Current Perspectives on Therapy Dog Welfare in Animal-Assisted Interventions

Horses' Cardiovascular and Glucocorticoid Responses to Equine-Assisted Therapy with Women with Intellectual Disability: An Exploratory Study

Research on equine-assisted therapy (EAT) has primarily been centered on human health. Relatively few studies have addressed the impact of EAT on horses. This study sought to monitor four experienced therapy horses' cardiovascular and glucocorticoid activity over the course of standardized EAT sessions designed to support women with intellectual disability. In the control condition, horses completed the EAT protocol solely with the therapist, thereby resembling a training session. Descriptive data analysis revealed higher levels of heart rate during an experimental EAT session and increased salivary cortisol when horses were navigated by the client through an obstacle course during the "challenge" phase of the protocol, pointing at a greater physical demand due to the recipient on horseback. Given the parasympathetic activity and overall heart rate variability across experimental EAT sessions and the cortisol recovery after the sessions, the findings do not give rise to any acute animal welfare concerns. For a more holistic interpretation of the present research results, further investigation into the horse perception of EAT, based on a bigger sample size and additional markers of welfare, is needed.

Behavioural differences and similarities between dog breeds: proposing an ecologically valid approach for canine behavioural research

The behaviour of dogs holds great relevance for not only scientists from fundamental and applied research areas, but also due to the widespread roles of dogs in our societies as companions and working animals; their behaviour is also an important factor in animal and human welfare. A large proportion of dogs currently under human supervision belong to one of roughly 400 recognised breeds. Dog breeds can be characterised by distinctive, predictable and reproducible features, including some of their behavioural traits. To the scientist, the comparative analysis of the behaviour of dog breeds provides an opportunity for investigating an array of intriguing phenomena within an easily accessible model organism created from natural and human-driven evolutionary processes. There are many ways to design and conduct breed-related behavioural investigations, but such endeavours should always be based around biologically relevant research questions and lead to ecologically valid conclusions. In this review, we surveyed recent research efforts that included dog behaviour-related comparisons and applied a critical evaluation according to their methods of breed choice and the subsequent research design. Our aim was to assess whether these two fundamentally important components of experimental design provide a solid basis to reach valid conclusions. Based on 97 publications that fulfilled our selection criteria, we identified three primary methods used by researchers to select breeds for their investigations: (i) convenience sampling; (ii) hypothesis-driven, ancestry-based sampling; and (iii) hypothesis-driven, functional sampling. By using the SWOT (Strengths, Weaknesses, Opportunities, Threats) evaluation system, we highlight each of these techniques' merits and shortcomings. We identify when particular methods may be inherently unable to produce biologically meaningful results due to a mismatch between breed choice and the initial research goals. We hope that our evaluation will help researchers adopt best practices in experimental design regarding future dog breed comparisons.

Participation in a Prison-Based Training Programme Is Beneficial for Rescue Dogs

Dogs are often relinquished because of behavioural issues which may be exacerbated in rehoming centres. Prison-based dog training programmes (DTPs) may enhance outcomes for rescue dogs by providing socialisation and training opportunities to improve behaviour, welfare and likelihood of rehoming. We assessed whether dogs benefitted from participation, 1-3 times per week, in a prison-based DTP in which male young offenders learn how to train and care for dogs waiting to be rehomed. Within DTP sessions, there was significant improvement on a range of training tasks (n = 42 dogs). Analyses of videos (n = 17 dogs) in the kennels and a training barn pre- and post-DTP participation showed improvement in some positive behaviours, but no significant change in other behaviours. Subjective ratings by staff of the dogs' behaviour were made (n = 20 dogs). Desirable behaviours (e.g., playful/friendly) increased, and most undesirable behaviours (e.g., frustrated and noisy) decreased. Participation in the DTP did not mitigate all negative behaviours. However, improvements are consistent with enhanced welfare and likelihood of successful rehoming. Prison-based DTPs can be effective in supporting the work of animal rescue organisations to improve outcomes for dogs, while offering people in custody an opportunity to engage in purposeful activity and provide a community service.

Going to the office - What's in it for the dog?

Benefits and challenges of dogs being present at the office were analyzed from three perspectives: the company view, the dog owner (employee) and the dog view. For companies, office dogs may serve as a branding symbol, leading to higher employee satisfaction and productivity, increased stress resilience and fewer turnover intentions. Yet, companies need to apply pet policies, risk management strategies and mitigate nuisance such as barking, loose fur or excrement. Additional breaks to walk the dogs are required and other employees or customers may be irritated. Employees take advantage of stress reduction, social support, higher job satisfaction, not having to leave their animal at home. Still, an office dog is an added responsibility in terms well-being, safety, distraction from work and emotional involvement. Although the animal perspective has not yet been scientifically addressed, we propose potential benefits such as less separation distress by having the owner nearby, higher social engagement and additional walks during breaks. Challenges for dogs may involve unwanted attention, aversive environmental stimulation, being restrained via leash or crate, irritation caused by conspecifics, emotional contagion or individual requirements.

Developing and Planning a Protocol for Implementing Health Promoting Animal Assisted Interventions (AAI) in a Tertiary Health Setting

The Ottawa Charter identifies that multiple levels of government, non-government, community, and other organizations should work together to facilitate health promotion, including in acute settings such as hospitals. We outline a method and protocol to achieve this, namely an Action Research (AR) framework for an Animal Assisted Intervention (AAI) in a tertiary health setting. Dogs Offering Support after Stroke (DOgSS) is an AR study at a major tertiary referral hospital. AAI has been reported to improve mood and quality of life for patients in hospitals. Our project objectives included applying for funding, developing a hospital dog visiting Action Research project, and, subsequent to ethics and governance approvals and finance, undertaking and reporting on the Action Research findings. The Action Research project aimed to investigate whether AAI (dog-visiting) makes a difference to the expressed mood of stroke patients and their informal supports (visiting carers/family/friends), and also the impact these visits have on hospital staff and volunteers, as well as the dog handler and dog involved. We provide our protocol for project management and operations, setting out how the project is conducted from conception to assess human and animal wellbeing and assist subsequent decision-making about introducing dog-visiting to the Stroke Unit. The protocol can be used or adapted by other organizations to try to avoid pitfalls and support health promotion in one of the five important action areas of the Ottawa Charter, namely that of reorienting health services.

Investigating Dog Welfare When Interacting with Autistic Children within Canine-Assisted Occupational Therapy Sessions: A Single Case Study

Human-animal bond is defined as the mutually beneficial relationship between humans and animals. Recent years have seen increasing research regarding the benefits of interaction with animals for autistic children. However, there continue to be limited studies exploring the impact of this interaction on the welfare of therapy dogs. As part of a pilot randomised control trial assessing the efficacy of canine-assisted occupational therapy with autistic children, this project assessed welfare markers of the therapy dog involved. A total of twenty-one saliva samples were taken from the therapy dog to assess cortisol, alpha amylase, and oxytocin concentrations at home and throughout the treatment days. Additionally, six hours of therapy session videos were analysed for stress indicators of canine behaviour. No significant differences were found between days spent at home and treatment days for any of the biomarkers or stress indicators. Results suggest that the therapy dog involved did not experience increased stress resulting from interaction with the autistic children throughout the therapy sessions. This study supports the need for further research regarding therapy dog welfare when interacting with autistic children including an increased sample size of therapy dogs and therapists.

Cross-disciplinary method development for assessing dog welfare in canine-assisted pedagogical work: a pilot study

Research on so-called social service dogs' welfare in schools is scarce and tends to suffer from positive bias; i.e., lacking critical approaches to claimed welfare benefits for dogs. To contribute method development for studying effects on dogs in pedagogical work, we applied and evaluated a combination of four data collection methods: Ethogram, Qualitative Behaviour Assessment (QBA), ethnographic observations, and interviews with dog-handling pedagogues. We followed pedagogues (n = 5) and their dogs (n = 8) in their daily work, observing 16 canine-assisted sessions in total at five different schools. Follow-up semi-structured interviews were carried out with all pedagogues. Our findings suggest combining either ethogram or QBA with ethnographic data that gives contextual information on the events causing the dog's behavior. The method choice will, ultimately, depend on study design, but the specific premises of QBA seem to work particularly well with ethnography. We further suggest a shift from simultaneous (parallel) to synchronous (connected) documentation of data. To minimize anthropocentric bias and power arrangements involved in animal welfare research, it is necessary to critically scrutinize accepted conventions regarding social service dogs and their work situation.

Understanding the Role of Therapy Dogs in Human Health Promotion

Dogs may provide humans with a range of physical, mental and social benefits. Whilst there is growing scientific evidence of benefits to humans, there has been less focus on the impact to canine health, welfare and ethical considerations for the dogs. The importance of animal welfare is increasingly acknowledged, indicating that the Ottawa Charter should be extended to include the welfare of non-human animals supporting the promotion of human health. Therapy dog programmes are delivered across a variety of settings including hospitals, aged care facilities and mental health services, highlighting the important role they play in human health outcomes. Research has shown that that there are biomarkers for stress in humans and other animals engaged in human-animal interactions. This review aims to assess the impact of human-animal interactions on therapy dogs engaged in providing support to human health. While challenging, it is paramount to ensure that, within the framework of One Welfare, the welfare of therapy dogs is included, as it is a key factor for future sustainability. We identified a range of concerns due to the lack of guidelines and standards to protect the wellbeing of the dogs engaged in these programmes. Extension of the Ottawa Charter to include the welfare of non-human animals with leveraging through a One Welfare approach would promote animal and human health beyond current boundaries.

Animal-Assisted Interventions and Animal Welfare-An Exploratory Survey in Germany

BACKGROUND

Animals play a crucial role in social occupational fields. The positive effects of animals are described in theory and practice. However, the significance of animal welfare in animal-assisted intervention settings has not yet been extensively researched, so that the aim of this explorative study was to investigate the perception and significance as well as the understanding of animal welfare and its implementation on the part of professionals working with animals.

METHODS

In the present project, 270 animal-assisted professionals from Germany were interviewed about their individual perceptions of animal welfare and their implementation of animal welfare with the help of questionnaires with closed questions (5-point agreement scale) and open questions. The quantitative data were analyzed using the statistical software SPSS and MS Excel. The qualitative data were analyzed using thematic coding.

RESULTS

The quantitative and qualitative results show that animal welfare poses high importance for people working in animal-assisted interventions. The structure and design of assignments, animal-related aspects and conditions, and education and knowledge are mentioned as generally relevant conditions for ensuring animal welfare from the perspective of animal-assisted intervention practitioners. In addition, different concrete courses of action to ensure animal welfare are described, which are characterized as stopping or changing the setting at different levels.

CONCLUSIONS

Animal welfare plays a central role for professionals working with animals. However, further studies are necessary in order to record other animal welfare-relevant aspects in the animal-assisted interventions, depending on the respective animal species, and to examine the implementation of animal welfare-related measures.

Using Pet Therapy to Decrease Patients' Anxiety on Two Diverse Inpatient Units

BACKGROUND

The physical benefits for patients who spend time with a therapy dog have been reported, including decreased anxiety. Pet therapy has decreased anxiety in various hospitalized patient populations. The human-animal bond is the foundation for the positive interaction therapy dogs create.

AIMS

This study's purpose was to explore the use of pet therapy as an intervention to decrease patients' anxiety levels on two diverse inpatient units: Behavioral Health (BHU) and Pediatrics (PEDS).

METHODS

This was a quantitative study using a convenience sample, with systematic assignment to the experimental and control group. The State Anxiety Scale (SAS), a 6-item, Likert-type Short Form version of the State-Trait Anxiety Inventory, was used with adults and children; a Pediatric Emoji Method was constructed to assist children with the SAS. After consent, both groups completed the SAS pretest. Intervention patients then spent up to 15 minutes with a therapy dog and handler. The SAS posttest was completed 1 hour later by the experimental and control group. Descriptive and inferential statistics were used, including an independent samples t test, paired-sample t test, Wilcoxon signed rank tests, and Spearman correlation coefficients.

RESULTS

Findings revealed that the therapy dog visitations had a positive effect on lowering anxiety supporting the hypothesis. Both the PEDS and BHU participants experienced a significant decrease in their anxiety level following the dog visits.

CONCLUSION

Patients on the BHU and PEDS units benefitted from their visit with a therapy dog by experiencing a decrease in their anxiety level.

Assistance Dogs for People with Younger (Early)-Onset Dementia: The Family Carer's Experience

There is growing evidence for trained assistance dogs promoting the health, wellbeing, and quality of life of people in a variety of circumstances, including for those with dementia. Little is known about people with younger (early)-onset dementia (YOD) and family carers. As part of a larger study involving 14 people with YOD matched with trained assistance dogs over a two-year period, we report analyses of interviews with 10 family carers conducted on multiple occasions investigating their experience with an assistance dog. Interviews were recorded, transcribed and subjected to inductive thematic analysis. They told a range of experiences; the good and the challenging. Findings fell into three areas: the human-animal bond; relationship dynamics; and responsibility for caring. Concerns were raised with respect to the resources required of carers together with the financial resources needed to support an assistance dog. The study concludes that trained assistance dogs can play an important role promoting the health and wellbeing of both people with YOD and of their family carers. However, support needs to be in place as the circumstances of the family member with YOD changes and the role of the assistance dog as part of the family also changes. Practical (financial) support of a scheme such as the Australian National Disability Insurance Scheme (NDIS) could be important to sustaining such support.

Horses' Tactile Reactivity Differs According to the Type of Work: The Example of Equine-Assisted Intervention

Tactile perception in humans varies between individuals and could depend on extrinsic factors such as working activity. In animals, there is no study relating the influence of animals' work and their tactile reactivity per se. We investigated horses' tactile reactivity using von Frey filament in different body areas and compared horses working only in equine-assisted interventions (EAI), in riding school (RS) lessons, and in both activities (EAI-RS). We further compared tactile actions by people with or without mental and/or developmental disorders during brushing sessions. The results indicated that EAI horses showed higher tactile reactivity compared to EAI-RS and RS horses, both in terms of number of reactions overall, and especially when the test involved thin filaments. All horses showed high tactile reactivity when tested on the stifle, and this was particularly true for EAI horses. These differences could be related to humans' actions, as participants diagnosed with disorders brushed more the hindquarters and showed more fragmented actions. This study opens new lines of thought on the influence of EAI working activity on horses' tactile reactivity, and hence, on horses' sensory perception. Tactile reactivity outside work, may be directly (via tactile stimulations) or indirectly (via the welfare state), influenced by working conditions.

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.

Fur, Fin, and Feather: Management of Animal Interactions in Australian Residential Aged Care Facilities

Animal-assisted interventions (AAI) have been occurring in Australian Residential Aged Care Facilities (RACF) for more than 40 years and may relieve loneliness and improve quality of life. The presence of animals in RACF poses an inherent risk to residents and the animals involved. Little is known about the policies and guidelines for including animals in the Australian RACF. We anticipated that most RACFs would have some policies, but they may lack the detail necessary to keep humans and animals safe. Using an adapted survey, we surveyed and interviewed a small but representative sample of Australian RACF managers. The results demonstrated that RACF did have animal policies; however, the content regarding the need for hand washing, infection prevention, and animal welfare was lacking. Including unregulated family pets in RACF was an unexpected additional risk factor identified during data analysis. There is a need for national guidelines tied to the national aged care policy, which includes training and educational resources for RACF and AAI providers.

Are children and dogs best friends? A scoping review to explore the positive and negative effects of child-dog interactions

Personal wellbeing is greatly influenced by our childhood and adolescence, and the relationships formed during those phases of our development. The human-dog bond represents a significant relationship that started thousands of years ago. There is a higher prevalence of dog ownership around the world, especially in households including children. This has resulted in a growing number of researchers studying our interactions with dogs and an expanding evidence base from the exploration of child-dog interactions. We review the potential effects of child-dog interactions on the physical, mental, and social wellbeing of both species. A search of the SCOPUS database identified documents published between January 1980 and April 2022. Filtering for key inclusion criteria, duplicate removals, and inspecting the references of these documents for additional sources, we reviewed a total of 393 documents, 88% of which were scientific articles. We were able to define the numerous ways in which children and dogs interact, be it neutral (e.g., sharing a common area), positive (e.g., petting), or negative (e.g., biting). Then, we found evidence for an association between childhood interaction with dogs and an array of benefits such as increased physical activities, a reduction of stress, and the development of empathy. Nonetheless, several detrimental outcomes have also been identified for both humans and dogs. Children are the most at-risk population regarding dog bites and dog-borne zoonoses, which may lead to injuries/illness, a subsequent fear of dogs, or even death. Moreover, pet bereavement is generally inevitable when living with a canine companion and should not be trivialized. With a canine focus, children sometimes take part in caretaking behaviors toward them, such as feeding or going for walks. These represent opportunities for dogs to relieve themselves outside, but also to exercise and socialize. By contrast, a lack of physical activity can lead to the onset of obesity in both dogs and children. Dogs may present greater levels of stress when in the presence of children. Finally, the welfare of assistance, therapy, and free-roaming dogs who may interact with children remains underexplored. Overall, it appears that the benefits of child-dog interactions outweigh the risks for children but not for dogs; determination of the effects on both species, positive as well as negative, still requires further development. We call for longitudinal studies and cross-cultural research in the future to better understand the impact of child-dog interactions. Our review is important for people in and outside of the scientific community, to pediatricians, veterinarians, and current or future dog owners seeking to extend their knowledge, and to inform future research of scientists studying dogs and human-animal interactions.

Informing Implementation: Perspectives from the Australian University Community Regarding an Animal Assisted Intervention

Animal Assisted Interventions (AAIs) have become increasingly popular in the university setting; however, there is limited research exploring their potential on an Australian university campus and participants' views prior to implementation. Therefore, this study aimed to explore university staff members' and students' interest in participating in an AAI and their perspectives on intervention characteristics. This was a mixed methods study, using an online survey and semi-structured interviews. The survey had 344 responses, and 45 interviews were conducted. A large majority of participants (86%) were interested in participating in an AAI. In the survey, participants indicated their preferred intervention characteristics for the location of the intervention, frequency of participating, and ways of hearing about the intervention. Participants also expressed concerns regarding therapy animal welfare. In interviews, participants discussed various considerations which may impact the intervention (such as the accessibility of the location, the impact of workload on participating, the effectiveness of promotion strategies, and factors that may assist therapy animal welfare, such as the therapy animals' handlers). Gaining an insight into the university community's views prior to implementation may ensure the intervention is feasible to implement and can be beneficial to both humans and therapy animals.

The Effect of Dog Presence on the Therapeutic Alliance: A Systematic Review

The development of a therapeutic alliance represents one of the most important processes that occurs in psychological therapy and is one of the strongest predictors of treatment outcome. To ensure the effective delivery of psychological interventions, it is important to explore factors which may improve the therapeutic alliance. There are well-documented effects of human-animal interactions in social settings, and researchers have also considered the effect of dog presence on the therapeutic alliance. A systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Database searches included CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, and Scopus. The inclusion criteria were studies that assessed the effect of dog presence on the therapeutic alliance and provided a quantitative outcome measure. Six studies met the inclusion criteria and were included in the systematic review. Three of the included studies observed no significant effect of dog presence on the therapeutic alliance; three studies did observe a positive effect, with effect sizes ranging from d = 0.10 to d = 0.58. All six studies took place in either research or clinical settings. Studies differed in terms of help-seeking versus non-help-seeking populations, where help-seeking populations were genuinely pursuing a psychological intervention. Heterogeneity was observed regarding study procedure and outcome measures used. Current data is limited, and initial evidence suggests that the effect of dog presence on the therapeutic alliance remains unclear, illustrated by inconsistent outcomes across the included studies. Further research is warranted before introducing dogs into therapeutic settings for this purpose.

Issues Regarding the Welfare of Assistance Dogs

While the roles and efficacy of assistance animals have received attention in the literature, there has been less research focused on animal welfare issues regarding assistance animals. This is a pertinent area, given the burgeoning of types of assistance animals, situations in which they are employed, and access issues arising from increased assistance animal engagement. Animal welfare as pertains to assistance animals is discussed in this paper with respect to overall research on animal welfare concerns in a variety of contexts, training and access issues, and legal and regulatory concerns. Relevant examples from global contexts, as well as the specific Australian context, are offered. Conclusions include that while human quality of life is often considered and protected in laws and policies, this is much less true for assistance animals. Additional attention is required to ensure that the quality of life of both persons with disabilities and their assistance animals can be ensured. Support for a person to meet the needs of an assistance animal, as well as considerations for keeping such working dyads together in changed circumstances (e.g., following a move to an assisted living mode of accommodation), are recommended.

Animal-Assisted Interventions Improve Mental, But Not Cognitive or Physiological Health Outcomes of Higher Education Students: a Systematic Review and Meta-analysis

Due to the high burden of mental health issues among students at higher education institutions world-wide, animal-assisted interventions (AAIs) are being used to relieve student stress. The objective of this study was to systematically review of the effects of AAIs on the mental, physiological, and cognitive outcomes of higher education students. Randomized controlled trials using any unfamiliar animal as the sole intervention tool were included in this review. Study quality was assessed using the Cochrane Risk-of-Bias tool. Where possible, effect sizes (Hedges' g) were pooled for individual outcomes using random-effects meta-analyses. Albatross plots were used to supplement the data synthesis. Of 2.494 identified studies, 35 were included. Almost all studies used dogs as the intervention animal. The quality of most included studies was rated as moderate. Studies showed an overall reduction of acute anxiety and stress. For other mental outcomes, studies showed smaller, but nonetheless beneficial effects. Studies showed no clear effect on physiological or cognitive outcomes. Strong methodological heterogeneity between studies limited the ability to draw clear conclusions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-022-00945-4.

Animals in Animal-Assisted Services: Are They Volunteers or Professionals?

With the increasingly common practice of Animal-Assisted Services (AAS), whether in therapy, coaching, education, or volunteering programs, the concern over animal welfare has also risen. However, no standards have yet been established for good practices to ensure the animal’s mental health. This is largely due to the wide variety of roles played by animals in interventions and the lack of ‘job descriptions’ for the animal in diverse settings. Some professionals call their animal a ‘volunteer’, others mention that some directive guidance is given to the therapy animal, and some assistance animals are highly trained. Misunderstandings could be avoided if the integrated animal were to receive a justifiable label: volunteer or professional. Choosing either one comes with obligations for the owner, handler, or therapist. In this paper, we compare the roles of human volunteers and professionals to the roles of animals involved in therapy. We also demonstrate the obligations that come along with the decision to label animals as such either volunteers or professionals. Furthermore, we make a plea for animal-friendly interventions, whether in a volunteer position or as a professional, in order to stimulate the animal’s cooperation and motivation. Studying dopamine and translating the findings into context-ethograms can provide a way to judge behavior more objectively.

Animal-assisted Interventions as an Adjunct to ABA Services: Clinician Practices and Perceptions

Although the popularity of animal-assisted interventions (AAI) continues to increase, an examination of these practices among clinician populations that may incorporate AAI in their clinical services are largely absent from the literature. This study examined the practices and desirability of incorporating animals into ABA services. A total of 544 ABA clinicians completed a web-based survey. Data revealed respondents not only considered incorporating animals into ABA services (n = 307), but almost 20% (n = 107) also reported engaging in this practice. Dogs were reported as the most frequently incorporated animals and an examination of animal sources and prior training revealed substantial variability. Animal incorporation practices were viewed as desirable, feasible, and a majority of respondents reported being interested in AAI implementation. Implications of these results beget a discussion about potential adverse consequences to clients and clinicians that participate in these practices. This discussion includes physical safety risks, financial threats, and potential Behavior Analysis Certification Board (BACB) code violations. Animal welfare concerns, which are often omitted from discussions about AAI, are also discussed to inform clinicians of the added responsibilities that need to be considered. In total, survey results and the accompanying discussion should urge ABA clinicians to pause when considering the incorporation of animals into their clinical practices. No published articles could be found that examine the use of animal incorporation practices within the area of clinical ABA services. Personal and professional risks and animal welfare concerns associated with the utilization of these practices, as identified in this study, should inform programmatic decision-making by clinical practitioners and supervisors interested in engaging in these practices. Results of this survey highlight the potential need for modifications to professional standards and ethical codes of the BACB and state licensing authorities. As this is a novel area of investigation, this article illustrates the need for further empirical evaluation of animal-assisted interventions as an adjunct to ABA services.

Defining Terms Used for Animals Working in Support Roles for People with Support Needs

Simple Summary

Although animals are being employed for a growing number of roles to support people, the terms used to describe those animals (e.g., “therapy animal” and “emotional support animal”) can be confusing. The same term may be used to describe different types of work, or the same role can be described with different terms. This paper presents the results of a collaboration between over 100 researchers, practitioners, and end users of animal-based supports from all over the world. We created working definitions for the following nine terms: “assistance animal”, “companion animal”, “educational/school support animal”, “emotional support animal”, “facility animal”, “service animal”, “skilled companion animal”, “therapy animal”, and “visiting/visitation animal”. In this paper, we describe the defining characteristics of each animal type and how it is different from the other types. We recommend phasing out the terms “skilled companion animal” and “service animal”, because they are similar to other terms. We discuss how our definitions may be received in different parts of the world.

Abstract

The nomenclature used to describe animals working in roles supporting people can be confusing. The same term may be used to describe different roles, or two terms may mean the same thing. This confusion is evident among researchers, practitioners, and end users. Because certain animal roles are provided with legal protections and/or government-funding support in some jurisdictions, it is necessary to clearly define the existing terms to avoid confusion. The aim of this paper is to provide operationalized definitions for nine terms, which would be useful in many world regions: “assistance animal”, “companion animal”, “educational/school support animal”, “emotional support animal”, “facility animal”, “service animal”, “skilled companion animal”, “therapy animal”, and “visiting/visitation animal”. At the International Society for Anthrozoology (ISAZ) conferences in 2018 and 2020, over 100 delegates participated in workshops to define these terms, many of whom co-authored this paper. Through an iterative process, we have defined the nine terms and explained how they differ from each other. We recommend phasing out two terms (i.e., “skilled companion animal” and “service animal”) due to overlap with other terms that could potentially exacerbate confusion. The implications for several regions of the world are discussed.

Horses’ attentional characteristics differ according to the type of work

Attention is a central process of cognition and influences the execution of daily tasks. In humans, different types of work require different attentional skills and sport performance is associated with the ability to attention shift. Attention towards humans varies in dogs used for different types of work. Whether this variation is due to the recruitment of individuals suitable for specific types of work, or to the characteristics of the work, remains unclear. In the present study, we hypothesized that domestic horses (Equus caballus) trained for different types of work would also demonstrate different attentional characteristics but we also explored other possible factors of influence such as age, sex and breed. We exposed more than sixty horses, working in 4 different disciplines, and living in two types of housing conditions, to a visual attention test (VAT) performed in the home environment. Individual attentional characteristics in the test were not significantly influenced by age, sex, breed or conditions of life but were strongly related to the type of work. Riding school horses showed longer sequences and less fragmented attention than all other horses, including sport horses living in the same conditions. Interestingly, sport performance was correlated with attention fragmentation during the test in eventing horses, which may need more attention shifting during the competitions. Working conditions may influence attention characteristics indirectly through welfare, or directly through selection and training. Our study opens new lines of thought on the determinants of animal cognition and its plasticity and constitutes a further step towards understanding the interrelationship between working conditions and cognition.

Canine-Assisted Interventions and the Relevance of Welfare Assessments for Human Health, and Transmission of Zoonosis: A Literature Review

CAIs (canine-assisted interventions) include "canine-assisted therapy" in which a therapist sets client-oriented goals, 'canine-assisted activities' with recreational goals for clients, and 'canine-assisted education/learning' in which teachers or coaches create learning goals for students or clients. CAIs vary in nearly every way; their only common trait is the involvement of dogs to respond to human need. However, the benefits of involving dogs are highly dependent on the animal's health and behavior. A dog exhibiting negative behavior or an unwell dog might pose a risk, especially for CAI target groups, specifically individuals with immunosuppression, chronic illness, children, elderly, etc. Therefore, positive animal welfare as preventative medicine to avoid incidents or transmission of zoonosis is an attractive hypothesis, with implications for human and animal, health and well-being. This review aims to summarize the current published knowledge regarding different aspects of welfare in CAIs and to discuss their relevance in the light of health and safety in CAI participants. As method for this study, a literature search was conducted (2001-2022) using the Prisma method, describing issues of dog welfare as defined in the Welfare Quality® approach. This welfare assessment tool includes 4 categories related to behavior, health, management, and environment; it was, therefore, applicable to CAIs. Results indicate that dogs working in CAIs are required to cope with diverse variables that can jeopardize their welfare. In conclusion, we propose regular welfare assessments for dogs in CAIs, which would also protect the quality of the CAI sessions and the clients' safety and well-being.

The Efficacy of Animal-Assisted Therapy in Patients with Dual Diagnosis: Schizophrenia and Addiction

The objective of the study was to evaluate the efficacy of an animal-assisted-therapy (AAT) program in patients diagnosed with schizophrenia-spectrum disorders and substance-use disorders in residential treatment in order to intervene in the remission of negative and positive symptoms and improve quality of life and adherence to treatment, favouring the clinical stabilization of patients who participate in the AAT program, within the context of a mental-illness-treatment device. This was a quasi-experimental prospective study with intersubject and intrasubject factors. The sample comprised 36 patients (21 in the experimental group and 15 in the control group) who were evaluated at three time points (in the 3rd, 6th, and 10th sessions). The program lasted 3 months and consisted of 10 sessions that were implemented once a week, with a maximum participation of 10 patients per group. The participants were evaluated with the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and the Life Skills Profile-20 (LSP-20) questionnaire. We observed a decrease in the positive symptoms of psychosis (F: 27.80, p = 0.001) and an improvement in functionality (F: 26.70, p < 0.001) as the sessions progressed. On the basis of these results, we concluded that AAT seems to be valid as a coadjuvant therapy as part of the rehabilitation processes of patients diagnosed with schizophrenia and addiction-spectrum disorders (dual diagnosis).

Molecular Biomarkers of Adult Human and Dog Stress during Canine-Assisted Interventions: A Systematic Scoping Review

Positive relationships, including those between humans and other animals, particularly dogs, may be a way to reduce stress in humans. However, research into this area is relatively new, and a comprehensive review of the impacts of these interactions on humans and dogs has not been conducted. A scoping review of the scientific literature was conducted to explore what is known about the impacts of canine-assisted interventions on molecular biomarkers (e.g., cortisol and oxytocin) and associated measures (e.g., heart rate and blood pressure) of human and canine stress. As reported across 27 identified studies, canine-assisted interventions have consistently been demonstrated to elicit positive changes in human stress markers, and typically do not cause negative impacts on the studied canine stress markers. However, results were inconsistent across measures of stress. For example, in humans, it was common for a study to show improvements to cortisol levels but no change to self-reported stress, or vice versa. Many of the reviewed studies also had significant methodological issues, such as not aligning the timing of sample collections to when the analyzed stress biomarkers could be expected to peak. More rigorous research should be conducted on the impacts of canine-assisted interventions on a wider range of stress biomarkers.

Handlers' Representations on Therapy Dogs' Welfare

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.

Effects of a Nutritional Supplement (DìRelaxTM) on Anxiety in Dogs in a Randomized Control Trial Design

Simple Summary

The effects of a nutraceutical product, DìRelax^TM, were tested in a cohort of anxious dogs by the C-BARQ questionnaire to assess the presence of problematic behaviors, and by the impossible task paradigm, an experimental procedure to explore dogs’ cognitive performance following an expectancy frustration. Hematological and biochemical analyses showed no adverse effects. The treatment with DìRelax^TM showed a positive effect on the dog’s performances, with some of the behaviors appearing improved. The results suggested that DiRelax^TM may have some ameliorative effect on the cognitive performances of anxious dogs.

Abstract

This study aimed to investigate the efficacy of DìRelax^TM, a nutraceutical formulated to reduce anxiety in dogs, using a randomized controlled trial (RCT) design. The C-BARQ questionnaire, some clinical investigations, and the impossible task test were performed in dogs before and after treatment. The C-BARQ questionnaire is particularly useful for assessing the frequency and severity of problematic behaviors. The impossible task paradigm provides insight into the decision-making processes in the realm of expectancy frustration. Results showed an ameliorative effect on the performances of treated dogs during the solvable phases, with a significant decrease in the time needed to solve the task. No behavioral difference was found between treated and untreated anxious dogs during the unsolvable phase. According to the results from the C-BARQ questionnaire, some of the behaviors appeared to improve. Clinical investigations, including a complete blood cell count and blood chemistry, showed no difference between groups, thus suggesting the safety of the product. In general, this study suggests that DìRelax^TM can be safely administered with no adverse effects and can exercise a beneficial effect on anxious dogs by enhancing their cognitive abilities, but further studies should investigate the best method of administration.

Review on Selected Aggression Causes and the Role of Neurocognitive Science in the Diagnosis

Simple Summary

Aggression in dogs is often a reason for abandonment and/or euthanasia. Recently, knowledge about aggression has been subjected to more detailed analysis. In recent years, it has been studied in terms of factors affecting it, such as diet (especially nutritional supplements) and physiology (endocrine system). In addition, recently, new methods of brain research, such as neurocognitive research, have appeared, which enable a significant increase in knowledge about dog behavior, including aggression.

Abstract

Aggression as a behavior is not always desirable, often ends in abandonment and/or euthanasia. However, it is possible to prevent the occurrence of unwanted aggression in domestic dogs. Aggression is not a fully understood phenomenon. In recent years, many studies have focused on the influence of diet and physiology (including the endocrine system) on the emergence of behavioral disorders. In particular, the emphasis was put on nutritional additives such as fatty acids, amino acids, and probiotics. In addition, the possibility of using neurocognition in the observation of abnormal behavior in dogs has also been discussed, which may allow for a more detailed determination of the basis of aggressive behavior in dogs. In this review, the concepts related to aggression and its potential causes have been gathered. In addition, the possible influence of diet and hormones on aggression in dogs has been discussed, as well as the application of neurocognition in the possibility of its diagnosis.

Dog training alleviates PTSD symptomatology by emotional and attentional regulation

Background

Post-Traumatic Stress Disorder (PTSD) symptoms include re-experiencing, avoidance, hyperarousal, and cognitive deficits, reflecting both emotional and cognitive dysregulation. In recent years, non-pharmacological approaches and specifically animal-assisted therapy have been shown to be beneficial for a variety of disorders such as Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and PTSD. However, little is mentioned in the literature about the reciprocal effects of the animal-human interaction.

Objective

To evaluate the effects of a one-year dog training programme on PTSD symptomatology in youngsters with PTSD and on dogs' behaviour.

Methods

Fifty-three adolescents, previously exposed to interpersonal trauma, were clinically diagnosed with PTSD and assigned to a dog-training programme group (n = 30) and a control group (n = 23) that engaged in other training programmes (e.g. cooking, hairstyling, etc.). Both groups were evaluated at baseline and following 12-months by The Clinician-Administered PTSD Scale for DSM-5 in Children and Adolescents (CAPS-CA-5) and Beck-Depression Inventory (BDI). Additionally, we physiologically measured both emotional and attention dysregulation.

Results

Post-12-months training, a significant alleviation of PTSD symptomatology accompanied by lower depression severity was observed in the dog-training group, compared with a insignificant recovery in the control group. Furthermore, improved emotional and attentional regulation was observed in the dog-training group. Measuring the dogs' behaviour revealed increased anxiety and decreased selective attention performance, which was inversely correlated with the beneficial effects observed in the dog-training programme group.

Conclusions

Our findings emphasize the role of emotional and attentional regulations on the dog-handler interface, as evidence-based support for the beneficial effects of the dog-training programme, as either a non-pharmacological intervention or as complementary to anti-depressants treatment of PTSD. Though pharmacological treatments increase the patients' well-being by treating certain PTSD symptoms, our suggested dog-training programme seems to influence the PTSD diagnostic status, thus may be implemented in civilians and veterans with PTSD.

Dogs as Therapeutic Partners, Not Therapeutic Tools: Ethical Considerations for AAT in the Correctional Setting

Although the benefits of animal assisted therapy for people are well established, the ethical considerations for the welfare and safety of the non-human animals involved are not. Without an accrediting body responsible for creating and overseeing national standards, therapy animal organizations are forced to create their own guidelines, creating inconsistencies within the field. Based on interviews conducted with therapy teams who have worked with Parenting, Prison & Pups (PPP), a parenting program provided to incarcerated jailed women that is integrated with the use of animal-assisted therapy (AAT), this article explores the extent of ethics training offered for AAT teams and will examine how agencies and handlers promote and ensure the safety of canine partners, especially in a correctional setting. The research suggests that specific protocols put forth by individual AAT organizations, which can provide for a national model, can afford for the safety and comfortability of canine partners, especially in a corrections environment, but implies that in order to maintain consistency and increase therapy team professionalism, national standards are a necessity. Guidelines are specifically essential for mental health professionals, who lack guidelines from their own accrediting bodies’ code of ethics, and may incorporate non-human therapy partners into their work settings, without proper supervision.

The Animal Welfare Science of Working Dogs: Current Perspectives on Recent Advances and Future Directions

Working dogs are prevalent throughout our societies, assisting people in diverse contexts, from explosives detection and livestock herding, to therapy partners. Our scientific exploration and understanding of animal welfare have grown dramatically over the last decade. As community attitudes toward the use of animals continue to change, applying this new knowledge of welfare to improve the everyday lives of working dogs will underpin the sustainability of working with dogs in these roles. The aim of this report was to consider the scientific studies of working dogs from the last decade (2011–2021) in relation to modern ethics, human interaction, and the five domains of animal welfare: nutrition, environment, behavioral interaction, physical health, and mental state. Using this framework, we were able to analyze the concept and contribution of working dog welfare science. Noting some key advances across the full working dog life cycle, we identify future directions and opportunities for interdisciplinary research to optimize dog welfare. Prioritizing animal welfare in research and practice will be critical to assure the ongoing relationship between dogs and people as co-workers.

Therapy Dog Welfare Revisited: A Review of the Literature

During the past decade, the field of human-animal interaction(s) research has been characterized by a significant increase in scientific findings. These data have contributed to our current understanding of how humans may benefit from contact with animals. However, the animal experience of these interactions is still an under-researched area. This paper addresses the welfare of dogs who participate in animal-assisted interventions (AAIs) to improve health in human recipients. This paper builds on previous work by Glenk (2017) and provides an updated review of the literature on therapy dog welfare published from 2017-2021. New advances in scientific methodology, such as the determination of salivary oxytocin, breath rate and tympanic membrane temperature, are analyzed regarding their value and limitations for research in AAIs. Moreover, welfare-related social and environmental factors (e.g., freedom of choice, exploration of novel environments, inequity aversion, individual development, working experience, relationship with handler and handler skills) that profoundly influence dog perception and well-being are reviewed and discussed. Accounting for the globally increasing interest and the number of dogs utilized in AAIs, safeguarding therapy dog well-being, and identifying situations, circumstances and protocols that may challenge animal welfare remains an emerging and crucial area of scientific effort.

Animal Assisted Interventions in the Green Care Framework: A Literature Review

Green Care (GC) and Animal Assisted Interventions (AAI) are recognised practices useful to enhance the wellbeing of people through interaction with nature and animals. This study aims at understanding the interconnections between GC and AAI by analysing deeply which interaction with animals is conducted. Therefore, we carried out a literature search through Web of Science and Google Scholar that allowed retrieval of 993 records; after the PRISMA selection process, 42 were included. Relevant information was extracted: year of publication, geographical location, objectives, settings in agricultural environment, animal species, characteristics of users involved, type of human–animal interaction, coexistence of other activities without animals, animal health and welfare issues. From the review emerged that research on GC with animals is common in high-income countries and that the line between AAI and occupational therapy is often vague. Moreover, the most common setting for these interventions appears to be the farm, and frequently animals involved are not selected according to their ethological characteristics. Users in this context are extremely various and not only involved in activities with animals. Within the included studies, we noted a lack in the consideration of animal welfare that indicates the need for increased awareness among practitioners and a more ethical approach when animals are involved.

The Research of Standardized Protocols for Dog Involvement in Animal-Assisted Therapy: A Systematic Review

Dogs are considered the most important species involved in animal-assisted therapy (AAT), and the scientific literature focuses on the benefits linked to the involvement of dogs in various therapeutic areas. In this study, we carried out a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, exploring the scientific literature from the last 5 years (2016-2021) on three databases (PubMed, Scopus, and Web of Science) to highlight the characteristics of the dogs involved in AATs. Based on the scientific literature relevant to such dogs, we considered different parameters (i.e., number, age, sex, breed, temperament, methods of choice and training, health status, research goals, and activities with dogs) to include studies in our paper. After screening 4331 papers identified on the searched databases, we selected 38 articles that met the inclusion criteria. Analysis of the included articles showed that the characteristics of the dogs were neglected. Our findings indicated a lack of information about the dogs, as well as the absence of standardized and univocal criteria for dog selection, training programs, and health protocols.

A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part I): Methods and Results

Animal-assisted interventions (AAIs) use human-animal interactions to positive effect in various contexts including cancer care. As the first installment of a 2-part series, this systematic literature review focuses on the research methods and quantitative results of AAI studies in oncology. We find methodological consistency in the use of canines as therapy animals, in the types of high-risk patients excluded from studies, and in the infection precautions taken with therapy animals throughout cancer wards. The investigated patient endpoints are not significantly affected by AAI, with the exceptions of improvements in oxygen consumption, quality of life, depression, mood, and satisfaction with therapy. The AAI field in oncology has progressed significantly since its inception and has great potential to positively affect future patient outcomes. To advance the field, future research should consistently improve the methodological design of studies, report data more completely, and focus more on the therapy animal’s well-being.

Can Animals Be the Key to the Development of Tourism: A Case Study of Livestock in Agritourism

Simple Summary

Animals are an integral and important part of human life. It is clear that when traveling, tourists often choose places where animals are present. They look for places with wild animals more often. Our article introduces issues concerning the role of farm animals in the creation of agritourism products and the prospects of using animals in agritourism. On the one hand, farm animals are an additional source for people who run agritourism farms and make the stay of tourists in rural areas more attractive. The presence of livestock acts as a magnet, attracting more tourists to these farms and achieving higher returns on agritourism activities. However, among the reasons for the lack of contact with animals in agritourism offerings, farmers indicated: the lack of financial resources and the lack of conditions to provide the animals with adequate maintenance. It is worth introducing farm animals as a tourist attraction in agritourism offerings.

Abstract

Animals are an integral part of human life. Currently, they constitute a relevant factor contributing to the tourist experiences of individuals travelling for tourist purposes. Domestic (farm) animals constitute a tourist attraction, are a source of income for individuals running agritourism farms, and render the tourists’ stay in rural areas more attractive. It is important to maintain the welfare of livestock based on principles of sustainability. The authors conducted research among agritourism providers in Wielkopolska Voivodeship. The aim of the survey was to determine whether agritourism farms keep livestock, what species they are, and whether they are important in building an agritourism product and what the prospects are for using animals in agritourism. A questionnaire was used for the study. The use of a variety of animal species facilitates the maintenance of biodiversity on the farm. Our research shows that 57.3% of the analysed agritourism providers included animals. Additionally, we discovered that the presence of livestock acts as a magnet that draws more tourists towards the individuals running agritourism farms and thus causes them to obtain higher profit from the agritourism business. According to the surveyed individuals, the most influential reason for the absence of livestock on their farms was the lack of financial resources and conditions to provide the animals with proper maintenance. Such findings may prompt the introduction of livestock as a tourist attraction in agritourism in other regions.

Effects of Animal-Assisted Therapy on Gait Performance, Respiratory Function, and Psychological Variables in Patients Post-Stroke

Background: Animal-assisted therapy using dogs is being administered to patients post-stroke for the purpose of recovering psychological and physical activity. Objective: This study was conducted to confirm the effect of animal-assisted therapy using dogs on gait performance, pulmonary function, and psychological variables in patients post-stroke. All outcomes were analyzed using two-way repeated-measure analysis. Methods: In total, 30 post-stroke patients were divided into an experimental group (gait training by animal-assisted activity, n = 15) and a control group (gait training, n = 15). Gait performance (cadence, gait speed, stride length, symmetric index), respiratory pulmonary function (forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP)), and psychological variables (rehabilitation motivation and depression assessment) were measured before and after eight weeks of intervention. Results: Gait performance, respiratory pulmonary function, and psychological variables significantly increased in the experimental group compared to the control group. Conclusion: Based on this study, it was found that animal-assisted therapy using dogs is an effective intervention for recovery of psychological and physical activity in patients post-stroke.

An Animal-Assisted Education Intervention with Dogs to Promote Emotion Comprehension in Primary School Children-The Federico II Model of Healthcare Zooanthropology

Emotion comprehension (EC) is a crucial competence for children, as it determines the quality of peer interactions. This study assessed the efficacy of an animal-assisted education (AAE) intervention with dogs based on the Federico II Model of Healthcare Zooanthropology (FMHZ) to promote EC in a group of primary school children. One hundred and four children (48 females) aged 6-7 years took part in the study, of whom 63 participated in the AAE intervention (i.e., experimental group) and 41 did not (i.e., control group). The intervention was deployed in a school setting through a group format and consisted of five bimonthly sessions. EC was assessed pre- and post-intervention, and at a 3-month follow-up. Student's t-test and mixed-model ANOVA were performed to analyze the effect of the intervention on EC. EC significantly improved in children of the experimental group compared to the control group. Significant time effects from pre- to post-intervention, post-intervention to follow-up, and pre-intervention to follow-up assessment were found in the experimental group only. AAE based on FMHZ was effective in improving EC in children.

The guidelines and policies that influence the conduct of Animal-Assisted Activities in Residential Aged-Care Facilities: A systematic integrative review

INTRODUCTION

For some time, Residential Aged Care Facilities (RACF) have incorporated animals into their environment to relieve loneliness and isolation for aged-care residents. However, research examining this practice is not as developed. This paper aims to identify the policies and practices influencing the conduct of Animal-Assisted Activities (AAA) in RACF focusing on the Australian context.

METHODS

Peer-reviewed and gray literature were searched using an array of databases including CINAHL; Embase; Medline; Pubmed; Scopus and Web of Science; Google Scholar; PROSPERO, Proquest Dissertations; Theses Global; Animal Studies Repository; Medicine and Health Science Commons; Open Gray and a targeted Google search for relevant Australian Guidelines. Database searches had no time limits. Nine documents published between 1990 and 2018 were identified, appraised and subsequently included in the analysis.

RESULTS

Facilities have not developed or implemented core policies; instead, there appears to be a reliance on AAA providers ensuring resident safety. Animal welfare is also identified as an emerging area, warranting further action and policy development.

CONCLUSION

The requirement for effective AAA policies for RACF staff continues to be an area of need. Over the last 30 years, the development of policies guiding the provision of animal activities within RACFs has been inconsistent in both content and application, including the implementation of basic hygiene policies. If the international situation is indicative, further work is needed in Australia to develop and enforce infection control, risk management and animal welfare policies in RACF and AAA organizations.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration # CRD42020150440.