Performing Department
LG ANML CLIN SCI
Non Technical Summary
Antimicrobial resistance is a global threat to human and animal health and increased adoption of antimicrobial stewardship (AMS) is needed to maintain efficacy of antimicrobials. Veterinarians are a source of advice about antimicrobial usage (AMU), but farm workers detect and treat most diseases of dairy cows without direct veterinary supervision, thus improving AMU requires increased collaboration between veterinarians and producers. Mastitis and metritis account for most AMU on dairy farms and small changes in treatment of these diseases can result in reductions in AMU. However, many producers are skeptical about benefits of changing antibiotic treatments. Most dairy farmers believe that they are currently using an appropriate amount of antibiotics and do not have access to benchmarks that define "normal" AMU. Enhancing knowledge about appropriate AMU requires increased engagement of veterinarians and producers to recognize potential benefits of enhanced AMS. We hypothesize that providing benchmarks for AMU and educational resources to overcome barriers will increase engagement of veterinarians and dairy producers in AMS programs. To achieve this, we will:Determine barriers to changing AMU by surveying farmers and veterinarians in MI and WI to identify their beliefs, attitudes, and practices about AMU.Promote awareness of appropriate AMU by increasing access and value of benchmarking AMU. This aim will expand access to AMU benchmarking, provide economic assessments of currently used treatment protocols and train veterinarians and dairy professionals on how to overcome barriers to AMS.
Animal Health Component
100%
Research Effort Categories
Basic
0%
Applied
100%
Developmental
0%
Goals / Objectives
The overarching goal of this integrated project is provide a comprehensive approach to optimizing antimicrobial usage (AMU) practices on dairy farms. Our approach includes qualitative research to identify beliefs and practices of veterinarians and dairy producers that impact decisions regarding AMU on dairy farms. The results of the qualitative research will be used to guide extension programming to raise awareness of benefits of improving AMS. The extension program will increase access and relevance of peer benchmarking of AMU by including data from smaller herds and adding economic assessments of current treatments. The integrated extension program will add peer AMU data from smaller farms and assesses changes in knowledge and practices based on benchmarking AMU. Together, these aims will generate knowledge to guide and optimize usage of antimicrobials on dairy farms as well as provide increased knowledge of how to overcome barriers to enhanced AMS on dairy farms.OBJECTIVE 1: IDENTIFYING BARRIERS TO ENGAGEMENT. This objective will identify knowledge, beliefs, and practices of veterinarians and dairy producers about prudent use of antibiotics on dairy farms and identify barriers to improving AMS. We will evaluate knowledge based and behavioral barriers to enhancing adoption of antimicrobial stewardship (AMS). Antimicrobial usage practices are influenced by the knowledge, beliefs, social conventions and communication skills of farm owners and employees. The relationship with the farm veterinarian is an important driver of AMU. In this objective we will use on-line (veterinarians) and mailed (producers) surveys to learn about knowledge, attitudes and practices that impact AMU decisions of both veterinarians and dairy producers.OBJECTIVE 2: INCREASING ACCESS AND VALUE OF BENCHMARKING OF AMU. In human healthcare, as compared to educational programming or public commitment, comparison of prescribing antibiotics among peers has been shown to be a more effective intervention for reducing inappropriate AMU. To date, most farms that have performed benchmarking of AMU have contained at least 200 cows have used one of 2 computerized dairy management programs. In this objective we will raise awareness of appropriate AMU on additional dairy farms by increasing the number and diversity of dairy veterinarians and farmers who perform peer benchmarking with emphasis on extending benchmarking to smaller and midsized farms. This objective is focused on increasing engagement of veterinarians and dairy producers in AMS by developing and expanding use of tools that facilitate assessment of AMU. We will add value to our online benchmark tool report by adding a report that estimates the economic impact of current treatment protocols.
Project Methods
EFFORTObjective 1. We will perform surveys of veterinarians and dairy producers in Michigan and Wisconsin to learn about knowledge, beliefs and practices related to prudce use of antibiotics on dairy farms and to identify barriers to improving antimicrobial stewardship. An online survey of dairy veterinarians will include questions in 6 key areas: 1) practice characteristics, 2) prescribing practices and volume of drug sales, 3) current antimicrobial usage practices on client farms, 3) knowledge of prudent drug usage principles, 4) values and beliefs concerning use of antimicrobials and risks of antimicrobial resistance, 5) barriers to changing antimicrobial usage practices and 6) demographics of respondent. A mailed survey of dairy farmers will include questions in 6 key areas: 1) farm characteristics, 2) current antimicrobial usage practices, 3) knowledge of prudent drug usage principles, 4) values and beliefs concerning antimicrobial use and antimicrobial resistance, 5) management culture and barriers to improving antimicrobial usage, and 6) characteristics and demographics of farm owners, workers, veterinarians, and overall dairy producer context.Objective 2. We will revise the AMU benchmarking program to include more inputs and to include economic assessments. This aim will include increased programing of the code that underlies the benchmarking program. We will also perform an intervention to evaluate the impact of benchmarking AMU on decision making about AMU on dairy farms.EVALUATIONObjective 1. Evaluation of survey responses will consist of descriptive statistics (means, medians, and standard deviations) for all questions, including demographics, attitudes, beliefs, treatment practices and protocols, barriers for AMU and sources of information for AMU. Multiple linear or logistic regression models depending on type of outcome (continuous or dichotomous), will be used to analyze the relative and combine effects of different factors associated with key outcomes, e.g., barriers to improving AMU and current AMU.Objective 2. To determine if the intervention fosters optimal changes towards changing habits and treatment protocols, pre-post analysis of variance (ANOVA) will be used to identify significant changes in beliefs, attitudes, knowledge, and treatment practices. The analysis will consist of assessing whether there was a difference in antimicrobial usage practices, knowledge of prudent drug usage principles, values and beliefs concerning antimicrobial use and antimicrobial resistance, and barriers to improving antimicrobial usage before and after the intervention. The analysis will consist of descriptive statistics (mean, median, and standard deviations), plots comparing before and after the intervention, factor analysis, ANOVA, and analysis of covariance (ANCOVA). Multiple linear or logistic regression models depending on type of outcome (continuous or dichotomous) will be used to analyze the effects of beliefs, attitudes, and AMU practices on AMU.