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Equine Assessment Procedures in Professional Association of Therapeutic Horsemanship Unmounted Programs
Sarah Andersen1, Michael L. Pate1,*, Judy Smith2, Holly Clement2, Rose Judd-Murray1
Published in Journal of Agricultural Safety and Health 29(2): 99-108 (doi: 10.13031/jash.15457). Copyright 2023 American Society of Agricultural and Biological Engineers.
1Department of Applied Sciences, Technology, and Education, College of Agriculture and Applied Sciences, Utah State University, Logan, Utah, USA.
2Department of Animal, Dairy, and Veterinary Science, College of Agriculture and Applied Sciences, Utah State University, Logan, Utah, USA.
*Correspondence: michael.pate@usu.edu
The authors have paid for open access for this article. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License https://creative commons.org/licenses/by-nc-nd/4.0/
Submitted for review on 15 November 2022 as manuscript number JASH 15457; approved for publication as a Research Article by Community Editor Dr. Garey Fox of the Ergonomics, Safety, & Health Community of ASABE on 3 March 2023.
Highlights
Abstract. The Professional Association of Therapeutic Horsemanship International (PATH Intl.) is an organization that supports equine-assisted services (EAS). As the standard setting organization for EAS programs, PATH Intl. established evaluation metrics to ensure the safety of both humans and equines. One of the standards, Equine Management and Welfare Standard 2 (EQM-2), calls for EAS programs to have an unbiased equine assessment process. This standard can be implemented in different ways depending on program policies. Survey data was collected on each type of center with regard to the implementation of the equine assessment standard in unmounted (ground) activities, as well as self-reported safety and equine evaluation procedures for unmounted (ground) activities. The primary research objective was to identify differences between PATH Intl. Premier Accredited Member Centers and PATH Intl. Member Centers. No significant differences were found between center types except for incidents of human injury (?2[2] = 9.908; p =.007). Both types of centers had a variety of responses related to the implementation of their evaluation procedures, including, but not limited to, how many individuals evaluate each equine, the type of assessment tool, and the frequency of evaluations. Future studies should examine the different evaluation methods in depth to determine an objective standard for equine evaluation procedures in EAS programs and how best to keep human participants safe during therapeutic services.
Equine-assisted Services (EAS) involve trained professionals who work with humans with various cognitive, mental, or physical challenges using trained equines to meet a variety of learning, horsemanship, and therapy goals. Some examples include equine-assisted learning in organizations (learning), adaptive riding (horsemanship), and mental health services that incorporate equines into their practice (therapy) (Wood et al., 2020).
While interactions with equines through EAS have resulted in quality of life, social, psychological, and physical benefits for the participants involved (Kendall et al., 2015; Marchand et al., 2022; McDaniel and Wood, 2017; Rigby and Grandjean, 2016; Robinson, 2022; Stergiou et al., 2017; Zadnikar and Kastrin, 2011), there are risks associated with unmounted (ground) and mounted (riding) equine interactions. These include injuries ranging from mild to severe and even death. These risks are largely due to equine behavior, especially behaviors derived from the equines’ fight or flight instincts (Camargo et al., 2018; Kiss et al., 2008; Guyton et al., 2013; Theodore et al., 2017; Thomas et al., 2006; Thompson and von Hollen, 1996). It is critical for EAS programs to prevent harm to both human and equine participants via risk assessments.
The Professional Association of Therapeutic Horsemanship International (PATH Intl.) is “a federally registered 501(c)3 organization [that] leads the advancement of professional equine-assisted services (EAS) by supporting [their] members and stakeholders through rigorously developed standards, credentialing, and education” (PATH International, n.d.a) and works to keep both horses and humans safe in EAS programs. They support over 800 member centers, nearly 7000 members, and serve over 53,300 individuals a year. PATH Intl. supports both PATH Intl. Premier Accredited Centers (referred to as Premier Centers) and PATH Intl. Member Centers (referred to as Member Centers). Premier Centers are required to meet a certain number of standards set out by PATH Intl. in the Professional Association of Therapeutic Horsemanship International Standards for Certification and Accreditation manual (2021). Member Centers are encouraged, but not required, to meet the standards. Member Centers have access to resources through PATH Intl., may display the PATH Intl. logo, and be included in the PATH Intl. directory of centers. Once a program has been a Member Center for at least one year, they may apply to become a Premier Accredited Center. They must go through a rigorous accreditation process to ensure their center meets all the standards laid out by PATH Intl. This new designation does come with increased recognition, opportunities for funding, and additional resources. Programs may choose to remain a Member Center and not pursue Premier Center membership due to the time, money, and resources it takes to go through accreditation (PATH International, n.d.b).
Due to the many risks associated with equine interaction, equine evaluations should be utilized as a precaution to reduce injury risk. PATH Intl.’s standards establish best practice evaluations for EAS programs to follow that support the “safety of participants, volunteers and equines” (PATH International, 2021). Compliance with a certain number and type of standards is mandatory to be recognized as a Premier Center. Compliance with the standards is recommended but not required to be a Member Center. This raises the question of potential differences between PATH Intl. center types and the level of safety practices used to reduce injuries to participants.
One of these standards that is recommended to follow is the PATH Intl. Equine Welfare and Management Standard 2 (EQM-2). Part I of this standard states that centers should establish “written procedures for the evaluation of the suitability of new equines prior to participating in center activities/services” (PATH International, 2021). Specifically, centers should utilize an “unbiased tool for effective measurement of the ability and suitability of all equines participating in center activities/services.” Unbiased refers to the tool’s ability to assess an equine’s ability objectively and fairly. An example of a bias is when an evaluator, without completing a thorough assessment of the equine, claims that a certain breed of equine cannot be safely used for EAS programs. The evaluation procedures the center has in place must, according to the standard, delineate the following:
- “Who is the ultimate decision maker?
- Who performs the equine evaluations?
- What specific criteria/behaviors an equine must demonstrate prior to being placed into each activity/service?”
Under the standard, a PATH Intl. center has the autonomy to define and implement the equine evaluation procedure. A great deal of variability is anticipated between PATH Intl. Centers, given the latitude to develop a process that is meaningful and feasible for their program. The purpose of this research was to describe differences between PATH Intl. centers’ (Premier Centers vs. Member Centers) unmounted (ground) equine evaluation procedures and unmounted (ground) program safety. The research objectives guiding the study were as follows:
- Describe unmounted equine evaluation procedures performed by PATH Intl. Centers.
- Determine the association between PATH Intl. Center Type and unmounted equine evaluation procedures.
- Determine the association between PATH Intl. Center Type and self-reported injury incidents in unmounted EAS.
Materials and Methods
To meet the objectives, the Equine Evaluation Procedures in PATH Intl. Centers Survey was created using Qualtrics. Human subjects research was approved under Utah State University IRB Protocol #11170. The survey consisted of 19 questions to collect information on respondent demographics, self-reported equine evaluation practices, injury incidences, and open-ended response prompts.
The survey was reviewed by a panel of five experts from the fields of equine science, equine-assisted services, veterinary science, agricultural safety, and program evaluation. These experts determined the survey to be content and face valid. The survey was then field tested by members of [STATE] Equine Experience’s team prior to distribution among PATH members. The survey was updated and edited for readability as well as clarity.
Participants
The population chosen for the survey were EAS centers from PATH Intl.’s website directory that had a listed, current email address and provided groundwork activities. This resulted in a population of 536 centers as of September 2, 2020. Based on a population size of 536, a 95% confidence interval and a 5% margin of error were used to estimate the sample size of 224. To account for incorrect or non-deliverable email/contact information for individuals listed as the contact for a PATH center, the sample size was increased to 250. Emails were sent to the email listed on PATH Intl.’s website. The email requested that an individual from the program who was familiar with the evaluation processes and over the age of 18 complete the survey.
Distribution
The survey was open for response collection over a seven-week period. Multiple reminder emails were sent to the participants to encourage survey completion. Two hundred and fifty emails were sent from a university email address that described the study and requested survey responses. Five email addresses were incorrect or no longer valid. These email contacts were marked as “undeliverable.” This resulted in 245 valid contacts.
Responses to open-ended prompts were coded using inductive coding (Medelyan, 2020). The codes were as follows:
- Question 9, which asked how passing scores were defined: Responses were divided between a “not clearly defined passing score” and a “clearly defined passing score.”
- Question 10, which asked who performs the evaluation: Responses were divided between “one person listed” and “more than one person listed.”
- Question 11, which asked who the ultimate decision maker was on if a horse passed or not: Responses were divided between “one person listed” and “more than one person listed.”
- Question 13, which asked if they believed their evaluation process was biased or unbiased: Responses were divided between “no,” “yes,” “in between,” and “unclear.”
Descriptive statistics were analyzed using IBM SPSS Statistics (version 27.0.1). A Chi-square test of association was used to determine the association between PATH Intl. Center Type and evaluation procedures. To check for non-response bias, an additional Chi-square test of association was used to determine the association between PATH Intl. Center Type and responder type. Early responders were defined as those that responded prior to the date of the final reminder email, while late responders were defined as those that responded on or after the date of the final reminder email.
Results and Discussion
Response Rate
Of the centers contacted through email, 29% started the survey (n = 71). Of those that started, 77.1% completed the survey in its entirety (n = 55). Missing data for each question varied. For each question, the total number of responses is noted. The overall response rate for this survey was lower (29%) than previous emailed surveys to PATH Centers with 36% reported by Rankins et al., (2021) and 40% reported by Watson et al., (2020). Premier Centers accounted for 51% of responses, while Member Centers made up the other 49% of responses (n = 65). There was no association between early and late responders and type of PATH Intl. center (?2[1] =.905; p =.341).
Program and Respondent Demographics
All respondents were associated with a program that provided groundwork, as was part of the search parameters in selecting the study population (n = 65). All but one (98.5%) had an evaluation process for equines in their program, while one respondent was unsure (n = 66). Respondents held a variety of positions at their PATH Intl. center. Respondents noted holding more than one position at their center. The most common positions held were program director (f = 37), equine/herd manager (f = 32), equine trainer (f = 20), and executive director (f = 15). The majority of respondents were certified PATH Intl. Certified Therapeutic Riding Instructors (CTRIs) (50.8%), while the rest held both the PATH Intl. Equine Specialist in Mental Health and Learning (ESMHL) certification and PATH Intl. CTRI certification (20%), held neither the PATH Intl. ESMHL or PATH Intl. CTRI certifications (13.8%), held “other” credentialing (9.2%), or were certified PATH Intl. ESMHL professionals (6.2%) (see fig. 1) (n = 65). There was a non-significant association between the type of PATH Intl. center and the certifications held by the respondent (?2[4] = 2.759; p =.599).
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| Figure 1. Proportion of certifications held by respondents. |
Evaluation Procedures
Centers assessed many ground skills and behaviors on their evaluations, including grooming (f = 54), leading at the walk (f = 54), reaction to arena props (f = 54), leading at the trot (f = 53), leading over obstacles (f = 53), standing tied (f = 51), back up (f = 49), catching and haltering (f = 49), and others (f = 31).
When asked how evaluation procedures were completed, 37% used a checklist, 26% selected a rating scale, 26% selected “other method,” and 11% used a rubric (n = 54). There was a non-significant association between the type of PATH Intl. center and the type of evaluation used (?2[3] =.212; p =.976).
When asked what constitutes a passing score for an equine, 36.7% of respondents used an objectively defined method (i.e., used a defined percentage, number, rating scale, or yes/no checklist that must be achieved by the equine prior to them entering the program), while 63.3% did not use an objectively defined method (n = 49). For example, they would determine the equine was “safe and sound,” but did not use a quantitative aspect to determine this claim. There was a non-significant association between type of PATH Intl. center and type of passing score (?2[1] =.492, p =.483).
Most respondents (71.2%) had more than one individual evaluate an equine, with the remaining 28.8% utilizing only one evaluator (n = 52). There was a non-significant Chi-square result indicating no significant association between the type of center and the number of individuals (one or more than one) who performs the evaluations (?2[1] =.321; p = .571). When asked who evaluates the equines, a wide range of positions were listed. The positions can be broadly summarized as barn/equine staff, directors, managers, instructors, staff, and volunteers.
When asked who made decisions on horse acceptance in to the program based on the evaluation, 66% of respondents noted one person while 34% of respondents noted more than one person (n = 50.) When asked who this individual was, many positions were listed but could be broadly summarized as barn/equine staff, directors, managers, instructors, staff, and volunteers.
Respondents were asked how often equines were evaluated at their program. Respondents indicated that equines were evaluated only prior to their initial placement in the program (20.4%), every year (20.4%), and at “other” intervals (59.3%; n = 54). For those that selected “other,” they responded in a variety of alternative interval times such as once a season, after an injury/illness/occurrence, as needed, or continuously. There was a non-significant Chi-square result, indicating no significant association between type of center and the evaluation intervals (?2[2] = 1.008; p =.604).
Exploring the level of bias respondents perceived within their program’s equine evaluation procedures was important as the EQM-2 calls for an “unbiased” evaluation process (PATH International, 2021). “Unbiased” refers to an individual’s ability to assess an equine objectively and fairly. Because they employed methods to reduce or eliminate bias, 63.5% of respondents considered the procedures to be unbiased. These methods included having multiple individuals evaluate, evaluating on different days, using a rating scale with a clear pass/fail score, or using a checklist with “strict criteria.” Unclear responses accounted for 15.4% of responses and may be attributed to an unclear definition of bias in this context. Responses that were in-between biased and unbiased added up to 13.5% of responses. Some of the stated reasons for this view were that evaluators have inherent biases related to their attachments to the equine but can make an unbiased assessment based on characteristics such as breeds, blemishes, gender, and color. The remaining 7.7% of responses acknowledged that the evaluation process was biased due to the natural biases that evaluators hold (n = 52). There was a non-significant Chi-square result indicating no significant association between type of center and the perceived bias (?2[3] = 7.00; p =.072).
Safety and Injury Incidents
Respondents were asked to report what safety issues occurred during ground programming. Biting/nipping was the most common response (f = 16). Other responses included reacting to/spooking at external stimuli (f = 10), stepping on a person’s foot (f = 8), irritation/aggression/agitation (f = 4), not responding to handler cues (f = 4), pulling on/dragging handler (f = 4), kicking (f = 3), loose horse (f = 2), spinning (f = 2), charging (f = 1), crowding personal space (f = 1), and not standing tied (f = 1).
Respondents were asked to report if EAS participants had received an injury in the last two years from participating in groundwork. An injury is defined as an occurrence resulting in first aid, self-care medical treatment, or physician medical treatment. Ten respondents reported an EAS participant injury(ies) during ground activities/therapies at their center (n = 55). Injuries were reported more frequently by individuals working at Premier Centers than Member Centers (?2[2] = 9.90; p =.007).
When asked to identify responsibility for the incident, most respondents (62.5%) noted that the fault for the injuries was shared by both the equine and human (n = 8). The specific causes of all injuries were grouped into two categories: the equine stepped on a person or the equine bit a person. An example of an injury occurring due to both equine and human fault is when the equine shifted their weight and stepped on an individual who was standing too close. An example of an equine being fully at fault for the injury was when an equine spooked and landed on an individual’s foot. Of those injuries noted as an equine only fault, 87.5% of the equine involved in the incident were evaluated as acceptable for use (n = 8). There was a non-significant Chi-square result, indicating no significant association between type of center and if the equine had been through the evaluation process (?2[1] =.16; p =.686).
When asked, “How does an evaluation process for equines before they are used in program impact equine and human safety?” many responses clarified that evaluations are important for the safety of both the equine and the human. Two themes arose from the responses: (1) evaluations identify areas of risk, and (2) evaluations determine if the equine is suited for its intended job based on physical characteristics and temperament of the equines.
Respondents were asked to indicate their level of agreement with the statement, “An unbiased equine evaluation process increases both horse and human safety during therapies, learning activities, and adaptive horsemanship.” The majority of responders strongly agreed with the statement (35.5%). The rest of the responses were as follows: agree (31.4%), strongly disagree (17.6%), and neither agree nor disagree (15.7%) (n = 55). There was a non-significant Chi-square result indicating no significant association between type of center and level of agreement with the statement (?2[3] = 7.81; p =.050). Premier Centers tended to strongly agree or agree, while Member Centers tended to agree or strongly disagree.
Conclusions
This survey research documented the current unmounted (ground) equine evaluation procedures of several PATH Intl. Centers. Both Premier Centers and Member Centers are incorporating equine evaluation guidelines in similar ways. Program and respondent demographics were as expected in relation to the programs having a groundwork program and an equine evaluation process. The range of evaluation procedures and policies across centers reflected the centers’ autonomy provided under the PATH Intl. Equine Welfare and Management Standard 2 (EQM-2) criteria. Results from the survey indicated a need for well-defined best practice procedures for equine evaluation to serve in EAS programming. For example, the continuous evaluations were noted by less than 50% of respondents. Additionally, the consistency of equine evaluations is questionable among responding centers. This was noted by the primary role of the individuals (e.g., barn/equine staff, directors, managers, instructors, staff, and volunteers) who completed evaluations. Over a quarter of respondents (28.8%) indicated one person completed the evaluation, which calls into question whether the evaluation is reliable and unbiased.
Furthermore, most centers did not have an objectively defined passing score. This could increase the chance of bias in evaluations, which should be reduced where possible. A recommendation is to apply a reliable and valid equine evaluation procedure. One example of a reliable and valid evaluation rubric is the Basic Ground Skills Assessment for EAS equines (Andersen, 2021). This assessment provides objective and well-defined measures to score equines on ten basic ground skills competencies. The ground skill competencies are like those reported by PATH Intl. Centers who participated in this study.
Data gathered on injuries and safety perceptions demonstrated that there is a relatively low number of injuries during ground programs. More data should be collected to determine why Premier Centers reported a higher rate of injury incidents. A potential explanation is that Premier Centers may serve a greater number of participants, which could have resulted in a higher incidence of injuries reported. In the future, the injury rates should be calculated by contact time with equines to provide an accurate rate of injury, as the current numbers gathered from the survey lack the comparative statistics needed to draw accurate conclusions on the rate of injury. More research is needed to document the severity of injuries and how PATH Intl. Centers will address future prevention strategies. The injuries that were noted by respondents (i.e., an equine biting a person or stepping on a person) correlate to the potential risks of injury during equine interaction identified by the respondents and in the literature. Evaluation procedures should screen for these behaviors to minimize the chances that future individuals will be at risk of injury due to biting or getting stepped on.
Finally, the responses related to how the evaluation processes affect safety fall in line with what PATH Intl. and others have stated (Chapman and Thompson, 2016; De Santis et al., 2017; PATH International, 2021). While most respondents had a positive perception towards evaluations, it was interesting to note that not all individuals agreed that an unbiased equine evaluation process increases both horse and human safety during EAS. This could have been due to the wording of the question (both horse and human), but should be further investigated to determine the receptiveness of individuals to future recommendations on equine evaluation procedures.
Limitations
The largest limitation of this survey was the small response rate. This could have been caused by confusing questions, a long survey, the distribution channels, or research fatigue caused by COVID-19 (Patel et al., 2020). The impact of the smaller number of respondents was reduced by comparing early to late responders and finding no statistical difference between the center types. Additionally, it should be noted that the questions were geared towards unmounted/ground evaluations and not mounted evaluations.
The results from the survey identified equine assessment areas that could be further developed. Specifically, the following questions should be explored:
- What is an objectively defined measure that indicates if an equine is or is not suitable for EAS?
- How many individuals should evaluate an equine to ensure the assessment is reliable and unbiased?
- Who should evaluate equines for EAS?
- How often should evaluations occur to be reliable and valid?
Additionally, a deeper investigation into the injury rates and causes would be merited. While some trends were discovered in this survey, more information is needed to better understand the link between evaluations and safety. Utilizing additional survey methods, such as interviews, may result in a higher response rate.
The similarity in Premier Member and Member Center responses alluded to the fact that PATH Intl. centers, regardless of designation, meet standard EQM-2 in a similar way. It should be noted that having an equine evaluation procedure is not a mandatory PATH Intl. standard, yet 98.5% of respondents reported having a procedure for evaluation. The range of responses could fuel future research in procedures to determine a “gold standard” for equine evaluation procedures in EAS programs. If centers had an accessible tool to meet standard EQM-2 that also followed current evaluation trends, consistency across the field may be more commonplace.
Acknowledgments
This research was supported by the Utah Agricultural Experiment Station, Utah State University, and approved as journal paper number 9621.
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