Using motivational interviewing in veterinarian-farmer communication: towards improved uptake of veterinary advice

Scrase, A., Main, David, Haase, Anne, Roe, Emma, Whay, Becky and Reyher, Kristen (2015) Using motivational interviewing in veterinarian-farmer communication: towards improved uptake of veterinary advice. In Cattle Practice: Part 2: Proceedings of the Congress of the British Cattle Veterinary Association. vol. 23, pp. 203-204 .

Abstract

In the UK dairy industry, lameness and mastitis are endemic diseases. Research indicates that a third of the UK dairy herd are lame at any given time (Barker and others 2010), while, on average, 46 cows per 100 suffer from clinical mastitis each year (Bradley and others 2007). These figures reflect a less than ideal existence for the dairy cow and a huge financial burden for farmers, with average annual costs per farm of £12,000 and £15,000 mastitis and lameness respectively (Dairyco 2015). Despite significant advances in research and identification of key risk factors and management strategies implicit in these disease processes, implementation of changes on-farm still appear to be inadequate (Whay and Main 2010).

Motivating farmers to enact management changes is increasingly the role of the herd veterinarian, whose training and advising of farmers places them at the forefront of knowledge dissemination (FAWC 2011). Whilst veterinarians recognise their influence and the need to be proactive advisors, acting upon this awareness and improving the uptake of recommendations in daily practice is a challenge (Jansen and others 2010a). Two critical barriers to this process can be identified. First, farmer behaviour in controlling lameness and mastitis is complex; ambivalence towards facing these problems is common as a result of practical and psychological considerations. Second, clear communication between veterinarians and farmers is crucial to invoke change, yet research suggests that the skills of veterinarians in this area are limited. In domestic consults, veterinarians rely predominantly on closed questions in data gathering, rarely employ empathetic statements in relationship building and rarely encourage client participation in consultations (McArthur and Fitzgerald 2013, Shaw and others 2004). Communication research within the dairy context is scarce, however Jansen and others (2010b) recorded herd health consults between Dutch cattle veterinarians and farmers (n= 17, mean duration 96 minutes) and found a heavy reliance on closed questions, minimal solicitation of farmer opinion and veterinarian dominance in agenda setting, as suggested by the domestic literature (McArthur and Fitzgerald 2013, Shaw and others 2004). This directive style actually serves to elicit arguments from farmers that favour continuation of existing behaviours instead of supporting change, ensuring that ambivalence prevails and advisory recommendations remain unheeded.
In the medical realm, practitioners similarly report issues of ambivalence and communication impeding progress in helping people make positive health choices. To face these challenges, medics are increasingly employing an evidence-based communication methodology called Motivational Interviewing (MI) (Miller and Rollnick 2013). MI specifically explores and resolves ambivalence to influence the motivational processes that facilitate change. Empirical studies indicate that MI communication outperforms traditional advice-giving in the treatment of a broad range of behavioural problems and diseases, improving client behavioural and medical outcomes (Lundhal and others 2013, Rubak and others 2005). Where ambivalence and clinical communication are acute stumbling blocks for the implementation of positive change in lameness and mastitis management, equipping veterinarians with MI communication skills could facilitate meaningful improvements in how farmers perceive and manage these diseases. In light of this, unique research will be reported here that is the first to investigate the applicability of MI to the veterinary realm, focussing on cattle veterinarian’s communication with farmers.

This project aims to provide a detailed picture of the current advisory and communication strategies employed by UK cattle veterinarians on herd health, especially in relation to lameness and mastitis. Preliminary investigations into this topic are made with a mixed-method methodology that discusses both quantitative and qualitative data collected from veterinarian-farmer communication. First, the language employed in lameness and mastitis consults in role play sessions (n=15, mean duration 11.2 minutes) between cattle veterinarians and an actor (experienced in medical and veterinary education) are quantitatively analysed. Findings from this study are then critically examined through insights from a second study that qualitatively analysed veterinarian-farmer communication during routine consults at UK dairy farms (n=12). This second study involved face-to-face, in-depth interviews with the farmer and the veterinarian, separately, about how they experienced recent communication encounters with one another. The results of this second study offer insight into the practical reality of communicating about disease during day-to-day practices that can help explain the findings of the first quantitative study. Together these two studies reveal new critical insight into what is the nature of, and what influences, veterinary communication with farmers. To conclude the discussion, the potential for MI to be harnessed as a communication methodology by the veterinary profession is appraised, supported by these preliminary data.

This use of MI in the veterinary realm is a novel and as yet unexplored application. It should be of interest to all those in the profession tackling the most critical of challenges: translating veterinary knowledge into meaningful change on-farm.

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Contributors

Author: Emma Roe

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