Abstract
Promoting dog walking among dog owners is consistent with One Health, which focuses on the mutual health benefits of the human–animal relationship for people and animals. In this study, we used intervention mapping (a framework to develop programs and resources for health promotion) to develop a clearer understanding of the determinants of dog walking to develop curricular and educational resources for promoting regular dog walking among dog owners. Twenty-six adult dog owners in Ontario participated in a semi-structured interview about dog walking in 2014. Thematic analysis entailing open, axial, and selective coding was conducted. Among the reasons why the participating dog owners walk their dog were the obligation to the dog, the motivation from the dog, self-efficacy, the dog's health, the owner's health, socialization, a well-behaved dog, and having a routine. The main barriers to dog walking were weather, lack of time, the dog's behavior while walking, and feeling unsafe. We compared interview results to findings in previous studies of dog walking to create a list of determinants of dog walking that we used to create a matrix of change objectives. Based on these results, we developed a print resource to promote regular dog walking among dog owners. The findings can be used by veterinary educators to inform course content that specifically educates veterinary students on the promotion of dog walking among dog owners and the benefits to both humans and animals. The study also offers veterinarians a further understanding upon which to initiate a conversation and develop educational resources for promoting regular dog walking among dog-owning clients.
One Health is an initiative devoted to improving the health of humans and animals by integrating human health care and veterinary medicine.1 One Health focuses on the human–animal interface and the health benefits that this interaction has for both humans and animals.1 In a recent study, the American Heart Association noted the association between dog ownership and the decreased risk of cardiovascular disease, suggesting in the statement that the association may be causal.2 In comparison, a recent study found that 30 minutes of daily activity for a dog has a positive influence on a dog's weight or body condition score.3 Other research has demonstrated that obese dogs that lose weight have an improved quality of life.4 Dog walking specifically provides a valuable One Health opportunity for the veterinary profession. Through dog walking, dog owners and dogs have the opportunity to share physical activity (PA) on a regular basis, and this can be mutually beneficial to the health of both the human and animal involved. Veterinary education has an important role furthering the One Health initiative and educating veterinary students about the mutual health benefits for humans and animals that can be achieved through dog walking when carried out at an appropriate intensity and duration. It is also important that veterinary educators work to prepare veterinary students with the communication skills and resources needed to promote dog walking in veterinary practice.
For humans, walking is a form of moderate-intensity PA that can help individuals achieve the public health recommendations for moderate-to-vigorous PA.5 It is a simple, inexpensive activity with very few physical barriers.6,7 Previous studies have indicated that dog owners generally spend more time walking and doing moderate-intensity PA than individuals who do not own dogs.6,8 Individuals who walk their dog are more likely to meet the recommendations for moderate-to-vigorous PA than dog owners who do not walk their dog (non–dog walkers) and individuals who do not own dogs (non–dog owners). There are also fewer obese dog walkers compared to non–dog walkers and non–dog owners.9–12 Approximately 35% of Canadian households own a dog13 and about one third of dog owners do not walk their dog regularly,11,12 suggesting an opportunity to increase the PA of this population by promoting dog walking. In the literature, key determinants of dog walking include obligation to the dog, motivation from the dog, self-efficacy, social support from the dog, attachment to the dog, and walkability of the neighborhood.6,9–12,14,15
Although key determinants of dog walking have been identified, there are few dog-walking intervention studies targeting dog owners. A recent pilot study found that dog owners who received messages about the benefits of exercise for dogs, advice about dog walking, motivational quotations from dog owners, and other readable materials increased their walking over 12 weeks.16 The results supported using messages about the health benefits of exercise for dogs to promote and increase PA among dog owners.16 However, it appears that the messages in the intervention were not based on theories of behavioral change or on any theoretical constructs. Using specific theories of behavioral change in program development can help us to better understand and predict behavioral change, and to develop interventions targeting particular issues.17 For example, a meta-analysis of breast cancer screening interventions found that interventions using a theoretical framework were the most effective at increasing screening rates.18 Similarly, a systematic review of Internet-based interventions for health promotion found that more extensive use of theory was associated with increases in effect size. The same review found that interventions using multiple techniques for behavioral change have a better chance of being effective than interventions that use fewer techniques.19 Recently, Richards, Ogata, and Ting reported results that supported the acceptability and feasibility of a pilot intervention to promote dog walking that was based on social cognitive theory (SCT) and used email messages to provide motivational cues to encourage dog walking.20 The messages were intended to influence self-efficacy through the use of various SCT constructs, including providing educational information about the health benefits of dog walking (outcome expectations), encouraging goal setting (self-regulation), and recommending dog walking with family and friends (social support). The intervention group in this study increased dog walking by about 79 minutes per week post-intervention whereas the control group increased dog walking by approximately 19 minutes per week.20
Intervention mapping (IM) is a framework to develop programs and resources for health promotion.17 Within the veterinary profession, IM is a valuable approach for the development of curricular and educational resources that promote dog walking. A benefit of IM is that it focuses on constructs from multiple theories rather than relying on a single theory to conceptualize an intervention more comprehensively. Specifically, IM involves an initial needs assessment, development of a matrix of change objectives (change needed in determinants of sub-behaviors for dog walking), and use of theory-based methods and applications to inform the development of educational materials. The systematic process of IM can lead to improved documentation in program development and assist in moving the health education field toward evidence-based practice.17 Many programs have been developed using IM, including an intervention to help adolescents stop smoking21 and interventions for increasing fruit and vegetable consumption, increasing PA,22,23 and increasing rates of cancer screening.24 Few studies have investigated the effectiveness of interventions developed using IM. However, recent studies are emerging such as Boucher, Gagne, and Cote's evaluation of a program that was developed using IM to promote fruit and vegetable consumption among young adults.25
The purpose of the current study (needs assessment) was to develop a clearer understanding of the determinants of dog walking to inform the development of One Health initiatives within veterinary curricula and the development of an educational resource promoting regular dog walking among dog owners for the benefit of the humans and animals involved.
The authors' university provided ethics clearance for the study and written consent was obtained from all participants.
Interview guide—We developed a semi-structured interview guide based on concepts or constructs from theories of behavioral change (i.e., SCT and theory of planned behavior) and determinants of dog walking found in previous studies.6,9–12,14,15 We used the following interview questions:
-
Can you tell me a bit about your dog? (This was contextual information.)
-
Explain to me your reasons for walking your dog.
-
What barriers do you experience when it comes to walking your dog?
-
We will be making a print resource to encourage dog owners to walk their dogs more. What types of things do you think we should include in the resource to achieve this?
Five adult dog owners (all women; mean age of 33.8 years [23–50 range]; four identified themselves as regular dog walkers and one identified herself as a non–dog walker) recruited through word of mouth participated in a pilot test of the interview guide to assess the comprehensibility of the questions and to ensure the interview guide elicited productive discussion. The interview questions did not change from the pilot test to the final interview guide; however, the pilot test assisted in identifying appropriate probes.
Lexington Attachment to Pets Scale (LAPS)—The LAPS was used to measure participants' level of attachment to their dog. This is a widely used 23-item Likert scale that has good validity and reliability.26,27 The LAPS consists of three subscales: general attachment, people substituting, and animal rights/welfare.
Participants were recruited through posters in the Guelph community (e.g., community centers, pet stores, and dog groomers), on-site promotion at PawsWay (a place in Toronto where owners bring their pet to socialize and take part in pet-friendly events and activities), and snowball sampling. Participants who identified themselves as the primary caregiver of a dog and were 18 years of age or older were eligible to take part in the study. When potential participants expressed interest in participating in the study, they were asked a question to determine if they are regular “dog walkers” or “dog owners who do not walk their dog.” Regular dog walking was defined as walking with the dog for at least 20 minutes (in bouts of at least 10 minutes) on 3 or more days per week. This definition (with the exception of 10-minute bouts) was used in a previous study of dog walking.6 The criterion of 10-minute bouts is consistent with current PA guidelines.28,29 In 2014, each participant took part in a semi-structured individual interview (approximately 30 minutes) with the principal author, either face-to-face (n=12) or over the phone (n=14). Participants' demographic and background information were collected at the time of the interview or by email before the interview if it was conducted over the phone. All interviews were audiotaped and transcribed verbatim.
Data analysis—We analyzed quantitative data with descriptive statistics (i.e., frequency, mean) using SPSS 20.0, and we analyzed interview transcripts with NVivo 10. The principal author conducted thematic analysis through open coding (i.e., assigning preliminary themes and codes in the margins of transcripts), axial coding (i.e., examining how the preliminary themes are connected and then organizing them into larger clusters), and selective coding (i.e., highlighting illustrations of themes).30 She regularly discussed the identified themes with the second author to strengthen her perception and interpretation of the data and themes. When no new information emerged, this indicated the point of data saturation.
Educational resource development—We created a matrix of change objectives by referring to both the determinants of dog walking identified from a literature review and the interview data. Participants' suggestions on how to encourage dog owners to walk their dogs more helped us develop the print resource. We chose theory-based methods and practical applications to address the matrix of change objectives when developing the final educational resource. The educational resource was pilot tested with five additional individuals who provided feedback over the phone. These individuals were also dog owners who were recruited through word of mouth. They were asked one open-ended question and were also probed about their opinions on the appearance of and information provided in the print resource.
For the main study, we recruited 26 different adult dog owners who were the primary caretaker of their dog, which is more than the recommended 12 interviews necessary to yield data saturation.31 Table 1 shows participants' characteristics as well as characteristics of their dogs. The average age of participants was 43.5 years (24–75 range), most participants were women (84.6%), and most reported that they usually walk their dog for at least 20 minutes on 3 or more days per week (92.3%). Participants were recruited from both urban and rural communities; however, we did not investigate whether they lived in a specific community.
|
| Characteristic | Mean (SD) or % |
| Age (years) | 43.5 (11.4) |
| Sex | |
| Male | 15.4 |
| Female | 84.6 |
| Marital status | |
| Never legally married | 23.1 |
| Legally married (and not separated) | 65.4 |
| Divorced | 3.8 |
| Widowed | 7.7 |
| Average days per week that the dog gets walked | 5.8 (1.9) |
| Average time (minutes) spent dog walking on a typical day | 34.9 (17.6) |
| Size of dog | |
| Small | 30.8 |
| Medium | 42.3 |
| Large | 26.9 |
| Age of dog (years) | 5.7 (5.2) |
| Participants who own more than one dog | 23.1 |
| LAPS* | |
| General attachment subscale | 2.6 (0.4) |
| People substituting subscale | 1.6 (0.5) |
| Animal rights/welfare subscale | 2.3 (0.6) |
*The possible range for LAPS subscale scores is 0 (low attachment) to 3 (high attachment).
Table 1 shows the mean score for the LAPS subscales. Considering that scores can range from 0 to 3, participants had a strong general attachment to their dog and viewed their dog as a family member. During the interviews, all participants reported being attached to their dog. Three themes emerged as participants discussed their relationship with their dog. Many dog owners viewed their dog as a member of the family.
“She is the most precious thing in my life other than my husband. I have this incredible, internal bond with her. She's my baby. She's my baby girl. I know it sounds crazy but she is.” (P4)
“He's definitely a member of the family. We hate putting him in a kennel. We have once, when we went south to Cuba, because he couldn't come. We all share the commitment, we all love to spend time with him, and we take his needs into account when we're deciding what we're going to do.” (P11)
However, a few participants commented that their dog was nonetheless a dog.
“Of course, he's a part of the family. I think dogs, in general to me, are a part of the family, but they are not a replacement for kids. I think dogs are dogs and people are people.” (P8)
“I'm very fond of her. However, in our house, a dog is a dog. I don't treat them like people, although I take excellent care of her and I enjoy her. I don't let her sleep on my bed or sit on the furniture or eat off the table or any of those things.” (P26)
Most participants felt that their dog was a great companion.
“She's a really great companion. The other thing is that she's really sensitive, like when you want quiet time or you just want to relax, she'll just curl up right beside you on the couch. She's just the best companion—really wonderful.” (P25)
“Other than my husband, they're my best friends—my two doggies.” (P19)
Eight themes for why participants walk their dog emerged from the interviews. First, most dog-walking participants felt a sense of obligation as a dog owner to walk their dog regularly. Some participants stated that they usually feel guilty if they do not take their dog for a walk. Several felt that the word “obligation” sounded too negative and instead preferred discussing the notion of a responsibility to walk their dog. Others asserted that people should not own a dog if they are not willing to walk it.
“If you're going to have a dog, then I think walking comes as part of it. You have an obligation to take the dog out for a walk.” (P12)
“But we also knew they were a higher energy dog. They need exercise and so one of the reasons to walk is because he needs to walk. It's that sort of accountability; you made that commitment, and you have to walk.” (P11)
Second, many participants mentioned that their dog motivates them to get out and walk. They felt that they would rarely go for walks if they did not have their dog.
“I would probably go on almost no walks if it wasn't for the dog. I like that I'm going on them but to be honest, before I had a dog, I don't think I went for many walks just for pleasure.” (P10)
“There are times that the weather is terrible and I'm tired and whatever other reasons, but [my dog] definitely motivates me to walk more.” (P1)
The third theme was self-efficacy. Many participants who walk their dog expressed confidence in their ability to walk their dog regularly. They felt that they are able to walk their dog regardless of barriers encountered. However, a few participants were not confident about keeping their dog obedient during walks.
“I find that I can walk pretty much any dog. Even people that I know, they say, ‘Oh, my dog doesn't walk on the leash. She doesn't know how to heel.’ Well, all dogs know how to heel if you know how to handle it. Some of them, of course, may have higher energy and it may feel harder to get there but I don't find it hard.” (P8)
“I usually walk him and his sister, so I feel comfortable navigating traffic and getting him to follow commands at the crosswalks and stuff like that.” (P3)
The fourth theme was the dog's health. All participants wanted their dog to live a long, happy life and so they walked their dog to keep the dog healthy. They commented that people and dogs need PA.
“I think it [dog walking] is good for them. It keeps them healthy. Her weight hasn't varied from when she became an adult dog until now, and she's 11. And it's always within just a few ounces different. She benefits from the exercise. She enjoys it.” (P20)
“I walk my dog to keep him healthy. We love him and we want him to be around as long as he possibly can be.” (P2)
The fifth theme was the owner's health. Some participants walked their dog as a strategy to be physically active and healthy themselves and particularly to relax mentally during neighborhood walks.
“The best piece of exercise equipment I ever got was my dog. I think it's also good for your mental health because you just get out on your own with the dog.” (P11)
“We both work from home, both self-employed, so we thought it would be a good thing to get a dog to break up the day and break the tension and force us to get off our ass to go for a walk and that kind of thing… So it's as much for us as it is for her.” (P4)
The sixth theme was participants walking their dog to personally socialize and connect with people in the community. Also, they highlighted that it was an opportunity for their dog to meet other people and dogs.
“It's good socialization for the dog obviously and good socialization for people. It's a great way to know your neighbors and what's going on in the community because you're out there all the time.” (P6)
“I knew no neighbors in my neighborhood. Now I know so many people. I know all of the people who own dogs in my neighborhood and we chat fairly regularly. I know other people who come up and say ‘oh, what kind of dog is that?’ and so I've gotten to meet so many people. It makes you feel more connected to people in your neighborhood.” (P25)
The seventh theme was to have a well-behaved dog. Many participants walked their dog to release some of the dog's pent-up energy from being indoors all day, thereby helping the dog be calmer at home. Some participants also used this walking time as an opportunity to practice different training techniques with their dog.
“I notice an increase in anxiety or chewing behaviors if she's not getting the exercise that I feel she needs.” (P26)
“Walking is also part of the bonding I do with [dog's name]. We do some training sometimes then so I enjoy doing that. She enjoys it and she's often looking for more than just a walk. She's looking for a little bit more stimulation so we do some training. She enjoys that.” (P9)
As the eighth theme, some participants expressed that dog walking is part of their daily routine. These participants liked that dog walking is habitual and fits into their daily tasks.
“When I first got her, she was a puppy. She needed to go out frequently because she needed to go to the bathroom, so we just got into the habit of going out and just sort of fell into a routine. Always first thing in the morning, going out for a walk 10–15 minutes. And then first thing when I get home, go out for a walk 10–15 minutes. Then later on in the evening, around 8 or 9 o'clock, we go for a half-hour or longer walk. And then last thing before she goes to bed, I take her out one more time so… it's like a routine. A routine but we fell into it when I first got her and learned from the breeder about how important walking your dog is.” (P25)
“I think it's just a matter of getting them into a routine and doing it consistently and building that habit because some people come up with excuses not to do it. So it's… building the habit of doing it and finding something like a trigger to get you to do it.” (P3)
Participants identified four main barriers to walking their dog. Participants said that winter weather conditions such as snow, ice, and cold temperatures deterred them from walking. Also, they were concerned about salt on the sidewalk that gets into their dog's paws. They also mentioned rain, hot temperatures, and wind as barriers.
“The winter time is more of a struggle because of the salt. We have [dog] boots but… sometimes when it's really cold out, we'll just let him out in the backyard because it's easier, instead of taking him for walks. But the main barrier is the winter with the salt, so we put boots on him.” (P3)
“It would probably be the weather. When it's raining, we don't go out. And when it's minus 30. If I went out, it would be very short.” (P15)
Many participants reported lack of time to walk their dog. Their busy work schedule, family commitments, and parenting required a lot of their time.
“It's really just a lack of time and also the winter. I hate the cold weather so much so that's the two main reasons. I would love to walk him every day [but] if it's icy out, obviously I won't, and we just don't have a lot of time.” (P18)
“Just lifestyle and what I mean by that is I have two children and I work shift-work, so those would be the barriers. It would be the time outside of that [to walk my dog].” (P9)
Some participants did not enjoy taking their dog for a walk because of the dog's behavior while walking, such as pulling on the leash, not getting along well with other dogs, and excessive barking.
“When they're on the leash, it's not very enjoyable because they're barking and pulling on the leash and everything. So I almost hope I don't see anyone when I'm going on the walk.” (P24)
“Probably one of my biggest sources of frustration with her is walking her on a leash and also off the leash because she doesn't come back. So I am pursuing more obedience training because we need more.” (P26)
Some participants living in more rural or secluded neighborhoods reported feeling unsafe walking their dog where there are no sidewalks and limited street lighting at night.
“The timing issue, so the darkness in the winter. There are no lights around here, plus there are wolves. So we don't go out in the dark around here.” (P19)
“There are no paths so it's just a loop through the neighborhood and we have two street lights in the whole neighborhood.” (P18)
Unique barriers expressed by non–dog walkers included physical issues that make it difficult for their dog to walk regularly (e.g., related to the dog's older age) and believing that the dog receives adequate exercise by running in a large backyard in a rural neighborhood.
Participants suggested the print resource should highlight how dog walking benefits both owner and dog and allows the owner to socialize with others in the neighborhood. They also suggested that we include advice from experts, testimonials from people who walk their dog, and strategies to help owners make time for walking in their regular routine.
Table 2 shows the matrix of change objectives based on the determinants of dog walking identified in previous studies and the interviews with dog owners, which guided the development of the print resource. Performance objectives (sub-behaviors for dog walking) describe specifically what participants in the intervention need to do to make the desired change of walking the dog regularly. Change objectives, which reflect the intersections of performance objectives and determinants,17 refer to change needed in determinants of dog-walking sub-behaviors. The bolded text in the cells in Table 2 indicates the change objectives that were addressed in the print resource. Self-efficacy, obligation, and motivation from the dog emerged from both the literature6,10,11,14 and the interviews. Outcome expectations were not a determinant of dog walking identified in the literature or the interviews but we included them in the matrix because they have an important role in people's self-efficacy.32 According to the interviews, the participating dog owners walk their dog for the dog's health and their own health. These themes are addressed through the awareness/knowledge determinant in the matrix because dog owners may be influenced to walk their dog for either their dog's health or their own if they are aware of the health benefits. The theme of a well-behaved dog, which emerged in the interviews, is addressed through both the awareness/knowledge and motivation determinants. Dog walking as part of a regular routine was another theme that emerged in the interviews. This involves getting into the regular habit of dog walking, so this theme is represented by the habit determinant. Social support from the dog is a determinant of dog walking in previous studies.10,11,33 For the interview participants, socialization with other people appeared to play a larger role in dog walking than social support from the dog. Socialization is not listed as a determinant in the matrix because it is not an easily modifiable determinant in the current context. However, socialization was a major theme from the interviews and therefore it is addressed through performance objective 6.
|
| Performance objective | Determinants of dog walking | |||||
| Awareness/knowledge | Motivation | Obligation | Skills and self-efficacy | Outcome expectations | Habit | |
| PO 1: Decide to walk your dog regularly | AK 1: Identify positive health benefits of dog walking for the owners and the dog | M 1a: Feel motivated to walk your dog regularly so that you and your dog will enjoy this PA | O 1: Feel obligated to walk your dog regularly for the physical and mental well-being of your dog | SS 1a: Express confidence in your decision to walk your dog regularly | OE 1a: Expect that walking your dog regularly will result in health benefits to you and your dog | |
| M 1b: Feel motivated to walk your dog regularly to attain (dog owner) physical and mental health benefits | SS 1b: Demonstrate that you are capable of walking your dog | OE 1b: Expect that walking your dog regularly will enhance your relationship with your dog | ||||
| PO 2: Assess your current and previous experiences with walking your dog (e.g., frequency of dog walking) | AK 2a: Identify PA recommendations for adults (people) | M 2a: Recognize how frequently you walk your dog | H 2a: Examine your dog walking habits | |||
| AK 2b: Identify PA recommendations for dogs | M 2b: Recognize any positive feelings that you have during or after walking your dog | H 2b: Identify any cues or prompts that currently remind you to walk your dog | ||||
| M 2c: Recognize your dog's positive behaviors during or after walks | ||||||
| PO 3: Set a goal for how often you will walk your dog | AK 3: Understand what an attainable goal is and how to set one | M 3: Recognize the positive feelings associated with achieving a goal | SS 3a: Express confidence in setting an achievable goal | OE 3: Expect that setting this goal will help you walk your dog regularly | ||
| SS 3b: Demonstrate the ability to set an attainable goal | ||||||
| SS 3c: Express confidence in achieving the goal | ||||||
| PO 4: Make a plan for how you will achieve the goal related to dog walking | AK 4: List locations of dog trails and parks in your area | SS 4(i): Express confidence in planning when, where, how long, and how often you will walk your dog SS 4(ii): Develop a dog-walking plan | OE 4: Expect that having an organized plan will make it easier to achieve your goal | H 4: Identify prompts and cues to promote dog walking | ||
| PO 4a: Create a dog-walking schedule/routine | AK 4a: Identify strategies for getting into a routine | M 4a: Recognize that going for regularly scheduled walks with your dog is good for you and your dog's health | O 4a: Feel obligated to routinely walk your dog | SS 4a: Express confidence in being able to adhere to a schedule, even when encountering barriers | OE 4a: Expect that dog walking will become part of your regular routine and will be maintained over time | |
| PO 4b: Ensure that you have appropriate dog-walking equipment/materials (e.g., leash, water, and clothing for you and your dog, sneakers for you) | AK 4b: Identify which winter dog clothes, etc. are most appropriate for your dog and where to obtain them | M 4b: Feel motivated to choose equipment/materials that will make dog walking a positive experience for you and your dog | O 4b: Feel obligated to provide a safe, healthy, and enjoyable environment when walking your dog | SS 4b: Express confidence that you can get and use appropriate dog-walking equipment/materials | OE 4b: Expect that having appropriate dog-walking equipment/materials will make it easier for you to walk your dog regularly | |
| PO 5: Cope with barriers to dog walking (e.g., time, weather, dog pulls) | AK 5: Identify barriers and how to overcome them | M 5: Feel motivated to learn obedience training skills and consistently practice good dog-walking skills so that dog walking is safe and enjoyable | SS 5a: Express confidence in being able to overcome barriers | OE 5: Expect that using strategies will help you overcome barriers, which will make it easier to walk your dog regularly | H 5: Consistently practice good dog-walking skills and use strategies to overcome barriers | |
| SS 5b: Demonstrate the ability to cope with barriers | ||||||
| SS 5c: Practice dog walking in challenging situations regularly | ||||||
| PO 6: Socialize with other people and dogs while you are walking your dog | AK 6: Understand that walking your dog can lead to meeting people in your neighborhood | M 6: Feel motivated to create a social environment that will encourage you to walk your dog regularly | O 6: Feel obligated to create a social environment for your dog during walks to ensure that your dog is properly socialized with other people and dogs | OE 6: Expect that you will have social interactions when walking your dog | ||
| PO 7: Evaluate/monitor progress | AK 7: State how to measure changes in dog-walking behavior and health | M 7: Feel motivated to identify any positive changes in your walking behavior and your dog's (e.g., frequency and duration) and health | SS 7: Express confidence in your ability to continue to monitor dog walking | OE 7: Expect that evaluating/monitoring progress will help improve and maintain your dog walking routine | ||
Bolded text in the cells indicates change objectives that were addressed in the print resource.
PO=performance objective; AK=awareness and knowledge; M=motivation; O=obligation; SS=skills and self-efficacy; OE=outcome expectations; H=habit
To develop the print resource, we chose theoretical methods such as consciousness raising, modeling, goal setting, action planning, cue altering, and planning coping responses from among the various theories of behavioral change and the CALO-RE taxonomy of behavior-change techniques34 (see Table 3). We applied these methods in the print resource by listing information, using testimonials, offering suggestions, and referring to other resources. In pilot testing the draft print resource, the five participants provided positive feedback such as approval of the pictures and colors selected because both owners and dogs look happy in the pictures and the colors are pleasing to the eye. They liked the selected quotations because they evoked positive emotions. In regards to the text, most participants liked the succinct bullet statements but some participants suggested that simpler language be used. We used this feedback to revise the print resource and make the readability appropriate for an eighth-grade reading level. The current resource is a three-panel print resource.a
|
| Change objective | Method | Application |
| PO 1: Decide to walk your dog regularly | ||
| AK 1: Identify positive health benefits of dog walking for the owners and the dog | Consciousness raising, gain-framed messages | List health benefits for owners and dogs |
| M 1a: Feel motivated to walk your dog regularly so that you and your dog will enjoy this PA | Modeling | Testimonials |
| M 1b: Feel motivated to walk your dog regularly to attain (dog owner) physical and mental health benefits | Consciousness raising | List health benefits for owners |
| O 1: Feel obligated to walk your dog regularly for the physical and mental well-being of your dog | Consciousness raising, modeling | List physical and mental health benefits for dogs, testimonials |
| OE 1a: Expect that walking your dog regularly will result in health benefits to you and your dog | Modeling | Testimonials |
| OE 1b: Expect that walking your dog regularly will enhance your relationship with your dog | Consciousness raising | Discuss how walking your dog is a great way to enhance your connection with your dog |
| PO 2: Assess your current and previous experiences with walking your dog (e.g., frequency of dog walking) | ||
| AK 2a: Identify PA recommendations for adults (people) | Consciousness raising | List PA recommendations |
| AK 2b: Identify PA recommendations for dogs | Consciousness raising | List PA recommendations |
| PO 3: Set a goal for how often you will walk your dog | ||
| SS 3b: Demonstrate the ability to set an attainable goal | Goal setting | Suggest dog owners set a goal for how long they want to walk their dog |
| PO 4: Make a plan for how you will achieve the goal related to dog walking | ||
| AK 4: List locations of dog trails and parks in your area | Consciousness raising | Describe how owners can get information about locations of dog trails and parks in their area |
| SS 4(ii): Develop a dog-walking plan | Action planning | Explain how to plan effectively by deciding when and where to walk the dog |
| H 4: Identify prompts and cues to promote dog walking | Cue altering | Suggest examples of cues to prompt dog walking (e.g., time of day, putting the leash by the front door) |
| PO 4a: Create a dog-walking schedule/routine | ||
| AK 4a: Identify strategies for getting into a routine | Consciousness raising | Provide tips for getting into a routine |
| SS 4a: Express confidence in being able to adhere to a schedule, even when encountering barriers | Planning coping responses | List tips for overcoming main barriers |
| PO 4b: Ensure that you have appropriate dog-walking equipment/materials (e.g., leash, water, and clothing for you and your dog, sneakers for you) | ||
| AK 4b: Identify which winter dog clothes, etc. are most appropriate for your dog and where to obtain them | Consciousness raising | Explain how owners can obtain equipment/materials |
| PO 5: Cope with barriers to dog walking (e.g., time, weather, dog pulls) | ||
| AK 5: Identify barriers and how to overcome them | Planning coping responses, barrier identification/problem solving | List main barriers and tips for overcoming barriers |
| M 5: Feel motivated to learn obedience training skills and consistently practice good dog-walking skills so that dog walking is safe and enjoyable | Consciousness raising | Suggest dog obedience training |
| PO 6: Socialize with other people and dogs while you are walking your dog | ||
| AK 6: Understand that walking your dog can lead to meeting people in your neighborhood | Consciousness raising, modeling | Explain how walking the dog can lead to meeting people, testimonials |
| O 6: Feel obligated to create a social environment for your dog during walks to ensure that your dog is properly socialized with other people and dogs | Consciousness raising | Describe importance of socializing your dog |
PO=performance objective; AK=awareness and knowledge; M=motivation; O=obligation; OE=outcome expectations; PA=physical activity; SS=skills and self-efficacy; H=habit
In this study, we used the IM process to develop a theory- and evidence-based understanding of the determinants of dog walking to further develop the One Health initiative within veterinary education, with a focus on dog walking and PA for humans and animals. This process also informed our development of an educational resource, specifically a print resource to promote regular dog walking among dog owners. The print resource addresses main determinants of dog walking and provides tips on how to overcome common barriers to dog walking. The information used to develop the print resource also provides guidance on course content for teaching veterinary students about their role in promoting dog walking as part of One Health.
During the interviews with dog owners, the major themes that emerged regarding why they walk their dog were an obligation to the dog, motivation from the dog, self-efficacy, the dog's health, the owner's health, socialization, a well-behaved dog, and having a routine. These results add to the evidence that obligation,6,11,15 motivation,10 and self-efficacy11,15 are key predictors of dog walking. During the interviews in the current study, all participants shared some level of attachment to their pet, either expressing their relationship with their dog as an owner–dog companionship or viewing their dog as an integral member of the family. Also, the LAPS scores showed that participants in this study had a strong general attachment to their dog. This study mostly consisted of individuals who already walk their dog regularly. Previous research has found that dog walkers have higher levels of attachment to their dog than do non–dog walkers.12
Results from the interviews with dog owners in the current study were similar to those found in another qualitative Canadian study.35 In the previous study, participants discussed how caring for their dog motivated them to become more physically active outdoors because they needed to meet the physical and social needs of their dog. This is comparable to the responses from many participants in the current study who explained that they walk their dog to keep the dog healthy (both physically and mentally) and to allow their dog to socialize with other people and dogs. Also, dog owners in both studies mentioned the idea of including dog walking in their everyday routine in order for it to become a habit.
Other studies have highlighted the importance of social support from the dog as a predictor of dog walking.10,11,33,36 Participants in the current study perceive their dog to provide some sense of social support while walking; however, they more often reported that they find other social aspects of dog walking appealing, such as meeting new people and walking with friends and family members. Participants continue to walk their dog regularly because they enjoy these social interactions. This finding is supported by studies that have found dogs to be facilitators for human social interactions, which could play a role in the association between pet ownership and psychological health.35,37–39 For example, Antonacopoulos and Pychyl found that dog walkers who talked to people they met while walking their dog were slightly less lonely than dog walkers who did not engage in conversations with others.37 Participants in the present study described the dog's behavior while walking as either a barrier to dog walking if their dog is disobedient during walks or as a motivator if their dog is well behaved. This has not usually been discussed in previous dog-walking studies and should be explored further.
The print resource was developed based on the results of both a literature review and interviews with dog owners. There is evidence suggesting that newer technologies such as website-based resources or using mobile devices to deliver programs are not more effective than traditional print resources. A study comparing Internet- and print-based PA interventions found that there were no significant differences in PA outcomes between a tailored Internet program, a standard Internet program, and a tailored print program.40 This suggests that web-based and print-based interventions used by veterinarians and veterinary students may be equally effective in increasing PA levels. In a systematic review of the efficacy of print interventions to promote PA, it was found that there were positive intervention effects on PA levels in 7 of the 12 randomized trials examined.41 Most of the interventions that were found to be effective were theory-based interventions. The current print resource is based on theory and evidence and is therefore a promising resource that offers guidance for curriculum development to help veterinarians' efforts in promoting dog walking as part of One Health.
A major strength of this study is that IM was used and therefore our understanding of the determinants of dog walking and the resulting print resource are strongly based on theory and evidence. A limitation of this study is that the sample primarily consisted of women who already walk their dog regularly, although two participants were not regular dog walkers. This potential selection bias is similar to a survey study of Canadian dog owners who walk their dog, which had a sample comprising 84% women,37 and dog-walking intervention studies that had samples comprising approximately 80% women.16,35 Also, the predominance of women in the current sample is consistent with previous research results showing that women are the primary dog walkers within a family. For example, McCormack, Rock, Sandalack, and Uribe found that women walked their dog more frequently than men did,42 and Degeling, Burton, and McCormack found that women were more likely than men to achieve a specific duration of dog walking.43 Thus, as the main dog walkers, women can be targeted to maintain and increase their participation in dog walking. Additional research targeting men may be warranted to explore determinants of dog walking in this specific population.
The disproportionate number of regular dog walkers in this study compared to non–dog walkers is a further limitation. However, the definition used for “regular dog walking” was a guideline for which there is not a well-established definition. The results from this study can potentially be used to help dog owners overcome the discussed barriers and consequently increase their time spent walking their dog. This could lead to an increase in dog owners who achieve the recommended PA guidelines.
Although developing a print resource potentially limits the behavior-change techniques that can be applied (i.e., because only techniques that can be implemented via print rather than in-person can be used), the findings of the current study in general can be used to include a broad range of behavior-change techniques within veterinary curricula.
In conclusion, the findings of the current study are based on theory and evidence and can be used by veterinary educators to develop course content related to the promotion of dog walking, and by veterinarians to directly promote regular dog walking among dog owners. This is consistent with the focus of One Health, which encourages the integration of human health care and veterinary medicine to improve the health of humans and animals.1 The print resource developed as part of this study has been distributed to veterinary clinics across Canada with the assistance of an industry partner. This broad dissemination will allow us to promote dog walking among many veterinarians, dog owners visiting veterinary clinics, and potential dog owners. A multi-component intervention is likely needed to promote and increase community-wide dog walking. A dog-walking community campaign that uses various media (e.g., print, television) to target dog owners in other settings (e.g., beyond veterinary clinics) could be developed and implemented and include the print resource as a component. Future studies could investigate the effectiveness of resources for behavioral change that are based on the determinants of dog walking, such as the print resource developed in this study, to measure the impact they have on dog-walking behaviors. In addition, research comparing the effectiveness of programs developed through IM versus other approaches is warranted.
Acknowledgements
The authors acknowledge the contributions of Owen Roberts from the Office of Research at the University of Guelph and Len Kahn and Francesco Piccioni from Kahntact Marketing in Guelph in the development and design of an initial version of the brochure. We acknowledge the contributions of Randy Valpy from Pets Plus Us in further development and dissemination of the final brochure. Appreciation is extended to PawsWay for their assistance with recruitment for this study.
a A print resource to promote dog walking among dog owners is available from the second author. Please contact John Dwyer at [email protected]
| 1. | Hodgson K, Darling M. Zooeyia: an essential component of “One Health”. Can Vet J. 2011;52(2):189–91. Medline:21532829 Medline, Google Scholar |
| 2. | Levine GN, Allen K, Braun LT, et al; the American Heart Association Council on Clinical Cardiology, the Council on Cardiovascular and Stroke Nursing. Pet ownership and cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2013;127(23):2353–63. http://dx.doi.org/10.1161/CIR.0b013e31829201e1. Medline:23661721 Medline, Google Scholar |
| 3. | Byers CG, Wilson CC, Stephens MB, et al. Owners and pets exercising together: canine response to veterinarian-prescribed physical activity. Anthrozoos. 2014;27(3):325–33. http://dx.doi.org/10.2752/175303714X14036956449224 Google Scholar |
| 4. | German AJ, Holden SL, Wiseman-Orr ML, et al. Quality of life is reduced in obese dogs but improves after successful weight loss. Vet J. 2012;192(3):428–34. http://dx.doi.org/10.1016/j.tvjl.2011.09.015. Medline:22075257 Medline, Google Scholar |
| 5. | Kruger J, Ham SA, Berrigan D, et al. Prevalence of transportation and leisure walking among U.S. adults. Prev Med. 2008;47(3):329–34. http://dx.doi.org/10.1016/j.ypmed.2008.02.018. Medline:18445507 Medline, Google Scholar |
| 6. | Brown SG, Rhodes RE. Relationships among dog ownership and leisure-time walking in Western Canadian adults. Am J Prev Med. 2006;30(2):131–6. http://dx.doi.org/10.1016/j.amepre.2005.10.007. Medline:16459211 Medline, Google Scholar |
| 7. | Bryan SN, Katzmarzyk PT. Patterns and trends in walking behaviour among Canadian adults. Can J Public Health. 2009;100(4):294–8. Medline:19722344 Medline, Google Scholar |
| 8. | Christian HE, Westgarth C, Bauman A, et al. Dog ownership and physical activity: a review of the evidence. J Phys Act Health. 2013;10(5):750–9. Medline:23006510 Medline, Google Scholar |
| 9. | Coleman KJ, Rosenberg DE, Conway TL, et al. Physical activity, weight status, and neighborhood characteristics of dog walkers. Prev Med. 2008;47(3):309–12. http://dx.doi.org/10.1016/j.ypmed.2008.05.007. Medline:18572234 Medline, Google Scholar |
| 10. | Cutt H, Giles-Corti B, Knuiman M. Encouraging physical activity through dog walking: why don't some owners walk with their dog? Prev Med. 2008;46(2):120–6. http://dx.doi.org/10.1016/j.ypmed.2007.08.015. Medline:17942146 Medline, Google Scholar |
| 11. | Hoerster KD, Mayer JA, Sallis JF, et al. Dog walking: its association with physical activity guideline adherence and its correlates. Prev Med. 2011;52(1):33–8. http://dx.doi.org/10.1016/j.ypmed.2010.10.011. Medline:21047528 Medline, Google Scholar |
| 12. | Oka K, Shibata A. Prevalence and correlates of dog walking among Japanese dog owners. J Phys Act Health. 2012;9(6):786–93. Medline:22898456 Medline, Google Scholar |
| 13. | Perrin T. The Business of Urban Animals survey: the facts and statistics on companion animals in Canada. Can Vet J. 2009;50(1):48–52. Medline:19337613 Medline, Google Scholar |
| 14. | Cutt H, Giles-Corti B, Knuiman M, et al. Understanding dog owners' increased levels of physical activity: results from RESIDE. Am J Public Health. 2008;98(1):66–9. http://dx.doi.org/10.2105/AJPH.2006.103499. Medline:18048786 Medline, Google Scholar |
| 15. | Oka K, Shibata A. Factors associated with the stages of change for dog walking among Japanese dog owners. J Phys Act Health. 2013;10(1):122–31. Medline:22398632 Medline, Google Scholar |
| 16. | Rhodes RE, Murray H, Temple VA, et al. Pilot study of a dog walking randomized intervention: effects of a focus on canine exercise. Prev Med. 2012;54(5):309–12. http://dx.doi.org/10.1016/j.ypmed.2012.02.014. Medline:22405707 Medline, Google Scholar |
| 17. | Bartholomew LK, Parcel GS, Kok G, et al. Planning health promotion programs: an intervention mapping approach. San Francisco: Jossey-Bass; 2011 Google Scholar |
| 18. | Yabroff KR, Mandelblatt JS. Interventions targeted toward patients to increase mammography use. Cancer Epidemiol Biomarkers Prev. 1999;8(9):749–57. Medline:10498393 Medline, Google Scholar |
| 19. | Webb TL, Joseph J, Yardley L, et al. Using the Internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010;12(1):e4. http://dx.doi.org/10.2196/jmir.1376. Medline:20164043 Medline, Google Scholar |
| 20. | Richards EA, Ogata N, Ting J. Dogs, physical activity, and walking (dogs PAW): acceptability and feasibility of a pilot physical activity intervention. Health Promot Pract. 2015;16(3):362–70. http://dx.doi.org/10.1177/1524839914553300. Medline:25288560 Medline, Google Scholar |
| 21. | Dalum P, Schaalma H, Kok G. The development of an adolescent smoking cessation intervention—an Intervention Mapping approach to planning. Health Educ Res. 2012;27(1):172–81. http://dx.doi.org/10.1093/her/cyr044. Medline:21730251 Medline, Google Scholar |
| 22. | Cullen KW, Bartholomew LK, Parcel GS, et al. Intervention mapping: use of theory and data in the development of a fruit and vegetable nutrition program for girl scouts. J Nutr Educ. 1998;30(4):188–95. http://dx.doi.org/10.1016/S0022-3182(98)70318-8 Google Scholar |
| 23. | McEachan RR, Lawton RJ, Jackson C, et al. Evidence, theory and context: using intervention mapping to develop a worksite physical activity intervention. BMC Public Health. 2008;8(1):326. http://dx.doi.org/10.1186/1471-2458-8-326. Medline:18808709 Medline, Google Scholar |
| 24. | Fernández ME, Gonzales A, Tortolero-Luna G, et al. Using intervention mapping to develop a breast and cervical cancer screening program for Hispanic farmworkers: cultivando la salud. Health Promot Pract. 2005;6(4):394–404. http://dx.doi.org/10.1177/1524839905278810. Medline:16210681 Medline, Google Scholar |
| 25. | Boucher D, Gagné C, Côté F. Effect of an intervention mapping approach to promote the consumption of fruits and vegetables among young adults in junior college: a quasi-experimental study. Psychol Health. 2015;30(11):1306–25. http://dx.doi.org/10.1080/08870446.2015.1050393. Medline:25970738 Medline, Google Scholar |
| 26. | Anderson DC. Assessing the human–animal bond: a compendium of actual measures. West Lafayette, IN: Purdue University Press, Purdue University; 2007 Google Scholar |
| 27. | Johnson TP, Garrity TF, Stallones L. Psychometric evaluation of the Lexington Attachment to Pets Scale. Anthrozoos. 1992;5(3):160–75. http://dx.doi.org/10.2752/089279392787011395 Google Scholar |
| 28. | Canadian Society for Exercise Physiology (CSEP). Canadian physical activity guidelines for adults 18–64 years [Internet]. Ottawa: CSEP; 2011 [cited 2016 Sept 16]. Available from: http://www.csep.ca/CMFiles/Guidelines/CSEP_PAGuidelines_adults_en.pdf Google Scholar |
| 29. | U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans [Internet]. Rockville, MD: Office of Disease Prevention and Health Promotion; 2008 [cited 2016 Sept 16]. Available from: https://health.gov/paguidelines/pdf/paguide.pdf Google Scholar |
| 30. | Neuman WL, Robson K. Basics of social research: qualitative and quantitative approaches. Toronto: Pearson Canada; 2015 Google Scholar |
| 31. | Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006;18(1):59–82. http://dx.doi.org/10.1177/1525822X05279903 Google Scholar |
| 32. | Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215. http://dx.doi.org/10.1037/0033-295X.84.2.191. Medline:847061 Medline, Google Scholar |
| 33. | Cutt H, Giles-Corti B, Knuiman M, et al. Dog ownership, health and physical activity: a critical review of the literature. Health Place. 2007;13(1):261–72. http://dx.doi.org/10.1016/j.healthplace.2006.01.003. Medline:16503185 Medline, Google Scholar |
| 34. | Michie S, Ashford S, Sniehotta FF, et al. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health. 2011;26(11):1479–98. http://dx.doi.org/10.1080/08870446.2010.540664. Medline:21678185 Medline, Google Scholar |
| 35. | Degeling C, Rock M. ‘It was not just a walking experience': reflections on the role of care in dog-walking. Health Promot Int. 2013;28(3):397–406. http://dx.doi.org/10.1093/heapro/das024. Medline:22752107 Medline, Google Scholar |
| 36. | Kushner RF, Blatner DJ, Jewell DE, et al. The PPET Study: people and pets exercising together. Obesity (Silver Spring). 2006;14(10):1762–70. http://dx.doi.org/10.1038/oby.2006.203. Medline:17062806 Medline, Google Scholar |
| 37. | Antonacopoulos NMD, Pychyl TA. An examination of the possible benefits for well-being arising from the social interactions that occur while dog walking. Soc Anim. 2014;22(5):459–80. http://dx.doi.org/10.1163/15685306-12341338 Google Scholar |
| 38. | McNicholas J, Collis GM. Dogs as catalysts for social interactions: robustness of the effect. Br J Psychol. 2000;91(Pt 1):61–70. http://dx.doi.org/10.1348/000712600161673. Medline:10717771 Medline, Google Scholar |
| 39. | Wells DL. The facilitation of social interactions by domestic dogs. Anthrozoos. 2004;17(4):340–52. http://dx.doi.org/10.2752/089279304785643203 Google Scholar |
| 40. | Marcus BH, Lewis BA, Williams DM, et al. A comparison of Internet and print-based physical activity interventions. Arch Intern Med. 2007;167(9):944–9. http://dx.doi.org/10.1001/archinte.167.9.944. Medline:17502536 Medline, Google Scholar |
| 41. | Short CE, James EL, Plotnikoff RC, et al. Efficacy of tailored-print interventions to promote physical activity: a systematic review of randomised trials. Int J Behav Nutr Phys Act. 2011;8(1):113. http://dx.doi.org/10.1186/1479-5868-8-113. Medline:21999329 Medline, Google Scholar |
| 42. | McCormack GR, Rock M, Sandalack B, et al. Access to off-leash parks, street pattern and dog walking among adults. Public Health. 2011;125(8):540–6. http://dx.doi.org/10.1016/j.puhe.2011.04.008. Medline:21803384 Medline, Google Scholar |
| 43. | Degeling C, Burton L, McCormack GR. An investigation of the association between socio-demographic factors, dog-exercise requirements, and the amount of walking dogs receive. Can J Vet Res. 2012;76(3):235–40. Medline:23277705 Medline, Google Scholar |
