Does midterm reinforcement improve compliance with farm-specific cow-comfort recommendations? Evidence from a nested randomized controlled trial in Kenyan smallholder dairy farms.
- 1Faculty of Veterinary Medicine, University of Calgary, CWPH Building, 3280, Calgary, AB T2N 4Z6, Canada.
- 2People, Policies, and Institutions Program, International Livestock Research Institute (ILRI), P.O. Box 30709, Nairobi, 00100, Kenya.
- 3Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Canada.
Abstract
Farm-specific cow-comfort recommendations are often incompletely implemented. We evaluated whether midterm reinforcement increased implementation on Kenyan smallholder dairy farms and examined associations between achieved compliance and welfare and milk yield. Of 318 randomized farms, 212 received recommendations and 106 were controls. Recommendation recipients underwent a second randomization to reinforcement or no reinforcement (106 per group). Compliance was measured as weighted implementation fidelity (0-100%), combining recommendation effort and implementation status. Farm-level outcomes were compared by reinforcement assignment using available-case, covariate-adjusted models. Separate inverse-probability-weighted models estimated associations between achieved compliance (≥40% versus <40%) and outcomes. Among intervention farms with defined endline compliance scores, the covariate-adjusted difference by randomized reinforcement assignment was 12.0 percentage points (95% CI 2.7 to 21.3; p = 0.012), higher milk yield (1.33 kg/day; 95% CI 0.32 to 2.35; p = 0.011), and lower mean within-farm lameness prevalence (-19.75 percentage points; 95% CI -33.55 to -5.96; p = 0.005). In weighted analyses of achieved endline compliance, higher compliance was associated with lower endline lameness prevalence (-49.39 percentage points; 95% CI -60.64 to -38.15; p < 0.001), while the milk yield contrast (+1.00 kg/day) was not statistically significant (p = 0.121). Reinforcement assignment was associated with greater implementation, although incomplete follow-up limits inference. Higher achieved compliance was associated with lower lameness prevalence, but its nonrandomized, concurrent assessment with endline outcomes precludes a firm causal interpretation.
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BibTeX
@article{muunda2026does,
title = {{Does midterm reinforcement improve compliance with farm-specific cow-comfort recommendations? Evidence from a nested randomized controlled trial in Kenyan smallholder dairy farms.}},
author = {Emmanuel Muunda and Elizaphan James O Rao and David C Hall and Caroline Ritter and Maria Camila Ceballos and John VanLeeuwen},
journal = {Veterinary and animal science},
year = {2026},
month = oct,
doi = {10.1016/j.vas.2026.100914},
url = {https://europepmc.org/article/MED/42999916},
note = {CC BY},
}
RIS
TY - JOUR
TI - Does midterm reinforcement improve compliance with farm-specific cow-comfort recommendations? Evidence from a nested randomized controlled trial in Kenyan smallholder dairy farms.
AU - Emmanuel Muunda
AU - Elizaphan James O Rao
AU - David C Hall
AU - Caroline Ritter
AU - Maria Camila Ceballos
AU - John VanLeeuwen
PY - 2026
DA - 2026/10/24
JO - Veterinary and animal science
DO - 10.1016/j.vas.2026.100914
UR - https://europepmc.org/article/MED/42999916
AB - Farm-specific cow-comfort recommendations are often incompletely implemented. We evaluated whether midterm reinforcement increased implementation on Kenyan smallholder dairy farms and examined associations between achieved compliance and welfare and milk yield. Of 318 randomized farms, 212 received recommendations and 106 were controls. Recommendation recipients underwent a second randomization to reinforcement or no reinforcement (106 per group). Compliance was measured as weighted implementation fidelity (0-100%), combining recommendation effort and implementation status. Farm-level outcomes were compared by reinforcement assignment using available-case, covariate-adjusted models. Separate inverse-probability-weighted models estimated associations between achieved compliance (≥40% versus <40%) and outcomes. Among intervention farms with defined endline compliance scores, the covariate-adjusted difference by randomized reinforcement assignment was 12.0 percentage points (95% CI 2.7 to 21.3; p = 0.012), higher milk yield (1.33 kg/day; 95% CI 0.32 to 2.35; p = 0.011), and lower mean within-farm lameness prevalence (-19.75 percentage points; 95% CI -33.55 to -5.96; p = 0.005). In weighted analyses of achieved endline compliance, higher compliance was associated with lower endline lameness prevalence (-49.39 percentage points; 95% CI -60.64 to -38.15; p < 0.001), while the milk yield contrast (+1.00 kg/day) was not statistically significant (p = 0.121). Reinforcement assignment was associated with greater implementation, although incomplete follow-up limits inference. Higher achieved compliance was associated with lower lameness prevalence, but its nonrandomized, concurrent assessment with endline outcomes precludes a firm causal interpretation.
SN - 2451-943X
ER -