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Delays in reporting highly contagious animal diseases
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Delays in reporting highly contagious animal diseases

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Delays in reporting highly contagious animal diseases, presented at the 10th European Congress of Psychology, 3-6 July, 2007, Prague, Czech republic

Delays in reporting highly contagious animal diseases, presented at the 10th European Congress of Psychology, 3-6 July, 2007, Prague, Czech republic

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Delays in reporting highly contagious animal diseases Delays in reporting highly contagious animal diseases Presentation Transcript

  • Delays in reporting highly contagious animal diseases Marjan Gorgievski, Erasmus Universiteit Rotterdam Armin Elbers, CIDC - Wageningen UR Peter van der Velden, IVP Zaltbommel Kiumars Zarafshani, Razi University Kermanshah
  • Need for better early NAD detection
    • Experience with classical swine fever (1997-1998) and Avian Influenza epidemics (2003) in The Netherlands teaches us:
    • The time between the first clinical appearance of a Notifiable Animal Disease (NAD) and the actual reporting to the authorities is too long, extensive spread among other farms can hardly be stopped.
    Bron: Agrarisch Dagblad Bron: Agrarisch Dagblad
  • High-Risk period
    • High- risk period (HRP) starts when the first animal in the area (country) gets infected and ends when the first case is reported to the authorities and preventive measures have taken effect (stand-still, elimination of infected animals, etc.)
    • The longer the HRP, the bigger the risk of extensive spread of the disease to other farms
  • HRP classical swine fever (CSF)
    • UK (1986) 4 weeks
    • The Netherlands (1992) 6 weeks
    • Belgium (1993) 3 weeks
    • Germany (1997) 8 weeks
    • The Netherlands (1997) 6 weeks
    • Spain (1997) 9 weeks
    • UK (2000) 8 weeks
    • Irian Jaya (2004) > 12 weeks
    • Papua New Guinea > 16 weeks
    • Germany (2006) > 8 weeks)
  • Reconstructi on CSF- epidemi c 1997-1998
    • Early January 1997 non-typical symptoms witnessed in pigs (low food intake, coughing, blue ears, increased mortality);
    • January 15. Veterinarian confirms clinical symptoms and increased mortality; diagnoses : pneumonia therapy: antibiotics
    • January 20. Veterinarian visits the farm again, because the treatment is unsuccessful diagnoses : blue ear disease Two pigs sent to the community health service for laboratory tests
    • Between January 15 – February 4 about 80 of 180 breeding sows and 800 pigs for consumption die (Much more than the norm);
    • February 3. New material was send to the community health service. Another section shows suspected material pointing at the possibility of CSF
      • The High Risk Period of this case could have been 2-3 weeks shorter if the serious clinical symptoms had been reported to the authorities faster, or with better differential diagnoses in the lab.
  • Reconstructi on Avian Influenza -epidemi c 2003
      • February 23. First bird farm with mortality among broilers of 5-7 x more than normal (veterinarian was contacted, material send for research to the community health service
      • February 23- 28. Increased mortality on 5 different bird farms. None of these cases are reported to the authorities. Material is being investigated by the community health service (industry)
      • February 23 - 28. Several farms send in their material to the community health service, but their lab does not test for AI
      • February 28. AI is being tested as the last alternative explanation for the clinical symptoms. Again the authorities are not notified until after positive test-results have been obtained.
      • The High Risk Period of this case could have been 5 days shorter if the serious clinical symptoms had been reported to the authorities faster, or with better differential diagnoses in the lab.
  • Therefore
        • A large scale research project was started, beginning with
        • Group discussions (2005)
        • Qualitative research (2006)
  • Design Qualitative Study
    • Group discussions with small groups of 4-5 subject matter experts: Representatives of different agricultural sectors (pig -, dairy -, poultry -, sheep - and goat farms), and veterinarians.
    • Face to face interviews with farmers, veterinarians, community health service professionals and governmental officials that had all been involved in 10 company visits that were initiated after a NAD had been reported to the authorities (all cases turned out to be negative).
    • Additional telephone interviews with 15 farmers and 5 veterinarians who did not have any prior experience with signaling and reporting NAD
  • Analyses Interviews
      • We stopped interviewing when saturation was reached an no new information came up in the interviews
      • Discussions and interviews were recorded on tape. Interviews were transcribed.
      • All discussions and interviews were content analyzed by three researchers (two of whom were student researchers)
      • Final clustering of topics was done based on a discussion
  • Most Important Results
    • First important issue is that different stages of the decision making process could clearly be distinguished in the stories
    • Second: at different stages different mechanisms cause a delay in reporting NAD’s
  • Decision ladder
    • Information: cues in the environment
    • Diagnosis: recognize significant changes in the environment that require more conscious processing
    • Goal(s): definition of the desired situation
    • Strategies and procedure: define and evaluate different alternative routes to reach this goal
    • Action: Performing the chosen activity
    O’Hare, 2000
  • Actions in the Decision Ladder
    • Levels of activity
    • (based on Rasmussen, 1980)
    • S = Skill based, automatic
    • R = Rule based, familiar problems lead to performance of well known procedures
    • K = knowledge based, new and unfamiliar problems require active goal setting and weighing of pros and cons of alternative actions
    O’Hare, 2000
  • Animal disease decision ladder
    • One day the farmer gets up in the morning and:
      • Information : it is a beautiful day, the newspaper says there is a case of CSF in Czech Republic, clock says it is time to start feeding animals, etc.
      • Diagnosis: for the past seven days several pigs in one department have been suffering respiratory problems. Four pigs died, and one pig has bleedings on the back and shoulders. Several pigs have a fever. They eat less than they normally do.
      • Goal(s): I need to cure them. Next week I need to send a group of pigs to the slaughterhouse
      • Strategies and procedure: I will first try to give them antibiotics. If this does not work, I will call my vet.
      • Action: Performing the chosen activity
    O’Hare, 2000
  • Problems with Information
    • First important problem is inability to recognize a NAD
      • Information. The information in the environment may contain cues that should alarm farmers of possible increased vulnerability. In the example it was a story in the newspaper about a case of CSF in Czech republic.
      • Does such information capture farmers’ attention?
      • Do they recognize its relevance? (e.g. cases of CSF in Czech republic are not considered a very high risk factor for The Netherlands, cases in West Germany are considered a higher risk ( proximity ) . L ow pathogenic AI can mutate into high pathogenic, but farmers do not know).
  • Problems with diagnosis and goal setting
    • Occurrence of a NAD at the farm is a highly rare event, and therefore recognition is difficult. E.g. it has been 10 years since The Netherlands was confronted with classical swine fever.
  •  
  • Problems with diagnosis and goal setting
    • Occurrence of a NAD at the farm is a highly rare event, and therefore recognition is difficult. E.g. it has been 10 years since The Netherlands was confronted with classical swine fever.
    • The symptoms of classical swine fever, as of many other NAD’s are common in the early stage of disease , ( i.e. also produced by other non-reportable diseases), and occur frequently
    • The first response is therefore to diagnose and find treatment for common non-reportable diseases and do not think of notifying the authorities.
  • If a NAD is identified
    • Finally, if the veterinarian or the farmer realizes there may be a question of a NAD, they are highly insecure about the accuracy of this diagnosis
    • Notifying the authorities in case there is indeed such a disease is considered very important. Farmers realize the importance of acting quickly.
  • If a NAD is identified
    • Especially among farmers there is a huge reluctance to notify the authorities in case of a false-alarm (not a NAD).
      • Negative consequences for the business
      • Negative social consequences
      • Negative expectations about the process based on experience with outbreaks in the past. E.g. lack of feedback.
      • Few negative consequences related to not reporting
  • To Conclude
    • Based on qualitative results we found that the most important reason for not reporting notifyable animal diseases is related to information error and diagnosis error.
    • The second reason is a combination of the insecurity about the diagnosis, and perceived consequences.
      • Reporting will in most cases lead to a false alarm, with many perceived negative consequences (but also some positive consequences, such as relief.)
      • There are few hits. In that case farmers realize it is important to report as quickly as possible in order to minimize losses.
  • Follow-up Projects in 2006 - 2008
        • Evaluation study of the development of a diagnostic instrument for ruling out classical swine fever (2006)
        • Development of a simple decision support instrument for diagnosing 20 different pig-diseases based on clinical symptoms, including 5 NAD’s. Supported by pictures and films of ill animals (2007).
        • Development of a complex, computerized decision support system to support veterinarians when diagnosing classical swine fever (2007).
        • Two quantitative Social Psychological stud ies about farmers’ opinions and possible responses when they are confronted with NAD’s (2006-2007)
  • Social Psychological Survey on Farmers’ Attitudes and Opinions
    • N = 140 farmers
      • 92 % male
      • Mean Age : 46 years (range 21-72)
      • Livestock Sectors (N=)
        • 24 Dairy,
        • 33 Poultry,
        • 75 Pigs,
        • 20 Goats / Sheep
  • Opinion on factors influencing diagnosis (information)
    • According to farmers people would report quicker if:
    • Symptoms are serious 80
    • Symptoms not typical for the animal 52
    • Symptoms are not common 55
    • In case of frequent contact with other farms 52
    • After introduction of new animals on farm 48
    • If there are many farms in the area 50
    • In case of recent outbreak nearby 85
    • In case of good contact veterinarian 51
  • Predictors of intention to report attitudes Social norm Perceived behavioral control Behavioral intention Ajzen, 1988. Theory of Planned Behavior Outcome beliefs
  • Adaptation intentions
    • Before the behavioral intention to report a NAD, farmers first seek more certainty
      • Wait to see if clinical situation gets worse
      • Try to solve the problem by giving medication
      • Consult other farmers, family
      • Consult veterinarian
      • Consult professional help-desk (Animal Health Service)
  • Adaptations attitudes and outcome expectancies
    • Attitudes and outcome expectancies depend on the expectation whether there really is a NAD
      • Negative outcome expectancies in case there really is something wrong are inavoidable, do not outweight the importance of notifying the authorities
      • In case nothing is wrong, farmers also have negative outcome expectancies (image, management of the farm). Those are avoidable if you do not notify the authorities. There are only few negative consequences of not reporting
      • Farmers see no use for reporting false alarms.
  • Social norm
    • Social norm
      • Colleagues , neighbours and family members understand it if you do not report low / middle suspect cases, even if that means you are violating the law.
      • Even though everyone agrees that reporting NAD’s as early as possible is extremely important, the first farmer that notifies the authorities often gets stigmatized.
  • Perceived Behavioral Control
    • It seems easy enough to pick up the phone and just call
      • Farmers do not want to make the call, because they are insecure about the procedure and what they can expect
      • Farmers and veterinarians have experienced that similar phone calls are not treated in a similar manner.
      • The people answering the telephone are not disease experts. They register the call, but you cannot discuss with them whether they think that the phone call is appropriate
  • Adapted research model Negative consequences for business of ‘false alarms’ Social norm (accept dodging regulations) Perceived Behavioral control (barriers related to center for reporting) Intention to report in case of small probability disease Report Intention to seek more confirmation Positive attitude towards hits (importance) Negative consequences for business of “hits” Attitudes towards false alarms (embarrassment, uneasy) + - - + + + + - - +
  • Measurement Instrument alpha label .75 2 items Intention to report .63 3 items Intention to seek more confirmation - 1 item Perceived behavioral control (barriers related to centre for reporting) .85 4 items Social norm .90 8 items Negative consequences business false alarms .82 4 items “ Negative attitudes “false alarms” (embarrassment) .90 5 items Negative consequences for the business “hits” .80 2 items Positive attitudes “hits” (importance)
  • Results 141 Farmers Negative consequences for business of “false alarms” Social norm (accept dodging regulations) Perceived Behavioral control (barriers related to centre for reporting) Intention to report in case of small probability disease Report Intention to seek more confirmation Positive attitude towards hits (importance) Negative consequences for business of “hits” Attitudes towards “false alarms” (embarrassment, uneasy) .38 -.23 .18 .27 -.24  2 = 5.97, df=10, p=0.82