are complex, multifactorial diseases which means, statistically it’s possible for a dog with a good score, still to have bad hips. Similarly, mating 2 dogs with good hips could still result in puppies with clinically poor hips, or dogs with poor hips could produce a puppy with no problem. The probabilities are that dogs with better grades will produce puppies with better grades and vice versa. Unfortunately, many breeders want “definitive” answers just like they might get with a DNA test that gives a Clear, Carrier or Affected result.
In the recently developed Respiratory Function Grading Scheme launched by the KC for brachycephalic breeds, advice for breeders is based on a risk matrix. This enables breeders to identify combinations of a screened sire and dam that would minimise the risk of producing puppies at risk of BOAS. There are no certainties about the puppies’ BOAS status but, by selecting from lower risk combinations, over time, breed health will be improved. This principle applies to all the clinical screening programmes for complex conditions.
One of the other challenges to getting people to make the move from data to action is that there may well be “alternative facts” that can be used to disprove the overwhelming evidence that exists. All that is needed is one research paper that contains data that apparently contradicts the prevailing evidence. It’s then easy to cherrypick from that paper and persuade others that all the other evidence is flawed. I came across an example of this recently where evidence from a paper on surgery for a health condition was being used to contradict screening evidence. The two data sets simply weren’t comparable.
It’s tempting for those with scientific training to think that more data and evidence is the answer but, all too often, this just results in responses such as:
- My dogs have never suffered from that condition and I’ve had the breed for x decades
- It’s only research, what we need are facts
- It’s too soon to be making these decisions about breeding recommendations
- It’s only a problem with the commercial and back-street breeders; our dogs are better/healthier
For many pedigree health issues we already have plenty of data so if people aren’t acting on that data by now, providing more data is unlikely to persuade them to change their behaviour.
The “science” that is missing is that of Human Behaviour Change and an analysis of the lack of action from a behavioural change perspective would lead to very different conclusions than “give them more data/evidence”. We need to understand which of 3 types of reasons are preventing people from taking action to improve canine health.
Firstly, do they have the capability to change, including do they know why it is important and how to take action? Mostly, science has answered those questions, so a lack of action is less likely to be due to a capability gap.
Secondly, do they have the opportunity to take action? This includes, for example, whether people have the time or money to participate in screening programmes. More importantly, this is also affected by whether they see their peers taking action; if nobody else is worried about low genetic diversity, why should I be? Social norms are powerful influencers, so finding ways to incentivise early adopters are vitally important.
Finally, do they have the motivation to act to improve breed health? Are they worried about any adverse consequences if they don’t act? Do they feel they want to or need to act and do they believe it would be a good thing to do? There is plenty of evidence that some health issues have become normalised, both by owners and vets. “It’s normal for a (breed name)” or “They all do that” are clues that an issue has been normalised.
In conclusion, we should stop trying to beat people into submission with more data and put more emphasis on finding answers to why people can’t or won’t change.
To end on a slightly more humourous note, remember “A mathematician is a device for turning coffee into theorems.” [Paul Erdos].