Culture eats strategy for breakfast – my June 2020 “Best of Health” article

I’m not overly persuaded by the many comparisons of Covid19 testing and death rates in different countries. Statisticians David Spiegelhalter and Sylvia Richardson said recently:

…it’s tempting to link a country’s statistics to the measures they have taken to control the virus: for example, has Sweden’s more relaxed policy been as effective as lockdown? But countries differ in so many ways: basic demographics, compliance and social networks, testing capacity and policy, health service characteristics and so on.”

We face a similar situation in the world of dog health; there are lots of examples of comparisons made between different breeds. Our main interest has, inevitably, been focused on breed health in the UK but, for some breeds, there have also been international comparisons.

It’s perfectly valid and useful to make comparisons of the prevalence of particular diseases across different breeds. Many of these differences can be attributed to genetics and/or conformation. Indeed, the fact that we have created so many different breeds makes the pedigree dog a really useful resource in the search for the genes associated with diseases that may have parallels in humans.

International comparisons within breeds can also be useful and breeds such as Irish Wolfhounds and Bernese Mountain Dogs have extensive databases that can be used to investigate different health issues across the world. Increasingly, there is also genetic data from Genomewide Association Studies (GWAS) that is identifying different geographical clusters within breeds. This information could be used to address the lack of genetic diversity in some breed population sub-groups.

In my breed, Dachshunds, we are often (rightly) criticised for exaggerated length and shortness of leg and the claimed association of this with Intervertebral Disc Disease (IVDD). It is argued by some that we need to amend the Breed Standard to encourage shorter bodies and longer legs with more ground clearance, similar to that specified in the FCI Breed Standard. Unfortunately, this ignores the fact that the prevalence of IVDD is little different between FCI registered Dachshunds and UK dogs. In fact, there is more variation in IVDD prevalence between the 6 Dachshund varieties despite the fact they all share the same Breed Standard. For those interested, Wires and Longs are the least likely to have IVDD and Smooths and Mini Smooths are about 4-5 times more likely to have it. The research into the conformational differences and their association with IVDD is also contradictory. Nevertheless, it is clear that some Dachshund breeders (and judges) need to remind themselves of the original function of the breed and the KC mantra of “fit for function”.

3 levels of benchmarking

When I run benchmarking skills workshops, we talk about 3 levels of benchmarking: Metrics, Process and Culture. Metrics tell you “what the performance is”; Process tells you “how that performance was achieved” and Culture tells you “why” those processes achieved the particular level of performance.

Just comparing the metrics (e.g. disease prevalence or mutation frequency) ignores processes (such as breeder education, testing protocols and recording systems) and the cultural issues such as leadership, teamwork, compliance and enforcement. 

There’s a quote I use in relation to organisation design: “All organisations are perfectly designed to get the results that they do”.

For breed health improvement: “all breeds are perfectly designed to get the health that they do”.

Whatever any government, kennel club, breed club or campaigning group says about its strategy for improving canine health and welfare, it’s worth remembering Peter Drucker’s quote “Culture eats strategy for breakfast”.

International resources

Benchmarking metrics is easy, but tells you very little about how to improve.  Benchmarking processes tells you how others do what they do.  Adding in an understanding of the “soft stuff” helps explain why they get the performance that they do and is probably the most difficult area to adopt/adapt for your own breed’s use.

Visitors to the International Partnership for Dogs website (dogwellnet.com) will find a wealth of resources supplied by Kennel Clubs and Breed Clubs from around the world. It is a unique resource of data and tools (metrics and processes) that have been freely given and then curated in a single, accessible format.

Among the data, you can find breed health survey results and information on registration statistics. Having led the Breed-specific Health Strategies workstream at the 4th International Dog Health Workshop, I’m particularly interested in the tools and techniques that are being collated. These include examples of Breed Health Strategy templates which any breed club could use to get a baseline picture of what’s going on in their breed. In the UK, these are our Breed Health and Conservation Plans. The KC has completed these for 51 breeds so far and each Breed Health Coordinator for the remaining breeds has been given a simplified self-completion template to help them make a start.

The IPFD has plans to develop a Health Strategies Database along similar lines to its existing Harmonisation of Genetic Testing database. This would be an interactive resource including health conditions where recommendations have been made by Health Strategy Providers (HSPs) including kennel and breed clubs and veterinary organisations. It will include information on prevalence, severity, screening tests/programmes, links to health data etc.

This would be supported by an IPFD Expert Panel who would provide collective opinions on key questions, e.g. the quality and utility of genetic tests, their application within breeds, geographical areas, etc. and in the context of the broader view of health in the breed.

It’s all about people!

Making these internationally-sourced resources available is great but their applicability will be very dependent on the cultural context in each breed and each country. For example, approaches that have been successfully applied in the Nordic countries where there are fewer breeders than in the UK may simply not be workable here. In the USA, things will be different again; we’ve seen from their Covid19 lockdown protests that some Americans don’t take kindly to being told what to do!

I also think there would be some value in categorising the various types of breed health improvement intervention (processes) using human behaviour change principles. I’ve written before about Susan Michie’s (UCL) behaviour change wheel which identifies 7 policy categories and around 90 different types of behavioural change technique. We will only improve breed health if individuals’ behaviour changes (breeders, buyers, judges, vets etc.). Behaviour change research in the field of human health (e.g. smoking and obesity) suggests that successful change typically requires around 10 different techniques to be employed. Incidentally, this explains why the reliance on “breeder education” has been consistently unsuccessful.

Returning to my initial thoughts on Covid19, some readers will be aware that Susan Mitchie is one of the advisors to the government on behaviour change associated with the pandemic. So, if you are interested to understand what’s been done in the past few months to shape your behaviour, I’d recommend you do some reading on behaviour change techniques. 

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