20 Feb
Tamzin Furtado
Job Title
Equine asthma poses a significant health challenge for horses and their owners.
Managing this condition requires the active participation of horse owners in implementing preventive measures and treatment plans, working alongside their veterinarian. However, owner adherence to veterinary recommendation is reportedly poor (Simões et al, 2020).
In the past few years, the field of behaviour change science has gained prominence in the context of human health care, offering valuable insights into understanding and influencing human behaviour, and it is increasingly being applied to veterinary science (Glanville et al, 2020).
While we have little scientific evidence around owner decision-making and experience in relation to equine asthma specifically, this article takes a theoretical approach to exploring the application of behaviour change science to horse owners managing equine asthma, emphasising the importance of proactive measures and informed decision-making.
Equine asthma is a chronic respiratory condition characterised by airway inflammation, bronchoconstriction and increased mucus production. Common triggers include dust, mould spores and environmental pollutants, making ongoing management crucial for the well-being of horses (Couetil et al, 2020; Kinnison et al, 2022).
For example, owners may need to consider a host of ongoing alterations, ranging from medication or inhaler use to altering bedding and forage choices. This could mean reducing stabling, moving yards, altering exercise regimes, and even, at times, reconsidering whether the horse is suitable for the purpose the owner originally intended (Hotchkiss, 2022).
Reconfiguring horse management in this way requires extensive cognitive adaptation on the part of the owner, and requires sustained change over time, with frequent adaptations according to changing circumstance. Sustaining change effectively across a period of time can be complex to achieve, as any readers who have tried to maintain any behaviour change over time will know.
Moreover, changes relating to equine asthma will need to be individualised according to the specific horse, owner and yard combination, and advice owners perceive as “one size fits all” can be unhelpful. Therefore, the approach used during veterinary communication in consults about asthma is likely to be pivotal to successful behaviour change. Understanding the drivers of human behaviour will help vets and vet nurses to best support owners and their animals.
Behaviour change science, which brings together fields including behavioural economics and behavioural psychology, focuses on understanding the factors influencing human behaviour, identifying barriers to change and employing strategies to promote positive changes. In the context of equine asthma management, applying principles from behaviour change science can enhance horse owners’ ability to adopt and sustain effective management practices.
Owners faced with a new diagnosis of equine asthma require accurate and comprehensive information about the condition, its causes, symptoms and management.
However, hearing about a new condition and the need to reconfigure management is likely to be a stressful experience for owners, which can impair ability to comprehend and use new information (Broadstock and Michie, 2000; Donovan, 1995). Therefore, allowing for and empathising with the emotional stress owners may feel – and giving information, without overloading the owner – is important.
In equine obesity studies, a successful strategy involves an initial discussion about the diagnosis and management options, and explaining that change will be required.
However, the owner and vet will need to work together to create an individualised approach – vets bringing their medical expertise and the owner, their expertise on the individual horse and what changes will work well for them (Lindley et al, 2022).
Owners are then given information to read in their own time, and check back in with veterinary surgeons or vet nurses after a period of time to collaboratively create an adapted management plan.
Behaviour change science teaches us that we must consider how the physical environments are impacting our behaviour; how easy something is to achieve in the real world will substantially impact the likelihood of that behaviour being carried out.
For example, studies on obesity find that livery yard rules about the way the physical environment can be used can sometimes hinder change, or can make change easier, depending on the individual yard and changes required (Furtado et al, no date).
It is likely that these findings would apply similarly to owners dealing with equine asthma – and, therefore, discussing with owners what is allowed on their yard, and whether they feel pressured by other people will help vet-owner collaboration.
Behaviour change science emphasises making changes as simple and convenient as possible (Michie and West, 2013). Which changes are easy to achieve and will make the owner feel like they’re achieving? Start with those. If the environment cannot be adjusted to suit the horse and owner as a pair, then obviously a yard move is sometimes necessary. This is a complex level of behaviour change for owners, and veterinary advice on what specifically should be required of the new yard in relation to turnout, bedding and management is important.
Behaviour change is often more successful when individuals have a supportive social network. Conversely, unhelpful social groups or peer pressure can make behaviour change more difficult. Studies in obesity management have found that peer pressure on livery yards, or among online groups, can make it difficult for owners to make changes, for example, when their peers say that they are being cruel (Furtado et al, no date).
During ongoing behaviour change, such as that required for equine asthma management, it is important to consider who is around the horse owner, and where they will find social support.
Some studies show people change their behaviour more successfully when they are paired up with a “buddy”, or a peer facing a similar situation to them, who can both help to ensure accountability, and help trouble-shoot (Ploderer et al, 2014).
If owners are concerned about peer pressure around them, it is vital to ensure that they have a supportive network that will help them maintain change over time. Therefore, an open discussion of the importance of ongoing support, and asking owners who they trust to support them, will assist in sustained behaviour change. In an ideal world, the support network would include the vet/VN working with them, as well as other professionals such as an instructor, yard manager and also peers. Facilitating communication and collaboration among horse owners, veterinarians and equine professionals can create a community that shares experiences, advice and encouragement.
Motivation plays a pivotal role in driving behaviour change, and clear, achievable goals related to equine asthma management are likely to help in making changes.
It may, therefore, be helpful to work with owners to discuss short and long-term goals, and what “success” looks like for each of these goals. For example, short-term goals might include learning to administer medication, including sometimes a new device such as an inhaler, and making immediate changes to forage provision (for example, steaming hay) and bedding.
How will an owner know if they are successful in those changes? What long-term goals will be appropriate for the individual case? Working with the owner to design these in a personalised and tailored way is likely to foster a sense of empowerment, accomplishment and continued adherence to the management plan.
Additionally, discussing how the owner should monitor change over time, and feed back to you (or an appropriate colleague), will assist in managing that change consistently and adapting when required.
One of the main concerns horse owners have about changing management is their horse’s emotional well-being (Smith et al, 2022). Changes owners perceived to be unpleasant for their horse are subsequently more difficult for owners to engage with. Therefore, making behaviour changes as positive as possible for both horse and owner has multiple benefits. Firstly, the horse will be calmer and therefore easier to manage, and secondly, the owner will be able to, and happy to, engage in change over time. Thirdly, owners will be encouraged by veterinary professionals who take into account their horse’s emotional well-being.
A good example of how this can be incorporated is shown in the use of an asthma inhaler, which may seem intimidating for both horses and owners at first. Therefore, using a step-by-step approach with positive reinforcement training (for example, clicker training) can make this process enjoyable for both, and something that they look forward to.
In turn, this will be easier to embed into a habit. People respond well to positive reinforcement, too, so praising owners for small changes, or being willing to make change, will contribute to the formation of lasting routine.
Habits are extremely powerful behavioural drivers, and occur when we have a cue, a behaviour and a reward. As an example, when we first wake up in the morning (a cue) we might have a habit of putting on the kettle (behaviour) for a reward (a cup of tea; Fogg, 2020).
Animals can help us form these habits, such as when the cat persuades us to feed them in the morning by miaowing (a cue), causing us to feed (behaviour) and stopping miaowing (reward). As habits are hard to break and an important part of our everyday life, it’s important to think about them in behaviour change. Do existing habits exist that make change harder, or easier, to carry out? Or, can habits be aligned with existing activities?
As an example, if an owner already has the habit of spending Saturday morning at the yard, this is a good time to have them embed the habit of a full muck out and removal of dust from the stable. If an inhaler or medication is to be given, how and when will this occur so as to make sure that it becomes a part of everyday routine? Encouraging horse owners to integrate asthma management practices into their daily routines enhances the likelihood of sustained adherence over time.
Applying behaviour change science to equine asthma management will help to empower horse owners to actively participate in their horses’ well-being.
By understanding the principles of behaviour change, tailoring information, setting realistic goals, providing positive reinforcement and fostering social support, veterinary professionals will help horse owners to work towards effective asthma prevention and management. This holistic approach not only enhances the health of individual horses, but also contributes to good client relations.
