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Estimating the best way forward: Expert and farmer evaluations of environmental interventions to reduce human exposure to E. coli O157. Paul Cross, Dan Rigby & Gareth Edwards-Jones RELU funded ‘Reducing Escherichia coli O157 risk in rural communities’ . Uncertainty & O157 Management.
Paul Cross, Dan Rigby & Gareth Edwards-Jones
How people become infected (sporadic infection)
Effectiveness of measures
Likelihood of measures being adopted
Many potential measures
Absence of hard (e.g. RCT) evidence on measures to reduce risk
A (perceived) need to act
= a problem
Identify all possible interventions
Elicit ‘expert’ opinion on interventions
Aim: Identify best candidate interventions
How to elicit their views?
Take all the “most effective” & “least effective” choices
5 item set we gain information on 7of the 10 paired combinations
Respondent chooses the two measures with the maximum difference in performance (best and worst)
Maximises the ability to predict peoples choices
Experts had higher CV scores than farmers for ‘effectiveness’ (p<0.001) and ‘practicality’ (p<0.01)
Farmer CV mean scores were very similar between Scotland and Wales.
The mean confidence interval for the practicality assessment was 0.86 for farmers and 1.46 for experts (p<0.001) and for effectiveness was 0.94 and 1.35 respectively (p=0.002).
Reducing stocking densities by 50%
P &E Scores are widely distributed indicating poor agreement amongst respondents
16. HACCP for manure handling
Reduce cattle stocking
densities by 50%.
1: Hand washing
27: Reduce cattle
12: Septic tank
Best suited to the evaluation of large sets of standalone measures
Best suited to the evaluation of multidimensional measures (effectiveness and practicality)
Smaller multi-level sets of measures, identify the ‘best’ bundles (ACA, CBC)
Health Protection Agency; Health Protection Scotland; University of Glasgow: School of Veterinary Medicine; Scottish Agricultural Ccollege; Veterinary Laboratory Agency; Scottish Infection Research Network; HPS Colindale; FSA: Microbiological Safety Division; Bioss Scotland; Wageningen University and Research Centre; Liverpool John Moores University: Centre for Public Health; NFUScotland; NFUCymru; Farmers Union Wales; Office of the Chief Veterinary Officer Wales; Meat Promotion Wales; Quality Meat Scotland; Countryside Council Wales