Understanding the mastitis mindset: applying social psychology in practice

Abstract

Being successful in improving mastitis management is synonymous with behavior change, which is fully dependent on the mindset: is someone willing and able to change his or her behavior? Behavior of the farmer or his employees, behavior related to every day milking routines or to an ad hoc response to an outbreak of clinical mastitis, it all comes down to the same thing. We have a lot of technical knowledge, but when not applied, it is of no value. Social psychology provides us many tools for behavioral change, which are generally unknown to people professionally working in the dairy industry. The Theory of Planned Behavior, the Health Belief Model, the Elaboration Likelihood Model and ‘Nudging’ are often applied to understand and change people’s behavior related to health decisions. Interestingly, farmers and their workers are people too, and within a herd there are various health issues at stake. Understanding and applying these theories by policy makers, veterinarians, other advisors and farmers themselves could contribute to further improve udder health on a national or regional, as well as the farm level. In this paper some of the most relevant social psychology theories will be discussed, as will be some challenges that you may come across when trying to optimize the mastitis mindset on a farm.

Full text

In: Proceedings National Mastitis Council 55th Annual Meeting Jan 31-Feb2, 2016, Glendale, Arizona, pages:5-15
UNDERSTANDING THE MASTITIS MINDSET: APPLYING SOCIAL PSYCHOLOGY IN PRACTICE
Jolanda Jansen1,2, Roeland J. Wessels1,2 and Theo J.G.M. Lam1,3,4
1Communication in Practice, Nijmegen, The Netherlands
2 St Anna Advies, Nijmegen, The Netherlands
3Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University,
Utrecht, The Netherlands
4GD Animal Health, Deventer, The Netherlands
Being successful in improving mastitis management is synonymous with behavior change, which
is fully dependent on the mindset: is someone willing and able to change his or her behavior?
Behavior of the farmer or his employees, behavior related to every day milking routines or to an
ad hoc response to an outbreak of clinical mastitis, it all comes down to the same thing. We have
a lot of technical knowledge, but when not applied, it is of no value. Social psychology provides
us many tools for behavioral change, which are generally unknown to people professionally
working in the dairy industry. The Theory of Planned Behavior, the Health Belief Model, the
Elaboration Likelihood Model and ‘Nudging’ are often applied to understand and change people’s
behavior related to health decisions. Interestingly, farmers and their workers are people too, and
within a herd there are various health issues at stake. Understanding and applying these theories
by policy makers, veterinarians, other advisors and farmers themselves could contribute to further
improve udder health on a national or regional, as well as the farm level. In this paper some of the
most relevant social psychology theories will be discussed, as will be some challenges that you
may come across when trying to optimize the mastitis mindset on a farm.
Behavior Cannot be Planned
From a historical perspective, agricultural extension specialists, researchers, and veterinarians
assumed that dairy farming was an activity executed by an individual farmer, based primarily on
rational, technical, and economic considerations (Burton, 2004; Leeuwis, 2004). Although such
rational choices are crucial in farm management, we learned that farmers’ decision making about
mastitis management is hardly ever rational (Vaarst et al., 2002; Jansen, 2010). One of the most
used theories to understand people’s behavior is the Theory of Planned Behavior (TPB) (Ajzen,
1991; Fishbein and Yzer, 2003). The TPB, which is schematically presented in Figure 1, actually
is an adaptation of the Theory of Reasoned Action (Ajzen and Madden, 1986). The TPB model is
often used to explain famers behavior in various contexts. See e.g. Garforth (2010) who presented
this theory in detail regarding mastitis management at NMC before. In short, the model says that
if a farmer is actually willing to solve mastitis problems, is positively influenced by important
peers and has the feeling he can actually control and perform his actions, he will change.
Although the TPB model is widely used, it is based on the assumption that behavior can be planned
and rationalized if all signs are positive. We do know that real life is not that easy, and that there
often is a big gap between a positive intention and actual behavior (Sheeran, 2002, Webb and
Sheeran, 2006, Armitage and Connor, 1999, 2001). Research on TPB factors applied to mastitis
has confirmed the complexity of understanding farmers preventive mastitis behavior, the
underlying mindset and the effect on mastitis (Jansen et. al, 2009, 2010a,b; Jansen and Lam, 2012).

In: Proceedings National Mastitis Council 55th Annual Meeting Jan 31-Feb2, 2016, Glendale, Arizona, pages:5-15
In these studies, 92% of the farmers wanted to improve udder health and thus reported the intention
to change. However, when farmers’ were asked about the implemented preventive measures, this
self-reported behavior explained only 12% of the variance in clinical mastitis incidence and 14%
of the variance in bulk milk somatic cell count (BMSCC), showing that asking farmers what they
actually do- or not do- has a limited predicting value as well as asking about their basic intentions.
This means that you have to find other ways to unravel their management decisions. For example,
if you want to know if a farmer or employee cleans the cows teats properly before milking, you
can ask them: “Do you have the intention to clean teats before milking?” Most of them would say
yes, but that does not mean it will actually always happen. This is called the intention-behavior
gap. If you ask them “Do you always clean the teats before milking?” most would say yes as well,
but that does not give you any information about how clean the teats actually will be, because the
concept ‘clean’ is perceived different from person to person. Probably the best predicting question
to ask that correlates most with the actual behavior is: “How important is it for you that the teats
are clean before milking?” Such ‘mindset’ questions explain already a bit more about the
differences in mastitis incidence between farms: 17% of clinical mastitis incidence and 47% of the
variance in BMSCC (Jansen et al, 2009).
Figure 1. Schematic representation of the Theory of Planned Behavior (Ajzen, 1991; Ajzen and
Madden, 1986).
Perceived threat and perceived solutions
The results of several studies of the Dutch Udder Health Centre UGCN (Jansen and Lam, 2012,
Jansen 2010) showed that two specific factors of the farmer mindset are important behavioral
determinants for mastitis prevention: belief in a personal threat (influenced by perceived
susceptibility to, and perceived severity of the disease), and belief in the efficacy of preventive
behavior (influenced by perceived benefits from, and perceived barriers to prevention of the
disease). Interestingly, these factors are also known to be indispensable in motivating people to
work on their own health and are included in the so-called Health Belief Model (HBM), that is
presented in Figure 2 (Janz and Becker, 1984). In our earlier studies 58% of the respondents
worried about mastitis, and 60% had changed some of their management practices because of
udder health problems in previous years (Jansen et al., 2004, 2009, 2010a). Although 79% of the
farmers were interested in the prevention of mastitis, only 38% of the respondents thought that
they should actually do more about mastitis prevention. Although most farmers considered mastitis
as a serious problem and wanted to do more to prevent mastitis, they perceived they had low
behavioral control, felt insecure and doubted the efficacy of preventive measures: only 32% of the
farmers perceived that they had enough knowledge to prevent mastitis problems and 90% said that
mastitis is a difficult disease and very hard to tackle. Again, this shows a large intention-behavior
gap. Efforts to stress the importance of mastitis prevention probably have less effect, as most
Perceived behavioral control
Attitude
Subjective norm
Intention
Behavior

In: Proceedings National Mastitis Council 55th Annual Meeting Jan 31-Feb2, 2016, Glendale, Arizona, pages:5-15
farmers acknowledge that, and actually want to reduce mastitis incidence. Stressing effective
solutions and the perceived benefits and removing possible barriers is probably more effective as
that results in an action frame: “when I am in situation X, I will do Y, and that will have effect Z.”
As most people do not have the time to elaborate extensively on every action to take, these concrete
action frames help to make life much easier and probably have more effect on herd health than
only empathizing the problem itself.
Perceived susceptibility
Perceived severity
Perceived benefits
Perceived barriers
Belief in a personal threat
Belief in the effectiveness of a
preventive behavior
Preventive behaviorCue to action
Figure 2. The Health Belief Model (Janz and Becker, 1984, adapted by Koelen and Van den Ban,
2004)
How to overcome the intention-behavior gap?
According to fundamental social psychological theories, basically two different approaches can be
distinguished related to chancing behavior, such as mastitis management:
1) the comprehensive traditional ‘central’ route, which assumes that people make rational
decisions based on scientifically-proven information and argumentation.
2) a more indirect and unconscious ‘peripheral’ route that includes cues or heuristics that
automatically and unconsciously persuade farmers to change their behavior without using rational
argumentation or reasoning.
Both approaches are part of the Elaboration Likelihood Model of Persuasion (Petty and Cacioppo,
1986; Petty and Wegener, 1999) and is presented in Figure 3. Generally interventions aiming at
changing people’s behavior on udder health follow the seemingly most logic approach, using
rational arguments to convince people to change behavior; “when they have more knowledge, they
will understand, and they will change” i.e. the central route. As described above when discussing
the TPB and the HBM, we know that the central route has a limited effect (Leeuwis, 2004; Webb
and Sheeran, 2006, Bargh and Morsella, 2008).

In: Proceedings National Mastitis Council 55th Annual Meeting Jan 31-Feb2, 2016, Glendale, Arizona, pages:5-15
Motivated to process?
Ability to process?
Argument quality
A change in cognitive
structure?
Peripheral change
Is a peripheral; process operating?
Retain or regain initial attitude and
behavior
yes
poor
no
no
no
yes
Yes
(favourable) Yes
(unfavourable)
no
Enduring change
yes
Figure 3. The Elaboration Likelihood Model of Persuasion (Petty and Cacioppo, 1986; Petty and
Wegener, 1999), left aligned the central route, right aligned the pheripheral route.
If people are not motivated, or not motivated enough, the central route will not work, but they may
be effectively approached by the peripheral route. That approach uses cues, heuristics and ‘nudges’
as an unconscious ‘push’ in the desired direction. Heuristics are cognitive shortcuts. Instead of
weighing all the evidence when making a decision, people rely on heuristics to save time and
energy.
Our earlier findings showed that farmers’ familiarity with the tools and their interest in using them,
is associated with aspects of farmer mindset, such as the perceived importance of improving udder
health and the perceived economic benefit of udder health improvement. This suggests that for
farmers who are less motivated, that type of communication strategies is less effective and that
other ways need to be explored to reach these farmers (Jansen, 2010b). In that situation, a
peripheral communication strategies, where internal motivation is not an important prerequisite
(Petty and Cacioppo, 1986; Petty and Wegener, 1999), and that do not use comprehensive science-
based argumentation, can be successful, as for instance applied in the milking glove campaign
(Jansen, 2010b). Using peripheral communication strategies multifaceted goals of decreasing a
complex disease like mastitis will, however, not be met in the short term (Sheeran, 2002). The
peripheral route is suitable to implement single management practices (e.g. wearing milking gloves
during milking) and short-term behavior changes, because these are more easily adopted than a
combination of multiple actions to achieve a certain goal (Sheeran, 2002). Thus, in order to change
the management of suboptimal motivated people on a multifactorial disease such as mastitis,
peripheral communication strategies can be effective, if a step-by-step approach is chosen.

In: Proceedings National Mastitis Council 55th Annual Meeting Jan 31-Feb2, 2016, Glendale, Arizona, pages:5-15
Cues, Heuristics and Nudges, and other peripheral approaches.
In the daily conversations with farmers or employees, very often the peripheral approach is chosen.
Consciously and unconsciously peripheral ‘tricks’ are used, and can be very effective. The fact
that most behavior of people is based on routines and is executed more or less automatically and
impulsive without thoughtful considerations, is effectively used in marketing, sales and
advertising. Cialdini (2001) showed that cues such as authority or expertise (e.g. if my veterinarian
says so, it must be right), or cues of social proof (e.g. if all farmers are doing it, then it must be
good) are able to influence people without them being aware of it. Some of the tactics that can be
used and are based on various sources from social psychology (Cialdini, 2001, Heemskerk et al,
2014, Renes et al. 2011) are:
 Feedback nudge: Give people direct feedback at the moment they perform the behavior,
e.g. a thermosticker that reveals a smiley when the water is the right temperature for rinsing
a milk cluster after a high SCC cow.
 Stimulans nudge: use a practical tool or change the environment to stimulate the desired
behavior, e.g. disinfecting floor mat that is placed in such a way it cannot be avoided before
entering the young stock barn.
 Default nudge: use default settings as basis for a choice, and ask people to actively change
a default setting to create a barrier for the undesired behavior, e.g. default setting to rinse
and clean after every cow in an automatic milking system.
 Kludges: stimulate people to control their own behavior, e.g. an app to install on a
smartphone that regularly give reminders via pushed messages, e.g. assess body and teat
condition score
 Injunctive norm: Connect social proof to the desired behavior: e.g. a ‘good farming
practice’ is to not give waste milk with antibiotics to calves, show them that the desired
behavior fits their identity of e.g. being a good farmer, good breeder, good milker etc. by
showcasing the national udder health awards winners.
 Descriptive norm: Show that the desired behavior is performed by most of the relevant
peers, e.g use benchmarking tools like traffic lights to show how the farmer deviates from
others, like i.e in antibiotic usage, or BMSCC.
 Use a role model: use a messenger that is seen as ‘one of us’ to show that it is actually
possible to perform the desired behavior. E.g. use story telling by giving local farmers a
platform to share their experience in how they have succeeded to reduce BMSCC
 Commitment and consistency: Make sure people are emotionally involved to the subject
by confronting them with previous promises. E.g. write down goals and wishes and put
them in a visible place.
 Reciprocity: People tend to return a favor, e,g, give farmers the idea that they get something
for free, such as distributing free collecting tubes for milk samples to stimulate to return
them for diagnostic tests.
 Scarcity: stress the limited availability of certain products or resources, as they value things
more when they are scarce. E.g. “Only a few seats left for evening lecture on mastitis”.
 Priming: use peoples sensory system (smell, vision, taste etc) to evoke certain associations
automatically. E.g. when the parlor looks clean (but not truly disinfected) and smells like
citrus or bleach, staff will act more hygienically.

In: Proceedings National Mastitis Council 55th Annual Meeting Jan 31-Feb2, 2016, Glendale, Arizona, pages:5-15
Bringing it to practice: R.E.S.E.T. the mindset
The above discussed theoretical models and the peripheral approaches are all ingredients to change
the mastitis mindset of farmers and their employees, to change mastitis management, and
ultimately to improve udder health. The different information and ingredients should be used in a
coordinated way to make the approach successful. When talk about successful influencing the
mindset, it’s important useful to realize that different people respond different to stimuli. If you
want to change behavior of a group of people, it is important to realize that a ‘one size fits all’
approach, will not work. Some people are sensitive to a particular stimulus, while others are more
responsive to something else. People’s behavior, therefore, can be most effectively changed using
of an intelligent mix of different stimuli. Theoretically an analysis and individually adapted
approach of every farmer would work best, but in daily practice, this is impossible. Luckily, some
successful intervention strategies are available, to make life easier. One of them is the R.E.S.E.T
model, that we adapted from van Woerkum et al. (1999) and Leeuwis 2004, and has been applied
in a slightly different form to describe effective communication strategies for reducing mastitis
before (Lam, 2012; Jansen, 2010). The R.E.S.E.T. model is presented in Figure 4, and summarizes
the above presented models and peripheral approaches in five important cues to action: rules,
education, social pressure, economics and tools. Each of them is discussed below.
BEHAVIOURAL CHANGE
Compulsory
Internally motivated Externally motivated
Voluntary
Circumstances
Education Economic incentiveSocial pressure ToolsRegulation
Coercion
Norms & Values Provisions & MeansRewards & Fines
Figure 4. The R.E.S.E.T model (adapted from Van Woerkum et al. 1999, and Leeuwis, 2004).

In: Proceedings National Mastitis Council 55th Annual Meeting Jan 31-Feb2, 2016, Glendale, Arizona, pages:5-15
R is for rules: the structure seeker
Rules and laws, as well as their enforcement, compel you to perform a desired behavior. You are
forced to drive within the speed limit. If you exceed it, you commit an offence that could result in
a fine, or sometimes worse. The rule and its enforcement then leads people to change
their behavior, though not voluntarily. If the rules are relaxed or enforcement is discontinued,
people eventually lapse back into their old behavior patterns. So, rules can be effective, but only
as long as they exist and are enforced, for example milk quality or animal welfare regulations.
Another part of this approach is that some people are sensitive to clear rules, in the sense of having
clear directions on what to do.
E is for education: the information seeker
Education and awareness campaigns are an important stimulus for behavioral change. Some people
are more willing to apply information that they fully grasp and understand. Education is mainly
effective in behavior change in intrinsically motivated people. Nevertheless, they have to be
convinced that their behavior will influence the desired result, although that often requires a long
term learning process. Study programs for farmers and employees, lectures, online learning,
knowledge tests, and handbooks can be part of an educational route.
S is for social pressure: the status seeker
When you think about teenagers, you likely understand exactly what we mean by social pressure.
We humans impose certain norms and values on one another. Those who deviate from these are
cast aside, which is not a pleasant experience. That is why most people in the US use dips for teat
disinfection, while most people in New Zealand use sprays. That is what is considered ‘normal’
behavior. Most people would do anything in their power to become or remain part of a certain
group. We call this “herd mentality”. The urge to belong, for social cohesion, is an important
motivator for behavioral change. In the past, you were considered a wimp if you didn’t drink
alcohol because you had to drive home. Today, we have the ‘designated driver’, who is a special
guest at parties. Until recently, smoking was commonplace in public buildings. Now,
in most countries, lighting up in a restaurant gets you dirty looks and an escort outside. Vets and
other farm advisors play an important role in shaping this societal frame of reference as they have
a strong influence on animal owners’ opinions about animal health. Showcasing best practices and
giving awards such as ‘employee of the month’ are ways you can effectively use social pressure
to help motivate behavioral change. People mimic good examples and draw inspiration from role
models. Peer study groups make good use of this principle, because participants share good
experiences with one another.
E is for economic stimuli: the price seeker
Costs and benefits influence decisions about whether to do something or not. This is logical,
because money is a major stimulus in our free-market economy. Awarding financial bonuses for
desired behavior is a strong motivator to continue that behavior or even to improve it. Think, for
example, of setting up a bonus system to reward employees who have achieved goals on milk
quality. Fines are an economic incentive too. They also motivate people to change their behavior.
People do differ, however. One may respond better to rewards, while another is more sensitive to
penalties. If you want to change people’s behavior, you have to take these sensitivities into account.
Remember, however, that when a farmer says that a treatment is “too expensive”, this actually
means there is misbalance between profits and costs, he may not think you are that good as an

In: Proceedings National Mastitis Council 55th Annual Meeting Jan 31-Feb2, 2016, Glendale, Arizona, pages:5-15
advisor, or may not believe that the treatment you are suggesting will work, or may use the ‘cost
excuse’ to hide other perceived barriers. Economic stimuli sometimes have a counter-productive
side effect. Giving an overly generous discount, for example, might lead clients to doubt the quality
of your services.
T is for Tools and technical facilities: the convenience seeker
Technical facilities and tools play an underappreciated role in stimulating behavioral change. You
might receive ample information about the dangers of speeding, and the road fines in your country
might be sky high, but if it’s easy to drive too fast you will probably continue doing so. A speed
bump, however, forces you to perform the desired behavior. You slow down. Tools can be used to
change people’s behavior without them even being aware of it. Most of the previously mentioned
cues, nudges and heuristics are grouped under Tools. For example, if we want don’t want milkers
not to attach too quickly in a rotating milking parlor, we can make a fence that they cannot easily
pass.
Conclusion
Changing behavior of people, whether these are veterinarians, farmers or employees, is a science
on itself. Udder health specialist, farm advisors, veterinarians and farmers could learn from
strategies and tactics used in marketing and should be creative in finding ways to stimulate people.
Although the educational, central route is preferred by most policy makers, practice reveals that
using solely this strategy has limited effect. Communicative approaches should be taken seriously,
and alliances with social scientist could catalyze creativity in thinking of ways to implement
peripheral cues in udder health programs. The ‘R.E.S.E.T. the mindset’ approach integrates the
different social psychological models in a practical way. It shows that there are more ways to
change people’s behavior. It’s not just one button to push, but it’s the combination of multiple
strategies that makes communication successful in behavioral change.
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