One Health clinic promotes veterinarian-client trust among underserved pet owners and provides learning opportunities for veterinary students

Evaluation of a Student-Led Community-Based Veterinary Clinic for Disabled Low-Income Clients: A Case Study of the University of Florida PAWS Program

People with disabilities experiencing low socioeconomic position are priority populations when considering access to veterinary care. In this population, intersectional inequities lead to adverse health outcomes for both those individuals and the companion animals they care for. Community-based veterinary clinics provide an opportunity to target these inequities from a culturally sensitive lens, intending to improve human and animal outcomes. We conducted a process evaluation of a student-led community-based clinic for this population to better understand client satisfaction, assess learning outcomes among veterinary students, and improve program delivery and services. During academic year 2020-2021, the monthly clinics had 162 appointments in total with a median 15 Doctor of Veterinary Medicine (DVM) candidates volunteering at each clinic. Clients and volunteers responded to survey questionnaires designed to elicit information about their experiences with the clinic, including open-ended questions for further elucidation of measurable indicators of client-, patient-, and student-level impact. Clients attributed enrollment in the clinic with improved quality-of-life and reduction of financial burden; the program saved clients approximately $2,050 per pet during the evaluation year. Furthermore, the clinic widely facilitated completion of the college's core Primary Care and Dentistry learning outcomes. Beyond curriculum-standard learning objectives, students also reported positive attitude changes and increased readiness to provide care to people with disabilities and people experiencing low socioeconomic position. The results of this evaluation have significant implications for both veterinary and public health pedagogy. Especially, they highlight the significance of community health practice in veterinary trainee education.

Access to veterinary care: evaluating working definitions, barriers, and implications for animal welfare

Humans have a moral obligation to meet the physical and mental needs of the animals in their care. This requires access to resources such as veterinary care, which is integral to achieving animal welfare. However, "access" to veterinary care is not always homogenous across communities and currently lacks a consistent definition. The objectives of this scoping review were to (1) understand how "access" to veterinary care has been defined in the literature, (2) map a broad list of potential barriers that may influence access to veterinary care, and (3) identify how access to care impacts the welfare of companion and livestock animals. The literature search yielded a total of 1,044 publications, 77 of which were relevant to our inclusion criteria, and were published between 2002 and 2022. Studies were most frequently conducted in the United States (n = 17) and Canada (n = 11). Publications defining access to veterinary care (n = 10) or discussing its impacts on animal welfare (n = 13) were minimal. However, barriers to accessing veterinary care were thoroughly discussed in the literature (n = 69) and were categorized into ten themes according to common challenges and keywords, with financial limitations (n = 57), geographic location (n = 35), and limited personnel/equipment (n = 32) being the most frequently reported. The results of this scoping review informed our proposed definition of access to veterinary care. Additionally, our findings identified a need to further investigate several understudied barriers relating to access to care (i.e., veterinarian-client relationship, client identity) and to better understand how they potentially affect animal welfare outcomes.

A Survey of Veterinary Student and Veterinarian Perceptions of Shelter Medicine Employment

Shelter medicine appears to be popular among prospective veterinarians, but there is a shortage of veterinarians entering the field to fill available positions. The reasons for this discordance are not well understand. This study describes veterinary students' interest in shelter medicine, their perceptions of common duties, and their perceptions of employment attributes in shelter medicine, compared with those of current veterinarians. The sample included 146 first-year students, 155 final-year students, and 221 veterinarians who self-completed an online survey between September 2020 and March 2021. We found high levels of interest in shelter medicine, with 40% of first- and 43% of final-year students indicating they were likely to consider working in shelter medicine. Outreach clinics (84% of first-year students, 86% of final-year students), access-to-care clinics (82%, 83%), and loan forgiveness programs (75%, 64%) encouraged many veterinary students to consider working in shelter medicine. The risk of compassion fatigue, burnout, and stress (70%, 68%); weekend work (51%, 59%); euthanasia decision making (49%, 47%); euthanasia (43%, 41%); and expected salaries of shelter veterinarians (39%, 37%) acted as deterrents. Kruskal-Wallis H tests revealed students reported more positive ratings than veterinarians for most shelter medicine duties and employment characteristics, with moderate to strong consensus within groups. Little difference appeared between first- and final-year students. This study highlights target areas for animal shelters to boost recruitment of newly graduated veterinarians. Increasing veterinary students' exposure to shelter medicine throughout their veterinary training may also help address their concerns regarding euthanasia, salary, and quality of care.

US veterinarians' perceptions of discussing COVID-19 vaccination with animal owners during routine visits

COVID-19 vaccination uptake is disproportionately lower among rural, politically conservative, and underserved individuals in the United States. Engaging this population requires leveraging unique potential human health advocates, like veterinarians. Between September and October 2021, 103 veterinarians responded to open-ended prompts to assess providers' willingness and potential barriers to discussing COVID-19 vaccination within a veterinary visit. Veterinarians perceived they had a public health role in providing reliable and accurate COVID-19 information, including information related to approved vaccines. However, veterinary practitioners were aware of numerous potential barriers to having such discussions within a clinical visit (e.g., scope of practice concerns, shifting focus away from the animal, politicization of vaccination). Findings indicate policy efforts, aligned with the One Health initiative, are needed to address the role of veterinary medicine in human health care following catastrophic events, like the COVID-19 pandemic. Similarly, veterinarians require tailored vaccine materials that can be utilized within the clinic or community setting.

A Pilot Study Examining the Experience of Veterinary Telehealth in an Underserved Population Through a University Program Integrating Veterinary Students

Cost and transportation are two commonly cited barriers to accessing health care in both human and veterinary medicine within underserved communities. While human medicine has utilized telehealth as a means of breaking down this barrier, limited research exists to describe its use in veterinary medicine. The Pets for Life (PFL) program has partnered with the Penn Vet Shelter Medicine Program to provide veterinary appointments to clients, at no cost to the client, in underserved zip codes through virtual telehealth visits. These visits incorporated veterinary students as part of their clinical rotations through a service learning based model. Between January and August 2021, 31 PFL clients and nine veterinary students completed surveys to describe the role of telehealth in addressing barriers to accessing veterinary care, their perceptions of telehealth appointments, the human-animal bond, and changes in veterinary student empathy. PFL clients completed the survey immediately following their telehealth appointment, and veterinary students completed surveys prior to and following their participation in the PFL appointments during the rotation. Nearly 25% of clients reported that they would not have been able to secure transportation and 58% reported they would not have been able to afford an appointment at an in-person veterinary clinic. The population of clients who responded that cost was a significant barrier to accessing care did not entirely overlap with those who responded that transportation was a significant barrier to accessing care, indicating support for the use of telehealth in providing an alternative modality to address transportation challenges as a barrier to accessing veterinary care. Additional data suggests that both client and student experience was overwhelmingly positive, providing support for further service learning initiatives in veterinary student education. Further research is warranted to continue to assess the emerging role of telehealth in improving veterinary care for underserved communities.

Pet Owners' Perceptions of COVID-19, Zoonotic Disease, and Veterinary Medicine: The Impact of Demographic Characteristics

This study aimed to investigate the impact of sociodemographic characteristics on pet owners' concern about the transmission of zoonotic disease and SARS-CoV-2, and to describe owners' perceptions of veterinarians and physicians as resources for zoonoses information. Between September and October 2020, 1154 individuals completed an online survey via Qualtrics. Binary logistic regression models were used to examine the associations between owner demographics and perceptions of zoonoses and SARS-CoV-2. Most participants were minimally concerned about their pets contracting or transmitting zoonotic diseases or SARS-CoV-2, although perceptions of risk differed based on age, race, and education. Older participants were typically less concerned about the transmission of zoonotic diseases and SARS-CoV-2. Considering where participants obtained information about zoonoses, pet owners were more likely to contact their veterinarian for advice (43%) than their physician (17%). However, 17% of pet owners struggled to access veterinary care, and 51% said their access to veterinary care had become more difficult during the COVID-19 pandemic. Our findings highlight a need for further education about zoonoses and SARS-CoV-2, and suggest veterinarians may play a key role in these communications. The results also emphasize the need to address access to care issues in veterinary medicine.