Brief report: Don't kiss a sleeping dog: the first assessment of "the blue dog" bite prevention program

Epidemiology of dog bites to people in Uruguay (2010-2020)

BACKGROUND

Dog bites to people are a serious public health problem. Limited information exists at the country level in Latin America. The COVID-19 pandemic changed people's lifestyles and their relationship with pets, and this could potentially affect the incidence of dog bites injuries.

OBJECTIVE

The main objectives of our study were to determine the prevalence of dog-bite injuries in Uruguay from 2010 to 2020 and to compare the prevalence in 2020 to that of pre-pandemic years.

METHODS

Cross-sectional study. Dog-bite notifications for the 2010 and 2020 period were analysed using data from the Uruguayan Ministry of Public Health.

RESULTS

The annual dog-bite injury rate for the 2010-2020 period was 87.51 per 100,000 people. The frequency of bites varied with the victims' sex, with males accounting for 51.8% of the bites (p < 0.0001), and with age, with a higher frequency of bites in the ≤14 years old age group (p < 0.01). The frequency of dog bites was also higher in spring and summer than in autumn (p < 0.0001). There was no statistical difference in the frequency of dog-bite injuries when comparing 2020 with the pre-COVID-19 pandemic years.

CONCLUSIONS

In Uruguay, the frequency of dog-bite injuries varied with season and with the age and sex of the victim. In the first year of the COVID-19 pandemic, the number of people bitten by dogs was no different than that of previous years. This is the first study in Latin America to report national rather than regional data and to include all age groups.

Visual perception of emotion cues in dogs: a critical review of methodologies

Comparative studies of human-dog cognition have grown exponentially since the 2000's, but the focus on how dogs look at us (as well as other dogs) as social partners is a more recent phenomenon despite its importance to human-dog interactions. Here, we briefly summarise the current state of research in visual perception of emotion cues in dogs and why this area is important; we then critically review its most commonly used methods, by discussing conceptual and methodological challenges and associated limitations in depth; finally, we suggest some possible solutions and recommend best practice for future research. Typically, most studies in this field have concentrated on facial emotional cues, with full body information rarely considered. There are many challenges in the way studies are conceptually designed (e.g., use of non-naturalistic stimuli) and the way researchers incorporate biases (e.g., anthropomorphism) into experimental designs, which may lead to problematic conclusions. However, technological and scientific advances offer the opportunity to gather much more valid, objective, and systematic data in this rapidly expanding field of study. Solving conceptual and methodological challenges in the field of emotion perception research in dogs will not only be beneficial in improving research in dog-human interactions, but also within the comparative psychology area, in which dogs are an important model species to study evolutionary processes.

Current Perspectives on the Challenges of Implementing Assistance Dogs in Human Mental Health Care

The prevalence of mental health disorders, driven by current global crises, is notably high. During the past decades, the popularity of dogs assisting humans with a wide spectrum of mental health disorders has significantly increased. Notwithstanding these dogs' doubtless value, research on their legal status, certification processes, training and management practices, as well as their welfare status, has been scarce. This scoping review highlights that in contrast to other assistance dogs such as guide dogs, there exists no consistent terminology to mark dogs that assist humans with impaired mental health. Legal authorities monitoring the accreditation process, training and tracking of mental health supporting dogs are broadly lacking, with only few exceptions. This review emphasizes the need to address several topics in the promotion of progress in legal and welfare issues related to assistance dogs as well as emotional support dogs for humans with a mental health disorder. The current body of knowledge was assessed in three different areas of focus: (1) the legal dimension including definitions and certification processes; (2) the dimension of performed tasks; and (3) the dog welfare dimension including aspects of the relationship with the handler and risks associated with children recipients. Considering the challenges associated with a mental health diagnosis, collaborations of dog provider organizations and health care professionals would be desirable to continuously assess the efficiency of the human-dog dyad regarding their overall compatibility, general satisfaction and mutual well-being.

Assessment of the rabies education among middle secondary school students of southeastern Bhutan

Rabies is one of the most important zoonotic diseases that mostly affect children. We conducted a rabies education among 129 secondary school children (intervention group = 94 students, control group = 35 students) in two schools in southeast Bhutan and evaluated the effectiveness of the lesson by comparing the knowledge, perception and safety behaviour score about rabies before and after education. We also assessed the knowledge retention capacity of the students at three months post intervention. Our findings indicated that short rabies lesson significantly (P<0.001) improved the mean knowledge score from 19.98(±2.72) to 26.96(±2.24) in the intervention group. Similarly, mean scores for perception and safety behaviour improved significantly (P<0.001) from 10.77 (±1.89) to 13.95 (±1.36) and 9.809 (±1.85) to 12.97 (±1.54), respectively. Although the scores have reduced significantly (P<0.001) at three months post intervention, most of the rabies information was largely retained by the students. In control group, significant increase in mean scores were also observed for perception from 10.17 (±2.38) to 11.2 (±2.44) and safety behaviour from 9.14(±1.44) to 10.74 (±1.95) after 3 months of education. The finding demonstrate that a short rabies lesson is effective in improving knowledge, perceptions and understanding of dog bites safety behaviour among the school children. However, there is a need for a frequent awareness program, at least quarterly or half yearly. Rabies education should focus on critical points such as dog bites being the main source of rabies and the importance washing a dog/animal bite wound with soap and water, and visiting the hospital for medical advice following animal bites.

US Adults' Perceptions of Dog Breed Bans, Dog Aggression and Breed-Specific Laws

Dog aggression directed towards people is a leading reason for relinquishment and a major public health hazard. In response to the threat of dog aggression and dog bites, breed-specific legislation has been introduced in numerous cities within the United States and countries throughout the world. There is limited evidence, however, to suggest that such laws are effective. This study explored, through an online, anonymous, cross-sectional survey, US residents' views about the bite risk of common dog breeds, breed-specific legislation, and alternative options for improved public safety. A total of 586 surveys were completed by adult US residents, 48.8% female and 48.6% male. Approximately half of the respondents reported feeling that dog bites are a serious public health issue. Although 70% of respondents were opposed to a breed ban, only 56% felt that banning specific breeds creates an animal welfare issue. Females were less likely to support a ban or agree that specific breed bans improve public safety. When participants were asked to indicate their support of several alternatives to breed-specific legislation, the most frequently endorsed options included public education about animal welfare and animal behavior, and stricter leash laws. Further research pertaining to the most effective public education dissemination methods is warranted.

How Parents Perceive the Potential Risk of a Child-Dog Interaction

Dog attacks on children are a widespread problem, which can occur when parents fail to realise a potentially dangerous interaction between a dog and a child. The aim of the study was to evaluate the ability of parents to identify dangerous situations from several everyday child–dog interactions and to determine whether the participants connected these situations to a particular breed of dog. Five sets of photographs depicting potentially dangerous interactions from everyday situations between children and three dogs (one of each breed) were presented via an online survey to parents of children no more than 6 years old. Data from 207 respondents were analysed using proc GLIMMIX in SAS program, version 9.3. The probability of risk assessment varied according to dog breed (p < 0.001) as well as to the depicted situation (p < 0.001). Results indicated that Labrador Retriever was considered the least likely of the three dogs to be involved in a dangerous dog-child interaction (with 49% predicting a dangerous interaction), followed by Parson Russell Terrier (63.2%) and American Pit Bull Terrier (65%). Participants considered one particular dog-child interaction named ‘touching a bowl’ a dangerous interaction at a high rate (77.9%) when compared with the other presented situations, which were assessed as dangerous at rates of 48.4% to 56.5%. The breed of dog seems to be an influential factor when assessing a potentially dangerous outcome from a dog-child interaction. Contrary to our hypothesis, interactions involving the small dog (Russell Terrier) were rated more critically, similarly to those of the Pit Bull Terrier. These results suggest that even popular family dog breeds, such as Labrador Retrievers, should be treated with more caution.

Epidemiological profile of dog attacks to patients under 14 years old assisted at the pediatric referral emergency unit of a tertiary hospital in Campinas, Brazil

INTRODUCTION

Accidents involving dog attacks are very common, which makes this type of accident a global public health issue. The estimates point to 20% of the victims of such accidents seeking care in health units, and half of them being children. In addition to acute injuries, dog attacks might result in fractures, infections, scars, and psychological traumas. This study aimed to describe the epidemiological profile of dog attacks to children under 14 years old assisted in a pediatric emergency service in Brazil.

METHODS

The database of the Information and Toxicological Assistance Center of Campinas was surveyed to identify cases of children under 14 years old assisted after a dog attack in a 9-years period. Demographic data, number and type of lesions, type of exposure, part of the body affected, dog origin and condition, and the accident location and cause were analyzed. The data were presented in a descriptive way, and the age groups were classified as follows: 0-3 years old, 4-6 years old, and 7-14 years old. The different age groups were compared one to another regarding the markers evaluated using the chi-square test and the Fisher's exact test. A 0.05 alpha was adopted in all analyses.

RESULTS

The number of children assisted in the study period totaled 1,012. The 7-14-year-old group was the most affected (n = 498; 49.2%), male patients were also majority (n = 660; 65.2%). Most injuries were found on the head/neck area (n = 378; 37.4%). However, the older the patients were, the higher the frequency of lesions on upper and lower limbs was, as well as attacks occurred in external environments, thus involving animals that could not be observed. A significant increase in accidents with provoked causes was observed in younger patients.

CONCLUSION

Accidents involving dog attacks are more likely to happen among boys. Younger children run higher risks of becoming victims of these accidents inside homes, being attacked by pets, and showing a greater incidence of head and neck lesions. Older children present more injuries on their limbs, which are caused by dogs that cannot be observed.

Analysis of Pediatric Dog Bite Injuries at a Level 1 Trauma Center Over 10 Years

BACKGROUND

Dog bite injuries cause significant preventable patient morbidity and health care expenditure in children. This study aimed to characterize the patient and healthcare burden related to pediatric dog bite injuries at a level 1 trauma center.

METHODS

This is a retrospective review of 356 pediatric patients who presented to Virginia Commonwealth University Pediatric Emergency Department between July 2007 and August 2017 after sustaining dog bite injuries. Demographic information, injury details, management, outcomes, and financial information were analyzed.

RESULTS

Most pediatric dog bite injuries afflicted male children (55.6%), ages 6 to 12 years (45.7%), by a household dog (36.2%). The most common offending breed was a pit bull or pit bull mix (53.0%). Infants and grade schoolers were more likely to sustain bites to the head/face (P = 0.001). Usual management consisted of primary repair (75.9%), whereas approximately 25% of the patients required advanced reconstructive techniques. Most patients healed uneventfully, but prolonged antibiotics, additional wound care, or procedures were necessary in 8.4% of the patients. Hospital charges per patient averaged US $8830.70 and tended to be higher in the younger age groups. Insurance status was statistically associated with use of conscious sedation, surgical consult placement, and surgical repair.

CONCLUSIONS

Although most pediatric dog bite injuries in this study healed uneventfully from primary management in the emergency department, 25% required additional interventions. Furthermore, patient care for these injuries was associated with significant but potentially avoidable personal and financial burden to families. Our data reflect a need for safety education on animal care, behavior, and interaction.

Educating dog owners: how owner–dog interactions can benefit from addressing the human caregiving system and dog-directed parenting styles

Dogs need to adapt to a human environment to enhance their welfare and to avoid risks of undesired dog behaviour and relinquishment. Crucial to this adaptation may be how an owner interacts with the dog. Owner–dog interactions may be influenced by the human caregiving system with regard to how care, protection and resources are provided. This narrative review discusses how a consideration of the human caregiving system can benefit owner–dog interactions. Literature suggests that the human caregiving system and parenting styles could influence owner–dog interactions. Owner–dog education may improve these interactions. However, studies on owner–dog education present mixed outcomes for the dog. Also, only a few studies address owner outcomes, indicating a gap that needs filling. It is concluded that, when intervening in owner–dog interactions, more attention should be directed to aspects of human psychology. Dog-directed parenting styles can form one strategy as to improve owner–dog interactions and dog welfare.

Human Behaviour Change Interventions in Animal Care and Interactive Settings: A Review and Framework for Design and Evaluation

Simple Summary

In many cases, to improve animal welfare, we must change the behaviour of the people who manage them, care for them, and interact with them. This can be achieved through behaviour change interventions. In this review, we aimed to explore the current state of the behaviour change literature in animal care and interactive settings. We identified significant deficiencies in the design, evaluation, and reporting of these interventions. It was often unclear what behaviours were targeted, how the intervention was designed to work, what was in it, and how it was delivered. Without this information, interventions cannot be rigorously evaluated, built upon by others, or implemented in other settings. Transparent reporting and a structured approach to the design and evaluation of interventions is now required to help the field move forward in a more consistent and robust way. We present such a framework, the “Ten-Task” guide, based on the intervention mapping framework, and demonstrate how its adoption would help progress this field substantially.

Abstract

Behaviour change interventions may be one of the most promising avenues to improve animal welfare. Yet there has been limited systematic research involving them in animal-related settings. We searched three major databases for studies involving an intervention to change interactive or care-related behaviours in any animal-related setting. Forty-seven papers were included in the review and each paper was coded for specific design and evaluation elements. We found a series of limitations in the quality and consistency of intervention design, evaluation, and reporting. Hence, we present a framework, the “Ten-Task” guide, based on the intervention mapping framework, to guide future work in this field. Adopting this structured approach will improve the quality and efficacy of behaviour change interventions for animal welfare and allow for the field to progress in a harmonious way.

A Retrospective Analysis of Dog-Dog and Dog-Human Cases of Aggression in Northern Italy

Simple Summary

The prevention of dog bites is an important issue with multiple safety and welfare aspects. We investigated the characteristics of dog bite incidents reported to public authorities in the North of Italy with the aim of providing more data for future risk assessment and prevention tools. We found that no breeds in particular were responsible for severe or multiple bites towards either humans or dogs, but there was a trend of defensive bites towards human beings in private homes and a trend of offensive bites towards other dogs in public areas. We also found that crossbreed dogs and dogs adopted from shelters were significantly more likely to show defensive aggression towards their owners. Our findings indicate that defensive aggression towards owners is linked to fear and anxiety, and we suggest that helping owners to have a better understanding of their dogs’ welfare, behaviour and communication via educational programs is an important prevention tool.

Abstract

In this survey, a caseload of aggressive dogs (n = 170) was analysed to increase the available information about biting dog characteristics, contribute to risk evaluation and improve bite prevention tools. All dog data were collected from questionnaires completed by veterinary behaviourists in Northern Italy. All dogs were referred to them by public authorities to be evaluated and treated due to the incidence of one or more episodes of aggression. Between the two groups of human-directed and dog-directed aggressive dogs, significant associations were found: the dog-directed aggressive group inflicted significantly more severe bites (p < 0.01) and offensive aggression (p < 0.01), whereas defensive aggression was significantly more numerous in the human-directed aggression group (p < 0.01) and more significantly located in private homes (p < 0.01). No significant associations were found between the severity of bites and one or more specific breeds in either group. The prevalence of defensive bites in private homes in human-directed aggression indicate that owners’ understanding of their dogs’ behaviour and communication is fundamental to preventing aggression, and that owner education programmes are fundamental tools to reduce aggression risk factors and prevent aggression.

Best Practice Standards in Animal-Assisted Interventions: How the LEAD Risk Assessment Tool Can Help

Simple Summary

Animal-assisted interventions (AAI) in educational and other settings have steadily increased over the last fifty years. While scientific research on the effects of AAI is still growing, the application in the field has overtaken the science and seen a steep rise in many countries and settings in recent years. Surprisingly, while different organisations provide a range of guidelines, no unified, standardised guidelines exist, nor do easy-to-use risk assessment tools for AAI providers and users exist. With differences in practical application and different policies used by AAI providers worldwide, this means that in practice AAI takes place in an unregulated manner without a gold standard of best practice. To ensure safe AAI worldwide, we provide urgently needed unified guidelines on best practice in relation to risk assessment, safeguarding and animal welfare priorities. We also provide the first comprehensive risk assessment and animal welfare tools to achieve consistent welfare and safety standards for best practice across educational and other settings around the world.

Abstract

Animal-assisted interventions (AAI) in educational and other settings have steadily increased over the last fifty years and a steep rise in AAI has been observed in many countries and settings in recent years. Surprisingly, while different providers and organisations provide a range of guidelines, no unified, standardised guidelines or risk assessment tools for AAI exist. This means that in practice AAI takes place in an unregulated manner and without a gold standard of best practice. In addition, knowledge of which interventions are effective is still scarce and the mechanisms of successful interventions are not yet fully understood. This is partly due to AAI being a relatively new research field and standards of research and practice have often lacked rigour in the past. Furthermore, knowledge and experience of providers undertaking interventions varies greatly as there is no standardised training either. We address the striking lack of standardised guidelines and procedures. In all AAI, high importance should be placed on safety and welfare of all involved. Children and other AAI participants, staff and animals should be given equal consideration when assessing risks and welfare needs. To ensure safe AAI worldwide, we provide urgently needed guidelines on best practice in relation to risk assessment, safeguarding and animal welfare priorities. The guidelines were developed for a large-scale longitudinal, randomised controlled trial AAI project and are relevant to AAIs within educational and other settings. We also provide the first set of comprehensive risk assessment and animal welfare tools to achieve consistent welfare and safety standards for best practice across educational and other settings around the world.

Perception of dynamic facial expressions of emotion between dogs and humans

Facial expressions are a core component of the emotional response of social mammals. In contrast to Darwin's original proposition, expressive facial cues of emotion appear to have evolved to be species-specific. Faces trigger an automatic perceptual process, and so, inter-specific emotion perception is potentially a challenge; since observers should not try to “read” heterospecific facial expressions in the same way that they do conspecific ones. Using dynamic spontaneous facial expression stimuli, we report the first inter-species eye-tracking study on fully unrestrained participants and without pre-experiment training to maintain attention to stimuli, to compare how two different species living in the same ecological niche, humans and dogs, perceive each other’s facial expressions of emotion. Humans and dogs showed different gaze distributions when viewing the same facial expressions of either humans or dogs. Humans modulated their gaze depending on the area of interest (AOI) being examined, emotion, and species observed, but dogs modulated their gaze depending on AOI only. We also analysed if the gaze distribution was random across AOIs in both species: in humans, eye movements were not correlated with the diagnostic facial movements occurring in the emotional expression, and in dogs, there was only a partial relationship. This suggests that the scanning of facial expressions is a relatively automatic process. Thus, to read other species’ facial emotions successfully, individuals must overcome these automatic perceptual processes and employ learning strategies to appreciate the inter-species emotional repertoire.

Age- and Sex-Related Differences in Nonfatal Dog Bite Injuries Among Persons Aged 0-19 Treated in Hospital Emergency Departments, United States, 2001-2017

OBJECTIVE

No studies using national data have evaluated changes in nonfatal dog bite injuries among children, adolescents, and young adults during the past 2 decades. We examined estimates of annual nonfatal dog bite injuries among persons aged 0-19 treated in US emergency departments (EDs) from 2001 through 2017.

METHODS

We examined data from the Web-based Injury Statistics Query and Reporting System to compare estimates of the annual rates of nonfatal dog bite injuries in EDs among all persons aged 0-19, by age group (0-4, 5-9, 10-14, and 15-19), and by sex. We determined significance by comparing 95% confidence intervals (CIs), and we standardized rate calculations to the year 2000 population.

RESULTS

During 2001-2017, an estimated 2 406 109 (95% CI, 2 102 643-2 709 573) persons aged 0-19 were treated in EDs for nonfatal dog bite injuries (age-adjusted rate of 173.1 per 100 000 persons aged 0-19). The estimated number of nonfatal dog bite injuries declined significantly, from 181 090 (95% CI, 158 315-203 864) in 2001 to 118 800 (95% CI, 97 933-139 667) in 2017. The highest rate was among children aged 5-9. Male children, adolescents, and young adults were significantly more likely than female children, adolescents, and young adults to be treated in the ED for nonfatal dog bite injuries, driven by male-female differences in children and adolescents aged 5-14.

CONCLUSIONS

Although the estimated number of nonfatal dog bite injuries among persons aged 0-19 declined significantly in the past 2 decades, additional regulatory and educational efforts specific to age and sex may lead to further reductions in nonfatal dog bite injuries.

A randomized controlled field trial of iBsafe-a novel child safety game app

BACKGROUND

Injury is a leading cause of child morbidity and mortality worldwide. Delivering injury prevention programs via mobile platforms, such as applications (apps), may reduce risky behaviors. iBsafe is an "interactive Bike and Bite safety" mobile game app founded in behavioral theory and designed to educate kindergarten-aged children about bicycle and dog-related safety. This study assessed the relationship of iBsafe game play and child safety knowledge and skills; hypothesizing that iBsafe increases safety knowledge with translation to practice.

METHODS

This single-blinded, randomized, controlled field trial included sixty 5-6-year-old children. Parent-child dyads were randomly assigned to receive a weeklong field trial of iBsafe or control. Pre- and post-intervention safety knowledge tests were completed; post-intervention safety skills assessments occurred in a simulated safety lab using real props (i.e., safety street, bicycles, and live dogs). The primary outcome was child bicycle and dog-related safety knowledge and skills performance. Performance was assessed by blinded reviewers. Secondary outcomes included frequency of safety discussion in groups and iBsafe acceptability.

RESULTS

Thirty children were randomized to each group; there were no substantial demographic differences between groups. Compared to controls, post-intervention iBsafe children had higher bicycle and dog-related safety knowledge scores (9.2±0.9 vs. 8.7±1.0, P=0.029 and 8.2±2.1 vs. 6.7±1.8, P=0.003, respectively); and they exhibited more safety skills (median number bicycle skills 5 vs. 4, P=0.007; median number dog-related skills 5 vs. 3, P<0.001, respectively). Frequency of safety conversations increased among intervention families during the trial, and iBsafe acceptability was near universal.

CONCLUSIONS

iBsafe was effective at increasing child safety knowledge and improving safety skills. Child injury prevention programs that embrace interactive mobile platforms may expand reach and possibly decrease injury outcomes.

Teaching Children and Parents to Understand Dog Signaling

Safe human-dog relationships require understanding of dogs' signaling. As children are at particularly high risk of dog bites, we investigated longitudinally how children from 3 to 5 years and parents perceive and interpret dogs' distress signaling gestures. All participants were then taught how to link their perception of the dog with the correct interpretation of dogs' behavioral signals and tested again. Results show a significant increase in learning for children and adults, with them showing greater understanding of dogs' signaling after intervention. Better learning effects were found with increasing age and depended on the type of distress signaling of the dogs. Effects endured over time and it can be concluded that children and adults can be taught to interpret dogs' distress signaling more correctly. Awareness and recognition of dogs' stress signaling can be seen as an important first step in understanding the dog's perspective and are vital to enable safe interactions.

Caregiver Reports of Interactions between Children up to 6 Years and Their Family Dog-Implications for Dog Bite Prevention

In children up to 6 years, interactions such as interfering with the dog’s resources and also benign behaviors (e.g., petting) commonly precede a bite incident with the family dog. Therefore, the aim of the present study was to explore the development of everyday interactions between children up to 6 years and their family dogs and whether parents’ attitudes to supervision are related to those interactions. Additionally, we investigated whether behavior of dogs that had lived in the family for longer than the child differed from those that grew up with children. A self-selected sample of caregivers living with a child up to 6 years and a family dog was surveyed via an online questionnaire (N = 402). Frequency of observed child behaviors directed toward the dog and dog behaviors directed toward the child were scored on a six-point scale (1—never and 6—very often). Data on characteristics of the caregiver, the child, and the dog were collected, and a section surveying attitudes to supervision of child–dog interactions was included. Additionally, we asked whether the dog already injured the child. Benign child behaviors toward dogs were most frequently reported (mean ± SD: 4.1 ± 1.2), increased with child age (r_s = 0.38, p < 0.001), and reached high levels from 6 months on. Overall, resource-related interactions were relatively infrequent (2.1 ± 1.1). Most common was the dog allowing the child to take objects from its mouth (4.1 ± 1.7). This behavior was more common with older children (r_s = 0.37, p < 0.001). Reported injuries during resource-related interactions occurred while feeding treats or taking objects from the dog during fetch play. Dogs that had lived in the family for longer than the child showed less affiliative behaviors toward the child (e.g., energetic affiliative: U = −7.171, p < 0.001) and more fear-related behaviors (U = −3.581, p < 0.001). Finally, the caregivers’ attitudes to supervision were related to all child behaviors (e.g., allow unsafe behaviors—benign child behavior: r_s = 0.47, p < 0.001). The results of this study underline the need for a dog bite prevention approach directed toward the caregivers very early in the child–dog relationship, taking into account the child’s age and individual needs of the dog.

Systematic Review: Interventions to Educate Children About Dog Safety and Prevent Pediatric Dog-Bite Injuries: A Meta-Analytic Review

Objective

Dog-bite injury posits a significant threat to children globally. This review evaluated efficacy of cognitive/behavioral interventions for improving children's knowledge and behaviors around dogs.

Methods

Manuscripts published before January 3, 2014 evaluating cognitive/behavioral interventions for dog-bite prevention among children <18 years of age were eligible for inclusion. Among 2,270 abstracts screened, 123 full texts were retrieved. Twelve studies were included in the qualitative synthesis; nine were included in the meta-analysis. Risk of bias and quality of evidence were evaluated.

Results

Cognitive/behavioral interventions had a moderate effect in improving children's knowledge and a larger effect in improving children's behavior with dogs. The most effective intervention strategies were video for knowledge and instruction with live dogs for behaviors. Quality of evidence was poor.

Conclusions

Cognitive/behavioral interventions have potential to improve both children's knowledge and behaviors around dogs. Future interventions should include multiple follow-ups on dog-bite rates from an international perspective using rigorous randomized controlled trials.

Evaluating a Website to Teach Children Safety with Dogs: A Randomized Controlled Trial

Dog bites represent a significant threat to child health. Theory-driven interventions scalable for broad dissemination are sparse. A website was developed to teach children dog safety via increased knowledge, improved cognitive skills in relevant domains, and increased perception of vulnerability to bites. A randomized controlled trial was conducted with 69 children aged 4–5 randomly assigned to use the dog safety website or a control transportation safety website for ~3 weeks. Assessment of dog safety knowledge and behavior plus skill in three relevant cognitive constructs (impulse control, noticing details, and perspective-taking) was conducted both at baseline and following website use. The dog safety website incorporated interactive games, instructional videos including testimonials, a motivational rewards system, and messaging to parents concerning child lessons. Our results showed that about two-thirds of the intervention sample was not adherent to website use at home, so both intent-to-treat and per-protocol analyses were conducted. Intent-to-treat analyses yielded mostly null results. Per-protocol analyses suggested children compliant to the intervention protocol scored higher on knowledge and recognition of safe behavior with dogs following the intervention compared to the control group. Adherent children also had improved scores post-intervention on the cognitive skill of noticing details compared to the control group. We concluded that young children’s immature cognition can lead to dog bites. Interactive eHealth training on websites shows potential to teach children relevant cognitive and safety skills to reduce risk. Compliance to website use is a challenge, and some relevant cognitive skills (e.g., noticing details) may be more amenable to computer-based training than others (e.g., impulse control).

A randomized trial evaluating child dog-bite prevention in rural China through video-based testimonials

OBJECTIVE

Dog-bite injuries pose significant threat to children globally. School-age children are especially at risk because of their insufficient safety knowledge and cognitively immature tendency toward low perceived vulnerability to bites, and this risk is elevated further for school-age children living in rural China due to the large number of stray dogs, all potential rabies carriers, present in their communities.

METHOD

This randomized controlled trial evaluated whether viewing an educational video of testimonials would change safety knowledge, perceived vulnerability, and simulated behaviors with dogs among a sample of 280 third and fourth graders living in rural China. Participants were randomly assigned to view either an educational video of testimonials on dog-bite prevention (treatment) or an educational video of testimonials on drowning prevention (comparison). Safety knowledge, perceived vulnerability to dog bites, and simulated behavior with dogs using a dollhouse model were assessed both before and after exposure to the video of testimonials.

RESULTS

Children who watched the educational video of testimonials on dog-bite prevention had increased safety knowledge, higher perceived vulnerability, and less risky simulated behaviors with dogs compared with the comparison group. Mediation analysis revealed that the intervention successfully changed children's simulated behaviors with dogs through greater safety knowledge and increased perceived vulnerability.

CONCLUSIONS

Results suggest the incorporation of testimonials into injury prevention programs has potential for broad global dissemination. The fact that both increased knowledge and heightened perceived vulnerability mediated changes in simulated behavior suggests the dual roles of knowledge and appraisal on children's injury-risk behavior.

A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change

OBJECTIVE

The aims of this literature review are to (1) summarise how computer and mobile technology-based health behaviour change applications have been evaluated in unintentional injury prevention, (2) describe how these successes can be applied to injury-prevention programmes in the future and (3) identify research gaps.

METHODS

Studies included in this systematic review were education and behaviour change intervention trials and programme evaluations in which the intervention was delivered by either a computer or mobile technology and addressed an unintentional injury prevention topic. Articles were limited to those published in English and after 1990.

RESULTS

Among the 44 technology-based injury-prevention studies included in this review, 16 studies evaluated locally hosted software programmes, 4 studies offered kiosk-based programmes, 11 evaluated remotely hosted internet programmes, 2 studies used mobile technology or portable devices and 11 studies evaluated virtual-reality interventions. Locally hosted software programmes and remotely hosted internet programmes consistently increased knowledge and behaviours. Kiosk programmes showed evidence of modest knowledge and behaviour gains. Both programmes using mobile technology improved behaviours. Virtual-reality programmes consistently improved behaviours, but there were little gains in knowledge. No studies evaluated text-messaging programmes dedicated to injury prevention.

CONCLUSIONS

There is much potential for computer-based programmes to be used for injury-prevention behaviour change. The reviewed studies provide evidence that computer-based communication is effective in conveying information and influencing how participants think about an injury topic and adopt safety behaviours.

Human behavior preceding dog bites to the face

Facial injuries caused by dog bites pose a serious problem. The aims of this study were to determine human behavior immediately preceding a dog bite to the face and to assess the effects of victim age and gender and dog sex and size on the location of the bite to the face and the need for medical treatment. Complete data on 132 incidents of bites to the face were analysed. A human bending over a dog, putting the face close to the dog's face, and gazing between victim and dog closely preceded a dog bite to the face in 76%, 19% and 5% of cases, respectively. More than half of the bites were directed towards the central area of the victim's face (nose, lips). More than two thirds of the victims were children, none of the victims was an adult dog owner and only adult dogs bit the face. Victim's age and gender and dog's sex and size did not affect the location of the bite on the face. People who were bitten by large dogs sought medical treatment more often than people who were bitten by small dogs (P <0.01). Risk factors such as bending over the dog, putting the face close to the dog's face and gazing between human and dog should be avoided, and children should be carefully and constantly supervised when in the presence of dogs.

Dog Bite Prevention: Effect of a Short Educational Intervention for Preschool Children

This study aimed to investigate whether preschool children can learn how to interpret dogs’ behaviours, with the purpose of helping avoid dog bites. Three- to five-year-old children (N = 70) were tested on their ability to answer questions about dogs’ emotional states before and after participating in either an educational intervention about dog behaviour (intervention group) or an activity about wild animals (control group). Children who had received training about dog behaviour (intervention group) were significantly better at judging the dogs’ emotional states after the intervention compared to before. The frequency with which they referred to relevant behaviours in justifying their judgements also increased significantly. In contrast, the control group’s performance did not differ significantly between the two testing times. These results indicate that preschool children can be taught how to correctly interpret dogs’ behaviours. This implies that incorporating such training into prevention programmes may contribute to reducing dog bite incidents.

Evaluating a website to teach children safety with dogs

BACKGROUND

Paediatric dog bites are a significant public health problem worldwide. Existing prevention programmes focused on altering children's risky behaviour with pet dogs tend to be atheoretical and only moderately effective.

OBJECTIVE

Test efficacy of a website to train young children in relevant cognitive skills to be safe with pet dogs in their home.

SETTING

Birmingham, Alabama, USA.

METHODS

A randomised trial will be conducted with an expected sample of two groups of 34 children (total N=68) ages 4-6 years. One group will engage in the newly designed website at home for 2 weeks and the other group will engage in a control website on transportation safety for an equivalent amount of time. All participants will complete a battery of laboratory-based tests to assess safety with dogs and cognitive functioning at baseline and postintervention.

OUTCOME MEASURES

Primary analyses will be conducted through linear mixed models testing change over time. Children's cognitive functioning, knowledge about safety with dogs, and behaviour with dogs in simulation and in vivo will serve as the primary outcomes.

CLINICAL TRIAL REGISTRATION

This study is exempt from registry at the US government website, http://www.clinicaltrials.gov, based on being a behavioural trial in the early phases of testing.

Baby schema in human and animal faces induces cuteness perception and gaze allocation in children

The baby schema concept was originally proposed as a set of infantile traits with high appeal for humans, subsequently shown to elicit caretaking behavior and to affect cuteness perception and attentional processes. However, it is unclear whether the response to the baby schema may be extended to the human-animal bond context. Moreover, questions remain as to whether the cute response is constant and persistent or whether it changes with development. In the present study we parametrically manipulated the baby schema in images of humans, dogs, and cats. We analyzed responses of 3-6 year-old children, using both explicit (i.e., cuteness ratings) and implicit (i.e., eye gaze patterns) measures. By means of eye-tracking, we assessed children's preferential attention to images varying only for the degree of baby schema and explored participants' fixation patterns during a cuteness task. For comparative purposes, cuteness ratings were also obtained in a sample of adults. Overall our results show that the response to an infantile facial configuration emerges early during development. In children, the baby schema affects both cuteness perception and gaze allocation to infantile stimuli and to specific facial features, an effect not simply limited to human faces. In line with previous research, results confirm human positive appraisal toward animals and inform both educational and therapeutic interventions involving pets, helping to minimize risk factors (e.g., dog bites).

Antecedents and consequences of pediatric dog-bite injuries and their developmental trends: 101 cases in rural China

OBJECTIVE

Study the contextual antecedents and consequences of pediatric dog bites in rural China.

METHODS

A total of 101 caregivers from rural Anhui Province, China, whose children had suffered dog-bite injuries in the past year, participated in a structured interview about the circumstances, antecedents and consequences of their child's injury.

RESULTS

Contextual circumstances identified frequently included outside-home environment and presence of peers but not adult supervisors. Frequent antecedents were dogs' initiation of the encounter, children walking to/from school, and dogs unleashed. Consequences to children identified frequently were rabies vaccines, restricted activity, and fear of dogs. Developmental trends emerged, with bite circumstances differing by children's ages.

CONCLUSIONS

These results offer data on common antecedents and consequences of pediatric dog bites in rural China, a necessary prerequisite for development of empirically supported prevention programs in a vulnerable population.

National estimates of noncanine bite and sting injuries treated in US Hospital Emergency Departments, 2001-2010

OBJECTIVE

Injuries resulting from contact with animals and insects are a significant public health concern. This study quantifies nonfatal bite and sting injuries by noncanine sources using data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP).

METHODS

The NEISS-AIP is an ongoing nationally representative surveillance system used to monitor all types and causes of injuries treated in US hospital emergency departments (EDs). Cases were coded by trained hospital coders using information from medical records on animal and insect sources of bite and sting injuries being treated. Data were weighted to produce national annualized estimates, percentages, and rates based on the US population.

RESULTS

From 2001 to 2010 an estimated 10.1 million people visited EDs for noncanine bite and sting injuries, based on an unweighted case count of 169,010. This translates to a rate of 340.1 per 100,000 people (95% CI, 232.9-447.3). Insects accounted for 67.5% (95% CI, 45.8-89.2) of bite and sting injuries, followed by arachnids 20.8% (95% CI, 13.8-27.9). The estimated number of ED visits for bedbug bite injuries increased more than 7-fold-from 2156 visits in 2007 to 15,945 visits in 2010.

CONCLUSIONS

This study provides an update of national estimates of noncanine bite and sting injuries and describes the diversity of animal exposures based on a national sample of EDs. Treatment of nonfatal bite and sting injuries are costly to society. Direct medical and work time lost translates to an estimated $7.5 billion annually.

Examining parents' behaviors and supervision of their children in the presence of an unfamiliar dog: does The Blue Dog intervention improve parent practices?

OBJECTIVES

Young children are at particular risk for dog bite injuries. This study examined parents' supervision of and reactions to their children in the vicinity of an unfamiliar dog.

METHODS

A pre/post intervention/control group randomized design assessed whether exposure to The Blue Dog, a dog bite prevention and education program, positively impacted parent behaviors.

RESULTS

No group differences in pre or post-intervention measures emerged, indicating that The Blue Dog did not evoke improvements in parents' behaviors. Generally, parents showed risky reactions and encouraged children to interact with the dog, even though they knew very little about the dog's safety or disposition. Supervision measures (proximity, watching) remained unchanged (watching) or more lax (proximity) across sessions.

CONCLUSIONS

The results highlight the importance of targeting parent behavior, not just child behavior, in programs that aim to reduce risk of childhood dog bites. The Blue Dog did not effectively change parent behavior.

A multi-site study on knowledge, attitudes, beliefs and practice of child-dog interactions in rural China

This study examines demographic, cognitive and behavioral factors that predict pediatric dog-bite injury risk in rural China. A total of 1,537 children (grades 4–6) in rural regions of Anhui, Hebei and Zhejiang Provinces, China completed self-report questionnaires assessing beliefs about and behaviors with dogs. The results showed that almost 30% of children reported a history of dog bites. Children answered 56% of dog-safety knowledge items correctly. Regressions revealed both demographic and cognitive/behavioral factors predicted children’s risky interactions with dogs and dog-bite history. Boys behaved more riskily with dogs and were more frequently bitten. Older children reported greater risks with dogs and more bites. With demographics controlled, attitudes/beliefs of invulnerability, exposure frequency, and dog ownership predicted children’s self-reported risky practice with dogs. Attitudes/beliefs of invulnerability, dog exposure, and dog ownership predicted dog bites. In conclusion, both demographic and cognitive/behavioral factors influenced rural Chinese children’s dog-bite injury risk. Theory-based, empirically-supported intervention programs might reduce dog-bite injuries in rural China.

Human perception of fear in dogs varies according to experience with dogs

To investigate the role of experience in humans’ perception of emotion using canine visual signals, we asked adults with various levels of dog experience to interpret the emotions of dogs displayed in videos. The video stimuli had been pre-categorized by an expert panel of dog behavior professionals as showing examples of happy or fearful dog behavior. In a sample of 2,163 participants, the level of dog experience strongly predicted identification of fearful, but not of happy, emotional examples. The probability of selecting the “fearful” category to describe fearful examples increased with experience and ranged from.30 among those who had never lived with a dog to greater than.70 among dog professionals. In contrast, the probability of selecting the “happy” category to describe happy emotional examples varied little by experience, ranging from.90 to.93. In addition, the number of physical features of the dog that participants reported using for emotional interpretations increased with experience, and in particular, more-experienced respondents were more likely to attend to the ears. Lastly, more-experienced respondents provided lower difficulty and higher accuracy self-ratings than less-experienced respondents when interpreting both happy and fearful emotional examples. The human perception of emotion in other humans has previously been shown to be sensitive to individual differences in social experience, and the results of the current study extend the notion of experience-dependent processes from the intraspecific to the interspecific domain.

Reading faces: differential lateral gaze bias in processing canine and human facial expressions in dogs and 4-year-old children

Sensitivity to the emotions of others provides clear biological advantages. However, in the case of heterospecific relationships, such as that existing between dogs and humans, there are additional challenges since some elements of the expression of emotions are species-specific. Given that faces provide important visual cues for communicating emotional state in both humans and dogs, and that processing of emotions is subject to brain lateralisation, we investigated lateral gaze bias in adult dogs when presented with pictures of expressive human and dog faces. Our analysis revealed clear differences in laterality of eye movements in dogs towards conspecific faces according to the emotional valence of the expressions. Differences were also found towards human faces, but to a lesser extent. For comparative purpose, a similar experiment was also run with 4-year-old children and it was observed that they showed differential processing of facial expressions compared to dogs, suggesting a species-dependent engagement of the right or left hemisphere in processing emotions.

Dog bite prevention: an assessment of child knowledge

OBJECTIVES

To determine what children know about preventing dog bites and to identify parental desires for dog bite prevention education.

STUDY DESIGN

This cross-sectional study sampled 5- to 15-year-olds and their parents/guardians presenting to a pediatric emergency department with nonurgent complaints or dog bites. The parent/guardian-child pairs completed surveys and knowledge-based simulated scenario tests developed on the basis of American Academy of Pediatrics and Centers for Disease Control and Prevention dog bite prevention recommendations. Regression analyses modeled knowledge test scores and probability of passing; a passing score was ≥11 of 14 questions.

RESULTS

Of 300 parent/guardian-child pairs, 43% of children failed the knowledge test. Older children had higher odds of passing the knowledge test than younger children, as did children with white parents vs those with nonwhite parents. No associations were found between knowledge scores and other sociodemographic or experiential factors. More than 70% of children had never received dog bite prevention education, although 88% of parents desired it.

CONCLUSIONS

Dog bites are preventable injures that disproportionately affect children. Dog bite prevention knowledge in our sample was poor, particularly among younger children and children with nonwhite parents. Formal dog bite prevention education is warranted and welcomed by a majority of parents.

The Blue Dog: evaluation of an interactive software program to teach young children how to interact safely with dogs

OBJECTIVE

Pre-post-randomized design evaluated The Blue Dog, a dog safety software program.

METHODS

76 children aged 3.5-6 years completed 3 tasks to evaluate dog safety pre- and postintervention: (a) pictures (recognition of safe/risky behavior), (b) dollhouse (recall of safe behavior via simulated dollhouse scenarios), and (c) live dog (actual behavior with unfamiliar live dog). Following preintervention evaluation, children were randomly assigned to dog or fire safety conditions, each involving 3 weeks of home computer software use.

RESULTS

Children using Blue Dog had greater change in recognition of risky dog situations than children learning fire safety. No between-group differences emerged in recall (dollhouse) or engagement (live-dog) in risky behavior. Families enjoyed using the software.

CONCLUSIONS

Blue Dog taught children knowledge about safe engagement with dogs, but did not influence recall or implementation of safe behaviors. Dog bites represent a significant pediatric injury concern and continued development of effective interventions is needed.

Dog Bites to Children in the Czech Republic: the Risk Situations

The aim of this study was to analyse dog bites to children in the Czech Republic. Data were obtained from a questionnaire completed with children aged 4 to 13 years in 11 urban and rural primary schools. A total of 103 dog bites sustained by 92 children were analysed using chi square test and F test. There were 58 boys (56.3%) and 45 girls (43.7%) bitten, 57.3% of them once, 42.7% repeatedly. The evaluated answers showed that children were bitten when playing with own dogs (69.2%) or dogs known to them (30.8%) but not by unknown dogs (χ2= 25.397, df = 1,p< 0.001). Children were bitten outdoors by loose running unknown dogs (88.5%), known dogs (11.5%) but not by own dogs (χ2= 55.528, df = 2,p< 0.001). Thirty-two children were bitten indoors by small (53.1%), medium size (21.9) or large (25.0%) dogs. Small dogs were biting mostly indoors (51.5%), medium size (73.1%) and large (80.5%) dogs bit mostly outdoors (χ2= 9.0022, df = 2,p= 0.011). Most of the children that disturbed a resting or sleeping dog were bitten indoors (83.3%; χ2= 7.862, df = 1,p< 0.01), predominantly by small dogs (83.3%, χ2= 7.482, df = 2,p= 0.022). When stroking a dog, children were bitten by a medium size (45.5%), large (31.8%) or small dog (22.7%; χ2= 5.588, df = 2,p< 0.068). Children injured by their family-owned dog had accidentally caused pain to it before being bitten (83.3%; χ2= 7.862, df = 1,p< 0.012).These children were always bitten by a small dog (χ2= 7.482, df = 2,p= 0.022). Three children reported deliberately causing pain to a dog – these were all small dogs (100.0%; χ2= 6.279, df = 2,p< 0.05). Children teasing dogs were bitten most frequently by a small dog (75.0%; χ2= 6.98, df = 2,p< 0.032). Male dogs bit more frequently (66.7%) than females (33.3%; χ2= 6.338, d.f. =1,p= 0.014). These data were the first ones obtained from the bitten children. They suggest that in interactions with own, known and small dogs, children were more daring. The personal space of dogs, their warning signals, and defence were underestimated, the resulting aggression was mostly of possessive, territorial and fear type. Additional suggestions are made to complete the information on preventive measures for parents, children and the public. Importantly, all information types should point out that the dog remains a predator despite its long domestication history and close co-existence with humans.