Use of the Health Belief Model to identify factors associated with owner adherence to elimination diet trial recommendations in dogs

Abstract

OBJECTIVE To use the Health Belief Model to identify factors associated with owner adherence to elimination diet trial (EDT) recommendations by veterinarians for dogs with suspected cutaneous adverse food reactions (CAFRs). SAMPLE 192 owners of dogs prescribed an EDT between April 1, 2012, and April 1, 2017. PROCEDURES Owners of dogs prescribed an EDT to diagnose CAFRs were identified through review of medical records from a single veterinary dermatology specialty practice. Identified owners were invited to participate in an anonymous online survey that was developed on the basis of the Health Belief Model. Multivariable logistic regression was used to evaluate associations between potential predictor variables and 100% adherence to EDT recommendations. RESULTS 665 owners were invited to participate, and 192 (28.9%) completed the survey. Of the 192 respondents, 77 (40.1%) reported 100% adherence to EDT recommendations, and 115 (59.9%) reported < 100% adherence. Results indicated that the odds of owners reporting 100% adherence to EDT recommendations were significantly decreased by owner perception of barriers (adjusted OR [ORa] = 0.86) and were significantly increased by owner knowledge regarding diets and CAFRs in dogs (ORa = 1.30) and by self-efficacy or confidence in performing an EDT as directed (ORa = 1.18). CONCLUSIONS AND CLINICAL RELEVANCE Findings indicated that most prescribed EDTs were not followed strictly. Interventions to help owners reduce perceived barriers, increase self-efficacy, and improve related knowledge could improve adherence to EDT recommendations and, thereby, increase the diagnostic utility of EDTs.

Impacts of COVID-19 on Owner's Veterinary Healthcare Seeking Behavior for Dogs With Chronic Conditions: An Exploratory Mixed-Methods Study With a Convenience Sample

“…Our findings show that urgency to seek care for chronic conditions is driven primarily by the strength of relationship with a dog and HBM constructs. Previous studies utilized the HBM in exploring factors related to seeking healthcare focused primarily on seeking vaccinations and preventative care (33,34,74). Our study shows that HBM constructs are useful in predicting healthcare seeking for chronic health issues.…”

“…Strong associations between the behavior of seeking care and score on the urgency to seek care shows that owners who report high urgency on hypothetical scenarios likely apply a similar rule when deciding if their dog needs to seek care in real life. Self-efficacy to seek care was identified as an important predictor of seeking veterinary care in other contexts, such as adherence to elimination diet trial (74), showing that improving dog owners' health literacy, i.e., dog owner's ability to seek, evaluate, and apply knowledge regarding dog health, could increase their engagement with veterinary care. Changes in how care was delivered and difficulties in accessing care for nonemergency conditions identified in the qualitative analysis could lead owners of dogs with chronic health conditions to delay seeking care, reflected here.…”

A pilot study to identify perceived barrier and motivating factors of primary veterinarians in the USA for specialty referral and management of atopic dermatitis with allergen‐specific immunotherapy

“…Although there is a relative scarcity of similar studies within veterinary medicine, some have investigated the differences in patterns of adherence to immunotherapy. 15,16,18 The human medical field has long recognized the need to scrutinize clinician and patient factors in order to smooth out the referral process and make certain therapies more readily available to patients. [12][13][14][19][20][21][22][23] Findings from studies such as these have been used to improve the specialist-generalist relationship, provide better continuity of care and ensure better patient outcomes.…”

“…13 Physicians have long recognized the need to investigate perceived barriers to referral and specialized treatment which can include specialty services with restricted provider networks, inconvenient office hours, and difficulty in getting an appointment quickly. [14][15][16] To the best of the authors' knowledge, specific factors impacting referral to specialized veterinary medicine have not been evaluated in the veterinary dermatology subset. The objective of this pilot survey study was to establish the presence of and further characterize specific factors which could impact primary veterinarians' decisions to consider specialty referral or to offer allergen-specific testing and immunotherapy.…”

Diagnosis and management of adverse food reactions in dogs and cats

“…Given that there are no reliable diagnostic tests to confirm AFRs in dogs and cats, the only way to establish a diagnosis is to perform a strict diet trial. In one study, it was reported that only 40 per cent of 192 pet owners followed an elimination diet trial with 100 per cent adherence (Painter and others 2019). For this reason, it is vital that pet owners are well informed and motivated to perform these trials.…”