“I know prevention is better than cure… but …”: Barriers and facilitators to the implementation of on-farm preventive measures to reduce the risk of bovine tuberculosis on cattle farms in England

Bovine tuberculosis (bTB) remains one of the most significant challenges for the animal health industry in the United Kingdom, costing millions of pounds annually with associated trade implications. The Bovine Tuberculosis Advisory Service (TBAS) is a government-funded initiative in England assisting private veterinarians to provide tailored advice to farmers to help implement preventive measures to reduce the risk of bTB on their farms. However, limited understanding persists regarding factors influencing preventive measure implementation. The aim of this study were to identify the barriers and facilitators influencing preventive medicine implementation from the perspective of TBAS advisors and farmers who participated in the initiative. Thirteen semi-structured interviews were conducted with six farmers and seven TBAS advisors. Transcripts were analysed using inductive thematic analysis, followed by deductive mapping to the Capability, Opportunity, and Motivation Behaviour (COM-B) model of behaviour change. Opportunity and motivation emerged as the primary drivers of decision-making. Key barriers included a lack of time, expense, and the perceived feasibility of implementing a recommended measure (physical opportunity). Policy-related factors linked to the policy-farm disconnect (social opportunity) and farmers' perceived control over bTB (reflective motivation) also acted as a barrier. Facilitators included a good farmer-advisor relationship (social opportunity), involving farmers in decision-making processes (reflective motivation) and a clear understanding of the rationale and benefits of the recommendations (psychological capability). Integrating this knowledge into the TBAS programme, including strategies to overcome barriers and utilise facilitators, could improve the implementation of bTB preventive measures, and enhance its contribution to the goal of eradicating bTB.