The why and how of Breed-specific Health Strategies – “Best of Health” June 2019

Best of HealthWhen 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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My presentation to the 4th International Dog Health Workshop (IDHW4)

[You can view my slides here]

BSHS Title slide

When I spoke at IDHW3 in Paris, 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, 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.

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.

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.”

.

.

.

.

.

.

.

.

.

 

 

My report on the 4th International Dog Health Workshop for Our Dogs 7th June 2019

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The 4th International Dog Health Workshop, co-hosted by the Kennel Club and International Partnership for Dogs took place from 30th May to 1st June in Windsor. Around 130 delegates from 17 countries participated in this unique collaboration of Kennel Clubs, vets, geneticists, researchers, campaigners, trade representatives and, of course, dog owners and breeders. Royal Canin were sponsors.

Delegates registered on Thursday evening and were greeted by members of the KC’s events team, surrounded by an exhibition of posters displaying a wide range of canine research projects and initiatives.

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The workshop was launched early on Friday morning with welcomes from Dr Pekka Olson (IPFD Chairman), Caroline Kisko (representing the KC) and Dr Brenda Bonnett (IPFD Chief Executive). Day 1 comprised a series of short presentations by speakers who would later be leaders or facilitators in the participative breakout sessions. The whole point of this event is that it is a WORKSHOP, where collaboration can lead to agreed actions.

The 5 themes running throughout the workshop were:

  • What is a breed?
  • Supply and Demand
  • Breed-specific Health Strategies
  • Genetic testing
  • Exaggeration and extremes

Supply and Demand was a new theme and was seen to be important in light of several trends that have developed in dog-buying and dog-breeding. We’re all aware of the massive growth in popularity of Bulldogs, Pugs and French Bulldogs. Demand for these simply can’t be met by what most of us would recognise as “reputable breeders”. Puppy farmers, illegal imports and commercial breeders have all stepped in to meet the demand. That demand was estimated to be around 8 million puppies per year in the EU and 8-10 million in the USA.

All 5 themes also had a cross-cutting theme: human behaviour change. It has become increasingly evident that unless buyers, breeders and owners change their behaviour, the health and welfare issues facing (all) dogs simply cannot be addressed. Dan O’Neill from the Royal Veterinary College summed it up in the closing discussion when he said: “We need to stop saying it’s all about the dogs. It is clear that it is really all about the people”. Right at the start of the workshop, it was said that many of the approaches that had been tried so far, to influence people’s behaviour, had had very little effect. We’ve had reviews, reports, legislation, website resources, puppy contracts, education for breeders and judges to name just a few initiatives, yet any impact on canine health and welfare either isn’t happening or isn’t happening fast enough.

Now, that might all sound rather depressing but the point of many of the presentations and working sessions was to identify and highlight examples of what can be achieved by engaging with people in more creative ways than has perhaps been done previously. One of the most thought-challenging presentations was by Candace Croney of Purdue University in the US. She has been working on a programme with high-volume puppy breeders (Puppy Mills) to develop welfare standards for facilities, breeding and rearing of dogs. The standards have been developed in collaboration with these breeders and are focused on recognition, rather than legislation, compliance and punishment. Candace presented evidence to show that dog welfare had improved, buyer satisfaction had improved and participating breeders ended up with more profitable businesses. It all sounds quite counter-intuitive but the collaborative approach has resulted in benefits for everyone; buyers, breeders and the dogs.

There was a specific presentation on human behaviour change by Tamzin Furtado where she described the importance of understanding psychology and the process of change that people go through. Delegates could all relate to examples of how difficult personal change can be, for example stopping smoking, cutting down on drinking or not speeding when driving. Ingrained habits are hard to change and it takes lots of repetition to embed new habits. Many of the techniques of human behaviour change focus on positive reinforcement and creating “nudges” to drive new, desired habits. Telling people they need to change or the use of coercion are notoriously unsuccessful techniques.

During Friday, there were 2 breakout sessions where working groups discussed the challenges related to their 5 themes and worked towards ideas and solutions for addressing the challenges. The aim was for each thematic group to develop action plans that could be implemented after the workshop.

On Friday evening, there was a gala dinner which provided a further opportunity for networking among the participants before another early start on Saturday morning. The 5 thematic breakout groups reconvened to summarise their conclusions and proposed action plans.

Professor Steve Dean presented the “What is a breed?” team’s conclusions with some clear messages about the reality of breeds being under continuous development, through selection, even with closed stud books. Many Kennel Clubs already have policies in place to allow for bringing new blood into registries, for example with outcrossing programmes or introduction of unregistered working stock. More open stud books would, the group felt, be a helpful way to address some of the challenges of diminishing genetic diversity.

The Supply and Demand group (represented by Gareth Arnott) emphasised the importance of identification and traceability. They also felt there were opportunities for standardisation of policies and procedures across the EU (which raises interesting questions in light of Brexit, of course). Some of the ideas that the Purdue team had applied with commercial breeders in the US were also clearly transferrable to other countries.

The Breed-specific Health Strategies team (led by Gregoire Leroy) focused on the value of international cooperation and identified a number of areas where solutions from one country could be applied elsewhere. But, this would require a better flow of information and data-sharing between Kennel Clubs and Breed Clubs. The group also stated that there were plenty of tools already available to help individual breeds but some work was needed to make them more accessible.

The Genetic Testing group discussed a couple of challenges; validation of tests and the subject of genetic counselling. There is concern that DNA tests are being developed ever more rapidly but the published research doesn’t always include sufficient information on validity (i.e. is there a clearly understood mechanism by which the mutation causes clinical manifestation of a disease). That’s not always the fault of the researchers because project funding often doesn’t extend to validation. Therefore, this issue needs to be given more focus (and funding). We’re all aware of how breeders can be tempted to rush off and use the latest DNA test, just because it’s been made available commercially. Genetic counselling and improved guidance is required, in many cases, and this becomes more important where multiple DNA tests are available in a breed; how should people prioritise among these and how should the results be used?

Finally, the exaggerations and extremes group presented their report. Perhaps their most significant statement was that some of the most important people involved with this issue weren’t present at the workshop; breeders, owners and judges need to be involved. The learning about human behaviour change through engagement and collaboration had clearly struck a chord (and not just in this theme). We all know that work is underway on Breed Standards in the Brachycephalic breeds and the team highlighted the potential value of international collaboration on the brachy issue, rather than it continuing with individual countries doing their own thing. Interestingly, the group also recommended action in relation to canine obesity and challenged the IPFD and others to sign-up to an international charter to recognise obesity as a disease. The move from telling people their dogs are too fat to diagnosing and treating obesity as a disease opens up a new range of opportunities to influence human behaviour and the vets can play a major role here.

This final presentation was followed by some further brief discussions and a feedback poll of the delegates showed that 83% felt positive about the actionable outcomes of the workshop while just 1% were less convinced of its benefits (the remainder were “unsure” – probably a reflection of the need to “wait and see what happens after the workshop”).

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Pekka Olson and Brenda Bonnett wrapped-up the workshop with thanks to Caroline Kisko and the KC team as well as all the other helpers who had made the workshop possible. And now, the hard work begins!

Presentation at the 4th International Dog Health Workshop – Windsor 2019

My slide presentation is available online, here:

Tackling inherited orthopaedic problems in dogs – Symposium 6th October 2019

To book a place, contact carol.fowler@dogbreeding reformgroup.uk

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