Use of the Health Belief Model to identify factors associated with owner adherence to elimination diet trial recommendations in dogs

Abstract OBJECTIVE To use the Health Belief Model to identify factors associated with owner adherence to elimination diet trial (EDT) recommendations by veterinarians for dogs with suspected cutaneous adverse food reactions (CAFRs). SAMPLE 192 owners of dogs prescribed an EDT between April 1, 2012, and April 1, 2017. PROCEDURES Owners of dogs prescribed an EDT to diagnose CAFRs were identified through review of medical records from a single veterinary dermatology specialty practice. Identified owners were invited to participate in an anonymous online survey that was developed on the basis of the Health Belief Model. Multivariable logistic regression was used to evaluate associations between potential predictor variables and 100% adherence to EDT recommendations. RESULTS 665 owners were invited to participate, and 192 (28.9%) completed the survey. Of the 192 respondents, 77 (40.1%) reported 100% adherence to EDT recommendations, and 115 (59.9%) reported < 100% adherence. Results indicated that the odds of owners reporting 100% adherence to EDT recommendations were significantly decreased by owner perception of barriers (adjusted OR [ORa] = 0.86) and were significantly increased by owner knowledge regarding diets and CAFRs in dogs (ORa = 1.30) and by self-efficacy or confidence in performing an EDT as directed (ORa = 1.18). CONCLUSIONS AND CLINICAL RELEVANCE Findings indicated that most prescribed EDTs were not followed strictly. Interventions to help owners reduce perceived barriers, increase self-efficacy, and improve related knowledge could improve adherence to EDT recommendations and, thereby, increase the diagnostic utility of EDTs.