Establishing research priorities to improve the One Health efficacy of Australian general practitioners and veterinarians with regard to zoonoses: A modified Delphi survey

Abstract

While general medical practitioners (GPs) and veterinarians are often the first line responders in the face of a disease outbreak, pathways to improving the One Health efficacy of these clinicians remain unclear. A two-phase modified Delphi survey of professionals with known expertise in One Health (‘expert panel’) was used to 1) identify key knowledge, attitudes and practices (KAPs) of GPs and veterinarians that would be consistent with a One Health approach to zoonoses; and 2) determine priorities for future surveys with Australian GPs and veterinarians to identify important gaps that impede effective diagnosis and management of zoonoses. A list of 13 topics/sub-topics, as well as a list of 25 specific zoonotic diseases/agents emerged from the first phase of the survey. In the second phase the expert panel identified general knowledge of the clinical aspects and epidemiological aspects of zoonoses, as well as risk management practices, as the most important KAPs and research priorities for both GPs and veterinarians. In terms of diseases, the expert panel regarded knowledge of Hendra virus, Q fever, Australian bat lyssavirus (ABLV), anthrax and Brucella suis most important for veterinarians, whilst for GPs, Q fever, gastrointestinal/foodborne diseases, influenza, ABLV and local vector-borne diseases were found to be most important by the expert panel. Some differences were noted in terms of prioritization of topics/sub-topics and diseases/agents according to expert background (veterinary and non-veterinary). The Delphi survey technique enabled efficient collection of data from a diverse range of One Health ‘experts’/specialists and provided clear priorities for proposed future research, and potentially for educational interventions to improve One Health efficacy of clinicians.

What makes an effective One Health clinical practitioner? Opinions of Australian One Health experts

“…Findings from that study enabled identification of a number of priority topics and diseases. Alongside the quantitative findings reported previously [26], experts provided insights with depth and nuance of opinions in open responses that warrant further consideration to progress professional discussion of clinical One Health practice. In this paper we present a thematic analysis of these comments to gain a deeper understanding of the experiences and opinions of Australian One Health experts.…”

“…The methods and objectives for the Delphi survey have been described in detail elsewhere [26]. Members of the expert panel were from a range of One Health backgrounds including veterinarians (50% and 55.3% in Phase One and Two, respectively), medical practitioners, including infectious diseases and public health medicine specialists (17.7% and 14.9%), public health practitioners (17.6% and 14.9%), epidemiologists (7.4% and 6.4%), academics (5.9% and 8.5%) and others (1% and 0%).…”

“…This data was analyzed and 13 topics and sub-topics, including a list of 24 diseases and agents were identified. In Phase Two, participants were asked to rank these in order of importance generating quantitative data which has been previously published [26]. Participants were also given opportunities to provide general comments in both phases.…”

“…Therefore it is imperative they are equipped with knowledge and capacity to effectively respond to these threats, ideally employing a multi-disciplinary response to optimise outcomes [14,[21], [22], [23], [24], [25]]. However, the roles for GPs and veterinarians within the context of One Health are poorly defined and pathways enabling facilitation of interprofessional cooperation and collaboration at the clinical level are unclear [8,15,22,[26], [27], [28]].…”

Penguatan Kebijakan One Health dan Jejaring Laboratorium Dalam Deteksi Dini Leptospirosis di Indonesia

“…Kerjasama dan komunikasi yang baik dari ketiga kelompok tersebut akan sangat mengefisienkan kinerja One Health. 6 Sedangkan untuk membangun kerangka konsep One Health dalam deteksi dini leptospirosis, diperlukan tahapan berikut dengan mengadopsi dari teori prioritas zoonosis menggunakan One Health. 4…”