Preventive Veterinary Medicine 220 (2023) 106046 Contents lists available at ScienceDirect Preventive Veterinary Medicine journal homepage: www.elsevier.com/locate/prevetmed Improving the communication between farmers and veterinarians to enhance the acceptability of bovine tuberculosis eradication programmes Giovanna Ciaravino a, *, Josep Espluga b, Carlota Moragas-Fernández c, Arantxa Capdevila c, Vanessa Freixa d, Feliu López i Gelats e, Timothée Vergne f, Alberto Allepuz a a Departament de Sanitat i Anatomia Animals, Universitat Autònoma de Barcelona (UAB), Bellaterra, 08193 Barcelona, Spain b Departament de Sociologia / IGOP, Universitat Autònoma de Barcelona (UAB), Bellaterra, 08193 Barcelona, Spain c Departament de Estudis de Comunicació, Universitat Rovira i Virgili (URV), Tarragona, Spain d Asociación Obrador Xisqueta Montanyanes, Pallars Sobirà (Alt Pirineu), Spain e Càtedra d’Agroecologia i Sistemes Alimentaris, Universitat de Vic-Universitat Central de Catalunya, Spain f National Veterinary School of Toulouse, ENVT-INRAE IHAP, Toulouse, France A R T I C L E I N F O A B S T R A C T Keywords: France and Spain have been fighting against bovine tuberculosis (bTB) for years, even though new outbreaks Cattle continue to appear on both sides of the border, generating misconceptions about the disease and social distrust in Communication the eradication programme and competent authorities. The perceived disease risk and the commitment of all Press analysis interested parties are key factors for the successful implementation of control programmes, as they might in­ Metaphors Participatory methods fluence the acceptability of recommended measures. Effective communication can contribute to increasing knowledge, trust and stakeholders’ engagement, thus ensuring the acceptability of the eradication programme. This study was conducted in Catalonia (Spain) and Pyrenees-Atlantiques (France) in the frame of the INNOTUB project (https://innotub.eu/) to characterise the communication on bTB in the trans-Pyrenees region and provide recommendations to improve it. The communication on bTB was characterised by analysing 153 (Spain) and 66 (France) online freely available texts, published between 2018 and 2020, through Content Analysis and Critical Metaphor Analysis. Moreover, six farmers and four veterinarians were in-depth interviewed in each area to gather information about the communication on bTB. Interviews were made in original languages and analysed using a qualitative thematic approach. A pilot participatory intervention inspired by the Systematic Tool for Behavioural Assumption Validation and Exploration (STAVE) method was used to develop a list of proposals to improve communication and to promote the creation of territorial networks/committees on bTB prevention and control. It included three focus groups with farmers and veterinarians, a meeting with representatives of the regional veterinary services, and a final deliberative workshop. Results highlight the existence of a controversial debate on bTB and a heterogeneous understanding between stakeholders. Institutional and scientific commu­ nication mainly focus on bTB detection and control while other aspects are left in the background. On the contrary, farmers extend their communication to a greater variety of topics. The metaphorical framing strongly differed among actors, while veterinary services and researchers “fight” against bTB and “progress” toward the eradication, farmers place themselves in a framework of “sacrifice” and, particularly in Spain, they play a passive role. The proposals developed by the participants to improve the current communication on bTB included: (i) create participatory meeting spaces to share opinions and information; (ii) improve data accessibility (on epidemiological situations); (iii) develop clearer and written protocols and informative visual material; (iv) redesign the training courses (v) increase the stakeholders’ participation in the design of protocols. 1. Introduction requires changes in people´s behaviour and habits, and the maintenance of such changes over time (Moda, 2006; Pfeiffer, 2006; Ellis-Iversen The application of control programmes and preventive measures et al., 2010; Hidano et al., 2018). Behaviour changes are difficult to * Correspondence to: Edifici V, Campus de la UAB, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain. E-mail address: giovanna.ciaravino@uab.cat (G. Ciaravino). https://doi.org/10.1016/j.prevetmed.2023.106046 Received 28 March 2023; Received in revised form 4 September 2023; Accepted 9 October 2023 Available online 12 October 2023 0167-5877/© 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by- nc-nd/4.0/). G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 induce and maintain, even in situations where recommendations, mea­ veterinarians) and a reduction of their level of trust in risk managers (i. sures, or guidelines are evidence-based, practical, and affordable (Moda, e., governments, health authorities, official veterinary services), adding 2006; Pfeiffer, 2006; Ellis-Iversen et al., 2010). The willingness to adopt to the management of bTB a strong socio-political dimension (Enticott changes is influenced, among other factors, by prior knowledge and the et al., 2014; Hamilton et al., 2019; Ciaravino et al., 2017). In this perception of the disease risk (Calba et al., 2016; Ritter et al., 2017; context, the communication between stakeholders is of utmost impor­ Hidano et al., 2018). Moreover, trust in competent authorities and in­ tance as it may affect how the disease is perceived, thus the acceptability stitutions in charge of managing the risk, and confidence between and effectiveness of the bTB eradication programme. stakeholders are other important factors that affect attitudes related to Language is not neutral, and different ways of framing risks in the implementation of preventive and control measures (Enticott et al., communication may lead to different perceptions (Freudenstein et al., 2014). Therefore, stakeholders’ engagement and commitment are key 2020). Appropriate communication helps to ensure that all stakeholders factors for the successful implementation of preventive and control are informed of the nature and level of risk (i.e., improve understand­ strategies (Moda, 2006; Pfeiffer, 2006). Guaranteeing commitment re­ ing), and what behaviours are desirable to minimize it (EFSA European quires providing support and advice and acknowledging aspects that can Food Safety Authority et al., 2021), supporting informed decision critically affect it, such as social networks, sources of advice, the rela­ making and behavioural changes. Moreover, it can contribute to tionship between farmers and advisors and the trust between them. increasing trust in authorities and the degree of confidence among Bovine tuberculosis (bTB) constitutes a major concern both to human stakeholders (Keenan et al., 2020). Understanding how farmers and and veterinary public health sectors, due to the zoonotic aspects of this veterinarians conceptualize and frame bTB (i.e., how the risk is under­ disease and the important economic and sociological problems that it stood) is crucial to achieving effective communication and increasing implies. France and Spain have been fighting against bTB for years, the probability of success in eradicating the disease (Pfeiffer, 2006; although new outbreaks continue to appear on farms on both sides of the Ellis-Iversen et al., 2010; Ritter et al., 2017). Therefore, the objective of border. France is officially free of bTB since 2001, however, in the south- this study was to characterise the communication on bTB between western areas the bTB incidences are increasing, putting in jeopardy the people involved in the implementation of the eradication programme free status of the country (Crozet et al., 2019). In Spain, the eradication and to develop recommendations to improve the communication stra­ of the disease has not been achieved yet; the herd prevalence is very tegies in place. heterogeneous at the regional level, being below 1% in the northern regions and above 5% in the south-western regions (Anonymous, 2022). 2. Materials and methods In both countries, the statutory national control plan for bTB in cattle includes continued ante-mortem surveillance on farms (i.e., regular The research was carried out in Catalonia (Spain) and Pyrénées- testing of all animals older than 6 weeks within a herd and testing of Atlantiques (France) as part of the INNOTUB project (https://innotub. cattle prior movements), and passive surveillance at the slaughterhouses eu/) aimed at improving control and surveillance of tuberculosis in (i.e., systematic examination of slaughtered cattle and reporting of livestock and wildlife in the trans-Pyrenees region. suspected lesions) (Boschiroli and Bénet, 2014; Canini and Durand, 2020; Anonymous, 2022). The Single Intradermal Tuberculin Test 2.1. Study design (SITT) is the official test used for bTB detection, although the Compar­ ative Intradermal Tuberculin Test (CITT) and the interferon-gamma Analysis of communication materials collected from different sour­ assay (IFN-γ) may be also authorized. The frequency of the regular ces and in-depth interviews with farmers and private veterinarians were screening of cattle herds can differ within the country depending on the employed to characterise the communication about bTB (i.e., process, prevalence of the area. Cattle that test positive are slaughtered under discourses, and outcomes), and to identify the sociological factors that official control and subjected to post-mortem examination at the might affect it. In particular, the analysis of the communication mate­ slaughterhouses. Positivity is confirmed through culture of the myco­ rials was applied to disclose the main topics and actors in the public bacteria. Once bTB is confirmed, the scheme implemented to control the debate on bTB (i.e., messages communicated by the different) and to outbreak can be either the test-and-slaughter strategy with the explore how the disease is framed by the different stakeholders (i.e., the compulsory culling of tested positive cattle and the establishment of rhetorical strategies used and narratives that have been generated about movement restrictions until recovering bTB-free status after three bTB in order to explain and give meaning to the different events). The negative test rounds, or the whole herd depopulation with subsequent obtained results were then corroborated (and complemented) with the cleaning and disinfection of the farm and restocking after testing information gathered by in-depth interviewing farmers and veterinar­ (Boschiroli and Bénet, 2014; Canini and Durand, 2020; Anonymous, ians (i.e., opinions and perception about the current communication on 2022). The routine screening of cattle herds can be performed by private bTB, relationships between stakeholders, and most commonly used veterinarians accredited and authorized by the competent authority in communication channels). Results from both analyses (i.e., analysis of the territorial area; however, the official veterinary services at the communication materials and in-depth interviews) allowed to better regional and county level are responsible for the correct execution of the characterise how the bTB risk is perceived and understood, differences programme in the field. In particular, the official veterinarians perform between stakeholders’ views, and gaps/weaknesses and strengths of the the audits on the field-testing practices of the private veterinarians, current communication on bTB, providing prior information on the re-test cattle with doubtful results, and are in charge of investigating and context to be changed which was used as a baseline for the pilot inter­ managing bTB breakdowns (i.e., they conduct the outbreak investiga­ vention to improve the effectiveness of future communication tion, and supervise the slaughter of positive animals and the cleaning campaigns. and disinfections of establishments and utensils). The prolonged failure The development of recommendations to improve the communica­ of control programmes has led to a serious social distrust in the use­ tion between stakeholders was accomplished through a pilot participa­ fulness of the official health programmes and scepticism in the possi­ tory intervention involving farmers, private veterinarians, and official bility of eradicating bTB (Moda, 2006; Pfeiffer, 2006). Farmers and veterinary services. The pilot participatory process highlighted agree­ (private) veterinarian mainly attribute such failure to a lack of reliability ments, disagreements, and the reciprocal conceptualizations between of diagnostic tests, and a lack of control over the wild reservoirs (and farmers and veterinarians and allowed to develop, among all partici­ itself) which are considered responsible for the maintenance of the pants, proposals to improve the communication taking into account is­ disease in the territory (Ciaravino et al., 2017; Crozet et al., 2019; sues and communication failures identified through the context’s Ciaravino et al., 2020). This perceived lack of personal control on bTB characterization phase (i.e., analysis of communication materials and in- was linked in literature to low engagement of farmers (and depth interviews). 2 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 In qualitative research methodologies eliciting participant experi­ theoretical saturation of data (Palinkas et al., 2015). Furthermore, the ences and opinions through individual or group interviews is a key sampling was intentional and by quotas (i.e., type and number of means. Interviewing people involves engaging verbally with research farmers and veterinarians was set a priori), fulfilling the characteristics participants in order to gain access to their particular perspective. In this that were requested according to the research project aims and as­ context, the researcher’s role, personal characteristics, and perspectives sumptions on prior hypothesis made by the researchers. Only beef cattle in relation to the study population and the research topic (i.e., posi­ farmers were enrolled on the study since this production system is the tionality, identity, and power) may have a great influence on the data most common (in the studied areas), and the most affected by bTB collection and the interpretation of the results (Wilson et al., 2022). outbreaks (Allepuz et al., 2011; Boschiroli and Bénet, 2014; Palisson Accounting for such aspects, researchers with a different background (i. et al., 2016; Ciaravino et al., 2017). Once it was decided that only beef e., veterinarians, epidemiologists, sociologists and experts in commu­ farmers would be interviewed, other inclusion criteria considered for the nication and cultural studies) were involved in planning and conducting sample’s composition of farmers were: i) men and women, ii) farmers the research and the results/data obtained from the different methods (i. who experienced a bTB breakdown and farmers who not, iii) located in e., communication analysis and qualitative interviews) were integrated different counties of the study area (and, therefore, having different in the final interpretation of findings. referents from the official veterinary services). For the sample of vet­ erinarians, the main criteria were that they were private veterinarians 2.2. Analysis of communication materials (including men and women) accredited for performing the routine herds testing and working in different counties of the study area. The sampling frame was digital texts (i.e., press releases, and other Participants were interviewed individually in their native language communication materials) available online in Spanish, STUDY­ by researchers from the field of social science hired (and trained) for this LANGUAGE, or French. The keywords used for the online search were purpose. The interviewers did not previously know the interviewees. “Bovine tuberculosis”. The criteria applied for the screening and selec­ The interviews were conducted face-to-face and lasted between 40 and tion of the sample (set of full texts to be analysed) were: i) the 90 min each. An important criterion was to make the interview as easy geographical area of reference: national level, and Catalonia or as possible for the participant, therefore interviews were conducted in Pyrénées-Atlantiques (other regions were excluded); ii) the year of the place that each interviewee proposed, which was generally on the publication: only texts published between 2018 and 2020 were farm or in their house, although in some cases it was chosen a bar or included; iii) the diversity of sources: institutional, scientific, and sector- restaurant in the area. Before starting the interview, the participants specific sources (i.e., webpages of public institutions, research institutes, were informed about the contents and purpose of the study, thus they associations and unions, and newspapers and magazines from the fields were required to sign a written consent form. of agriculture and animal health); iv) the level of diffusion of the source The interviews were driven by a semi-structured thematic guide which was established according to read/consulted rankings (i.e., which consisted of questions regarding participants’ characteristics and number of views) and top positions in the main search engines (e.g., background, knowledge and previous experience about bTB, learning Google, Bing, Yahoo) located using the keyword ‘bovine tuberculosis’. and problem-solving processes, sources of information (formal and In the case of sector-specific sources, it was agreed to include in the informal), perceptions about the current communication on bTB and sample only the top-ten sources with the highest diffusion. The number suggestions to improve it (Table 1). Each interview began with questions of publications to select from each source was established under the to build rapport (i.e., icebreaker questions) and obtain information criteria of "repetition": new publications (i.e., digital texts) were about the participant’s background: age, working routine, previous included until reaching the saturation point (i.e., the text’s contents experience with bTB, and social networks (i.e., Background and social were similar to or the same than those already collected). The selected relationships in Table 1). Thereafter, the flow of conversation was sample was analysed both quantitively and qualitatively. Content guided by the respondent’s answers; the question order was allowed to Analysis (CA) was applied to identify the main themes covered (i.e., vary, and different lines of enquiry were also pursued to cover all topics communication’s contents), the actors involved in the debate on bTB of interest. The interviews were audio-recorded, upon participants’ and the role they play (communication processes), considering this consent, and transcribed verbatim. The transcripts were examined under method a systematic procedure for assessing the content of documented a qualitative analysis through an iterative comparative method, information (Wimmer and Dominick, 2014). Public discourses on bTB following a thematic codification (Flick, 2009) based on a grounded and the language used were investigated by using the Critical Metaphor theory orientation (Strauss, 1987). According to this analytical pro­ Analysis (CMA) proposed by Charteris-Black (2004, 2011), which fo­ cedure, the fragments of the interviews corresponding to each theme or cuses on metaphors as cultural and linguistic tools for conceptualising theoretical category (i.e., the major themes that they structured the the disease. A metaphor was identified when there was a break in the interview script) were identified and selected, and interpreted compar­ semantic coherence that altered the normal reading of a passage atively through all the interviews, in a joint reading that allowed to (Charteris-Black, 2011). The identified metaphorical expressions were extract main characteristics, possible divergences, nuances and contra­ classified according to the source domain they contain (i.e., the con­ dictions potentially expressed by the different interviewed. The results ceptual or semantic area from which the metaphorical expressions are of these interpretations, in a process of constant comparison, have drawn), and the target domain to which they refer (i.e., the domain that served to contrast the working hypotheses, as well as to develop new is understood through their use). hypotheses throughout the research process. Ethical approval for the study was obtained from the Research Ethics Committee of the Auton­ 2.3. In-depth interviews omous University of Barcelona. In-depth interviews were carried out in the two study areas between 2.4. Participatory intervention May and September 2021 to gather information about how the communication on bTB is perceived, and the most trusted sources of The pilot participatory intervention was conducted in Catalonia. Its information (i.e., processes and outcomes). In each area, six farmers and purpose was to generate, among all participants (i.e., farmers, private four private veterinarians were interviewed. A non-probabilistic con­ veterinarians, and official veterinarian services), recommendations to venience sampling strategy was used to ensure a balance between the improve the communication on bTB and to reassure and enhance the homogeneity (requiring smaller size) and the heterogeneity (requiring dialogue between the stakeholders. An approach inspired by the STAVE larger size) of the targeted population, making sure to avoid failures in (Systematic Tool for Behavioural Assumption Validation and Explora­ capturing insights, experiences, and opinions and, therefore, achieve the tion) method (Espluga et al., 2016) was applied to guide the study 3 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Table 1 The semi-structured thematic guide used to interview farmers and private veterinarians in Spain and France. The topic of interest and related questions ‘examples are given in the table. Major themes Application / Meaning Interview question (example) Background and social Characterisation of the respondent’s profile: • How many years have you been working in the sector? relationships - Years of professional experience and working routine. • Do you participate/are you part of organisations, trade unions, - Working routine and social network. professional associations etc. etc.? What is your role? What is the - Interactions and contacts with other people in the working and leisure frequency of meetings/contacts? spheres (i.e., veterinarians, farmers and/or other actors). • (farmers only): Do you practice mountain pastures? Are you part / Do you work with a cooperative? How many veterinarians usually visit your farm? why? (i.e., different profiles and circumstances). • (veterinarians only): How many farms do you usually visit in a day? In what circumstances (i.e., emergencies or regular visits)? How much time do you usually spend with the farmer? • How would you describe your relationship with other farmers/ veterinarians? (i.e., professional sphere) Knowledge on bTB Characterisation of previous experience with bovine tuberculosis (bTB): • Have you ever experienced any bTB outbreak? - Events that occur during detection and confirmation of bTB in a farm. • Do you know what happens when a positive or suspected bTB case is - Concrete examples of what respondents have experienced directly or detected in a farm? (If yes) How is the notification process handled? Who indirectly. is in charge to notify a bTB case (and to whom)? How is the case notified - Communication during bTB outbreaks or suspicions to the farmers? What is the protocol to follow after a bTB case is detected - The information offered and how it is perceived. and after the case confirmation? - How veterinarians handle their role in the programme and how they are • (farmers only) What happens during the bTB screening test (i.e., execution supported. and interpretation of results)? Have you received any communication on - Communication with farmers during outbreaks (notification, telephone, bTB? About which aspects? From whom? have you tried to contact visit, etc.). anyone? Who? Why? Was it easy/possible? • (veterinarians only) have you personally detected the bTB case? (If yes) Have you received (from the official veterinary services) all the information you needed to manage the outbreak and the communication with the farmer? Did you have to inform the farmer? How have you done it? What did you say? Learning and problem- Characterisation of knowledge on bTB: • How have you acquired knowledge about bTB? solving processes - How knowledge on bTB is generated and shared considering formal and • Do you usually talk about bTB? With whom (i.e., other farmers, informal communication channels. veterinarians? anyone else - other actors?) In what circumstances? - Person(s) of contact or reference in case of doubts about the disease and • How do you usually solve doubts about bTB and its control? Have you its control. shared them / talked about them with anyone? with whom? - What information is received and from whom (considering formal and informal). Sources of information Characterisation of the sources of information and the construction of the • From which source is the information on bTB usually received? “narratives” on bTB: • What do you think about the available information about the disease (i.e., - Formal and informal sources and channels of communication: explore how to prevent it and/or eliminate it)? Which information do you the information received from colleagues, by WhatsApp, by having receive? from which sources? What channels? heard it in the bar, by reading it on the internet, on Facebook, etc., as • (In the last 2–3 years): well as the information received by letter, e-mail, magazines, or official - Have you received any communication/information on bTB? How? publications, etc., from whom? On what aspects/topics? (Passive reception) - Content of the received information (formal/informal). - Have you actively searched for information on the disease? What information? Where? Was it easy to find? (Active reception) - Have you given and/or received any talks on TB? On which topics? What target audience? Who organised the event? (Active and passive sharing) • In addition to formal communication, what other channels of communication do you know? Who participates? • Which channels and/or sources of information do you trust the most? Perceptions of bTB Characterisation of the current communication on bTB: • How do you value the communication with the official veterinary services communication - Formal and informal communication between farmers, private regarding bTB? Why? veterinarians, and official veterinary services (considering all possible • What are the most commonly covered topics or the most frequently directions). communicated? Are these of your interest? - Weakness/Strengths of the communication strategy on bTB and • What are the weak and strong aspects of the current communication on suggestions to improve it. bTB? Who communicates best/worst and why? - Perceptions and opinions on the role and activities of associations and • What would you like to change about it? How would you like it to be? trade unions in the sector. What topics should be communicated? How (what channels)? Who should be in charge of it (from which sources)? The topics of interest were not covered in any order during the interview. In the table, bTB: bovine tuberculosis. design. The pilot intervention included sequential meetings with the The first round of focus group sessions was conducted with farmers farmers and private veterinarians, consultations with the official veter­ and private veterinarians separately (up to eight people per group) inary service veterinarians, and a final workshop. Participants were during November 2021. Selected results from the individual in-depth recruited through a purposive sampling strategy to seek a diversity of interviews were presented visually on slides as literal interview ex­ viewpoints within each group and provide the most comprehensive tracts and used for opening the discussion. Thereafter, the card clusters understanding of the factors at play. Farmers and private veterinarians technique was used to gather proposals and ensure the contribution of who had already taken part in the in-depth interviews were also invited each participant. Participants were invited to think individually and to participate. The focus groups were audio-recorded, with the permis­ write on sticky notes their proposals/ideas to improve the relations sion of participants, and detailed notes on the discussions were taken by between actors and communications on bTB (‘silent generation of the researchers. ideas’). Written ideas were shared, categorised by similar themes, and 4 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 discussed within each group. Preliminary findings from the groups were Table 2 presented and discussed with the regional veterinarian service in a The selected sample of digital text by source and geographical area. meeting on February 14, 2022. The received feedback was delivered to Sources Type Coverage Spanish French all the participants involved in the previous phases during a second Level Units (N units (N focus group session through a collective presentation joined by farmers = 153) = 66) and private veterinarians together (i.e., a deliberative focus group) Institutional Webpages of the National / 5 23 which was held on March 11, 2022. During the session, participants ministry and Regional were able to consider both the results produced during the first meeting departments of agriculture; other (i.e., ideas and suggestions) and the feedback received from the official material produced by veterinary services. The validity, relevance and suitability of the iden­ the official veterinary tified proposals were discussed within the group. Then, participants services were allowed to adjust and refine their findings (i.e., previously devel­ Scientific The material National / 9 14 produced by research Regional oped proposals), accordingly. Finally, a deliberative workshop (i.e., a institutes dialogue meeting) with representatives of farmers, private veterinar­ Sector-specific: Online journals and National 64 11 ians, and regional veterinary services was organised on April 22, 2022, Veterinary magazines. Webpage to find a consensus on the developed proposals. The workshop involved and animal and other material the key persons identified (up to five people per category) during the health produced by unions or associations previous activities. Sector-specific: Online journals and National / 75 18 Agriculture magazines. Webpage Regional 3. Results and farming and other material produced by unions or associations The results obtained from the three approaches (i.e., analysis of communication materials, individual in-depth interviews, and pilot participatory intervention) are described separately below. Table 3 3.1. Analysis of communication materials Themes covered by the selected sample of French and Spanish texts. Main covered themes Spain (N = France (N = A sample of 153 Spanish and 66 French digital texts (i.e., corpus) 153) 66) were analysed to investigate topics, metaphors, and actors of the Social and economic aspects 4.6% 0.0% communication on bTB. The type of sources and the number of texts bTB detection and control 57.5% 45.5% Training and communication/outreach 3.9% 9.1% extracted from each source (i.e., units of analysis) are presented in Proposals to change the bTB eradication 7.8% 6.0% Table 2. programme In the Spanish sample (N = 153), 46% of the units were targeted at Wildlife and domestic reservoirs other than 24.9% 25.8% veterinarians and 36% at farmers. The remaining units were addressed cattle to the scientific community (5% of the units) (i.e., researchers/experts) bTB risks and benefits of being bTB-free 1.3% 13.6% or to a more general public (13%), such as all the stakeholders involved in the control of the disease or the society/citizens. Differently, in the institutional communication of the Spanish and French samples were 18 French sample (N = 66), the general public was the primary target and 38, respectively. The metaphors detected through the scientific audience (52% of units), while farmers and veterinarians were targeted communication were 44 and 125 in the Spanish and French samples, by 24% of the units each. However, the thematic structure of the ana­ respectively. In both countries, institutional and scientific communica­ lysed units was similar in both countries. The main themes covered were tion made use of metaphors mainly to refer to the disease (i.e., target related to bTB detection and control and the role of wild and domestic domain). The source domain of “war” (i.e., military metaphors) was the reservoirs other than cattle, which together represented 82% and 71% of metaphorical expression most frequently used (e.g., “Necesidad de luchar the Spanish and French samples, respectively (Table 3). Whereas topics en diferentes frentes contra la enfermedad” [the need to fight against the related to training and communication/outreach or the proposals to disease on different fronts]; “lutte contre cette infection [.] des outils pour la change the bTB eradication programme were little covered in both combattre” [fight against this infection [.] tools to fight it]). It is worth samples. The major difference between the two samples was observed on noting that, in the Spanish sample, 23% of metaphorical expression themes related to the risks of bTB and the benefits of being disease free, identified in the scientific communication focuses on the role of science which appears in 13.6% and 1.3% of the French and Spanish texts, and researchers, making use of the frame of “motion”, indicating their respectively (Table 3). movement forward and advances in science (e.g., “Los investigadores The relationship between themes and targeted audience observed in hemos dado un paso más” [Researchers have gone one step further]) to Spain and France is shown in Figs. 1 and 2, respectively. It is worth refer to this target domain. The communication among farmers (i.e., mentioning that topics related to training and communication/outreach sector-specific communication targeting farmers) was more diverse than do not appear in the Spanish communication to farmers; and that social the institutional and scientific communication both in Spain and France. and economic aspects were topics of concern in the communication to Its variety was reflected by the wide range of target and source domains farmers and veterinarians, but not to other audiences (Fig. 1). On the that were presented in their communication. In addition to the disease, other hand, in the French sample, the proposals to change the bTB farmers communicated about themselves and their herds, wild reser­ eradication programme had certain relevance in the communication to voirs, but also about protocols, laws, and regulations, science, and about the farmers, while social and economic aspects were not addressed their relations with the official veterinary services. Out of 233 and 77 independently of the targeted audience (Fig. 2). metaphorical expressions detected, 85% and 77% of metaphors referred Overall, there were 349 and 246 metaphorical expressions detected to five target domains in the Spanish and French samples, respectively. in the Spanish and French samples, respectively. The most frequently Besides the metaphor of “war”, the domains of “motion” and “container” used metaphorical lines or frames referred to: “war” (n = 282; 47%), are largely used in both samples. As a peculiarity, the communication “religion” (n = 33; 6%), “container” (n = 101; 17%) and “motion” between Spanish farmers differed in that it included the usage of reli­ (n = 76; 13%), which together represented 83% of the used metaphor­ gious metaphors to refer to the farmer/livestock sector (i.e., target ical expressions. The metaphorical expressions identified in the 5 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Fig. 1. Relationship between themes and targeted audience in the Spanish sample. The figure shows the proportion of texts analysed in the Spanish sample by topic and target audience. Black bars refer to farmers, dark grey bars to veterinarians, and light grey bars to other audiences which include the scientific community and the general public. Fig. 2. Relationship between themes and targeted audience in the French sample. The figure shows the proportion of texts analysed in the French sample by topic and target audience. Farmers, veterinarians, and other audiences, which include the scientific community and the general public, are indicated with the black, the dark grey and the light grey bars, respectively. domains “farmers and herds”) (e.g., “Consecuencias sangrantes para el language, and accompanied by English translations, in the tables from sector” [Bloody consequences for the sector]; “No al castigo al ganadero five to ten. por unos protocolos injustos” [No to the punishment of the farmer due to unfair protocols]). Whereas the specificity of the French communication 3.2.1. Social relationships between actors was the use of military metaphors to refer to the relationship between Farmer-to-private veterinarian. In both countries, the interviewed farmers and the official veterinary services. Differences in the commu­ farmers reported that relationships with their private veterinarians are nication of veterinarians were observed. In the Spanish sample (92 generally good. Private veterinarians are the first person of contact in metaphorical expressions), the conceptual structure was close to that of case of doubts (about bTB or anything else) or when there are problems farmers in terms of the diversity of target domains and source domains. In the French sample (30 metaphorical expressions) the conceptual structure followed that observed in the institutional and scientific Table 4 Descriptive summary of the sample composition for the in-depth interviews. communication, with 80% of metaphorical expressions referring to the disease (i.e., target domain “bovine tuberculosis”). Pyrénées-Atlantiques (FR) Catalonia (ES) Farmers (N = 6) 83% Men Sex ratio 1:1 50% aged < 45 years 67% aged < 45 years 3.2. In-depth interviews 33% experienced bTB cases 50% experienced bTB cases 50% raised more species 17% raised more species The profile and composition of people interviewed in each area are Farms’ Size: Farms’ Size: shown in Table 4. • < 50 heads: 2 farms • < 50 heads: 1 farm • 50–100 heads: 3 farms • 50–100 heads: 3 farms The qualitative thematic analysis focuses on two major areas: the • > 200 heads: 1 farm • > 200 heads: 2 farms social relationships between actors (i.e., farmer-to-farmer, farmer-to- Veterinarians 75% Women Sex ratio 1:1 private veterinarians, farmer-to-official veterinarians, private-to-official (N = 4) 75% aged between 35 and 40 75% aged < 35 years veterinarians) and the communication/outreach processes (i.e., sources years of information, formal and informal communication, and training). 50% had experience with 50% had experience with bTB cases bTB cases Some extracts of the interviews (“Ei”) are presented in their original 6 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Table 5 Social relationships between actors: extracts from the interviews with farmers. Extract Sentences in Original language English Translation Code Farmer-to-private veterinarian E1 “El veterinari que fa la clínica hi tenim molta confiança. […] És una persona a qui We have a lot of confidence in the clinician (vet). […] we have a certain respect tenim cert respecte, i llavors li comentes coses.” (F3-ES). for our veterinarian and then we comment on things. E2 “On a une bonne relation avec les vétérinaires. Dès que j’ai des soucis, je pense We have a good relationship with veterinarians. As soon as I have some problem, I qu’un coup de fil pour ça, on est bien conseillé .” (F1-FR). think to call them, we are well advised E3 “El veterinari privat al final ha de fer el que li marquen. també li fan auditories a The private veterinarian has to do what they (OVS) tell him to do.they (OVS) also ell, si ho fa bé o malament. [.], també tens pressió allí . [.] Jo no en veig cap d’aliat audit him, whether he does it right or wrong. [.], you also have some pressure aquí . Al final aliat és el que li passa i plorar-nos entre nosaltres i no hi ha més.” (F3- there [.] I don’t see any allies here. Finally, your allies are those facing the same ES). problem as you and cry together and that is it. E4 “C’est vrai que voilà, autant avant on avait de très bonnes relations avec les Before we had very good relations with the veterinarians and now, we see that it vétérinaires et maintenant on voit que c’est tendu. [.] Autant avant il y a dix ans, is tense. [.] Ten years ago, before tuberculosis arrived, the “atmosphere” with the avant que la tuberculose arrive l’ambient c’est bon avec les vétérinaires. veterinarians was good. Now…there is something. Maintenant, on voit que y a quelque chose.” (F3-FR). E5 Il gagnent plus d’argent. Ça c’est inévitable. [.] Il y a le travail, bien sûr, mais après They make more money. That’s inevitable. [.] There is work, of course, but then il y a la prophylaxie. Avec la prophylaxie ils ont un fixe.” (F4-FR). there is prophylaxis. With prophylaxis, they have a fixed income. Farmer-to-official veterinarian E6 “Si, Si. Poc flexibles i poc dialogants. I fora de la realitat també . Perquè per They (OVS) are neither flexible nor open to dialogue. Moreover, they are out of nosaltres ens suposa un sacrifici que et dona la sensació que ells no veuen, saps. [.] touch with reality. Because it (bTB) implies a sacrifice for us that it seems they are en general venen a fiscalitzar, més que a fer suggeriments de millora”. (F4-ES). not able to see [.] In general, they come to inspect/audit, rather than to make suggestions for improvement. E7 “Ça fait des années qu’on leur dit qu’autre fois ils le gérer comme ça la maladie, For years we have been telling them that before the disease was managed aussi le positives, mais ils sont t ê tus, ils veulent rien savoir.” (F3-FR). differently, also the positive ones, but they are stubborn, they don’t want to know anything. E8 “Sí . En funció de la persona que trobes allà davant. Això és bastant important. (.) It depends on the person. That’s quite important. […] I do think that the OVS start Però jo si que penso que comença a haver-hi una mica més de sensibilitat per part having a little more empathy (It seems that there is a little more sensitivity) de l’administració.”. (F3-ES). Farmer-to-farmer E9 “Ens mirem d’ajudar (entre pagesos). A més aquí tenim l’Associació We try to help each other (with other farmers, not specifically cattle breeders). In Agroalimentària que vulguis que no si mai necessites ajuda o el que siguis ho pots addition, here there is the Agri-Food Association, if you need any help or demanar. (F2-ES).” whatever, you can ask them E10 “C’est l’amitié entre les éleveurs. […] C’est généralement correct. Si nous avons There is the friendship between farmers. […] It’s generally going well. If we need besoin d’un coup de main, nous appelons surtout avec des animaux, avec des some help, we call each other, especially with animals or when cows are about to vaches comme ça à vêler.” (F4-FR). calve E11 “La tuberculosi bovina no és un tema. ¿De parlar-ho nosaltres? No.” (F4-ES). Bovine tuberculosis is not an issue. Should we talk about it? No. E12 “Oui, oui, ça allait. Oui, ça allait un peu encore. Mais, mais. Au début, dans le Yes, yes, we had a good relationship [between farmers]. But then (after the first village, les deux premiers qui passe eu? Parlant de moi, parlant de l’autre… et bTB cases occurred), in the village, people started talking about me, about the quand on entend ça, c’est le r é sume. C’est très dur le monde agricole, c’est très other. and when you hear that, that sums it all up. It’s very hard in the farming dur, c’est très dur”. (F2-FR). world, it’s very hard, it’s very hard. E13 “Il n’y a pas une coopérative qui travaillent la vente ensemble.[…]. Ici on est trop No cooperative works on selling together. We are too jealous of each other here. jaloux entre nous. Il n’y a pas la volonté de coopérer. Il y a beaucoup qu’on essai de There is no willingness to cooperate. There are many things we try to do. But it is faire ça. Mais c’est très lourd”. (F5-FR). very heavy. E14 “No. Aquí el sector ramader cadascú batalla sol. Això és així i ja està.” (F2-ES). No. Here, within the cattle sector, each one battles alone. Indeed, and that is it. E15 “Non, c’est très individualiste, très, très individualiste. […] Chacun travaille de son No, it’s very individualistic, very, very individualistic. Everyone works on their côté et on est de moins en moins nombreux” (F6-FR). own and we are less and less. In the table, bTB: bovine tuberculosis; OVS: Official Veterinary Service; F: Farmer; V: private veterinarian; ES: Catalonia, Spain; FR: Pyrénées-Atlantiques, France in the farm. They are perceived by farmers as easily accessible, trusted, perceive the other farmers as competitors (i.e., marketing of their and respected (Table 5, E1-E2). However, a certain distrust arose when products) and their relationships became more complicated when dealing with a bTB-related issue/outbreak, since it is felt that different dealing with bTB because of the social stigma it generates (Table 5, E11- interests are represented by the two parties (Table 5, E3-E4). Some of the E13). Ultimately, some farmers expressed their feeling of working/living interviewed French farmers also perceived that bTB screening is a in an individualistic environment and with little support from their business activity for private veterinarians, which could be damaging for community (i.e., other cattle farmers) (Table 5, E14-E15). farmers (Table 5, E5). Private veterinarians-to-farmers. In both countries, the private veteri­ Farmer-to-official veterinarian. Farmers’ relationships with the official narians perceived their relationships with farmers as generally good, veterinary services are more complex and ambiguous, especially in areas although they acknowledged it may vary on individuals or farms, where bTB outbreaks have occurred. In general, official veterinarians (Table 6, E1-E2). Nevertheless, they pointed out that such a good rela­ are perceived by farmers as distant, not open to dialogue, and mainly tionship may easily change when some bTB problem occurs. In Spain, committed to monitoring or auditing than providing support. This was the interviewed veterinarians referred to experiencing “bad moments” observed in both the French and the Spanish samples (Table 5, E6-E7). when communicating about suspected or confirmed bTB cases since However, it is worth pointing out that, according to the Spanish farmers tend to "get angry" with them (Table 6, E3). In France, veteri­ farmers, relationships with official veterinarians can vary depending on narians reported that tense situations were caused by the execution of the people involved (i.e., some individuals are more empathetic than the bTB herds screening since farmers perceive it as aggression that others) (Table 5, E8). undermines the mutual trust among parties (Table 6, E4). The inter­ Farmer-to-farmer. Similar findings arose from the interviews con­ viewed veterinarians also highlighted that private veterinarians provide ducted in France and Spain. Farmers from the same territory maintain both technical assistance and psychological support to farmers, although mutual relationships (Table 5, E9-E10). However, the characteristics they are not usually skilled in how to deliver “bad news”, manage tense and type of relationships may vary depending on the context. On the one situations, or provide appropriate (psychological) support. Neverthe­ hand, they maintain relationships of friendship and talk about routine/ less, they assumed that delivering bad news to farmers is inevitable at daily working activities (i.e., farming management); on the other, they times and is part of their job and they would like to receive more training 7 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Table 6 Social relationships between actors: extracts from the interviews with the private veterinarians. Extract Sentences in Original language English Translation Code Private veterinarians-to-farmers E1 “Existeix el respecte al veterinari, jo crec. [.] Això depèn de cada granja. Però s í que There is respect for the private veterinarian, I think. [.] it depends on the farm. crec que hi ha respecte pels veterinaris”. (V3-ES) But I do think there is respect for the veterinarian. E2 “Et il y a un rapport qui se fait professionnel avec les éleveurs, qui dépasse à mon There is a professional relationship with farmers that, in my opinion, goes beyond avis l’origine de chacun. [.] En général, il y a une proximité avec les éleveurs et les the origin of each one. [.] In general, there are close and good relations. relations sont bonnes”. (V2-FR) E3 “És que no me’n recordo. Sí , el vaig trobar jo. Les vaig trobar positives. I crec que jo I don’t remember it well, but yes, I found reactors and I came back to do the vaig anar a la comparada, o alguna cosa així . Vaig anar a fer la comparada, em comparative skin test, or something, like that. And of course, I had to go with the sembla. I clar, vas amb la inspectora. i va sortir positiu i aquell home tenia officer veterinarian. the animals resulted to be bTB positive. The farmer had very poquíssimes vaques, menys de 10. I es va haver de matar tot. I l’home se’ns va few cows, less than 10 and he had to slaughter them all. The farmer got angry … enfadar. Però és que es va enfadar amb mi!”. (V3-ES) But he was angry with me!. E4 “Nous, on a plusieurs éleveurs qui ont dû mettre des animaux en prophylaxie et ça a We have several farmers who had to do the prophylaxis and ended up breaking all fini de rompre tout lien envers nous. Et oui. Ben oui, oui, ça, déclenché des hostilités ties with us… Well, yes, that triggered hostilities. […] Farmers perceive the bTB […] La prophylaxie est perçue comme une aggression. Vraiment. Et donc, on a des prophylaxis as an attack. Really. And so, our relationships have become very rapports qui se sont beaucoup tendus”. (V4-FR) tense. E5 “Il n’y a pas de soutien psychologique pour les éleveurs. Nous sommes le soutien There is no psychological support for farmers. We are their psychological psychologique. C’est nous, c’est nous, les psychologues des éleveurs. Non, il n’y a support. That is new … the psychologists of farmers. […] We manage to rien. [.] On arrive à les accompagner, mais c’est assez difficile et même accompany them (farmers with bTB cases), even psychologically, but it was quite psychologiquement. Psychologiquement, c’est très compliqué , très compliqué . difficult. Psychologically, it is very complicated, very complicated. […] It’s part […] Ça fait partie globalement du travail, que ce soit pour de la tuberculose ou pour of the job overall, whether it’s for tuberculosis or other problems. At some point, d’autres problèmes. À un moment, il faut savoir faire ça aussi. On n’est pas formés you have to know how to do that too. We are not trained for it, but we have to pour, mais il faut que savoir […] Même peut être un excellent vétérinaire si on ne know how to do it […] you can be an excellent veterinarian but if you do not sait pas accompagner les gens, ça se passe mal et à l’inverse, on peut être un know how to accompany people, things go wrong and conversely, you can be vétérinaire très moyen si on s’est accompagner correctement les éleveurs. Ça se average but if you properly accompany the farmers, it is going to be fine. passe très bien”. (V1-FR) E6 “un mal tràngol. ja L’assumeixo com a part de la feina”. (V2-ES) I had a very hard time. but I already assume it is part of the job E7 “Hi ha molt pique, molt. I es va intentar fer l’associació de ramaders, que semblava There is a lot of resentment, a lot. There has been an attempt to form a farmers’ que per primer cop a la història s’agrupava en una entitat tots tres sectors, oví - association, and it seemed that for the first time in history all three sectors, sheep- cabrum, boví i equí . Continua existint, però l’activitat és nul⋅la. Costa molt”. (V4- goat, cattle and equine, were grouped in one organisation. It still exists, but the ES) activity is null. It’s very hard. E8 “On a l’impression des fois que ce genre d’opération devrait presque être fait par des We sometimes have the feeling that the bTB screening should be done by vétérinaires qui ne sont pas les vétérinaires qui accompagnent les éleveurs. Parce veterinarians who are not working on farms. Because we are necessarily qu’on a forcément affectées avec les éleveurs, a aussi une relation de clientèle avec influenced, and we also have a customer relationship with them, we cannot be ces éleveurs à un moment où nos clients ne peut pas non plus être trop méchants too mean to them either. avec eux”. (V1-FR) Private-to-official veterinarians E9 “És a dir, no hi ha empatia per part del Departament cap als veterinaris de camp. There is no empathy from the Department (OVS) towards the private/field Zero. O menys. Sota zero. […] Si. I falla molt, molt i molt la relació entre veterinarians. Zero. Or less. Below zero […] Yes. The relationship between the Departament i veterinaris de camp, que és de poca confiança. Es pensen que tot ho Department and private veterinarians fails very, very often; there is very little fem per putejar, per fer-ho malament. no confien que vulguem fer les coses bé . No trust. They think we do everything to screw them, to do it badly… They don’t et diuen mai: ostres això ho feu molt bé . No és que vull que m’ho vinguin a dir, però trust that we want to do things well. They never say: dang, you are doing that la sensació sempre és que t’estan vigilant a veure on la cagues”. (V3-ES) well. It is not that I want them to come and tell me, but you always get the feeling that they are monitoring to see where you fuck up… E10 “Il y a très peu d’écoute, c’est à dire que si on les appelle pour se plaindre, ils sont There is very little listening, that is to say, if we call them to complain, they are forcés de nous écouter. Mais par contre, je n’ai pas l’impression, qu’on consulte forced to listen to us. But on the other hand, I don’t have the impression that we pour savoir comment ça se passe, est ce qu’on pourrait changer des choses? On nous consult to find out how things are going, could we change things? We are told dit ce qu’il faut faire et on le fait. Voilà. […] La D-FR pour nous, est comme les what to do and we do it. So… […] The D-FR for us is the same as we are for the éleveurs pour nous, a une notion de contrôle qui est très importante pour nous c’est farmers. They have a notion of control which is very important for us, it is a une autorité de tutelle. Il y a une notion de contrôle et c’est vrai qu’on va y plus supervisory authority. […] There is a feeling of control and it’s indeed easier to facilement s’adresser aux GDS, qui va être plus dans l’accompagnement que dans le approach the GDS, who will be more in support than in control and with whom contrôle et avec qui on va pouvoir parler plus ouvertement de certaines pratiques, we will be able to talk more openly about certain practices, of certain things in the de certaines choses dans les pratiques de tuberculination”. (V1-FR) practices of prophylaxis E11 “jo com a veterinari. jo em sento jutjat, com que l’Administració no confia amb Me, as a veterinarian, I feel judged, it´s as if the Administration doesn´t trust us. [.] nosaltres. […] El Departament no ens cita mai per explicar-nos segons què . només The Department never sets an appointment with us to explain something. only to ens cita per amenaçar-nos, per donar-nos lliçons, per dir-nos que si no s é què ens threaten us, to teach us a lesson, to tell us that if this or that, they will disqualify inhabilitaran”. (V4-ES) us E12 “Ils travaillent très distants. Oui, ça complètement. Bon, après, ils essayent de se They work very remotely. Yes, that is completely. Well, afterwards, they try to rendre compte qu’ils sont venus quand même sur le terrain. Ils sont venus nous realise/understand what happen in the field. They came to accompany us, to see. accompagner, voir. Je ne sais pas si c’était pour nous contrôler ou si c’était pour eux but I don’t know if it was to control us or to see se rendre compte”.(V4-FR) E13 “També posen faltes, si dius que eres a una hora i é s una altra. Si hi ha hagut algun They also give warnings, if you say a certain time but it’s another. If there has canvi ho has de dir. Tu has d’enviar la planificació de cada setmana dient on seràs a been any change you must say so. You have to send the schedule for each week cada hora. Jo què s é el dilluns a les 9 h si a aquella granja. Un dels veterinaris amb saying where you will be at each hour. What do I know on Monday at 9 am if at qui vaig a vegades t é una falta per això. Perquè a última hora no ho van poder fer that one farm. One of the vets I visit sometimes got a warning for that. Because, at per no s é què i. Hi ha aquesta mania persecutòria al Departament, de que fem les the last minute, they couldn’t do it for I don’t know what reason and. There is this coses per putejar-los. I li van fotre una falta perquè no havia avisat. Però és que va persecutory obsession in the Department, that we do things to fuck them. And ser un canvi.”. (V3-ES) they gave him a foul because he hadn’t been notified. But it was just a last-minute change. E14 “De la part de la D-FR il y a pas de d’adaptation, y’a pas d’option, il n’y a pas On the part of the D-FR, there is no adaptation, there are no options, and there is d’avancée, c’est le GDS plutôt. […] Je pense que quand même, ils ne sont pas no progress, it is rather the GDS. […] I still think that they are not totally totalement déconnectés de la r é alité et des problèmes que ça pose, mais que de disconnected from reality and from the problems that this poses, but that in any toute façon, personne n’a de solutions de proposition pour les r é soudre ou pour case, no one has any proposed solutions to solve them or to make things go better. que ça se passe mieux. C’est surtout ça. On a pas, on n’a pas d’autres, on a pas That’s mostly it. We don’t have, we don’t have others, we don’t have other d’autres options non plus n’ont pas mieux à nous proposer”. (V4-FR) options either, they don’t have anything better to offer us In the table, bTB: bovine tuberculosis; OVS: Official Veterinary Service; F: Farmer; V: private veterinarian; ES: Catalonia, Spain; FR: Pyrénées-Atlantiques, France 8 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 on such aspects (Table 6, E5-E6). The interviewed veterinarians also 3.2.2.3. Formal/Official communication on bTB in Catalonia 1 (Spain). pointed out a certain lack of cohesion among farmers which makes their According to both the farmers and veterinarians interviewed in Spain, work even more challenging (Table 6, E7). Moreover, according to those the official communication about bTB (i.e., routine control activities, interviewed in France, due to the client/commercial relationship be­ and management of positive or suspected cases) is not always fluid, well- tween farmers and private veterinarians, the bTB herds screening should structured, and accurate. The interviewed veterinarians reported that be performed by veterinarians other than those working on the farm sometimes they receive the same information several times (e.g., from (Table 6, E8). different sources or channels simultaneously), while at other times they Private-to-official veterinarian. Relationships between private veteri­ perceive to receive it by chance (Table 8, E1). The Spanish farmers narians and official veterinary services are described as formal and one- pointed out the lack of a well-defined information circuit in case of a bTB way. The interviewed veterinarians from both countries perceived the positive/suspected case and a clear protocol on what to do after official veterinary services as a control body (i.e., supervisory role) receiving its notification (Table 8, E2-E3). They also claimed that the which is distant from the field reality, has no empathy, and mainly delivered information is not exhaustive or clear enough and that the focused on control rather than supporting private veterinarians (Table 6, available information on bTB is limited and not easily accessible E9-E10). Moreover, the interviewed veterinarians had the perception of (Table 8, E4). being blamed and judged by the official veterinary service, which tends to put into question their work creating an atmosphere of distrust 3.2.2.4. Formal/Official communication on bTB in Pyrénées-Atlantiques (Table 6, E11-E12). In particular, the Spanish veterinarians pointed out (France). The farmers interviewed in France reported that the commu­ that the field audits of testing performance conducted by OVs make nication on bTB is mainly related to the national control plan activities them feel uncomfortable, because some unforeseen change (beyond (i.e., frequency of herds screening) and that they receive additional in­ their control) may arise (Table 6, E13). According to French veterinar­ formation only when bTB cases occur in nearby territories (Table 8, E5- ians, the official veterinary service works well and efficiently in tech­ E6). The received information is well-valued, although it is suspected to nical terms but does not always address their field’s practical needs to be incomplete and with many uncertainties (Table 8, E7). Moreover, the offer appropriate solutions (Table 6, E14). current way of notifying confirmed bTB cases was considered inappro­ priate (Table 8, E8), since it contributes to the social stigma against 3.2.2. Training and communication/outreach process farmers who have suffered a bTB outbreak. According to the interviewed veterinarians, in case of suspected or confirmed bTB cases on the farm, 3.2.2.1. Sources of information in Catalonia (Spain). In Spain, both the official protocol and the communication flow are clear and well- farmers and veterinarians reported that they often search for informa­ established (Table 8, E9). However, it was also reported that there is tion on bTB online. The institutional channels (i.e., the web pages of the little information on bTB which is useful to talk with the farmers (i.e., regional Department of agriculture) were the most mentioned sources of general contexts, risks and consequences, and sources of infections) information by the interviewed farmers. Besides, they reported (Table 8, E10-E11). Furthermore, according to both farmers and private acquiring information on bTB also through sector-specific newspapers veterinarians, the official veterinary service is not the most appropriate and magazines (e.g., Agrodigital, Agroinformación, etc.), from local actor to communicate on bTB to farmers, which would rather prefer to farmers ‘associations, by participating in workshops, and seminars receive these notifications from their private veterinarians (Table 8, (Table 7, E1-E3). According to the Spanish veterinarians, the institu­ E12-E13). tional channels (including the Official College of Veterinarians) are their main sources of information about the regulatory changes concerning 3.2.2.5. Perceptions of the received training. In both countries, the in­ bTB (Table 7, E4). In more general aspects, common sources of infor­ terviewees reported having attended some courses or workshops on bTB. mation are training courses and seminars (Table 7, E5). The university Courses were generally perceived as relevant and useful by the farmers, was also mentioned by veterinarians as a trusted source of reliable in­ but workload and time constraints were often mentioned as the main formation in case of specific doubts (Table 7, E6). Additionally, both barriers to participation (Table 9, E1-E3). The provided information was farmers and veterinarians referred to receive information from informal highly valued and considered the best information available (given the channels, among which social networks had a relevant role (i.e., great scientific uncertainty about the disease). However, it was consid­ WhatsApp groups) although such channels are used mainly for ered incomplete, and farmers often feel under-informed (Table 9, E4- communicating about social-related topics, or management and pro­ E5). In particular, the interviewed farmers complained about the lack duction issues (Table 7, E7-E9). of information about the disease prevalence in wildlife (i.e., species sampled, number of samples, detected prevalence), the bTB cases 3.2.2.2. Sources of information in Pyrénées-Atlantiques (France). The detected at slaughterhouses (i.e., suspicions and confirmed cases), and farmers interviewed in France indicated both the health defence groups the proportion of confirmed cases among the reactor animals detected and their own (private) veterinarian as their main sources of information on-farm. Moreover, the interviewed farmers perceived that the official on bTB (Table 7, E10). The Livestock health defence groups not only veterinarians (and, sometimes, also the private ones) are not very send information to farmers, but often they also organize training ses­ explicit or clear when talking about bTB and do not share all the in­ sions with them. Unions were another reported source, although the formation with them (Table 9, E6-E7). The feeling that official veteri­ issued information was sometimes perceived as rather ’exaggerated’ narians are hiding (from farmers) crucial information on the disease (Table 7, E11). The French Agency for Food, Environmental and Occu­ makes farmers suspicious and distrustful. pational Health & Safety (ANSES) and the Chamber of Agriculture were All the interviewed veterinarians attended some mandatory courses also mentioned as a source of information on bTB. According to the on bTB, and their perceptions of the training contents were similar in private veterinarians interviewed in France, the information on bTB is both countries. They acknowledged that such mandatory training is mostly provided by the official veterinary services and obtained mainly useful (especially for veterinarians with little experience in the field), through official reports and meeting with them. Professional associa­ however, its contents are perceived as too theoretical and remote from tions, such as the Livestock health defence groups or the “Groupement the actual reality in the field (Table 9, E8-E10). In their opinion, the technique vétérinaire (GTV)” were also reported as important sources (i. training focuses mostly on the technical aspects (e.g., the pathogenesis e., meetings and webpages) (Table 7E12-E13), while more informal of lesions, testing and interpretation of results), but not enough on the channels were not mentioned. holistic context related to the disease (i.e., the socio-economic impacts, bTB consequences for farmers, causes of the outbreaks, bTB in wildlife, 9 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Table 7 Sources of information: extracts from the interviews with farmers and private veterinarians Extract Sentences in Original language English Translation Code Sources of information in Catalonia (Spain). E1 “Tot a través de l’Oficina Comarcal del D-ES i una mica d’anar per casa.” (F1-ES). All through the D-ES Regional Office and a bit of going around the house. E2 “Si. I després també per curiositat també mires a aquests diaris digitals que hi ha. Yes. And then also out of curiosity you also look at these digital newspapers that Agrodigital, Agroinformación. bueno noticies que surten que tu vas llegint i vas are there. Agrodigital, Agroinformación. well news that comes out that you are buscant més informació. Veus algun article que hi publiquen.” (F3-ES). reading and looking for more information. You see an article published there. E3 “A veure, a l’Associació ens pengen sempre les jornades PATT i. Jo n’he fet Let’s see, at the Association we always have the PATT days and. I’ve taken several diversos de cursos al Ruralcat. Bé , ara no tinc gaire temps. Ja m’agradaria fer-ne courses at Ruralcat. Well, I don’t have much time now. I would like to do more. més.” (F2-ES) E4 “Si hi ha canvis, els veterinaris de l’oficina del D-ES ens ho comuniquen [.] If there are changes, the veterinarians at the D-ES office inform us [.] Also the També el Col⋅legi. El Col⋅legi de Veterinaris de Catalonia -Province cada dia pel College. The Veterinary College of Catalonia -Province sends members a list of matí als col⋅legiats ens envia un llistat de notícies importants relacionades amb la important news related to veterinary medicine every morning. And sometimes veterinària. I a vegades hi pot haver sortit alguna cosa de tuberculosi bovina.” (V1- something from bovine tuberculosis may have come out. ES) E5 “I de xerrades. es va muntar la PATT aquella quan va haver-hi el brot. Van muntar And of talks. the PATT was set up when there was the outbreak. They set up several diverses jornades de contacte entre fauna salvatge i domèstica”. (V2-ES) days of contact between wild and domestic fauna. E6 “Jo si vols que et sigui sincera, jo quan tinc dubtes de tuberculosi bovina o quan he If you want me to be honest with you, when I have doubts about bovine volgut muntar una xerrada sobre tuberculosi, ho vam fer a través de la universitat tuberculosis or when I wanted to set up a talk about tuberculosis, we did it through [.] És amb qui més confio de preguntar-los-hi. I també hi puc parlar sincerament”. the university [.] He is the one I trust the most to ask them about. And I can (V3-ES) honestly talk about it too E7 “Tenim el grup de WhatsApp que som 200 i pico. (.) I mira, ens serveix per: tinc un We have a WhatsApp group, we are 200 and counting. (.) And look, it’s useful for mamó per vendre, tal dia. Ho com que és molt social, fins i tot ‘tu que s’ha mort tal us: I have a calve to sell, one day. And people respect that. I think it is very social, persona’. Cobreix molts vertents això.” (F3-ES). even ’you who has died such and such a person’. It covers a lot of ground. E8 “El de l’Associació Agroalimentària. I després anem creant grups alternatius de. The one from the Agri-Food Association. And then we’re creating alternative anem a comprar planter. amb els mateixos o amb grups alternatius”. (F2-ES) groups of. we’re going to buy seedlings. with the same or with alternative groups. E9 “Si. A amb cada associació d’aquestes tenim un grup de WhatsApp. En el meu cas Yes. With each of these associations, we have a WhatsApp group. In my case, it is és contacte de feina i l’informal. A part hi ha el grup de WhatsApp de Ramaders. Hi work and informal contact. Apart from that there is the Farmers WhatsApp group. ha un grup de sanejament a l’Associació de Ramaders”. (V2-ES) There is a sanitation group in the Farmers Association. Sources of information in Pyrénées-Atlantiques (France). E10 “Oui, oui, on reçoive très souvent communications au tour la tuberculose par le Yes, yes, we very often receive communications about tuberculosis through the GDS. Souvent, c’est le groupement sanitaire qui gère les maladies et au niveau GDS. Often, it is the health group that manages the diseases at the departmental départemental et ceux qui nous envoient des informations. Mais bon, après, c’est level and those who send us information. But hey, afterwards, it’s always the same toujours la même chose quoi. Par mail, souvent par courrier. Un bulletin annuel thing. By e-mail, often by post. An annual bulletin in which all the diseases are que par rapport à toutes les maladies et donc qui font le point sur la maladie, le reported, their possible sources, the number of cases. and that’s it. nombre de cas… et voilà”. (F3-FR) E11 “C’est la Fédération départementale des syndicats d’exploitants agricoles […] Les It is the Departmental Federation of Farmers’ Unions [.] The information, despite informations malgré qu’elles soient exagérées, peut être un peut les syndicats being exaggerated, comes from a bit of the agricultural unions that trace the agricoles qui remontent les informations à la base. Des fois, il pousse un peu le information to the base. Sometimes he pushes things a bit too far. But hey, the bouchon un peu loin. Mais bon, l’information elle est bonne”. (F4-FR) information is good E12 “Information sur la tuberculose arrive de la GDS et le D-FR. Oui, bien sûr. Les deux Information on tuberculosis comes from the GDS and the D-FR. Yes, of course. The organismes”. (V4-FR) two organisms. E13 “Tout c’est fiable, je trouve. J’ai confiance avec la D-FR, j’ai confiance avec le GTV. Everything is reliable, I think. I trust the D-FR, I trust the GTV. It’s just that C’est juste que ça manque parfois de clarté . Mais la confiance je l’ai”. (V3-FR) sometimes it lacks clarity. But I have confidence. In the table, bTB: bovine tuberculosis; OVS: Official Veterinary Service; F: Farmer; V: private veterinarian; ES: Catalonia, Spain; FR: Pyrénées-Atlantiques, France; D- ES: Regional veterinary service in Catalonia; D-FR: Regional veterinary service in Pyrénées-Atlantiques; GTV: Groupement Technique Vétérinaire; GDS: Groupements de Défense Sanitaire. information on other territories) and it does not provide skills on how to informal WhatsApp groups, during private meetings (i.e., barbecues), or communicate with farmers (e.g., how to inform on bTB cases or explain in public community spaces or events (i.e., local livestock markets, or what will happen as a consequence of bTB detection). Moreover, ac­ bars) (Table 10, E4). The French farmers reported talking about bTB cording to the interviewees, the training is usually delivered through a with their veterinarians or with laypeople from the same areas (i.e., top-bottom approach, which rarely considers their knowledge and neighbours, friends, or relatives), but not necessarily with other farmers, experience from the field, while it should be more interactive, grounded and the target of conversations is usually the routinary herds screening on real cases, and create space for sharing opinions (Table 9, E11-E12). (Table 10, E5). As specificity, the veterinarians interviewed in France referred that since the (private) veterinarians themselves have many doubts about bTB (i. 3.2.2.7. The Informal communication on bTB among private veter­ e., sources and dynamic of infections), they could have transmitted this inarians. According to the veterinarians interviewed in Spain, private feeling of scepticism to the farmers (Table 9, E13), while some of the veterinarians share and receive information on bTB mainly through Spanish veterinarians perceived the mandatory nature of this training as informal channels (i.e., phone calls, WhatsApp groups or other social a “punishment” and a sign of distrust from the official veterinary service networks). In their opinion, informal communication is very important (Table 9, E14). since it provides them with an overview of what is happening in the field at any given moment. They also recognised a certain lack of internal 3.2.2.6. Informal communication on bTB among farmers. In both coun­ organization and communication between them (Table 10, E6). This was tries, bTB -related issues are not addressed much in the informal attributed, on the one hand, to the sensitive nature of the topic (i.e., bTB communication among farmers. According to the interviewed farmers, a and infectious diseases in general) and, on the other, to commercial higher priority is usually given to other concerns, such as management competition between them which hinders their mutual support or production issues, and bTB is a topic of discussion mainly when cases (Table 10, E7-E8). The private veterinarians interviewed in France re­ are detected (or suspected) in the nearby territory (Table 10, E1-E3). The ported that they do not share much information or experiences on bTB Spanish farmers referred that sometimes they talk on bTB through (Table 10, E9). It usually occurs among veterinarians who experienced 10 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Table 8 Formal/Official communication on bTB: extracts from the interviews with farmers and private veterinarians. Extract Sentences in Original language English Translation Code Formal communication in Catalonia (Spain). E1 “Però, nosaltres, al final, la branca més propera del Departament seria el comarcal. But, for us, in the end, the closest branch of the Department would be the county Et truca el Cap d’Oficina i et diu ‘escolta que aquest any.’. O, a vegades som branch. The Head of Office calls you and says ’listen, so this year.’. Or, sometimes nosaltres, que rebem informació d’altres llocs. La informació a vegades arriba més we receive information from other places. Information sometimes arrives more by per casualitat que per vies pròpiament formals, eh. [.] Per exemple, ‘ara han dit que chance than through properly formal channels […] For example, ’now they have ho han de fer al coll’. Això igual t’arriba de no s é on. Llavors ho preguntes al D-ES said that they have to do it in the neck’. This still comes to you from I don’t know per veure si és així o no. No hi ha un canal d’informació clar.” (V1-ES) where. Then you ask the D-ES to see if that is the case or not. There is no clear information channel. E2 “No. No! Que un correu ni res. Comunicacions personals amb el veterinari de No. No! That is an email or nothing. Personal communications with the veterinary l’oficina.[] No ho s é . És que arriba un punt, que no ho s é . Un protocol escrit de officer in the county […] I don’t know. There comes a point that I don’t know. We com va tot no l’hem vist mai. […] La comunicació hauria de ser més àgil. Entre have never seen a written protocol of how everything goes. […] Communication nosaltres i l’administració. O que fos més clara la informació. O que els protocols should be more agile. Between us and the administration. Or that the information fossin més. no s é .” (F1-ES) was clearer. Or that the protocols were more. I don’t know. E3 “Fèiem reunions amb el Departament. El que vam fer és posar en dubte tot el We held meetings with the Department. What we did is question the whole system sistema que tenien. Posar en dubte tot aquest procediment, protocol, perquè no they had. Questioning this whole procedure and protocol, because we didn’t think trobàvem que fos eficaç .” (F3-ES) it was effective. E4 “No. Fins i tot des de l’Oficina Comarcal tardaven dies a saber aquests resultats. I Yes, samples continue to be taken. But no one has ever told us anything about ara mateix se n’està fent, de proves d’aquestes a la fauna, encara. I van sortint whether or not positive boars have come out. And we find out why this one told animals positius. I mo n’enterem per què aquest m’ha dit, aquest ha fet, aquest no me, this one did, this one I don’t know what. There is nothing. I believe that there s é què . No hi ha res. Jo crec que no hi ha cap lloc oficial o cap web de la is no official place or website where you can go to look (at the data). Generalitat on anar a mirar i et diguin” (F1-ES) Formal communication in Pyrénées-Atlantiques (France) E5 “Cet autour de la prophylaxie qui nous en parlent le plus. Le souci, c’est que le souci It is around prophylaxis that we are most informed. The concern is the concern par rapport à la tuberculose, vraiment la tuberculose. Comme on n’est pas vraiment about bTB, really the bTB. As we are not really concerned, we feel a little far away, concerné , on se sent un peu loin malgré qu’on soit pris, on n’en parle pas trop. […] we do not talk about it too much. […] Communication was made as soon as there La communication a été faite dès qu’il y a eu des cas qui ont été pas trop trop loin were cases that were not too far from our home. […] The information around bTB de chez nous.[…] Les informations au tour de la tuberculose sont claires. Oui, ils is clear. Yes, they are clear because those who announced it to us, it was clear, they sont clairs parce que ceux qui nous ont annoncé , c’est clair, était en marqués sur were marked on the paper. papier.”. (F4-FR) E6 “à part le GDS, les vétérinaires qui nous donne des informations? L’administration? Apart from the GDS, which of the vets is giving us information? The … Non. Appart quand tu est touchée, ça il te donnent des informations. Sinon” (V3- administration?. No. Apart from when you are affected, then they give you FR) information. If not. I don’t know if there is better information out there. E7 “Oui, l’information est claire. Par contre, ceux qui nous donnent les informations Yes, the information is clear. On the other hand, those who give us the information n’ont pas encore la vérité sur la tuberculose et donc ils ne peuvent pas donner do not yet have the truth about tuberculosis and, therefore, they cannot give us quelque chose qu’ils n’ont pas. Donc, ils donnent des pistes pour s’en protéger.” something they do not have. (F2-FR) E8 “Voilà, donc, on était vu comme des gens sales. On avait la tuberculose. Ils So, we were seen as dirty people. We had tuberculosis. They could say it pourraient le dire autrement. Et voilà, donc il y a ça, c’est pas bien, je trouve […]. differently. And there it is, so there’s this, it’s not good, I think. When he called me Quand il m’a appelé pour me dire que le voisin avait la tuberculose… bon tanpis, to tell me that the neighbour had tuberculosis… well, we’ll be careful. Because on va faire attention. Parce que tout le monde l’avait, parce que tout le monde everyone had it, and because everyone knows what […] And the most worried? savez à quoi […] Et le plus inquiet? L’agriculteur qui a été le plus inquiet et le plus The farmer is the most worried and the most "olalà", he didn’t have any cows at “olalà”, il n’a pas eu de vaches chez lui ”.(F2-FR) home. E9 “La communication vétérinaire sanitaire qui est assez bonne et une simplification Veterinary health communication which is quite good and simplification which is qui se fait au fur et à mesure. Au début, c’était encore un petit peu brouillon. Ça done step by step. At first, it was still a little messy. It’s starting to be a lot clearer, commence à être beaucoup plus clair, même pour ceux, parce que nous on est déjà even for those, because we’ve already faced it, it’s a little easier for us than for confronté , c’est un peu plus facile pour nous que d’autres vétérinaires dans les other vets in the areas, they don’t always know very well what to do. Today, we zones savent pas toujours très bien quoi faire. Aujourd’hui, on a à disposition un have available a document for the measures which is quite clear, with indications document pour les mesures qui est assez clair, avec des indications directement sur directly on the document, which facilitates the interpretation of the results live, le document, ce qui facilite l’interprétation des r é sultats en direct, avec en plus with in addition a presentation to explain it. It’s pretty clear, that’s it. At first, I une présentation pour lui expliquer. C’est assez clair, ça, ça y est. Au début, j’étais was a little deficient. un peu déficient. ”.(V1-FR) E10 “Des information, des informations factuelles sur l’organisation de la champagne, Information…there is concrete information on how to organise the bTB screening sur le positif, mais pas d’information scientifique sur les voies de contamination. campaign, on the positives, but no scientific information on the routes of Est ce que dans quelle direction chercher? Est ce qu’il y a des recherches qui sont contamination/transmission. Which direction to look in? Is there research being faites sur justement la contamination par la faune sauvage et éventuellement sur la done on contamination by wildlife and, in case, on the measures to fight against it? lutte qu’on pourrait mettre en place? ”.(V1-FR) E11 “L’information, oui. L’information en question, oui. Mais après qu’est ce qu’on Information, yes. The information in question, yes. But then what can we really peut vraiment faire? C’est pas ça, c’est pas l’accès à l’information, c’est l’accès au do? It’s not that, it’s not access to information, it’s just access to the mode of mode d’action tout court. Qu’est ce qui se passe?”. (V4-FR) action. What is it that is happening? E12 “Eux, ils sont tellement habitués à parler de tuberculose qu’ils se rendent compte They are so used to talking about tuberculosis that they realize it’s like a doctor que c’est comme un docteur qui annonce un cancer. Il en annonce tous les jours. Il announcing cancer. He announces it every day. He tells you like that and when te le dit comme ça et quand tu es concerné , tu ne le prends pas… C’est pareil, je you’re concerned, you don’t take it… It’s the same, I compare it to that. compare à ça”. (F2-FR) E13 “Avec les vétérinaires du GDS, oui [je fais confiance], avec les vétérinaires With the GDS vets, yes (I trust them), with the OVS, no. And there, there are administratifs, non. Et là, il y a énormément d’efforts à faire par rapport à la enormous efforts to be made about bTB. But it’s always the same, we say, etc. tuberculose. Mais c’est toujours pareil, on dit, etc”. (F6-FR) In the table, bTB: bovine tuberculosis; OVS: Official Veterinary Service; F: Farmer; V: private veterinarian; ES: Catalonia, Spain; FR: Pyrénées-Atlantiques, France; D- ES: Regional veterinary service in Catalonia; D-FR: Regional veterinary service in Pyrénées-Atlantiques; GTV: Groupement Technique Vétérinaire; GDS: Groupements de Défense Sanitaire. 11 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Table 9 Perceptions of the training about bTB: extracts from the interviews with farmers and private veterinarians. Extract Sentences in Original language English Translation Code Perception of training among farmers E1 “N’he fet alguna, s í (Jornada PATT sobre TbB). Però ara fa temps que no, eh. Amb I have done some, yes (PATT Conference on bTB). But it’s been a while now, eh? temes de la fauna salvatge, de si era o no portadora” (F6-ES) About the themes of wild fauna, whether or not it was a carrier E2 “Il y a eu des formations faites par les vetos, des sessions d’une journée entière. Il y a There was training done by the vets, full-day sessions. Two years ago, years ago, deux ans, il y a des ans, quand on a commencé à voir des cas de tuberculose un peu when we started to see cases of tuberculosis almost everywhere at the level of the partout au niveau du GDS,du groupement départemental sanitaire. Ils ont GDS, the departmental health group. They started asking veterinarians in each commencé à demander aux vétérinaires de chaque secteur de faire des formations, sector to do training, information, and one-day sessions. Also, what does des informations, des sessions d’un jour. Aussi, que nous explique la tuberculose, tuberculosis tell us, how it works and how you can catch it? comment ça marche, comment on peut l’attraper ”. (F4-FR) E3 “Segurament ha estat més per desídia que per cap altra cosa. Per tenir molta feina It was probably more out of laziness than anything else. Because of the high i.” (F5-ES) workload and … E4 “ Après on a eu une formation obligatoire, quand on a la tuberculose, par le GDS, Afterwards, we had compulsory training, when you have tuberculosis, by the c’est le groupe de defense sanitaire, et cette formation est bien. Elle est bien parce GDS, the health defence group, and this training is good. It is good because we are qu’on est entre éleveurs et vétérinaires du GDS qui sont sympa, qui sont quand between breeders and veterinarians of the GDS who are nice, whatever. There’s même. Il n’y a pas de tabou, tout le monde dit, on a parlé , on a… et ça c’est bien, je no taboo, everyone said, we talked, we… and that’s good, I think that was very trouve ça c’était très bien. Elle était bien cet formation”. (F2-FR) good. It was a good training E5 “je ne sais pas si elle existe le meilleur information. Moi, la meilleure. Après il faut I don’t know if there is better information out there. For me, the best. Then you continuer les tests. Bon, très bien les améliorer parce que je pense que il y en a des have to continue the tests. Well, it’s very good to improve them because I think bons et des moins bones. Mais après la r é el information, buff… c’est compliqué à there are good ones and others that are not so good. But then the real information, dire”. (F3-FR) buff. it’s hard to say E6 “A tots dos [privat i oficial]. El que passa és que els hi fas preguntes a tots dos i són "To both [private and official]. The thing is, you ask them both questions and molt ambigus responent, perquè segurament no estan d’acord amb moltes coses, they’re very ambiguous in their answers because they probably don’t agree on a saps? [.] El de l’Oficina Comarcal poca cosa dirà, perquè ell sempre. naden i lot of things, you know? [.] The one from the County Office will say little because guarden la roba, no? I l’altre amb aquest percal tampoc parlarà molt, saps?”. (F5- he always. they swim and keep their clothes, don’t they? And the other one with ES) this perch won’t talk much either, you know?" E7 “Après ils ne nous disent pas tout. On le sait par les éleveurs, ce n’est pas par le “Afterwards they don’t tell us everything. We know this from the breeders, not vétérinaire. Ils nous disent les cas qui a eu et voilà. Ils ne te le disent pas, quoi. Parce from the veterinarian. They tell us the cases that had and that’s it. They don’t tell qu’après, il y a plusieurs formes de maladies. Il y a plusieurs, je ne sais pas comme you, what. Because afterwards, there are several forms of the disease. There are ils appellent ça, plusieurs… formes.”. (F3-FR). several, I don’t know what they call it, several…forms…”. Perception of training among veterinarians E8 “Nous devons faire la formation pour remplir notre mandat de santé , notre We have to do the training to fulfil our health mandate, our qualification as a qualification de vétérinaire pour faire de la prophylaxie, etc. une de ces formations veterinarian to do prophylaxis, etc. one of these courses is on the tuberculin skin porte sur la tuberculine, ce qui est intéressant et permet de modifier un peu ce test, which is interesting and allows you to modify this discourse a little discurs” (V1-FR) E9 “Era molta teoria sobre la tuberculosi bovina i jo ja feia anys que anava a ajudar al There was a lot of theory about bTB, and I have been doing the skin test for years, sanejament, i anava al curs pensant, amb ganes de saber, que m’explicarien com and I went to the course with the expectation (and wanting to know) they would reaccionar davant d’un positiu, quines són les passes a seguir després d’un positiu. I have explained how to react when detecting a reactor animal, what are the next el curs era tot teoria sobre tuberculosi i una mica de pràctica de com rasurar, steps to follow. And the course was all theory about bTB and a bit of practice on mesurar i punxar, com interpretar el resultat, o sigui què és un positiu i què és un how to shave, measure and prick, how to interpret the result, e.g., what is positive negatiu, però només això. I ja està. No ens van donar res d’informació de com and what is negative, but that’s all. And that’s it. They didn’t give us any actuar davant d’un positiu, de com donar la notícia, de quan tens un positiu quines information on how to act in the face of a positive, how to report it to farmers, conseqüències t é sobre el pagès, quines pel ramat. Res de tot això que era el que what consequences a bTB case has on the farmer, and what consequences for the més m’interessava” (V1-ES) herd. None of this, which was what I was most interested in E10 “Tous les vétos devaient passer (la formation obligatoire) et qui était n é cessaires. All vets had to pass (mandatory training) and that was necessary. […] So well, […] Alors bon, y’a pas de problème, on y va, on regarde, mais ça on l’avait déjà eu à there’s no problem, we go, we look, but that we had already seen at school, there l’école vu, clairement, il y avait des jeunes vétos qui peut être n’avaient pas le fait, were young vets who perhaps did not have the did, which was good, but there’s ce qui c’était bien, mais il y aussi pleines de véto qu’ils l’avait déjà fait, pas mal. Je also plenty of vetoes as they’ve already done, not bad. I don’t know if that was ne sais pas si c’était hyper utile. […]C’était un peu. Je trouvais le discours un peu super helpful. […] It was a little. I found the speech a little directive. There wasn’t directif. Il n’y avait pas trop de débats, alors personne ne disait rien. Moi, je trouve too much debate, so nobody said anything. I think it could have been put to better que ça aurait pu être mieux utilisés. […] La partie technique, peut-être. Mais pour le use. […] The technical part, perhaps. But for the rest, it surely fails. The reste, il p è che sûrement. La partie épidémiologie, la partie communication, le. epidemiology, the communication. What happens when I have a case? What will Que se passe-t-il quand j’ai un cas ? Qu’adviendra-t-il des agriculteurs?” (V3-FR) happen to the farmers? E11 “Sí . Es va fer una xerrada. allò també va ser interessant., que després de 10 anys del Yes. They (OVS) gave us a talk. that was also interesting. that after 10 years of the sector ramader i els veterinaris de camp dient que la fauna salvatge tenía livestock sector and field vets saying that wildlife had bTB and them saying that tuberculosi i ells de dir que no (l’Administració), allí per primera vegada ho vaig no (the Administration), for the first time I heard someone from the Department sentir a dir a algú del Departament.” (V4-ES) say it E12 “Si. Com una formació més real. Que no sigui les coses s’han de fer així i ja està. Que Yes. Like a “more real” training. Otherwise, things have to be done this way and sigui més aterrat al món real dels ramaders. […] És com que hi ha dos móns. El que that’s it. Be more grounded in the real world of farmers. [.] It’s like there are two es creu el Departament, el què es vol creure; i el que es fa.” (V3-ES) worlds. What the Department believes, what they want to believe; and what is actual done. (in the Department). E13 “Il y a beaucoup de choses qu’on ne maîtrise pas dans la tuberculose et qui font que There are many things that we do not control in bTB and that means that la communication avec les éleveurs de la part des vétérinaires a été déficiente aussi. communication from veterinarians to farmers has also been deficient. That is to C’est à dire que les vétos, on est complètement coupables aussi du fait que les say that the vets, we are also completely guilty of the fact that farmers say that it is éleveurs disent que c’est un test de merde parce que les vetos, ils n’avaient pas envie a shitty test because the vets did not want to do it or that they were queuing in de le faire ou qu’ils faisaient la queue en disant que de toute façon, c’était un test de saying anyway it was a shitty test merde.” (V1-FR) E14 “A nivell de formació, ens venen i ens diuen ‘si no feu més de x% de proves al coll, At the training level, they come to us and tell us ‘If you don’t do more than x% of sou susceptibles de ser sancionats o inhabilitats’. Llavors et fiquen allí la llista, tests on the neck, you are liable to be sanctioned or disqualified’. Then they put ‘aquest període hem inhabilitat a tants veterinaris’. Pues, mira” (V4-ES) you on the list: ’this period we disqualified so many vets’. Well, look… In the table, bTB: bovine tuberculosis; OVS: Official Veterinary Service; F: Farmer; V: private veterinarian; ES: Catalonia, Spain; FR: Catalonia, France; D-ES: Regional veterinary service in Catalonia; D-FR: Regional veterinary service in Catalonia; GTV: Groupement Technique Vétérinaire; GDS: Groupements de Défense Sanitaire. 12 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 some bTB outbreak and in informal contexts (e.g., after a training event) • Organise meetings which could also be used for discussing doubts or among those of the same health defence group (i.e., GTV) (Table 10, and simplifying procedures, or for the detection of administrative E10). They also recognised that there are some discrepancies in the in­ dysfunctions (i.e., working groups). formation provided by the different veterinarians to the farmers, which • Improve the accessibility of the information already available in the should be avoided (Table 10, E11). territory: simpler and more transparent mechanisms than those currently in place (e.g., updating websites or sharing databases). • Produce visual material (infographics, short videos, fact sheets, etc.) 3.3. Participatory pilot intervention with contextual information about the disease (impact, risks, pro­ cedures, etc.). The main proposals/ideas to improve the communications on bTB, • Redesign the training courses to make them less unidirectional (for which were developed by farmers and veterinarians (separately) during example, give space for sharing experiences and knowledge from the the first round of focus groups, are summarised in Figs. 3 and 4, field), and to widen the range of topics besides the more technical respectively. already included (e.g., content related to social, economic, peda­ Both farmers and private veterinarians expressed the need of sharing gogical, and administrative aspects). information on the epidemiological situation in the region and asked for more regular feedback on the number and location of bTB outbreaks and Farmers and private veterinarians also recognised that to realise updates on positive wildlife reservoirs. They also would like to have their proposals they should first strengthen their organization and more voice (i.e., greater participation) in the design of protocols and the engagement and generate an internal debate to identify the priority is­ decision-making processes. Especially farmers claimed protocols that sues to be solved together with the official veterinary services. It was can be adapted to specific cases, without generating comparative acknowledged that private veterinarians linked to livestock health grievances (“protocolised flexibility”) and the production of concise defence groups should play a major role in such an organizational (and written) documents which clarify rules and explain step by step the process. protocol to follow in case of doubt or bTB-positive cases (Fig. 3). Moreover, they suggested giving more value to their work through 4. Discussion pedagogical actions among the general population to raise awareness about the rural sector’s contribution to society. Finally, they proposed to In the trans-Pyrenees region, the bTB eradication programmes are establish a ‘Crisis Committee’ to support decisions on specific cases or carried out in a social context marked by a certain distrust between the bTB outbreaks (Fig. 3). various actors, which makes it difficult to reach a common under­ On the other hand, private veterinarians don’t feel that their work is standing of the disease and reduce the acceptability of the bTB eradi­ valued and relied by the official veterinary services, and they would like cation programmes in place. The study followed a comprehensive to receive constructive advice and not be just supervised or criticized approach which integrated different (mainly qualitative) social research (Fig. 4). The veterinarians also highlighted the need of creating partic­ methods to gain insight into the communication (i.e., contents and ipatory spaces to communicate doubts or make joint reflections and processes) existing among people involved in the bTB eradication pro­ share reliable information between farmers and veterinarians (e.g., gramme and to understand the sociological factors which might influ­ thematic conferences) (Fig. 4). ence their communication. This approach allowed us to address, from an The generated proposals were presented to the regional veterinary evidence-based perspective, the concerns and viewpoints of people officers (i.e., official veterinary services) and the feedback received from involved in the implementation of the bTB eradication programme. the official veterinary services was discussed jointly by farmers and Furthermore, it investigated possible solutions to the identified barriers veterinarians (i.e., second round focus group) to find a consensus and and developed recommendations to promote (and improve) communi­ agree on their validity. After discussion, the following list of proposals cation on bovine tuberculosis between stakeholders. was agreed upon between farmers and private veterinarians: Results from this study pointed out that the sociocultural and political-institutional dimensions of the bTB risks prevail over the eco­ • Meeting spaces: Creating communicative and participatory spaces to nomic and health dimensions and highlighted the importance of share opinions, and reliable and understandable information. Facil­ improving the level of information and trust between actors (i.e., itate meetings in the territory to make joint reflections (e.g., thematic farmers, private veterinarians, and official veterinary services). There is conferences). a heterogeneous understanding of bTB between people involved in the • Acknowledgement: Give more value to the work done by both vet­ eradication programme which is reflected in the different language used erinarians and farmers and implement pedagogical actions toward by the farmers, private veterinarians, and official veterinary services (i. the general population to raise awareness about the rural world and e., metaphorical strategies and topics communicated). The analysis its contributions to society. revealed the divergence between farmers and public bodies and scien­ • Clearer protocols: Have clear rules and protocols that can be adapted tists: the institutional and scientific communication focused almost to specific cases, without generating comparative grievances (“pro­ exclusively on the detection and control of the disease, while other social tocolled flexibility”). and economic aspects were left in the background. On the contrary, • Listening mechanisms: Carry out audits of private veterinarians not farmers extend their communication to a greater variety of themes and only to inspect their work but also to accompany and support them / in their communication referred to a large variety of target domains, their working activities. Give farmers and private veterinarians more indicating their concern for different aspects related to bTB and not only voice (greater participation) in designing protocols. Establish a for the disease itself. Moreover, the framing of bTB strongly differs ‘Crisis Committee’ to support decisions on specific cases (bTB out­ among actors, highlighting the existence of a controversial debate about breaks) → representatives of farmers, veterinarians, and OVS. bTB in which each party defends different positions: the official veteri­ nary services and researchers “fight” against bTB and “progress” to­ The above-described list of proposals was presented collectively and wards its eradication, farmers place themselves in a framework of discussed among farmers, private veterinarians, and representatives of sacrifice and, particularly in Spain, they play a passive role (Capdevila the official veterinary service in the final workshop. During this last et al., 2022). The literature agrees that the management of bTB in a meeting, all participants expressed to be aware of the need of improving territory (i.e., surveillance, prevention, and control) is a controversial, the communication processes. At the end of the workshop, participants conflictive, and complex issue (Grant, 2009; Cassidy, 2012; Enticott agreed to implement the following actions: et al., 2014; Maye et al., 2014; Naylor et al., 2014; Robinson, 2017; Allen 13 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Table 10 Informal communication on bTB: extracts from the interviews with farmers and private veterinarians. Extract Sentences in Original language English Translation Code Informal communication on bTB among farmers E1 (por diferentes grupos de whatsapp) “han circulat els últims anys alguna informació, Some information (on bTB) has circulated in recent years, beyond reporting that més enllà d’informar que un company ho ha tingut” (F6-ES) a colleague has had it E2 “On en parle avec les vetos, on en parle entre nous aussi, mais très peu. Parce que We talk about bTB with the vets, and we talk about it among ourselves too, but bon, comme je vous dis, on se sent pas concernés. On parle d’autres maladies. Il y a very little. Because well, as I tell you, we don’t feel concerned. We are talking d’autres problèmes sur l’éthique, sur les vaches, sur des avortements. […] Quand on about other illnesses. There are other issues regarding ethics, cows, or abortions. est en transhumance on fait attention à tout et à tout le monde parce que la maladie […] When we are in transhumance, we pay attention to everything and everyone n’est pas socialiste, comme on dit, c’est à dire on ne partage pas la maladie. On va because the disease is not socialist, as they say, it is to be said that we do not share partager les bons moments, les mauvais, mais la maladie se la garde eux même.” (F4- the disease. We will share the good times, and the bad, but the disease takes care ES) of itself. E3 “Oui, on été un peu renseigné parce que comme il n’y a dans le coin, pas très, très Yes, we were a little informed because as there is in the area, not very, very far. loin. […] Oui, mais après, on en revient toujours dans le problème. C’est que quand […] Yes, but afterwards, we always come back to the problem. It’s that when on est pas concerné , trop on le lit, on est pas… Et quand tu est là.” (F2-FR) you’re not concerned, you read it too much, you’re not. And when you’re there. E4 “No ho s é . La nostra actitud en front això ara és de moment no ha arribat, quan I do not know. Our attitude towards this right now is that it has not arrived yet, arribi ja ens n’ocuparem. Mira, l’altre dia vam fer una barbacoa amb noies when it arrives, we will deal with it. Look, the other day we had a barbecue with ramaderes. gent que es dedica al món dels boscos. tot això. No se’n va parlar. No és farmers. people who work in the world of forests. all that. It was not discussed. una preocupació ara. (F2-ES) bTB is not a concern now. E5 ”Oui, avec les voisins de la ville. Et avec les vétérinaires. Quand vient le temps de la Yes, with the people from the town. And with the vets. When the time for prophylaxie, on se demande si ça se passe bien ou pas. Suivons un peu les prophylaxis comes, you wonder if it’s going well or not. We follow the events a événements” (F5-FR) little. Informal communication on bTB among veterinarians E6 “Tenim un grup de WhatsApp, però bueno. Vam decidir a l’última reunió, de fa un We have a WhatsApp group, but hey. We decided in the last meeting, a year ago any o més, que faríem una reunió per zones de Catalonia amb veterinaris per or more, that we would hold a meeting in the area between veterinarians in explicar bé què és ADSG als veterinaris, i que els veterinaris ho expliquessin als seus Catalonia to explain well what ADSG is, so that the veterinarians would have ramaders. Per intentar fer una xarxa real per a què funcionés una mica millor”. (V3- explained it to their farmers. To try making a real network, work a little better ES) E7 “Hi ha algun grup de WhatsApp de veterinaris, que comenteu la jugada? No no. Som Is there a WhatsApp group of vets, who comment on it? no no, We are not very poc organitzats a vegades. (.) També a vegades prefereixes comentar-ho així o per organized sometimes. (.) Also sometimes you prefer to comment on it like now telèfon i no deixar res per escrit perquè de vegades no da lugar”. (V2-ES) (face-to-face) or on the phone, and do not leave anything written because sometimes it doesn’t work… E8 “i amb veterinaris privats, jo el que veig és molt més individualisme que en qualsevol and with private vets (of cattle), what I see is much more individualism than in altra espècie. [.] Per competència laboral totalment. ” (V4-ES) any other species. [.] For labour competition entirely E9 “On a pas ce regard là. Il y a une confidentialité totale. Il y a vraiment une opacité , We don’t have that look. There is total confidentiality. There is an opacity, even même autour de l’identité des élevages qui sont atteints pour les protéger, around the identity of the farms that are affected to protect them, obviously évidentment. ” (V4-FR) E10 “On se rencontre quand on a des r é unions, notamment chez GTV, par la formation. Ens trobem quan tenim reunions, en particular al GTV, mitjançant la formació nous avons aussi un groupement d’achat. Nous sommes donc un groupe de sept, sept per actuar tots junts de manera coordinada. Després tenim un grup de compres. ou huit cliniques ” (V1-FR) Per tant, som un grup de set, set o vuit clíniques E11 “Je pense qu’il y’a une vraie travail d’harmonisation du discours, etc. entre I think that there is a real work of harmonization of the discourses, etc. between vétérinaires, qui a faire dans un premier temps avant de communiquer. Avant de veterinarians, what has to do first before communicating. Before communicating communiquer avec les éleveurs, il faut que les vétérinaires trouve que le discours est with the farmers, the veterinarians have to find/feel/understand that the légitime, que la personne qui porte le discours est légitime et que toutes sont discourse is legitimate, that the person carrying the discourse is legitimate and d’accord avec ce discours là”. (V1-FR) that everyone agrees with that discourse In the table, bTB: bovine tuberculosis; OVS: Official Veterinary Service; F: Farmer; V: private veterinarian; ES: Catalonia, Spain; FR: Pyrénées-Atlantiques, France; D- ES: Regional veterinary service in Catalonia; D-FR: Regional veterinary service in Pyrénées-Atlantiques; GTV: Groupement Technique Vétérinaire; GDS: Groupements de Défense Sanitaire. ADSG: Association of Livestock health defence groups in Catalonia. et al., 2018; O’Hagan et al., 2016; Hamilton et al., 2019; Robinson, (Bougher, 2012). Metaphors express and reinforce different ways of 2019; Ciaravino et al., 2020; Keenan et al., 2020; Clarke et al., 2022) conceptualising and experiencing certain matters (Charteris-Black, with a dominant sociopolitical component. This is due on a wide range 2004; Charteris-Black, 2011). Therefore, the identification and inter­ of factors linked, on the one hand, to the characteristic of the disease and pretation of metaphors used when communicating about bTB enables its control (i.e., wildlife, testing, chronic progress) (Enticott et al., 2014; one to delve into the different views that the different stakeholders may Naylor et al., 2014; Allen et al., 2018; Crimes and Enticott, 2019) and, on have about the disease. In Spain and France, the communication on bTB the other hand, to broader psycho-sociological factors, such as scepti­ mainly focus on detection and control of the disease in cattle, being the cism and the perception of lack of self-control (Hamilton et al., 2019), greatest concern for all stakeholders related to testing, and the role of the lack of trust in government and public bodies (Enticott, 2008; wildlife. Results also confirm that farmers experience (and perceive) Enticott et al., 2014; Ciaravino et al., 2017) and the lack of perceived bTB in a particularly complex manner and there are several aspects of benefit of being bTB free (Ciaravino et al., 2017). their concerns. Gaps between scientific communication and circulating Especially in conflictual contexts, understanding how people knowledge on bTB have already been reported (Robinson, 2019). communicate on a topic is key. Discursive strategies and statements used Moreover, previous studies pointed out that wildlife and its manage­ in public debates can influence opinions and societal interest, percep­ ment, testing quality and its impact on the bTB scheme, and scepticism tions, and actions. Moreover, the language is the means by which people around eradication, among others, were important aspects of concern, create frames, i.e., the mental structures that reflect views and under­ influencing farmers (and veterinarians) attitudes and hampering moti­ standing of the world (i.e., how the reality is perceived, described, and vation and engagement (Enticott, 2008; Warren et al., 2013; Maye et al., evaluated) (Entman, 1993). The ideas underlying a frame are reflected 2014; Ciaravino et al., 2017; O’Hagan et al., 2016; Hamilton et al., 2019; in specific linguistic choices, being metaphor a relevant one (Gamson Ciaravino et al., 2020; Clarke et al., 2022). Therefore, it is envisage to and Modigliani, 1989). The use of metaphors allows people to broaden the themes covered by the institutional/scientific communi­ communicate a complex, new, or conflictive issue (in this case bTB) cation, since bTB has multiple dimensions that need to be addressed; in using realities that are closer to them or that are of common knowledge particular, addressing issues that directly affect and/or concern farmers 14 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 Fig. 3. Proposals to improve the communication on bTB developed by farmers during the first round of focus groups.Representation of the sticky notes with the proposals and recommendations generated by the farmers during the first group session (i.e., focus group). Fig. 4. Proposals to improve the communication on bTB developed by private veterinarians during the first round of focus groups. Representation of the sticky notes with the proposals and recommendations generated by the veterinarians during the first group session (i.e., focus group). (and private veterinarians), such as bTB risks and benefits, bTB conse­ rhetoric was mainly used by the official veterinary services and when quences for farmers, or topics related to economic and social aspects referring to the surveillance and control of the disease (e.g., “Necesidad would be beneficial and could contribute to their motivation and in­ de luchar en diferentes frentes contra la enfermedad” [the need to fight terest toward bTB. against the disease on different fronts], "Un plan de lutte national" [a The observed differences in the metaphors used to communicate on national plan to fight against]): bTB is explicitly placed in the role of bTB reveal divergent and sometimes even incompatible narratives by enemy and the farmers are implicitly placed in the role of a fighter. As in the different stakeholders. Military metaphors have been commonly a war, the official veterinary services decide the rules and use the “tools” used to refer to infectious diseases, being one of the standard metaphor provided by the scientist, but farmers (and to some extent private vet­ systems for animal and human diseases (Blankshain et al., 2023; Nerlich, erinarians) are just soldiers that have to fight against the disease. In 2004; Ribeiro et al., 2018; Wallis and Nerlich, 2005; Wicke and Bolog­ Spain, the “war” frame does not take farmers into account; they do not nesi, 2020). The use of the war rhetoric by policymakers and health appear in the developed narrative and, only in a few cases, do experts or authorities has been previously described and linked with political and authorities mention that farmers should be considered allies. In this scientific uncertainty about pathogens’ transmission and effective pre­ context, farmers perceive that they (the soldiers) are the only ones who ventive measures (Ribeiro et al., 2018; Wicke and Bolognesi, 2020), are suffering the consequence of this war (i.e., slaughtering cattle) and mobilization of resources and public support or to justify the imple­ they live the eradication programme as a kind of punishment that have mentation of severe control measure (i.e., movement restrictions, cull­ to suffer because of their condition of being a farmer. In the French ing, slaughtering, burying) (Nerlich, 2004). In both countries, the war context, it seems that farmers play a more active role, and they perceive 15 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 themselves to be part of the “fight” against bovine tuberculosis. How­ The participatory activities carried out with the farmers, private ever, the frequent use of the “war” frame as a conceptual metaphor to veterinarians, and official veterinary services raised some improvements refer to the official veterinary services, suggests the existence of tense that can be made in the communication about bTB. In the light of our relations between the two parties. Although the war rhetoric can be results, ensuring (or improving) farmers and veterinarians’ accessibility useful to justify the slaughter policy, it may lead to negative conse­ to data on bTB, sharing clearer and written protocols, and developing quences (Nerlich, 2004) or have minimal effects on individual attitudes informative (visual) material should be priority (first) steps for toward health policies (Blankshain et al., 2023). In a “war”, there are improving the communication on bTB. Moreover, the way information only “winners” and “losers” (i.e., being bTB-free is construed as winning, is delivered and knowledge shared are also of paramount importance, as while the occurrence of cases corresponds to losing the war/fight) and already highlighted in literature (Hamilton et al., 2019; Little, 2019). the Spanish farmers tend to perceive themselves as “losers”, which might Our findings suggest that the creation of horizontal meeting space to contribute to demotivation and concerns about loss of control. There­ share information, discuss doubts and simplify procedures (with no fears fore, a common understanding of bTB is needed as well as the search for of possible consequences) would be beneficial for the common and broader metaphorical frameworks. In agreement with knowledge-sharing process and it could contribute to improve re­ Keenan et al. (2020), we highlight the importance of sharing similar lationships between farmers, private and official veterinarians. At the frames on the disease, since using the same metaphors means assuming a same time, training courses on bTB should be designed in favour of a similar view on the issue. more holistic and bottom-up approach, covering not only technical but It would also be important to empower farmers to turn them into also social, economic, administrative, and pedagogical (i.e., how to active subjects of the measures, as also observed by Little (2019), when deliver bad news) aspects, and giving space for sharing experiences and comparing the bTB management strategies implemented in Michigan knowledge from the field. Finally, the stakeholders’ participation in the and the UK. However, the combination of companionship and mutual design of protocols on the prevention and control of bTB and risk distrust observed among farmers (i.e., farmer-to-farmer relationships) management measures should be increased. Some of the developed might represent a barrier to this process and their active participation in proposals (i.e., the creation of participatory meeting spaces and a ‘Crisis both disease control and prevention. Moreover, farmers (and to a lesser Committee’ together with the official veterinary services) indicate there extent veterinarians) obtain information and establish communication is a need to give more voice to farmers and private veterinarians and networks also through informal channels which seem to play an involve them at earlier stages of the decision-making process on the important role in making farmers feel as a part of a larger community, management of the disease (i.e., to make part of the solution). However, reducing the feeling of loneliness in their work sphere. Thus, such it also emerged that both farmers and private veterinarians should carry channels should be considered to share knowledge and information with out an internal debate to prioritize obstacles that make their daily work farmers and strengthen farmers’ empowerment and cooperation. difficult and identify needs and concerns. This should allow farmers and Participants’ viewpoints on the communication on bTB and on the veterinarians to play a more active role in the dialogue with the official social relations between farmers and veterinarians that emerged from veterinary services. As it was said above, private veterinarians from the both the Spanish and French in-depth interviews were similar. Farmers livestock health defence groups could be key players in this articulation, trust their private veterinarians, and, in a way, private veterinarians although it would be necessary to carry out preliminary informative and perceive themselves as closer to the farmers than to the official veteri­ pedagogical work to make them feel more involved and be better pre­ nary services. In agreement with other studies (Boireau et al., 2017), pared to participate in decision-making processes. private veterinarians resulted to be one of the major sources of infor­ Some potential limitations of the study should also be considered. mation for farmers, and the most suitable actor to fill the communication Analyses of the communication materials were based on a corpus of text gap between farmers and official veterinary services. Private veteri­ that has been constructed based on precise methodological criteria, narians were aware to be key actors in the communication with farmers however, the corpus only included text available online. As a limitation, but also to play a passive role, indicating the (perceived) scientific un­ our findings may not reflect all the topics and figurative frames that exist certainty on the disease and time constraints as the main reasons for on bTB. However, the existence of repeated contents within the sample their weak communication. At the same time, they highlighted diffi­ indicated that the most important aspects/themes were captured and the culties in their relationships with farmers when dealing with bTB-related results from in-depth interviews confirmed that the most relevant issues, which was attributed, on the one hand, to the lack of training in sources of information for farmers and private veterinarians were communication skills, and, on the other hand, to the commercial nature included in the sample. The sample size and the quota of farmers and of their relationship (i.e., farmers are their clients, and veterinarians veterinarians (six and four in each area, respectively) was established a worry of losing them), as already reported in the literature (Boireau priori. The selected number of participants relied on previous studies et al., 2017; Ciaravino et al., 2017; Crozet et al., 2019). The available based on grounded theory and it was considered that interviewing 10 (official) information was considered not exhaustive, accessible, or clear people from each study areas was sufficient to saturate the discursive enough, generating an atmosphere of permanent suspicion between space, especially considering that the interviewees would also partici­ official and private veterinarians and between veterinarians and pate in several iterative focus groups, so the quantity and quality of farmers. In addition, farmers sometimes perceive discrepancies in the qualitative data would be important. The STAVE approach was used to information received by the different veterinarians (i.e., regional vet­ enable the dialogue between regional veterinary services, farmers, and erinary services, local veterinary officers, and private veterinarians) and private veterinarians (i.e., people in charge of the implementation of in the criteria applied to manage bTB outbreaks. This feeling reinforced animal health policies and people targeted by such policies). This the perceived uncertainty on the cause of bTB breakdowns and the ef­ method is successful in reducing the mismatch between what people say ficacy of preventive and control measures. they do and what they actually do, facilitating the engagement process, Providing accurate information and effective communication mate­ and promoting the exchange of knowledge and views between different rial is crucial to avoid misunderstanding and confusion which, in turn, groups (Espluga et al., 2016). However, the dialogue between the may lead to low commitment and negative attitudes (i.e., refusal) to­ different parties cannot always be achieved because people may refuse wards the prevention and control of infectious diseases (Alders and to participate or due to the existence of polarised opinions (i.e., Bagnol, 2007; Boireau et al., 2017), in this case, bovine tuberculosis. controversial issues), as is the case of bovine tuberculosis (Hamilton However, it should be considered that perception of low self-efficacy et al., 2019; Ciaravino et al., 2020). In such circumstances, an additional (and powerlessness) or lack of trust in government and public bodies step might be required to engage people, and the STAVE method might (i.e., sources of information) may hamper the willingness to be informed serve as the starting point for finding a common framework to restore on a certain issue (Hamilton et al., 2019). the dialogue (Espluga et al., 2016). Furthermore, gathering several 16 G. Ciaravino et al. Preventive Veterinary Medicine 220 (2023) 106046 people in the same place on the same date is usually expensive and should be clear, visual, and easily accessible to all stakeholders, and the complex, especially in the case of these professional profiles, who tend to role of all actors acknowledged. A high level of participation of farmers be widely dispersed throughout the territory. Some of the researchers and (private and official) veterinarians should be ensured, especially at leading the study and participating to the field activities, mainly vet­ earlier stages of the decision-making process on the management of the erinarians and epidemiologists, are not totally unknown to the partici­ disease since their involvement in the development of recommendations pants. This facilitated the access to the sample and made it easier for and proposals can contribute to promoting their commitment and farmers and veterinarians to agree to participate in the deliberative empowerment. workshop and iterative groups discussion. However, this familiarity could also lead to some bias, such as inhibition or prudence when Financial Disclosure Statement explaining certain delicate or compromised topics. To minimize such potential bias, the in-depth interviews were carried out by sociologist This work was supported by the INNOTUB project [grant number (unrelated to the main researchers and unknown to participants) which EFA357/19/INNOTUB] funded by the Interreg-POCTEFA 2014–2020 were hired and trained for this purpose. Moreover, a researcher and co-financed from the ERDF (European Regional Development specialized in group dynamization techniques (unknown to partici­ Fund). The funders had no role in the study design, data collection and pants) managed and moderated the iterative groups discussion and the analysis, or preparation of the manuscript. deliberative workshops. Nevertheless, it is worth to mention that the research design based on the STAVE method seeks to strengthen the links between the participants so that they mutually construct their own Declaration of Competing Interest discourses and collectively reflect on them, trying to minimize the presence of researchers in the final results. The pilot intervention was The authors declare the following financial interests/personal re­ conducted in Catalonia (Spain) only, and the validity of the results for lationships which may be considered as potential competing interests: Pyrénées-Atlantiques (France) is therefore unclear. However, the simi­ Giovanna Ciaravino, Alberto Allepuz reports financial support was larity in the characteristic of the communication on bTB and the social provided by Interreg Europe. Giovanna Ciaravino, Alberto Allepuz re­ relationships strongly suggest that some of the recommendations, such ports financial support was provided by European Regional Develop­ as to design of new content for the training course on bTB, produce vi­ ment Fund. The authors declare no conflict of interest. sual informative material and improve the accessibility of the already available data, might be extrapolated and applied to the whole area References under study (i.e., the trans-Pyrenees region). Additionally, an online discussion group was organised with some private French veterinarians Alders, R.G., Bagnol, B., 2007. Effective communication: the key to efficient HPAI prevention and control. World’s Poult. Sci. J. 63 (01), 139–147. https://doi.org/ (February 7, 2022) to share and get feedback on the results from the 10.1017/S0043933907001365. press analysis and the in-depth interviews conducted in France. They Allen, A.R., Skuce, R.A., Byrne, A.W., 2018. Bovine tuberculosis in Britain and Ireland - a highlighted and agreed especially on the need of receiving regular (i.e., perfect storm? the confluence of potential ecological and epidemiological impediments to controlling a chronic infectious disease. Front. Vet. Sci. 5 (5), 109. monthly) feedback on the situation in the region (i.e., number of out­ https://doi.org/10.3389/fvets.2018.00109. breaks, number of positive badgers, their location, follow-up on the Allepuz, A., Casal, J., Napp, S., Saez, M., Alba, A., Vilar, M., Domingo, M., González, M. management of previous outbreaks, etc.) and on the need of including A., Duran-Ferrer, M., Vicente, J., Alvarez, J., Muñoz, M., Saez, J.L., 2011. Analysis of the spatial variation of Bovine tuberculosis disease risk in Spain (2006-2009). Prev. new content in the “Habilitation Sanitaire” training for veterinarians, Vet. Med. 100 (1), 44–52. https://doi.org/10.1016/j.prevetmed.2011.02.012. such as a session on psychological support to farmers. They also com­ Anonymous, 2022. Ministry of Agricultura, Pesca y Alimentación (MAPA), Spain. mented that the psychological support could be done either by private Programa Nacional de Erradicación de Tuberculosis Bovina (Infección por el complejo Mycobacterium tuberculosis) presentado por España. 〈https://www.mapa. veterinarians (as is usually the case) or it could also be offered by the gob.es/es/ganaderia/temas/sanidad-animal-higiene-ganadera/spainmtceradication official veterinary service. For the latter, it would be a very elegant way programme2022–2030final_tcm30–619674.pdf〉 (accessed 7 July 2023). to show farmers that the official veterinary service acknowledges that Blankshain, J.D., Glick, D.M., Lupton, D.L., 2023. War metaphors (What Are They Good For?): militarized rhetoric and attitudes toward essential workers during the Covid- the management of bTB can be extremely traumatizing. 19 pandemic. Am. Polit. Res. 51 (2), 161–173. https://doi.org/10.1177/ In conclusion, this study shows the structure of social relations, 1532673X221125713. power, understanding and viewpoints that exist between the different Boireau, C., Dufour, B., Praud, A., 2017. The importance of communication in promoting actors involved in the public debate on bTB (cattle farmers, private voluntary participation in an experimental trial: a qualitative study based on the assessment of the gamma-interferon test for the diagnosis of bovine tuberculosis in veterinarians, official veterinary services, etc.). Moreover, it suggests a France. PLoS One 12 (10), e0185799. https://doi.org/10.1371/journal. series of proposals, developed through participatory activities with pone.0185799. different stakeholders, that can be directly applied (by health authorities Boschiroli, M.L., and Bénet, J.-J., 2014. Bovine tuberculosis eradication in France. In: Zoonotic tuberculosis: mycobacterium bovis and other pathogenic mycobacteria, pp. and risk managers) to improve communication on bTB and boost trust 341–347. https://doi-org.are.uab.cat/10.1002/9781118474310.ch29. between farmers and (official) veterinarians. However, their effective Bougher, L., 2012. 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