Abstract
Dog walking is beneficial to dogs and their owners, and it supports One Health, an initiative devoted to improving the health of animals and humans. Despite the benefits of dog walking, many dogs and their owners are not engaging in adequate dog-walking exercise. One way to encourage dog walking is for veterinarians to counsel owners on dog walking during veterinary appointments. This pilot study used individual in-person or telephone interviews to understand veterinarians' perceptions of and experiences with counseling about dog walking in companion animal practice. Seventeen veterinarians licensed to provide canine care in Ontario participated in an interview in 2015. Thematic analysis was used to analyze the interview transcripts. Participants thought dog walking was important for both dogs and owners and discussed physical, social, and mental benefits of dog walking. Participants described barriers to dog-walking counseling including dog owners' lack of compliance or physical condition, dogs' behavior, and lack of time or low priority during appointments. Also, participants discussed how dog walking was not addressed in their professional veterinary education. These findings can be used to educate veterinary students and practicing veterinarians on the value of dog walking for people and dogs and the barriers they may face when counseling clients about dog walking.
Daily dog walking is important for the overall general health of dogs.1 There are benefits among dogs associated with dog walking that include weight loss, weight maintenance,2 and reduction in problem behaviors.3 To support a dog's need for regular exercise, it is recommended that dogs be walked 2–3 times per day.4 Physical activity is also important to living a healthy lifestyle among humans and helps reduce the risk of many chronic diseases.5 It is recommended that adults accumulate 150 minutes of moderate-intensity physical activity in bouts of at least 10 minutes throughout the week.6 Dog walking can benefit both humans and dogs as it provides an opportunity for them to be physically active together. Dog owners and regular dog walkers are more likely to meet these physical activity recommendations compared to non-dog-owners and non-dog-walkers.7 The mutual benefit of dog walking for humans and dogs supports the role of dog walking in the worldwide initiative of One Health, an initiative devoted to improving the health of animals and humans.8
Veterinarians estimate that approximately 55% of companion dogs do not receive adequate exercise to promote good health, which may be contributing to their rising incidence of overweight and obesity.9,10 Canine obesity is associated with several adverse health effects including a reduction in lifespan, an increased risk of disease,.11,12 cancer,12 and diabetes.13 Overweight and obesity in companion dogs are often associated with human management, specifically caused by an excess intake of energy or inadequate exercise.9,10
Like rates of canine overweight and obesity, rates of overweight and obesity among human adults have continued to rise in Canada over the past 5 years, and 54% of Canadian adults are overweight or obese.14 Only 15% of the Canadian adult population is meeting the physical activity recommendations,15 which may be a contributing factor in the rise in obesity rates. Overweight and obesity are associated with the risk of health conditions such as high blood pressure, stroke, type-2 diabetes, metabolic syndrome, and certain types of cancer.16 Overweight and obesity in humans, as in dogs, are often associated with diet and physical activity, specifically the imbalance of calorie intake and calorie expenditure via exercise.17
Regular daily walking is one approach to increase the level of exercise among dogs11 and their owners,18 which can promote their overall health and help reduce the incidence of overweight and obesity.17,19 Despite the mutual benefits of dog walking, a large percentage of dog owners do not walk their dog regularly (only 59% of dog owners walk their dog).7
One way to encourage dog walking for the benefit of animals and human health is for veterinarians to discuss and promote dog walking with owners during veterinary appointments. The average dog visits a veterinarian 2.6 times per year with their owner,20 which presents the opportunity for veterinarians to play an important role in discussing and promoting dog walking with owners. In addition, veterinarians have an important role in positively influencing both dogs' and humans' physical activity levels by providing specific counseling related to dog walking.21,22
To further support veterinarians in advising and promoting dog walking during veterinarian-client-dog interactions, a current understanding of veterinarians' perceptions of, experiences with, and barriers to counseling veterinary clients about dog walking is important. With this understanding, strategies can be developed to better position veterinarians to be involved in the promotion of dog walking. Constructs from the Integrated Model of Behavioral Prediction (IMBP), a behavior change theory, are relevant and useful for providing a framework to explore and better understand veterinarians' perceptions, experiences, and barriers related to counseling pet owners about dog walking. The IMBP has been used to predict and understand behavior within other health professions.23 The IMBP has previously been used to understand and predict adherence to post-operative treatment after weight loss surgery,24 the effects of sexual content on television on sex-related behaviors and cognitions among adolescents,25 condom use behaviors among those at high risk for HIV,26 and the behavior of health professionals.27
The core construct of the IMBP is behavioral intention (one's readiness to engage in a specific behavior) which, in turn, predicts behavior.28 This theory suggests that there are three main constructs that directly influence intention: attitudes (one's attitude toward engaging in a behavior), norms (the normative influence or social pressure that one feels toward performing a behavior), and self-efficacy (the belief that one has the necessary skills and abilities to perform a behavior).28 Secondary constructs that influence intention are external barriers (constraints that may influence an individual's performance of a behavior) and skills and abilities (skills and capabilities that an individual has that may influence his or her performance of a behavior).28 In addition, there are background factors such as behavior and demographics that indirectly influence behavior.28
To our knowledge, there have been no studies examining veterinarians' perceptions or their counseling behaviors regarding dog walking. The purpose of this qualitative pilot study was therefore to understand veterinarians' perceptions, counseling behaviors, and barriers related to the promotion of dog walking within veterinarian-client-dog interactions using constructs from the IMBP, specifically behavior, attitudes, norms, self-efficacy, external barriers, and skills and abilities.
The authors' university provided ethics clearance for the study and written consent was obtained from all participants.
In this pilot study, eligible veterinarians from four cities in southern Ontario (Kitchener, Cambridge, Waterloo, and Guelph) were recruited using an online veterinarian database.a This database provides the name, address, phone number, patient group (e.g., companion animals) and patient type (e.g., dogs) for practicing veterinarians in Ontario. The database has a filtered search option, which was used to identify veterinarians in the four cities who met specific criteria. To be eligible for participation in the study, veterinarians had to be practicing with a general class license and providing veterinary care to dogs according to the College of Veterinarians of Ontario. Eligible participants were then randomly selected for contact using a website that generates random numbers.b The sampling frame was 140 eligible veterinarians. Initially, 80 veterinarians from the sampling frame were randomly selected and invited by letter, and subsequently by phone, to participate in the study. The final sample consisted of 17 veterinarians.
Individual face-to-face or telephone interviews were conducted with veterinarians. The interviews were conducted using a qualitative, semi-structured interview guide and ranged from 30 to 45 minutes in duration. Then participants completed a questionnaire to provide their background characteristics, which were used to describe the sample and as contextual information. Participants were also asked if they could recommend additional veterinarians to the study, which supported recruitment via snowball sampling. Participants were given a $20 Starbucks gift card as a token of appreciation at the end of the interview.
First, the questionnaire included questions about participants' gender, veterinary college attended, and year of graduation from veterinary college. Second, the questionnaire included one general question about dog ownership and four additional questions about dog-walking habits, which were adapted from the International Physical Activity Questionnaire—Short Form (IPAQ- SF). The last four questions were used to determine if dog-owning participants walk their dog, and if so, the frequency and duration of their dog walking. Dog-owning participants were asked to recall how many days in the last week (i.e., the past 7 days) that they had walked their dog for at least 10 minutes and the total duration of dog walking on one of those typical days. In addition, dog-owning participants were asked how many days in the last week that they engaged in moderate-intensity dog walking and the duration of dog walking on one of those typical days. Moderate-intensity dog walking was defined as activities that take moderate physical effort and make the owner breathe somewhat harder than normal. Finally, the questionnaire included six questions from the IPAQ-SF to estimate participants' physical activity level. They were asked to recall the number of days and duration of time engaged in walking, moderate-intensity activities, and vigorous-intensity activities for at least 10 minutes at a time during the last 7 days. The IPAQ-SF has acceptable psychometric properties compared to other self-reported physical activity measures.29
A semi-structured interview guide (Table 1) was used in this pilot study. The interview questions were developed to examine constructs from the IMBP. To understand the participants' behaviors and perceptions, the following main constructs in this model were addressed: behavior (whether and how participants talk to owners about dog walking), attitudes (the importance and benefits of dog walking), perceived norms (norms regarding dog owners and other veterinarians), external barriers (barriers that participants experience when talking to owners about dog walking), self-efficacy (participants' confidence in talking to owners about dog walking), and skills and abilities (training that participants received regarding counseling owners on dog walking). The interview guide and the questionnaire for participants' background characteristics were tested in a preliminary study with two veterinarians who are faculty employed at the Ontario Veterinary College (OVC) at the University of Guelph. Positive feedback was given regarding the interview guide, background questionnaire, and interview process, and therefore no revisions were made. Data collected from this preliminary study were excluded from the pilot study because both participants worked at the OVC, where they were involved with teaching veterinary students; therefore, their interviews were considered not representative of veterinarians in day-to-day general practice.
|
| Theoretical construct | Interview question |
| Behavior | 1. Can you tell me about your approach to talking to clients about dog walking? |
| 2. I appreciate that this can be challenging as a veterinarian, but I am interested in how you have advised dog owners with overweight or obese dogs. Can you tell me about the advice or counseling you have given to the owner of an overweight or obese dog? | |
| Attitudes | 3. In your opinion, is it important for owners to walk their dogs? (probe further) |
| 4. Can you tell me about some of the benefits of dog walking? | |
| External barriers | 5. What are some of the challenges you may face when discussing dog walking with clients? |
| 6. Can you tell me about some of the circumstances or situations where you may feel uncomfortable or hesitant to discuss dog walking with clients? | |
| 7. Are there any circumstances where you would be more inclined to discuss dog walking with clients? (probe further) | |
| Norms (regarding dog owners and other veterinarians) | 8. Do you think other veterinarians promote or discuss dog walking with their clients? (probe further) |
| 9. In the veterinary profession, what do you feel are the expectations of you to discuss dog walking with dog owners? | |
| Self-efficacy | 10. Can you tell me about your confidence in discussing dog walking with dog owners? (probe further) |
| 11. Can you tell me more about where this confidence comes from? | |
| Skills and abilities | 12. Can you tell me about some of the training that you may have received regarding counseling dog owners on dog walking? |
The interviews were recorded on audio. Audio recording allowed the researchers to use constant comparison when transcribing the data to confirm that the transcripts were accurate before analysis began..30,31
Statistical softwarec,d was used to analyze the quantitative data from the background questionnaire. To estimate participants' physical activity level, scores were calculated for each participant for walking, moderate-intensity activity, vigorous-intensity activity, and total activity32 using metabolic equivalent (MET) values (i.e., values that indicate the energy expenditure of specific activities; for example, sitting is a 1-MET activity)33 and frequency and duration for each activity, and these values were then expressed as MET minutes per week. These scores were then used to categorize each participant's activity level as low, moderate, or high, using the IPAQ data analysis guidelines.32
The interviews were transcribed verbatim by three members of the research team (KB, GT, and SW), and each transcript was compared to the audio recording and reviewed by the first author to ensure accuracy.34 Qualitative data analysis softwaree was used to manage this qualitative data. Thematic analysis that entailed open coding, axial coding, and selective coding was used. Three of the authors (KB, GT and SW) first performed open coding, which involved creating and assigning preliminary themes in the margins of the transcripts.35 Open coding is a form of memoing which adds to the credibility and the trustworthiness of qualitative research as it provides records of the meaning that is derived from the data.36 Second, the three authors performed axial coding, which involved reviewing preliminary themes to identify new themes, merge themes and identify connections among themes. At this stage, a summary of the study results was sent to participants inviting them to comment on whether these themes captured the information that they shared in the interview. Third, the first author used selective coding to further collapse themes and select quotes to represent the themes.35 Despite the small sample size, data saturation was reached as no new data were uncovered and little to no changes were made to the themes when the final transcripts were being analyzed. Analyst triangulation is the use of multiple sources to understand and analyze data and, here, it refers to the use of three authors to review and analyze the data.37,38 Analyst triangulation establishes data credibility and strengthens the quality of the data by ensuring it is comprehensive and well developed.37,38
Of the 17 veterinarians who participated in this pilot study, 11 were randomly sampled and 6 were recruited by snowball sampling. Participants' background characteristics are presented in Table 2. Most participants were female (94.1%) and dog owners (88.2%). All participants were OVC graduates, and 47.1% of participants graduated between 2010 and 2013. Of the 15 participants who were dog owners, all of them reported walking their dog. They reported walking their dog for a median of 6.0 days in the last 7 days with a median duration of 30.0 minutes on a typical day. Also, they reported walking their dog at a moderate-intensity level for a median of 4.5 days in the last 7 days, with a median duration of 30.0 minutes on a typical day. The percentage of participants reporting moderate or high levels of total physical activity was 82.3%.
|
| Characteristic | n | % or median (minimum, maximum) |
| Gender | 17 | |
| Male | 5.9% | |
| Female | 94.1% | |
| Veterinary college attended | 17 | |
| OVC | 100% | |
| Year of graduation from veterinary college | 17 | |
| 1986–1989 | 11.8% | |
| 1990–1993 | 5.9% | |
| 1994–1997 | 0% | |
| 1998–2001 | 5.9% | |
| 2002–2005 | 17.6% | |
| 2006–2009 | 11.8% | |
| 2010–2013 | 47.1% | |
| Own a dog | 15 | 88.2% |
| Walk their dog | 15 | 100% |
| Average amount of dog walking during the last 7 days | 15 | |
| Days of dog walking | 6.0 (1, 7) | |
| Time spent dog walking on a typical day (minutes) | 30.0 (20.0, 90.0) | |
| Average amount of moderate-intensity dog-walking during the last 7 days | 15 | |
| Days of moderate-intensity dog-walking | 4.5 (0, 7) | |
| Time spent in moderate-intensity dog-walking on a typical day (minutes) | 30.0 (0, 45.0) | |
| IPAQ-SF (total physical activity level) | 17 | |
| Low | 17.6% | |
| Moderate | 29.4% | |
| High | 52.9% |
Percentages may not add up to 100 due to rounding.
Most participants described how dog walking is not a typical discussion during routine veterinary appointments and that they commonly counsel dog owners on dog walking when the dog owner initiates the conversation. For example, participant 11 said, “Unless [dog walking] is brought up directly to me, it's not usually a normal talking point for routine exams.”
Most participants identified specific situations in which they discussed dog walking with dog owners. These situations related to the current physical condition of the dog and the behavior of the dog. In terms of the current physical condition of the dog, just over half of participants talked to dog owners about dog walking only when a dog presents with an obvious, overt health issue that is affecting the animal's physical activity. Participants discussed not talking about dog walking with owners when the dog appears healthy and when there are no health concerns for the dog. For example, participant 15 said, “In a general health exam or vaccine appointment, if the dog is young, healthy and fit, I probably wouldn't bring [dog walking] up.”
Overweight and illness were two physical conditions that participants indicated had an influence on their discussions about dog walking. First, many participants reported talking about dog walking specifically if the dog appears to be overweight or if the dog has a body condition score classified as overweight or obese. Participant 16 said, “The only time that [dog walking] comes up is when you have a dog that is overweight and we're trying to come up with some kind of weight loss plan.” As a first step in approaching overweight or obesity to gain client buy-in, many participants discussed the importance of dog owners being aware that their dog is overweight or obese. Participants often talked about doing a body condition assessment in appointments and how they use this to help owners understand that their dog is overweight. For example, participant 4 said, “Sometimes it's hard to get [the owners] to accept that their dog is overweight… So I do body condition out of five and I tell them where their dog stands.”
Many participants stated that the behavior of the dog influences discussions of dog walking in routine veterinary appointments. They are more inclined to talk about dog walking with an owner when a dog has behavioral issues. For example, participant 6 said, “A lot of behavioral issues stem from lack of getting that energy out. They need that energy outlet, so if I hear behavioral issues, then that [dog walking] is kind of my first go-to.”
Most participants perceived dog walking as an important part of dog ownership. For example, participant 6 said, “I think [dog walking] is a huge aspect of owning a dog, absolutely.” In contrast, a couple of participants perceived that dog walking is not always important. They commented that dog walking is not important for all dogs and that other forms of exercise can be beneficial. To illustrate, participant 1 said, “I think it depends on the dog. I think there are some dogs that are quite happy to get played with and go out in the yard. If they never went for a walk, they would not miss it.”
Participants elaborated on their perceived benefits of dog walking. Three major themes were identified: bonding, benefits for the dog, and benefits for the owner. Many participants discussed how dog walking promotes bonding between the dog and the owner as it is a time for the owner and dog to spend together. For example, participant 11 said, “I think [dog walking] strengthens the bond between the owner and the pet.”
Participants commented that dog walking has many benefits for the dog, including physical, social, and mental benefits. First, many participants described the physical benefits that dog walking can have for the dog. Some physical benefits include weight management, maintained functionality, and disease-risk reduction (e.g., arthritis). For example, participant 7 said, “From a health perspective, keeping good lean body mass and keeping the right weight and keeping good muscle. Muscle is so important in preventing arthritis and keeping bone structure the way it should be.” Participants also discussed weight loss, improvements to general health, longevity, and injury prevention as benefits of dog walking. For example, participant 15 explained, “If [dogs] are moving, then they're keeping their joints healthy and they're maintaining muscle mass… We want them to live long and taking them for walks means they get to live longer.” Second, many participants also discussed the social benefits that dog walking has for the dog. They often identified the social interactions with other dogs and other people as benefits of dog walking since it provides the opportunity to socialize a dog with other people and dogs. For example, participant 9 stated, “[There is] interaction with other animals, and there is the social interaction of the dog with other people.” Third, many participants discussed the mental benefits that dog walking provides for the dog. Participants highlighted how dog walking can benefit the dog's behavior and help to prevent behavioral issues by providing stimulation and an energy release. For example, participant 1 said, “There are a lot of high-energy dogs that really benefit emotionally, for their well-being, from [dog-walking] exercise.” Participant 13 commented, “I've learned that exercise can solve a lot of behavior problems. A tired dog is going to chew less, do less destruction in the house.”
Participants additionally highlighted that dog walking can benefit the owner. They discussed the physical and social benefits that are associated with dog walking for the owner. First, the majority of participants talked about how dog walking provides the opportunity for owners to go outside and get exercise. For example, participant 4 said “For the person, getting out of their house, getting fresh air and getting exercise.” Second, many participants discussed the social benefits for the owner. They discussed how dog walking can encourage relationships between dog owners and other people including neighbors, family, and other dog owners. For instance, participant 5 said, “You get out there walking, and you meet your neighbors, and you can build relationships from there. I think it's a very good way to build a sense of community in your neighborhood as well.”
Many participants perceived that other veterinarians discuss dog walking with their clients in a similar capacity to themselves, which relates to descriptive norms (i.e., the perception that other veterinarians are doing the behavior). For example, participant 18 said, “We do definitely talk [about dog walking] because I know the veterinarians here [at this clinic] all share a similar viewpoint [on dog walking].” Participant 14 also explained, “There has been a move towards preventive medicine in the last 15-20 years in veterinary medicine, so I think [dog walking] is a much more common thing than maybe it would have been.” Many participants discussed that dog owners do not have expectations that their veterinarian talk about dog walking, which relates to injunctive norms (i.e., the perception that others think you should or should not engage in the behavior). To illustrate, participant 4 said, “I would say that people sometimes seem surprised that I bring up anything other than the medical and the nutrition side of things. [Dog-walking recommendations] wouldn't be something coming from us. That would be more from a dog trainer or from someone else, but not from the veterinarian.”
Three themes were identified when participants were asked about the challenges they face when talking to dog owners about dog walking: owner-related barriers, dog-related barriers and barriers of time and priority in appointments.
Participants described several owner-related barriers that they experience when talking to dog owners about dog walking. First, many participants discussed that a dog owner's busy schedule is a barrier when talking to them about dog walking. For example, participant 2 said, “[Dog owners] are pretty much as busy as they can be and they don't tend to have time or necessarily the energy to get out more with their dog, or even get out maybe as much as they should.” Second, some participants described that dog owners' lack of compliance with dog-walking recommendations is a challenge for them when talking about dog walking. For instance, participant 8 said, “I think the biggest challenge is the follow-through. People will put things off, and I find the follow-through is the hardest part.” Third, most participants described how the physical condition of the dog owner makes the discussion of dog walking more difficult. One situation where the discussion of dog walking is difficult is when owners have a physical disability that affects their ability to walk. To illustrate, participant 7 identified difficulty “if owners are either unfit or if they are unwell,” observing, “And you get people with disabilities that actually can't walk.” Another situation where participants indicated discussions of dog walking were complicated was when the owner appeared to be overweight or obese. For instance, participant 3 explained, “[It is] when [dog owners] are obese themselves. Absolutely, that's always a difficult conversation.”
Some participants described dog-related barriers as a challenge when talking to owners about dog walking. For instance, participant 15 said, “The behavior of the dog on the walk can be a huge [challenge]. I have dogs who are leash-aggressive, or aggressive toward other dogs.” Participant 11 also said, “The biggest challenges that come to mind are that the dog is really difficult to walk, a really big puller, or just really bad on leash.”
Some participants reported that time and priority pressures in appointments make their ability to have conversations about dog walking more difficult. For example, participant 5 said, “Time is a big factor in whether something like walking your dog gets talked about.” Some participants described dog walking as a low priority in appointments. For example, participant 13 said, “In an appointment when there are a lot of things on the table, it [dog walking] will be less of a priority because we're working on other things.”
Most participants described having a high level of confidence related to talking about dog walking with dog owners. For instance, participant 2 said, “I have pretty good confidence that my [dog-walking] recommendations are appropriate and accurate.” Most participants described that this confidence originates from their personal experiences. They discussed how their own previous or current dog ownership has positively influenced their confidence in talking to dog owners about dog walking. To illustrate, participant 11 said, “I have a dog myself, and I've had dogs for a while, so I'm fairly confident.” Alternately, some participants expressed that they have a low level of confidence when talking to owners about dog walking. For example, participant 13 said, “I'm less confident in talking about exercise than about nutrition… I'm a little worried about my ability to promote [dog walking] and to make specific safe recommendations.”
When discussing skills and abilities, participants focused on their knowledge to counsel about dog walking. Most participants described that their professional veterinary education did not include talking to dog owners about dog walking. They discussed that their formal education did not provide the knowledge to discuss dog walking with dog owners or to make dog-walking recommendations. For instance, participant 16 said, “I don't know if I have ever been taught about the right [dog-walking] recommendations, about what [dog-walking recommendations] people are expecting, or the benefits of such recommendations… I would say formally in the education aspect, at least through four years of school, I have probably received very little [training on dog walking].”
Many participants described how their knowledge about dog walking comes from personal experience. They discussed that their personal experiences from owning a dog and their professional experience as a veterinarian both contribute to their knowledge and abilities to discuss dog walking. For instance, participant 4 stated, “[My dog-walking knowledge] has all been based on my own experiences, talking to other people, and I have a dog myself.”
To our knowledge, this is the first study to explore veterinarians' perceptions of and experiences with counseling about dog walking. The IMBP was used to examine specific constructs to better understand veterinarians' behavior regarding dog-walking counseling during veterinarian-client-patient interactions. The findings of this study provide information regarding veterinarians' approaches to discussing dog walking with dog owners, their beliefs about dog walking, and their norms, barriers, self-efficacy, and skills and abilities related to talking to owners about this topic.
Participants reported discussing dog walking when the dog presented as overweight or obese or when the dog had an illness or injury. This result suggests that discussions of dog walking may be prompted by canine health conditions that may benefit from walking, as it can positively influence weight2 and assist in the recovery and treatment of illnesses or injuries.39 Participants also described how they were more inclined to discuss dog walking when the dog exhibited certain behavioral issues. This inclination may be explained by the positive role that dog walking has on behavior, as it can help prevent destructive behavior and reduce problem behaviors.3,40,41
Regarding the benefits of dog walking, participants discussed the mutual benefits for the dog and the owner, including human-animal bonding. Previous research supports this, as dog walking can enhance the health of both the dog and the owner by increasing their physical activity levels,42 and it also presents an opportunity for the dog and owner to bond. Second, participants identified weight management, weight loss, maintained functionality, disease-risk reduction, and improvements to general health as some of the physical benefits of dog walking. These physical benefits for the dog are highlighted in other research that shows that dog walking can help promote weight loss and weight maintenance2 and improve physical activity level,21,22 which, in turn, may help to reduce osteoarthritis11 and other diseases.13 Third, participants also highlighted the social benefits of dog walking for dogs, which include social exposure to other dogs and other people. These benefits are supported by the suggestion that dog walking encourages socialization and enjoyment, which can enhance a dog's quality of life.43 Lastly, participants discussed the mental benefits for dogs, specifically emphasizing that dog walking can positively influence the dog's behavior. This is reported in other research that indicates that dog walking can help reduce and prevent destructive and aggressive behavior.3 By routinely promoting dog walking during veterinarian-client-dog interactions, veterinarians have an opportunity to improve the health and welfare of their canine patients.
Participants also described how dog walking can promote physical activity among owners. Research on the human benefits of dog walking suggests that dog walking can help owners be physically active and may assist them in meeting the daily physical activity recommendations.7,18 This is important because participants in the current study recognized the benefits of dog walking to the owner and that they have the opportunity to improve the health and well-being of humans through specific dog-walking counseling.22 This highlights the role that veterinarians have in enhancing the health of humans and animals alike and further engages veterinarians in their One Health role through dog-walking counseling.8 Although participants recognized the mutual health benefits of dog walking for owners and their dogs, the results of the current study suggest that this is not a reason that veterinarians currently counsel owners about dog walking. Currently, it appears that for participants in this pilot study, dog walking is only discussed in situations where it directly impacts the dog's health (i.e., overweight and injury). This is likely due to the barriers to dog-walking counseling that veterinarians face, such as time constraints and topic priorities within day-to-day veterinary appointments. Therefore, the veterinary profession, including veterinary education, may find value in considering veterinarians' role in counseling dog owners about the human and animal health benefits of dog walking.
In addition, participants in the current study commented that dog walking encourages dog owners to interact and develop relationships with other dogs and people. Other research supports this, as dog owners often meet, socialize, and develop relationships with other pet owners while walking their dogs.44 Veterinarians can use this information to promote dog walking as an opportunity for dog owners to meet other dog owners and to promote social facilitation within their communities.
Participants in our sample perceived that other veterinarians discuss dog walking with dog owners in a similar way to themselves. This is important because, according to the IMBP, participants may be more likely to discuss dog walking if they perceive that other veterinarians do so as well.45 However, participants also perceived that dog owners do not have expectations that their veterinarian discuss dog walking. This may be because veterinarians have many responsibilities (e.g., giving vaccinations, administering medication, and performing surgeries), and owners may not recognize or expect that veterinarians are responsible for providing information on exercise and dog walking.46 This lack of expectation from dog owners may deter or put less of a priority on discussions of dog walking.45 Veterinarians may be more inclined to have these discussions if owners are expecting to talk about dog walking during their appointments.45 Dog owners may not view dog walking as a physical activity for themselves or their dogs, and veterinarians can play an important role in raising this awareness as they can promote dog walking as a form of exercise for both the dog and the owner. One way to increase these expectations is for veterinarians to make owners aware of accurate recommendations and advice on dog walking.
Participants identified that owners' busy schedules, their lack of compliance to dog-walking recommendations, and their physical conditions were barriers when discussing dog walking. First, participants said that owners' busy schedules were a barrier. This is not surprising, as lack of time is a major barrier in general to dog walking that owners face,47 which can negatively affect their dog-walking habits. Second, a lack of compliance to dog-walking recommendations is likely because there may be several barriers to dog walking for owners (e.g., the weather; the dog's behavior),48 and it may be difficult for veterinarians to address these barriers and positively influence dog-walking routines.47 Owners may also not understand the many benefits that dog walking has for the health and well-being of their pet, which may contribute to their lack of compliance. Third, participants commented that it is challenging to discuss dog walking when owners have a disability or appear overweight or obese. Perhaps participants in this study may have viewed owners' disabilities as a barrier because these conditions may impact their mobility and therefore potentially their ability to walk their dogs. Also, participants may perceive that owners without mobility issues may be more capable of walking their dogs. This is supported by research that found that dog walkers scored higher on objective mobility measures, as they had faster normal and rapid walking speeds compared to non-dog-walkers.49 Related to overweight and obesity, studies using longitudinal, objective,50 and cross-sectional self-report49 measures of owners' heights and weights showed that normal weight is associated with dog walking and that obese owners were less likely to walk their dog.49,50 This research suggests that a dog owner's mobility50 and normal weight49 are positively associated with dog walking, while dog-owner obesity is negatively associated with dog walking.50 It may therefore be difficult for veterinarians to discuss and promote dog walking among owners with disabilities or who appear to be overweight or obese, as they may be less able or willing to walk their dogs.49,50 Drawing attention to some of the barriers that veterinarians may face in relation to talking to dog owners about dog walking provides an opportunity to explore strategies to overcome these barriers and better promote dog walking among a broader population of dog owners. For example, to address owners' busy schedules, veterinarians may provide advice and tips on how to incorporate dog walking into their busy schedules. Also, to discuss dog walking with an owner with mobility issues, veterinarians can provide owners with alternative exercise suggestions (e.g., playing fetch, paying a dog walker) or suggestions for shorter and more frequent walks. Regarding discussing dog walking with obese clients, veterinarians can sensitively introduce the topic by asking clients for permission to discuss the topic and then promote dog walking by highlighting the value of exercise to the health and well-being of their pet.
Participants described dogs' behavior, specifically inter-dog aggression and reactivity on a leash, as a dog-related challenge when talking to dog owners about dog walking. This may be expected because these types of behavioral problems are barriers that dog owners can face when walking their dogs,43 and they can cause owners to be nervous or hesitant, which can negatively influence dog walking.48 The management of aggression toward other dogs and reactivity on leash can also be complicated, which further supports that these issues can make discussions of dog walking difficult for veterinarians.48 Although participants identified dog behavior as a barrier, they were also more inclined to discuss dog walking as a strategy for managing dogs with certain behavioral issues. This is likely because, although there are some canine behaviors that complicate dog walking (e.g., aggressive behavior), there are other situations when dog walking is a solution (e.g., destructive behavior). It is suggested that veterinarians inquire about why dog owners walk or do not walk their dog to gather information and to provide recommendations related to inter-dog aggression and dog walking. It is also important for the veterinarian to highlight the value of dog walking for both the animal and the owner and work with the client or refer the client and their dog to other resources to work on behavioral modification as required.
Participants identified that time constraints during appointments make conversations about dog walking more challenging. Lack of available time has been recognized as a barrier for veterinarians when communicating with clients, since it can prevent them from adequately addressing all topics during an appointment.51 Research involving other health professionals, specifically physicians, suggests that having limited time during an appointment is a barrier when providing physical activity counseling to patients.47,52 Participants in the current study also stated that discussing dog walking with owners is sometimes a low priority. This may be because owners and their dogs visit their veterinarian for a specific reason, for example regarding a health concern or a check-up, and there may not be enough time during the appointment to discuss topics related to health promotion such as dog walking. Veterinarians and veterinarian technicians may overcome this barrier by providing dog owners with additional resources and take-home handouts about dog walking to reduce the time needed during an actual veterinarian-client-dog interaction. This strategy would provide the veterinarian with an opportunity during the appointment to highlight the importance of dog walking to the health of the owner and their dog and to provide additional information resources that the client could access outside the appointment.53
Most participants described having a high level of confidence related to talking to owners about dog walking, confidence that came from their own personal experience of dog ownership. Confidence is positively related to intention to perform behavior, and veterinarians with higher levels of confidence related to dog-walking counseling may be more likely to discuss dog walking with owners.45 Participants in our study said that their professional veterinary education did not adequately teach them about talking to dog owners about dog walking. This may present an opportunity for veterinary colleges to incorporate more training to educate their students on dog-walking counseling and to highlight the positive impact that dog walking can have on human and animal health alike. The reported lack of formal training related to dog walking can also be addressed among current veterinarians through continued education programs for both veterinarians and veterinarian technicians. These continued education programs can include content such as the benefits of dog walking and strategies to overcome barriers to dog-walking counseling. Practicing veterinarians may also benefit from evidence-based recommendations on counseling dog owners on dog walking. This presents an opportunity for future research, as there are currently no such recommendations. Participants in the current study primarily discussed having the skills and abilities to talk about dog walking through their own personal experiences with dog ownership and their own professional experiences as veterinarians. This is promising because possessing the skills and abilities to talk about dog walking may positively influence these discussions with owners.45 Although many participants identified that they had the skills and abilities to talk about dog walking, a few participants said that they did not possess these skills. Similar results have been found in other research on physical activity counseling, as low confidence51 and lack of knowledge or training47 have been identified as barriers to physical activity counseling among primary care human healthcare providers. According to the IMBP, past behavior is a background variable that indirectly influences behavior.45 In the current study, participants' past personal and professional experiences may positively influence their confidence, skills, and abilities, and their intentions in turn. This highlights the role that these experiences may have on dog-walking counseling among practicing veterinarians.45 Despite the positive role that these experiences may have, not all veterinarians may have adequate personal and professional experiences to positively influence their counseling habits.
A strength of this study is the use of theory, specifically the IMBP, to structure the questions in the interview guide. The IMBP is a behavior change theory used to predict, understand, and modify behavior.45 The sample of 17 participants was small and was obtained from a limited geographical region in southern Ontario. The sample size in this study is supported by work suggesting that as few as 12 interviews may be required for data saturation.54 In addition, a sample of 20 participants or fewer is advantageous when conducting thorough interviews to establish rapport and to gather comprehensive data.55 As a limitation, the sample was relatively homogeneous, as the gender distribution in our sample was 94.1% females, as compared to 66.4% females in our sampling frame. In the current pilot study, all participants graduated from the OVC, which is not surprising as it is the only veterinary school in Ontario. Almost half of participants graduated between the years of 2010–2013, which suggests that our findings in this sample may be more reflective of recently trained veterinary veterinarians, and perhaps more established veterinarians have different perceptions and behaviors related to dog walking and dog-walking counseling.
This study was conducted with currently practicing veterinarians in the field, and our results reflect the current perceptions and behaviors of these participants related to dog walking and dog-walking counseling. Since only 33% of Canadian households own a dog, our sample had much higher rates of dog ownership than the Canadian population.56 This is likely because our sample consisted of veterinarians, whose careers are dedicated to maintaining and improving the lives of animals, and they may be more likely to own a pet than the average Canadian.
Several other areas for future research are suggested. Future research should examine methods to overcome the barriers that veterinarians encounter when discussing dog walking with owners. Given the importance of physical activity to human and animal health and the low cost of dog walking as a form of physical activity, future research should explore ways to communicate the benefits of dog walking to owners and veterinarians to encourage this physical activity. Additional research may examine behaviors related to dog-walking counseling among a larger, more diverse sample of veterinarians to better represent different geographical regions as well as veterinarians in general.
The results of this study have theoretical and practical implications. The theoretical implications pertain to the use of constructs from the IMBP in examining veterinarians' perceptions of and experiences with counseling about dog walking. This theory served as a good guide in identifying constructs to help understand veterinarians' perceptions and experiences with dog-walking counseling. As for the practical implications, the results can be used to increase and improve the discussions that veterinarians have with owners about dog walking. First, current and upcoming veterinarians may use this information to recognize and overcome some of the barriers to discussing dog walking with owners. By recognizing and possibly overcoming some of these barriers related to dog-walking counseling, veterinarians may be able to better promote dog walking among owners in veterinary appointments.45 Second, this study also highlights many benefits of dog walking that veterinarians recognize, which can be used to increase awareness of the benefits of dog walking among veterinarians. By increasing veterinarians' awareness of the benefits of dog walking, they may be more likely to have these discussions.45 Third, veterinarians can make owners aware that they are able to provide accurate advice and dog-walking recommendations to increase the owners' expectations. If owners expect their veterinarian to discuss dog walking with them, veterinarians may be more inclined to have these discussions during veterinary appointments.45 Further, this study highlights the opportunity to educate current and future veterinarians on the importance of dog walking, accurate dog-walking recommendations, and approaches to discussing dog walking with dog owners during veterinary appointments. The average dog visits the veterinarian 2.6 times per year,20 and research shows that 77% of dog owners have brought their dog to the veterinarian in the past year,19 presenting an opportunity for veterinarians to promote dog walking. It is important for veterinarians to discuss dog walking with owners because they are able to positively influence dog walking through specific exercise counseling, with benefits to both the dog and the owner,21,22 and because they may be treating dogs that would benefit from dog walking, such as overweight dogs and those with an injury or illness.57
a College of Veterinarians of Ontario [Internet]. Guelph, ON: College of Veterinarians of Ontario, c2015 [cited July 21, 2015]. Information for the public: find a veterinarian. Available from: http://www.cvo.org/Find-a-Veterinarian.aspx
b Research Randomizer [Internet]. Geoffrey C. Urbaniak and Scott Plous, c1997-2015 [cited July 21, 2015]. Available from: https://www.randomizer.org/
c IBM Corporation. IBM SPSS Statistics for Windows. Version 22.0 [software]. Armonk, NY: IBM Corporation, 2013 [cited July 21, 2015].
d IBM Corporation. IBM SPSS Statistics 22 Core System User's Guide. Armonk, NY: IBM Corporation, 2013. Available from: http://www.sussex.ac.uk/its/pdfs/SPSS_Core_System_User_Guide_22.pdf
e QSR International Pty Ltd. NVivo qualitative data analysis software. Version 10 [software]. Melbourne, Australia: QSR International Pty Ltd, 2012 [cited July 21, 2015].
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