Faculty of Veterinary Medicine
Utrecht University
Evaluation of the ‘Blok 3 advices’ among dairy farmers
Report of the research project of H.H.Vos
Master student Farm Animals and Veterinary Public Health at the Faculty of Veterinary Medicine of Utrecht University
Abstract
Veterinarians give a lot of advices. Veterinarian students that have chosen the master Farm Animals and
Veterinary Public Health are learning this during the course ‘Blok 3’, where they have to analyze a dairy farm
which has one or more specific problem(s). A product of the analysis is a report for the vet and farmer with
evidence based advices. The main goal of this project was to evaluate to what extent the given advices have
been followed by interventions of the dairy farmer. If the advices have been followed up, then the results
according to the farmer were evaluated. If the given advices have not been followed up, then was evaluated
why they have not been (fully) implemented by the farmer. In this study 23 farmers participated who received
482 advices in total. 181 (38%) of those advices were implemented, 103 (21%) advices have partially been
followed by interventions and 206 (43%) advices have not been followed up because of different reasons. The
number of advices that have been followed by interventions increased if the total number of advices increased.
Mostly mentioned results were improved technical results and better animal health and/or welfare.
Although the majority of the advices have been (partially) implemented, previous research demonstrated that
the advisory of veterinarians can be improved. To improve advisory effective communication is important,
because veterinarians are equipped with relevant information about welfare (including health) of animals and
heard health management, but their communication with the farmer can be better.
Introduction
In the profile of veterinarians, their social responsibility for the welfare (including health) of animals is a central
issue. Their skills are based on a broad scientific insight into (patho)biology, population biology and
epidemiology. From this position, veterinarians give a lot of advices. Students are learning this during their
training. In the bachelor, the anatomy, embryology, physiology, pathology and drug influence has been taught,
while during the master species/sector-specifics are central issues. In the master Farm Animals and Veterinary
Public Health of the Faculty of Veterinary Medicine of Utrecht University, students are trained in curative
medicine, but also in preventive strategies. This is important in herd health monitoring and advising. Students
practice these skills (in groups of three students) in ‘Blok 3’, where they have to analyze different farms (dairy,
pig and poultry farms) which have one or more specific problem(s). During the analysis, students visit the farm
several times and question the farmer and vet about all relevant aspects related to herd health management,
and the farm-specific problem(s) involved. Besides that, they analyze the technical results of the farm. The
products of the total analysis are a peer presentation for students, a presentation for the farmer (and his
employees and other related people) and a report for the vet and farmer that consists of a SWOT-analysis,
prioritization, work out of the farm-specific problems, farm-specific assignments about welfare, nutrition,
epidemiology, housing and climate and pharmacotherapy, and evidence based advices. These advices have
been followed up in cooperation with and evaluated by the local veterinarian.
From a historical perspective, veterinarians and other advisors assumed that farming was “a separate activity
executed by individual farmers, based primarily on rational, technical and economic considerations” [Cited by
Jansen et al., 2009]. Although these rational choices still play a role in farm management, we have learned that
farmers’ decision making based on these considerations is not always clear and understandable [Vaarst et al.,
2002]. Bigras-Poulin et al. (1985) found that socio-psychological variables explained 11 to 25 percent of the
variation, and management variables explained 0 to 16 percent of the variation in reproductive performances
1
of the herd. These studies made clear that attitudes should be taken into account in studies of farm
performances. The behavior of farmers can be explained by attitudinal factors (such as opinions, values, beliefs,
knowledge) and farmers’ perception of control. As far as farmers’ perception of control is concerned, social
psychological research has shown that a lack of feeling of control (or perceived behavioral control) could curb
their capacity to act upon the real situation [Jansen et al., 2009; Ajzen, 1991]. So the acceptability for the dairy
farmer depends on his personal vision, but also his feeling of control plays an important role.
When the farmer has a problem (or losing control), the way of advising is important. A sufficient SMART
(specific, measurable, acceptable, realistic, time bound) advice can make goals and interventions specific and
measurable. This can motivate the farmer and increases the feeling of control. Understanding the experiences
and motivations of the farmer increases the changes of the veterinarian to achieve successful herd health
monitoring and advising [Kristensen and Jakobsen, 2011]. A farmer should constantly make decisions whether
or not based on advices of vets, feed advisors or others. Some advices will be applied and others will not. For
advisors it is interesting to know if and why advices will be applied or not. During this veterinary research
project, 23 dairy farms that were analyzed by veterinarian students are revisited in order to evaluate the given
advices. The main goal of this project was to investigate to what extent the given advices have been followed
up by interventions of the farmer. If the given advices have been followed up, then the results according to the
farmer were evaluated. If not, then was evaluated why the advices were not (fully) implemented by the farmer.
Materials and methods
Data
In this study, 23 farmers that took part in Blok 3 between 2013 and 2015 were included. The farms were
randomly distributed across the Netherlands and their Blok 3 report had to be available. The students that
performed the analysis during Blok 3 had four supervisors, so 4-6 analyses per supervisor were included.
To evaluate the implementation of the advices among farmers, the farms have been visited. Before the visit,
the given advices were listed and numbered. During the farm visit, a questionnaire was used (see attachment).
Regarding each advice, the farmers was asked if it was followed by intervention, a partial intervention or no
intervention. If the given advice has followed up, then the results according to the farmer were recorded. If
not, then was asked why it was not (fully) implemented. Advices whereby farmers indicated that they were
already applied were removed from this study.
Data processing
Before the farm visit, the advices from the Blok 3 report were classified in different groups (topic, on initiative
of the farmer and/or students (based on the history and prioritization) and short or long term, see attachment).
The classification of the students was used as much as possible, but in some cases (if the classification did not
match with the classification of this study) it was adjusted by the researcher. Some advices are related to
multiple topics and an advice may cause more than one result or the farmer mentioned more than one reason
why it have not been followed up. The topics, results and reasons were all included in the results hereafter, so
the numbers in different figures are not always comparable. Advices that were related to more than one topic
have been reported more than once in figure 2 and 3.
Statistical analysis
The correlation between ‘total number of advices’ and ‘number of (partially) implemented advices’ and ‘total
number of advices’ and ‘number of not implemented advices’ was calculated. With a Chi-Squared test (R x C
contingency table) was evaluated if advices that were related on initiative of one group (farmer, students or
both) were implemented more often than others.
Results
Implementation of the advices
The 23 participants in this study received 482 advices in total, an average of 21 advices per farmer. 181 (38%)
of those advices were implemented, 103 (21%) advices have partially been followed by interventions and 206
(43%) advices have not been followed up. Figure 1 shows that the proportion between the categories differs
substantially between the farmers.
2
45
Number of advices
40
35
30
25
20
15
10
5
0
Implemented
Partially
Not
Figure 1: Implementation of the advices by the farmers. Each bar represents the advices of one farmer. The
partition of the bar shows how many advices the farmer have (partially) implemented or not.
The correlation between ‘total number of advices’ and ‘number of (partially) implemented advices’ was 0.8,
while the correlation between ‘total number of advices’ and ‘number of not implemented advices’ was 0.6.
The analyzed advices were classified in different topics, see figure 2. Advices among nutrition and water,
fertility, udder health and biosecurity and hygiene are the most given advices in the reports.
Figure 2: Distribution of the analyzed advices on different topics
1%
6%
0%
10%
9%
9%
5%
14%
6%
4%
9%
10%
17%
.
Legend
Clockwise, start at 12h:
Dark blue = udder health
Dark red = locomotion
Dark green = fertility
Purple = production
Ocean blue = housing and climate
Dark orange = nutrition and water
Light blue = biosecurity and hygiene
Red = health and welfare
Light green = management and work routines
Lilac = social aspects
Aqua = youngstock
Light orange = dry period
Ice blue = soil and crop
Figure 3 shows the degree of implementation of the advices on the different topics. As seen, there is a large
dispersion in the implementation of the advices of the topics.
3
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
1
51
55
46
24
33
47
44
24
10
29
16
22
4
3
16
15
21
13
74
21
22
54
1
22
0
24
42
21
11
16
3
10
52
1
1
26
5
22
Not
Partially
Implemented
Figure 3: Implementation of the advices of different topics. The bars represent the implementation in rates.
The numbers in the bars represent the number of advices in that category.
Results of implemented advices
If the farmer indicated during the farm visit that he had (partially) implemented an advice, the results according
to the farmer were evaluated. The mentioned results were divided into groups, see figure 4.
Figure 4: Results of the (partially) implemented advices
44
70
14
6
11
18
20
112
Legend
Clockwise, start at 12h:
Blue = improved technical results
Red = improved animal health and/or welfare
Green = more job satisfaction
Purple = improved (including) through other measures*
Aqua = not to say by another/underlying problem
Orange = it was too early to expect results
Ice blue = others
Pink = no result/not improved
*Measures which were not advised in the students’
report.
Most frequently mentioned results of (partially) implemented advices on nutrition and water, biosecurity and
hygiene, management and work routines and youngstock were more job satisfaction, improved technical
results and a better animal health and/or welfare. Interventions regarding nutrition and water and
management and work routines were also improved (including) by measures that were not advised in the
students’ report. Most frequently mentioned results of (partially) implemented advices on udder health,
production, dry period and housing and climate were improved animal health and/or welfare and improved
technical results. The most mentioned results by interventions on locomotion problems were the same, but
also ‘not to say by another/underlying problem’ was frequently mentioned. Fertility advices that were
implemented resulted mostly in improved technical results, while interventions on health and welfare
especially caused improved animal health and/or welfare.
Reasons why farmers did not implement advices
43 percent of the analyzed advices were not followed by interventions. Reasons that the farmers mentioned
are shown in figure 5. The distribution of the reasons about the topics is very variable.
4
Figure 5: Reasons why the farmer did not (fully) implement the advices
15
76
19
40
14
32
27
26
70
44
84
54
23
Legend
Clockwise, start at 12h:
Dark blue = no problem for farmer
Dark red = no priority for the farmer
Green = did not fit the farmer/ his business
Purple = too expensive
Ocean blue = farmer was not convinced
Dark orange = took too much time
Light blue = not practically feasible
Light red = not SMART enough
Light green = did not fit within the (current) work routines
Lilac = solved by other measures
Aqua = contradiction advice several advisers
Light orange = farmer is planning to implement it
Ice blue = results of previous investigations/changes
disappointed
Pink = no investments in the old stable
Mint green = others
Most mentioned reasons per topic are listed below:
Udder health and dry period: the farmer was not convinced that the advice would lead to the desired
result
Housing and climate and biosecurity and hygiene: the advice was not practically feasible
Fertility: implementation of the advice took too much time
Nutrition and water: contradicted advice of several advisers
Management and working routines: the advice did not fit the farmer or his business
Youngstock: the farmer found that no problem existed when an advice was given and/or the problem
was solved by other measures.
Initiative of the farmer, students or both
As mentioned above, a lot of advices were described if the advices are related on initiative of the farmer, the
students or both, see table 1.
Farmer
Students
Both
Total
(Partially) implemented
24
75
102
201
Not
25
56
96
177
Total
49
131
198
378
Table 1: R x C contingency table of the Chi-Squared test. In the columns are presented if the advices are
(partially) implemented or not and in the rows is presented if the advices are related on initiative of the farmer,
the students or both.
In a Chi-Squared test, the null hypothesis is that the (partially) implementation of the advices in the three
groups (farmer, students or both) were equal. These hypothesis can be assumed, because P = 0,53. So there
was no association between the implementation of the advices and the group.
Discussion
Sampling
In this study, 23 farmers that took part in Blok 3 between 2013 and 2015 participated. In total, about 60
farmers took part in Blok 3 in 2013, 2014 and 2015 together, so this study included around one third of the
whole ‘population’. Farmers that took part before 2013 were not included because of the expectation that they
could not remember changes due to measures (for example changed production results due to nutrition
changes) and farmers that participated in Blok 3 very recently (< 6 months before this study) were not included
because they did not have enough time to implement advices and/or expect results of their interventions (for
example changes in technical results of fertility).
The students that performed the analysis and wrote the report were accompanied by different supervisors in
Blok 3 to prevent bias, but the vets and veterinary practices that accompany the farms routinely were in some
5
cases the same. That might influence the results, for example if the vets stimulate improvement of specific
elements, although it is unclear if they accompany the farm particularly by their selves or if they regularly
consult colleagues/other advisors. So, to evaluate the implementation of the advices among farmers we chose
to visit the farms. Besides a survey that was used, a conversation with the farmer was important because of a
better explanation of all subjects.
Blok 3 advices
As described in Material and methods, the advices from the Blok 3 report were discussed and recorded during
the farm visit, but the Blok 3 report for the farmer and the vet contains more information (like problem
definitions, risk factors and analyses) that the farmer might have been inspired to take (other) measures or
questioning by other consultants. For that reason, not all effects of their Blok 3 participation would be
measurable. In a study of Sorge et al. (2010), that investigated the attitudes of Canadian dairy farmers towards
a voluntary Johne’s disease control program, about half of the farmers had taken other management measures
to make improvements beyond the program. They generally chose measures that were easy to implement and
those that had an immediate visual effect (e.g., more bedding or cleaning of stalls). On the other hand, a
number of farmers in this study indicated that some of the advices were already done before they participated
in Blok 3. Three different possible explanations could apply: 1) the students did not have the current state of
affairs in the picture, 2) the farmers were mixing up the time frame of when they started with the management
practice (i.e. recall bias), or 3) the communication from the students to the farmer about their observation/
expectations was unclear [Sorge et al., 2010]. Advices whereby farmers indicated that they were already
applied were removed from this study.
A difficulty of the current study was to separate results from interventions that were related to the same
problem around the same time. For example if the farmer improved the hygiene of the floor and used only one
cloth per cow for cleaning the teats. Both measures can improve the udder health, but the result of one specific
intervention is untraceable. Moreover, it would be interesting to examine the changes in technical results of
the farms that would participate in Blok 3 after some years, because this was a subjective study. The results
were based on the experience of the farmer.
Implementation of the advices
In this dataset, the number of advices that have been followed by interventions enlarged if the total number of
advices increased. However, Sorge et al. (2010) assumed that some veterinarians simply made too many
recommendations at once. In that study, farmers implemented, on average, only two. More advices seemed to
discourage and overwhelm the farmers, making them unable to implement all of them at once and to
distinguish between most important and less important recommendations. During Blok 3, farmers received an
average of 21 advices and the above described phenomenon happened, because several farmers mentioned
that some advices were not implemented because they had no priority for the farmer or because they were
planning to implement it.
Farmers mentioned a lot of reasons why they did not (fully) implement advices. In other studies, the
background of their reactions has been described. This information can help us to understand the behavior and
choices of the farmers. Kristensen and Jakobsen (2011) described that if farmers are confronted with an advice
suggesting a change of behavior, they are placed in a state of cognitive dissonance. That is the mental stress or
discomfort experienced by an individual who is confronted by new information that conflicts with existing
beliefs, ideas or values. To solve such dissonance, they may either comply with the advice or reduce the
dissonance by convincing themselves that the suggested change in management is impossible to implement
[Kristensen and Jakobsen, 2011]. In the current study, 389 reasons were mentioned why the farmers have not
been followed up the advices. 27 times was called that the advice did not fit the farmer or his business and 54
times that the advice was not practically feasible. These reasons together represent 21 percent of all causes
why the farmers did not (fully) implement the advices.
The inconvenience of breaking a habit seems also to hinder farmers from changing, most likely because they do
not expect to see any obvious benefits from the change. With risk-averse behavior they are avoiding
management changes with unknown outcome [Willock et al., 1999]. In this study, 8 times (2%) was mentioned
that advices were not implemented because they did not fit within the current work routines, 44 times (11%)
because the farmer was not convinced and 7 times (2%) that the results of previous investigations/changes
disappointed whereby the farmer was not motivated to follow up the (new) advices.
Some recommendations discourage the farmers because they would have required a major change in farm
setup or change was generally limited by restrictions in available space and facilities. The latter was one of the
biggest challenges that hindered farmers from implementing recommendations in the study of Sorge et al.
6
(2010). Similar observations were made by Jonsson and Matschuss (1998). They found that high costs
associated with the installation of necessary facilities for a tick-control program in Australia stopped producers
from implementing tick control on farms. In the current study, the farmers called 26 times (7%) that
implementation of the advice was too expensive, while 6 times (2%) was mentioned that the advice was not
implemented because the farmer did no investments in the old stable because of plans for new buildings.
The main reason farmers did not comply with recommended measures in the study of Jonsson and Matschuss
(1998) and the study of Lue et al. (2008) was that they perceived a change as unnecessary [Jonsson and
Matschoss, 1998; Lue et al., 2008]. Results of the current study did support this opinion, because the farmers
also mentioned that they were not convinced to implement advices (44 times, 11% of all reasons why farmers
did not (fully) implement the advices). On the other hand, advices that were related on initiatives of the farmer
(and students) did not implement more often than others (calculated with the Chi-Squared test, see above),
maybe because the farmer knows that he has been too strongly focused on his working methods.
Another reason why given advices will not been followed by interventions could be that the farmer has other
aims than the vet/students. Kristensen and Enevoldsen (2008) studied this subject through farmers'
expectations related to a herd health management program compared to perceptions of farmers' goals among
veterinarians. Subjects of the herd health management program could be divided into four families: teamwork,
animal welfare, knowledge dissemination and production. Teamwork was most important for farmers,
followed by animal welfare, knowledge dissemination, and production. The major view of veterinarians was
that farmers focused mainly on production and financial performance and least on the value of teamwork. In
the current study, teamwork might be the reason why nutrition advices are implemented mostly partially. The
farmers also consulted the food consultant, that suggested (also) his own measures. In figure 5 these
phenomena were described as ‘no problem/priority for the farmer’, ‘contradiction advice several advisers’ and
‘solved by other measures’. The difference in focus between the farmer and the vet may also lead to
differences of opinion when the farmer and veterinarian, respectively, evaluate the results of advices. The
veterinarian believes that the success criterion is increased production and subsequent profit whereas the
farmer expects to be part of a team working with shared ambitions and common goals [Kristensen and
Enevoldsen, 2008]. So, it is very important for veterinarians/students to be aware of the aims of the farmer
during consultancy and evaluation of results.
In the current study, farmers called that implementation of some advices took too much time (6% of all reasons
why the farmer did not (fully) implement the advices). A lot of these advices were related to detection of the
heat (advice: 2-3 times a day 20-30 minutes observation of the cows). There is no more information found
about this subject in other studies.
Communication
According to Lue et al. (2008), the skill of the veterinarian in communicating the reasons for a procedure was
crucial for the implementation of treatments in animals. Therefore, the communication of what is
recommended and the reasoning behind it has to be improved to increase compliance. Relevant information
may be available, but to be implemented at farm level it has to be communicated effectively. This requires a
trustworthy communicator. When giving advices, it is important that the farmer understands the ‘problem’, the
goals of the farmer and the veterinarian are the same, the veterinarian explains in detail the interventions and
backgrounds, the advices are prioritized when giving several advices, on the next visit the implementation of
the advices and the results will be evaluated [Kristensen and Jakobsen, 2011]. If communication was a point of
attention in Blok 3 was not examined in this study.
Conclusion
In the current study, 38% of the evaluated advices were implemented, 21% of the advices have partially been
followed by interventions and 43% of the advices have not been followed up because of many different
reasons. The number of advices that have been followed by interventions increased if the total number of
advices increased. Mostly mentioned results were improved technical results and better animal health and/or
welfare. It was difficult to compare the results of the current study with other studies, because not much
research has been done about the subject and the goals and methods of the different studies differ.
7
References
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Bigras-Poulin M, Meek AH, Martin SW, McMillan I. (1985). Attitudes, management practices, and herd
performance – a study of Ontario dairy farm managers. II. Associations. Prev. Vet. Med. 15;3:241–250.
Jansen J, Borne BH van den, Renes RJ, Schaik G van, Lam TJ, Leeuwis C. (2009). Explaining mastitis incidence in
Dutch dairy farming: the influence of farmers’ attitudes and behaviour. Prev. Vet. Med. 92 (3):210-23.
Jonsson NN, Matschoss AL. (1998). Attitudes and practices of Queensland dairy farmers to the control of the
cattle tick, Boophilus microplus. Aust. Vet. J. 76(11):746-51.
Kristensen E and Enevoldsen C. (2008). A mixed methods inquiry: How dairy farmers perceive the value(s) of
their involvement in an intensive dairy herd health management program. Acta Vet. Scand. 18;50:50.
Kristensen E and Jakobsen EB. (2011). Challenging the myth of the irrational dairy farmer; understanding
decision-making related to herd health. N. Z. Vet. J. 59(1):1-7.
Lue TW, Pantenburg DP, Crawford PM. (2008). Impact of the owner-pet and client-veterinarian bond on
the care that pets receive. J. Am. Vet. Med. Assoc. 15;232(4):531-40.
Sorge U, Kelton D, Lissemore K, Godkin A, Hendrick S, Wells S. (2010). Attitudes of Canadian dairy farmers
toward a voluntary Johne’s disease control program. J. Dairy Sci. 93,1491–9.
Vaarst M, Paarup-Laursen B, Houe H, Fossing C, Andersen HJ. (2002). Farmers’ choice of medical treatment of
mastitis in Danish dairy herds based on qualitative research interviews. J. Dairy Sci. 85(4):992-1001.
Willock, J, Deary IJ, McGregor MM, Sutherland A, EdwardsJones G, Morgan O, Dent B, Grieve R, Gibson G,
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Attachment: Questionnaire
Evaluation of the ‘Blok 3 advices’
At any advice:
Topic
o
o
o
o
o
o
o
o
o
o
o
o
o
-
Udder health
Locomotion
Fertility
Production
Housing and climate
Nutrition and water
Biosecurity and hygiene
Health and welfare
Management and working routines
Social aspects
Youngstock
Dry period
Soil and crop
On initiative of the farmer, students or both
Short/long term
Implementation of the advice:
o Implemented

Result







Improved technical results
Improved animal health and/or welfare
More job satisfaction
Improved (including) through other measures
Not to say by another/underlying problem
It was too early to expect results
No result/not improved
8






Better feces
Higher grass crop
Unchanged health despite less medication
Result not evaluated
…
Evaluation of the result

Persons
o
o
o
o
o

Method
o
o
o
o
On the eye
Technical results/incidence
…
Not

Reason



















o
Farmer
Vet
Hoof trimmer
Nutrition consultant
…
The farmer found that no problem existed which an advice was given
The part which advice was given on had no priority for the farmer
The advice did not fit the farmer or his business
Implementation of the advice was too expensive
The farmer was not convinced that the advice would lead to the desired result
Implementation of the advice took too much time
The advice was not practically feasible
The advice was not formulated SMART enough
Implementation of the advice did not fit within the (current) work routines
The problem was solved by other measures
Contradiction advice several advisers
The farmer is planning to implement it
Results of previous investigations/changes disappointed
No investments in the old stable due to new building
The collected data would not be used for evaluation
The farmer found it unsafe
The farmer could not follow the advice because of his own health
The farmer did not appreciate the advice
…
Partially

Reason why the farmer did not fully implement the advice

See above

Result of the intervention(s)

See above

Evaluation of the result

See above
9