Applying One Health to the Study of Animal-Assisted Interventions

Guidance on Minimum Standards for Canine-Assisted Psychotherapy in Adolescent Mental Health: Delphi Expert Consensus on Health, Safety, and Canine Welfare

As interest in animal-assisted therapy (AAT) and canine-assisted psychotherapy (CAP) grows, there are increasing calls for the management of related health, safety, and welfare concerns for canines, providers, and clients. Existing health and safety guidelines lack empirical support and are, at times, contradictory. Welfare is increasingly prioritized; however, tools to monitor and manage welfare are underutilized and under-reported. The aim of this study was to provide expert consensus on the minimum health, safety, and welfare standards required to develop and deliver a CAP group program to adolescents experiencing common mental health disorders. Diverse AAT experts were recruited globally. Using Delphi methodology, over two rounds, 40 panelists reached a consensus agreement to include 32 items from a possible 49 into the minimum standards. Health and safety measures included risk assessment, veterinary screening, preventative medicine, training in infection control, and first aid. Welfare measures included training in welfare assessment, documentation of welfare, and flexible, individualized responses to promote wellbeing. Intestinal screening for parasites and the prohibition of raw food were not supported. Flexible and individualized assessment and management of canine welfare were supported over fixed and time-limited work schedules. Clinical practice implications are discussed, and recommendations are made.

A Relaxed Horse-A Relaxed Client? An Experimental Investigation of the Effects of Therapy Horses' Stress on Clients' Stress, Mood, and Anxiety

Equine-assisted therapies are becoming increasingly popular for addressing physical and psychological disabilities in clients. The role of the horse's welfare in equine-assisted service receives increasing attention in research. Several studies have shown that horses are able to perceive human emotions and respond to human stress responses. However, no research has yet looked at the other side of the coin-whether and how humans perceive and react to equine stress levels during equine-assisted services. To fill this gap in the research, we employed a within-subjects design, in which horse-naïve participants had a standardized interaction with both an experimentally stressed horse and an experimentally relaxed horse. We assessed physiological indicators of stress (heart rate, heart rate variability, and salivary cortisol) in participants and horses, as well as psychological indicators of stress (state anxiety and positive and negative affect) in participants. Although our stress and relaxation manipulations were successful (indicated by horses' physiological indicators of stress), we did not find any difference in the participants' physiological or psychological indicators of stress between the interaction with a stressed and the interaction with a relaxed horse. Together with results from previous studies, this suggests that humans cannot intuitively recognize the (physiological) stress level of horses, which has important implications for effective communication and bonding between humans and horses and for the safety of equine activities.

The Triple-E Model: Advancing Equestrian Research with Perspectives from One Health

Equestrian sport has various welfare issues and educational needs. To address these complex interactions, we propose an integrated approach called the Triple-E Model, which focuses on the equine, equestrian, and environmental triad. A literature review of existing models suggests that complexities of these interactions are overlooked, despite the significant impact of equine industries on economics, healthcare, and animal welfare. This paper discusses current models and theories used to evaluate equine-equestrian-environmental interactions and introduces the Triple-E Model to foster multidisciplinary collaboration. Unlike the One Health triad, which focuses on disease emergence, transmission, and zoonosis, the Triple-E Model extends to non-infectious research, such as musculoskeletal injury. It promotes collaborative care and rehabilitation within the equestrian community by engaging multidisciplinary, multi-setting, and multi-sectoral teams. Given the nature of human-animal interaction and welfare considerations, this model fills the gap in understanding human-horse interactions. The paper highlights the limitations of existing models and explains how the Triple-E Model guides and encourages holistic team collaboration in the equestrian community.

Human-Animal Interaction in Animal-Assisted Interventions (AAI)s: Zoonosis Risks, Benefits, and Future Directions-A One Health Approach

Animal-assisted interventions (AAI)s represent the expression of integrated medicine, according to the One Health approach. Actually, animal-assisted therapies and animal-assisted activities are implemented in hospitals, rehabilitation centers, etc. The efficacy of AAIs is based on interspecific interactions and would be impacted by different factors, such as the characters of both the animal and the handler, a suitable selection of animal species, an appropriate animal educational protocol, the relationship between the handler and the animal, and mutual relationship among the animal, the patients, and members of the working team. AAIs produce many advantages for the patients but could expose them to zoonotic-pathogens transmission. Therefore, positive animal welfare, as preventative medicine to avoid incidents or transmission of zoonosis, is a relevant aspect with implications for human and animal health and wellbeing. This review aims to summarize the current published knowledge regarding the occurrence of pathogens in AAIs and to discuss their relevance in light of health and safety in AAIs participants. In addition, this review will contribute to defining the state of the art of AAIs through a careful benefits/challenges analysis and offers discussion points on the possible future developments according to the One Health approach.

What does One Health want? Feminist, posthuman, and anti-colonial possibilities

What does One Health want? Despite its touted interdisciplinarity, to date there has been limited engagement with the social sciences and humanities - in particular with streams of critical social theory that enable a response to this question. In this paper we draw on the critical social sciences to consider how One Health is defined, conceptualized, and positioned, and discuss what we see as vital challenges within One Health that both limit its potential for meaningful change and contribute to a potential for ongoing harm - namely, medicalization, anthropocentrism, and colonial-capitalism. We then advance three areas in the critical social sciences that hold potential for addressing these challenges - feminist, posthuman, and anti-colonial approaches. By doing so we seek to encourage a deeper transdisciplinarity within One Health - one that is open to a genuine engagement with insights from critical social theory and a re-orientation towards more creative and radical re-imaginings in the service of wellbeing for diverse peoples, animals, other beings, and the land.

A Review of Indigenous Perspectives in Animal Biosciences

This article addresses the underrepresentation of Indigenous perspectives in animal sciences by challenging the exclusive use of Western scientific paradigms in research and education. Because of the systematic exclusion of Indigenous peoples, Indigenous perspectives have rarely been represented through empirical study, leading us to believe this is a key reason for the underrepresentation of Native people in these fields. We conducted a literature review, searching for Indigenous contributions in animal sciences and finding a handful of articles in three areas: human-animal bonds, genetic testing and breeding programs, and Traditional Ecological Knowledge. Given the interconnected paradigm of Indigenous worldviews, we suggest that the ongoing siloes of scientific disciplines and the hierarchy of methodology contribute to the dearth of Indigenous perspectives. We suggest increased support for proper tribal consultation, contextualization of the history of research in Native communities, and the creation of scholarly spaces to support these conversations.

Integrative Model of Human-Animal Interactions: A One Health-One Welfare Systemic Approach to Studying HAI

The Integrative Model of Human-Animal Interactions (IMHAI) described herewith provides a conceptual framework for the study of interspecies interactions and aims to model the primary emotional processes involved in human-animal interactions. This model was developed from theoretical inputs from three fundamental disciplines for understanding interspecies interactions: neuroscience, psychology and ethology, with the objective of providing a transdisciplinary approach on which field professionals and researchers can build and collaborate. Seminal works in affective neuroscience offer a common basis between humans and animals and, as such, can be applied to the study of interspecies interactions from a One Health-One Welfare perspective. On the one hand, Jaak Panksepp's research revealed that primary/basic emotions originate in the deep subcortical regions of the brain and are shared by all mammals, including humans. On the other hand, several works in the field of neuroscience show that the basic physiological state is largely determined by the perception of safety. Thus, emotional expression reflects the state of an individual's permanent adaptation to ever-changing environmental demands. Based on this evidence and over 5 years of action research using grounded theory, alternating between research and practice, the IMHAI proposes a systemic approach to the study of primary-process emotional affects during interspecies social interactions, through the processes of emotional transfer, embodied communication and interactive emotional regulation. IMHAI aims to generate new hypotheses and predictions on affective behavior and interspecies communication. Application of such a model should promote risk prevention and the establishment of positive links between humans and animals thereby contributing to their respective wellbeing.

Handlers’ Representations on Therapy Dogs’ Welfare

Simple Summary

Most research about Animal-Assisted Interventions (AAI) has focused on the benefits on human health. In contrast, very little has been made on the impact of this work on therapy dogs, although it is part of the ethics of the practice to ensure their welfare. This study aimed to contribute to the knowledge on the welfare of therapy dogs by interviewing 111 handlers through an online questionnaire. The qualitative assessment of handlers’ representations underlined that the welfare of therapy dogs is multidimensional and can be impacted by various variables. Its consideration is important for the quality and safety of the sessions, both for the dog and for the beneficiaries involved. Handlers have a central role in the welfare of their therapy dog and must be trained on stress-related behaviors. Research needs to focus on the impact of interactions on therapy dogs.

Abstract

While research on the benefits of animal-assisted interventions is beginning to build a significant body of work, studies on the well-being of therapy dogs are still in their infancy. Since handlers are the people responsible for their therapy dog’s welfare, we interviewed 111 French handlers through an online questionnaire. Our results underlined that (i) therapy dogs’ welfare is multidimensional when physical and psychological welfare, a balance between work and dog life and the settings and interactions of sessions are all taken into consideration. (ii) The response of our handlers emphasized that considering therapy dog welfare is important for the quality and safety of AAI. (iii) Three categories of risks factors were highlighted: the spatio-temporal framework (planning and environment), the interactions with beneficiaries and the handler themselves. It is particularly important that handlers talk about the negative impact of interactions with beneficiaries since they are at the heart of AAI, however there are few studies focusing on interactions as a stressor for dogs in this practice. Moreover, since there is a potential for positive bias in the handlers’ representations, it is important that they be trained to identify and manage the stress in their dogs. Future research is particularly needed on the impact of interactions during sessions on therapy dog welfare.

One Health information management: health system reforms to support social well-being in Thailand

Background and Aim: The information about the health problems interaction between animal health, ecosystems, and human health that the "One Health (OH)" concept is becoming more complex. This study focused on OH information in Thailand to develop guidelines for establishing a "One Health Information Management (OHIM)" system by drafting the structure of an OH information strategic plan. Materials and Methods: A mixed methods approach was used and included questionnaires, interviews, focus groups, and observations in agencies across the country to gather evidence about actions relating to the OH concept, such as the Memorandum of Agreements between the Ministry of Public Health and eight main agencies. Results: The study concentrated on the key issue that understanding the OH concept is difficult, as the environment and human health sectors include less knowledge of this concept than the animal health sector. Further, there are concerns about the comprehension of OH concepts, and high-level information management and data storage relating to OH, including medicine, cattle, wild animal, environment, and environmental resource management. Data from OH researchers and publicly accessible government data are less integrated and inconsistently managed across agencies. Conclusion: The study of OHIM strategic development should consist of four important points: (1) Clarity in the OH concept, (2) OH staff development, (3) development of an OHIM data network and innovation, and (4) research and academic development, and global OHIM academic exchange. All of these points will lead to health system reforms to support social well-being.

Examining the concept of One Health for indigenous communities: A systematic review

Purpose

This paper examines whether the usage of the concept of One Health in Canada-based research aligns with traditional Indigenous notions of health and wellness.

Methods

A comprehensive search of the literature was conducted using primary databases, including Scholars Portal, ProQuest Social Science, Sociological Abstracts (ProQuest), OVID Healthstar, Embase, Medline, Pubmed and Google Scholar. Papers discussing One Health and Indigenous Health were selected and analyzed through Nvivo12 to generate common themes across the studies.

Results

The analysis identified three major themes that focused on One Health as it relates to climate change, zoonosis, and social relationships between humans and animals. Climate change was seen to have affected the environmental health of Northern latitude areas where many Indigenous communities reside. Infectious diseases within Indigenous communities were a frequent topic of study and indicated that infections transmitted by dogs are likely to be addressed with One Health interventions. One Health interventions are likely to equally address the health of humans, animals, and the environment.

Conclusions

No significant connection between One Health and Indigenous knowledges was established in the analyzed articles. Articles discussed One Health as it pertains to epidemiological surveillance and research. The implications of utilizing One Health towards Indigenous Peoples and culture were not explicitly addressed.

Donkey assisted interventions: A pilot survey on service providers in North-Eastern Italy

CONTEXT

Animal Assisted Interventions (AAI), which are generally defined as 'pet therapy', focus on the improvement of human health and wellbeing through a multidisciplinary approach and the involvement of domestic animals. An Italian survey conducted in 2017 revealed that donkeys were the third most involved species in AAI. Nevertheless, data on the main features of the providers of Donkey Assisted Interventions (DAI), especially in Italy, and their organisational models are scarce.

OBJECTIVE

This questionnaire-based pilot study aimed to collect information about the features of DAI providers in the Veneto Region to have a general framework about the field.

STUDY METHOD

In this descriptive mixed-method pilot study, we interviewed DAI providers through a computer assisted telephone interview. Respondents were selected by integrating data from the Veneto Region Livestock Database and from the Italian official register of AAI professionals. The questionnaire was designed following the advice from Equator Network.

MAIN OUTCOME MEASURES

Our outcome measures included the prevalent organisational system adopted by our respondents, main type of AAI programs, and users. Furthermore, we collected qualitative data about economic and income and respondents' personal opinions about DAI (strengths and weaknesses).

MAIN RESULTS

Data analysis revealed a heterogeneous picture of the DAI field with a prevalence of non-profit organisations providing mainly Donkey Assisted Activities to a large range of user categories. Despite the poor economic framework and low income from DAI, DAI providers were strongly motivated and spent more time and efforts in delivering this service.

Occurrence of Pasteurella multocida in Dogs Being Trained for Animal-Assisted Therapy

Animal-assisted therapy (AAT) is a non-pharmacological therapy aimed at people with physical and/or mental disabilities. Therefore, it is necessary to carry out interventions that guarantee its benefits for patients while also avoiding the risk of zoonoses due to contact with the animals or their mucous membranes. The present study aimed to detect the occurrence of Pasteurella multocida in the oral cavity of dogs attending a “dog educational centre” and training for AAT interventions. In addition, some of the potential predictable factors of infection (i.e., age, sex, breed, and living conditions) were analyzed. In total, 25/200 dogs examined (12.5%; 95% confidence interval = 8.4–18.1%) were positive for P. multocida, as confirmed by PCR. Sex, breed, and living conditions were risk factors associated with P. multocida as revealed by the logistic regression analysis. Specifically, cross-bred female dogs living prevalently outdoors were significantly associated with the presence of P. multocida (p < 0.05). This study represents the first epidemiological survey of the prevalence of P. multocida in the oral cavity of dogs involved subsequently in AAT interventions, highlighting the potential risk of P. multocida infection in patients, often belonging to risk categories (e.g., children, the elderly, and immunocompromised individuals). Therefore, healthcare guidelines could be suggested to integrate the current literature related to the health check of dogs involved in AAT. In this way, it could be ensured that, even with bodily contact during AAT, the risk of pathogen transmission by the co-therapist dog can be avoided.

The influence of human interaction on guinea pigs: Behavioral and thermographic changes during animal-assisted therapy

Guinea pigs are often involved in animal-assisted therapy (AAT) but there is little knowledge about the effects of human contact on guinea pigs involved in AAT. The aim of this study was to investigate effects of availability of a retreat, presence of conspecifics, prior experience with AAT, and human interaction on indicators of welfare in guinea pigs involved in AAT. Guinea pigs of both sexes and different ages (n=20) were assigned to a randomized, controlled within-subject trial with repeated measurements. Each guinea pig was tested in four settings: (I) therapy with retreat possibility with conspecifics, (II) therapy with retreat possibility without conspecifics, (III) therapy without retreat possibility, and (IV) setting without human interaction. We measured changes in eye temperature, as a proxy to infer stress levels, at 5-s intervals with a thermographic camera. All sessions were video recorded and the guinea pigs' behavior was coded using continuous recording and focal animal sampling. For the statistical analysis we used generalized linear mixed models, with therapy setting as a fixed effect and individual guinea pig as a random effect. We observed a temperature increase relative to baseline in settings (I) therapy with retreat with conspecifics present and (III) therapy without retreat. The percentage of time a guinea pig was petted was positively correlated with a rise in the eye temperature independent of the setting. Time spent eating was reduced in all therapy settings (I-III) compared to the setting without HAI (human animal interaction) (IV). In the setting with retreat (I), guinea pigs showed more active behaviors such as locomotive behavior or startling compared to the setting without retreat (III) and the setting without HAI (IV). When no retreat was available (III), they showed more passive behaviors, such as standing still or freezing compared to therapy with retreat (I). Based on our results we identified the behaviors "reduced eating", "increased startle" and "increased freezing" as indicators of an increased stress level. Petting the guinea pigs was correlated with a rise in the eye temperature and might be a factor which can cause stress. Our results support the suggestion that guinea pigs involved in AAT should have a retreat possibility, should have access to conspecifics, and should be given time to adapt to a new setting. In this way, stress might be reduced.

Risks associated with animal-assisted intervention programs: A literature review

The benefits of animal-assisted interventions (AAI), to utilize companion animals as an adjunctive treatment modality, is well-established and a burgeoning research field. However, few studies have evaluated the potential hazards of these programs, such as the potential for therapy animals to transfer hospital-associated pathogens between individuals and the hospital environment. Here we review the current literature on the possible risks of hospital-based AAI programs, including zoonotic pathogen transmission. We identified twenty-nine articles encompassing reviews of infection control guidelines and epidemiological studies on zoonotic pathogen prevalence in AAI. We observed substantial heterogeneity in infection control practices among hospital AAI programs. Few data confirmed pathogen transmission between therapy animals and patients. Given AAI's known benefits, we recommend that future research utilize a One Health framework to evaluate microbial dynamics among therapy animals, patients, and hospital environments. This framework may best promote safe practices to ensure the sustainability of these valuable AAI programs.

Patient Opinion of Visiting Therapy Dogs in a Hospital Emergency Department

To date there have been no studies examining whether patients want emergency department (ED) therapy dog programs. This patient-oriented study examined the opinions of patients about whether they would want to be visited by a therapy dog in the Royal University Hospital ED. Cross-sectional survey data were collected over a six week period from a convenience sample of 100 adult patients who had not been visited by a therapy dog in the ED. Most (80%) indicated they would want a visit by a therapy dog as an ED patient. A higher proportion of individuals who currently have a pet dog (95%) or identify as having lots of experience with dogs (71%) were more likely to indicate this want compared to those without a dog (90%) or little to no experience with dogs (62%). The majority were also of the opinion that patients may want to visit a therapy dog in the ED to reduce anxiety (92%) and frustration (87%) as well as to increase comfort (90%) and satisfaction (90%) and to a lesser extent to reduce pain (59%). There was no significant difference in findings by gender or age, other than a higher proportion of older adults and females identifying cultural background and tradition as a possible reason that patients may not want to be visited by a therapy dog. The findings of this study can help guide considerations for future ED therapy dog programs.

The Presence of Toxocara Eggs on Dog's Fur as Potential Zoonotic Risk in Animal-Assisted Interventions: A Systematic Review

Animal-assisted interventions (AAIs) usually contribute to the well-being and health of users/patients, but it is essential that the animals involved in these activities do not represent a source of zoonoses. This systematic review focused on the evaluation of the potential risk of the transmission of Toxocara by dogs' fur, considering their involvement as the main animal species in AAIs. Three databases were considered: MEDLINE/PubMed, Scopus, and Web of Science, and the PRISMA guidelines were used. Out of 162 articles found, 14 papers were identified as eligible for inclusion in the review. Although the findings were very heterogeneous, they showed that regular parasitological surveillance to plan effective control programs is strongly needed to guarantee the health of pets and consequently the public health, according to the concept of One Health. Since AAIs involve patients and/or users potentially susceptible, it is very important to appropriately treat dogs enrolled in these interventions after an accurate diagnosis of parasitic zoonoses.

The Human-Animal Relationship as the Focus of Animal-Assisted Interventions: A One Health Approach

BACKGROUND

Animal-assisted intervention (AAIs) represent an adequate expression of integrated medicine, according to the One Health approach. We argue that AAIs are interventions based on interspecific relationships between humans and animals. Although there are many studies on the effects of AAIs on animal and human health and wellbeing, research is still needed to give us more data. For example, information is still lacking on the aspects characterizing and influencing the interspecific relationships occurring in AAIs. The efficacy of an intervention based on interspecific relationships will be influenced by different factors, such as attachment styles and personalities of both the animal and the handler, an appropriate choice of animal species and their individuality, animal educational training techniques, the relationship between the handler and the animal, and relational reciprocity between animal, the patients, and members of the working team.

METHOD

This article aims to contribute to the study of interspecific relationships in AAIs via theoretical considerations. An interspecific relationship determines the result of safe interventions, which directly influences the welfare of the animal. Results and considerations: AAIs should be evaluated systemically as a network within a process in which every component interacts with and influences other components. Standardized methods using appropriate tests and parameters are needed to better select appropriate animals (i.e., species and individual subjects) using interspecific relational competences as well as appropriate educational training methods and health protocols to assess potential risks.

Animal-assisted therapy in a Canadian psychiatric prison

PURPOSE

Prison-based animal programs are becoming increasingly common in North America. The majority focus on community and animal well-being, with less explicit therapeutic goals for human participants. The purpose of this paper is to measure the objectives of a canine animal-assisted therapy (AAT) program in a Canadian psychiatric prison and examine whether the program supports inmates' correctional plans.

DESIGN/METHODOLOGY/APPROACH

A modified instrumental case study design was applied with three inmates over a 24-AAT-session program. Quantitative and qualitative AAT session data were collected and mid- and end-of-program interviews were held with the inmates, their mental health clinicians and the therapy dog handlers.

FINDINGS

Inmates connected with the therapy dogs through the animals' perceived offering of love and support. This development of a human-animal bond supported inmates' correctional plans, which are largely situated within a cognitive-behavioral skill development framework. Specifically, inmates' connections with the therapy dogs increased recognition of their personal feelings and emotions and positively impacted their conduct.

RESEARCH LIMITATIONS/IMPLICATIONS

The findings suggest that prison-based AAT programs emphasizing inmate mental well-being, alongside that of animal and community well-being generally, merit further exploration. It would be worthwhile to assess this AAT program with a larger and more diverse sample of inmates and in a different institutional context and also to conduct a post-intervention follow-up.

ORIGINALITY/VALUE

This is the first study of a prison-based AAT program in a Canadian psychiatric correctional facility.

A One Health Research Framework for Animal-Assisted Interventions

BACKGROUND

The integration of animals into healthcare, referred to as animal-assisted intervention, is a rapidly growing research field and was previously related to One Health. However, the assessment of synergistic effects of animal-assisted interventions (AAI) has been poorly addressed to date.

METHOD

We discuss experiences in integrated human and animal assessments in AAI and provide a methodical framework for One Health approaches in AAI research. We propose theoretical consideration of an integrated human and animal health assessment, as well as the use of such an integrated approach in research. Based on the existing research, we argue that, for a deeper understanding of AAI mechanisms, parallel research designs are needed.

RESULTS AND CONCLUSION

Our paper shows that a One Health study design is necessary to ensure that a tradeoff in health of animals is prevented and that an added value, or synergistic benefit, can be achieved on both sides during animal-assisted interventions.