Hello,
One of the questions on your grant application form asks if the project is IRB (Institutional Review Board) approved. I have a few questions about this:

1) Our intended research project seeks to simply measure progress and outcome variables between EAP and office-based therapy. The ONLY manipulation/intrusion that is experienced by the clients is filling out measures when asked (done in between sessions) and the fact that they will be randomly assigned to either the EAP or the office-based therapy group. Other than this, therapy proceeds as usual. Having said this, the anticipated risk to participants is nominal. Considering this, would HHRF still require our project to be IRB approved? (e.g. does HHRF require all proposed projects to be IRB approved?)

2) If HHRF does indeed require IRB approval, then I’m wondering about the timing of the approval. Several sections of the IRB initial review submission form require information about the sponsor of the research. If our project were to be approved, that sponsor would of course be HHRF. However, unless and until our research project is approved by HHRF, I cannot provide the IRB this information. As incomplete IRB forms are not accepted, this means that I cannot submit the forms, and therefore obtain approval, until after HHRF sponsorship is confirmed. What is procedure for this?

Our answers to this researcher’s questions, and to others who are wondering:

1) This group should have the research approved by the IRB, and this should be very straightforward since, as they’ve noted, there is minimal intervention. Any research that requires subjects to provide information – especially health information – that can be linked to them should be approved. Patient privacy rules and release of information are very sensitive areas, and the IRB should be aware of this research. If they don’t have a local IRB, Western IRB would likely approve this in about a month or less from time of submission.

2) Despite funding coming from HHRF, the group conducting the research is the Sponsor. Thus, this group could submit immediately. If, however, the research will not be performed without HHRF funding, we suggest they wait to submit to the IRB until they hear if they are awarded a grant. We would be satisfied, and give a good review score for the IRB portion, if they had identified an IRB that they plan to submit to and have the application prepared.

-KC Henry, HHRF ED

The New York Times published an article on April 15 called “The Horse Boy”. The beginning of the article reads:

When Rupert Isaacson decided to take his autistic son, Rowan, on a trip to Mongolia to ride horses and seek the help of shamans two years ago, he had a gut instinct that the adventure would have a healing effect on the boy. Mr. Isaacson’s instinct was rewarded after the trip, when some of Rowan’s worst behavioral issues, including wild temper tantrums, all but disappeared.

Read the rest of the article here: http://www.nytimes.com/2009/04/15/books/15horse.html
There is also lively discussion happening on a New York Times blog page, where autism experts and readers are invited to chime in, http://well.blogs.nytimes.com/2009/04/14/healing-autism-with-horses/.

HHRF’s entry on that page, in response to the article and the various posts:

This article highlights the certain need for the translation of anecdotal evidence of the impact of horses on humans (decades-worth of stories to add to the ones here!) to real substantiation. The Horses and Humans Research Foundation exists for this purpose.
www.horsesandhumans.org

One of our currently funded projects is researching “the effects of horses on the socialization and behavior of children with autism.” Other previously funded projects have looked at the impact of equine-facilitated hippotherapy on children with cerebral palsy.

Commentary here illustrates many of the challenges to making equine-assisted activities accessible to children like Rowan: a lack of available insurance reimbursements, skepticism from the rehabilitation and medical fields, and the lack of a model of best practice. All of these challenges can be overcome by supporting high-level research.

Also look for a Letter to the Editor from HHRF Founder and President Molly Sweeney to be published in the coming week.

First, please keep in mind that this is one of fifteen different items on the checklist that our scientific reviewers and board look at.  They are looking, first and foremost, for rigorous scientific research that is likely to be published in a peer reviewed journal. So, that being said, the research questions must be significant to both a specific scientific community AND to our EAA/T field.

The most pressing two areas of significance for the EAA/T field we have identified are: 1) Helping guide instructors and therapists in common areas of practice and decision-making (e.g. how long should a session be, how many weeks should a student ride, are there certain activities that that have greater impact on achieving goals?) or 2) Validating to insurance companies, medical industry, supporters and others  that EAA/T is effective.

Please understand  that we do not weigh therapeutic riding, hippotherapy, equine-facilitated mental health, education-based programs or any other areas as more important than another. The board has not chosen to do a call for proposals related to any  specific area or question at this time.

We do hope, in the future, to collaborate with other interest groups - such as autism, veterans, multiple sclerosis, eating disorders who will jointly sponsor specific calls for proposals related to their missions and co-sponsor the awarded funds.  Until then our consideration for large-impact research remains very broad.

KC Henry

I received a recent email – pointing out a terminology blunder – a real faux pas in this EAA/T industry.  We have all followed the ongoing terminology debates – most of us have tired of them.  But I must admit this complaint was well placed. 

In a press release we had mixed terms.  Basic ones, at that.

From a friend setting us straight: 

In reading the news release on the list serve about the new grants through HHRF, there is a summary of Tim’s work. (12th paragraph) In the description, it is stated that the children had 12 weeks of “therapeutic horseback riding” and then the next statement says, the study provided strong evidence that “hippotherapy”….Is there any way to proofread material to ensure that these two terms are used clearly, appropriately and not interchangeably?  TR is not hippotherapy! (I know I’m preaching to the choir, but…) I just presented at NARHA conference about the confusion (yet again) and to have a highly visible organization like HHRF get it mixed up is very frustrating.

Therapeutic Riding and Hippotherapy

Therapeutic Riding – Mounted activities including traditional riding disciplines or adaptive riding activities conducted by a NARHA certified instructor.

Hippotherapy – Physical, occupational or speech therapy treatment strategy that utilizes equine movement. This strategy is used as part of an integrated treatment program to achieve functional outcomes.

At the NARHA conference I facilitated a research forum. One of our presenters –Karolina Przewloka, from Poland, pointed out early that her terminology was quite different from NARHA’s – that “hippotherpy” in her study refers to all forms of equine assisted activities… and so the confusion moves forward as we cross the international boundaries that HHRF strives to cover.

For now, HHRF has posted definitions on our web site that we ask applicants to use.  We truly regret the inconvenience to our international applicants who have to “re-define” their vocabulary during their application process.  We know our scientific reviewers need common-terminology ground, and we have not yet come up with a better solution.

In the mean time – thanks for reading our press releases – and thanks for your professional terminology reminders – we will make it a point to adhere to HHRF’s terminology guide in our own publications.

If you have any questions or thoughts, please email me or post comments here on the blog.

-KC Henry

(KCHenry@HorsesandHumans.org)

HHRF Executive Director

www.HorsesandHumans.org

Attending the NARHA conference in Hartford Ct from Oct. 29 to Nov. 1 was, as always, an inspiring experience – I love being around so many folks who are exceptionally dedicated to EAA/T.

My favorite part was the chance to talk to the multitude of people – to hear what is going on in the small and large programs and in the industry as whole.

It strikes me that the diversity of this industry has increased dramatically.  There are so many exciting variations to EAA/T now! Including not only my personal background in recreational riding for people with disabilities, but also a strong and professional focus in areas of learning/education, corporate-team building (sample), hippotherapy, mental health, and many more.   The large number of people who expressed interest and support of EAA/T research was especially heartening to me!

Kathy Alm, NARHA President-elect and current V.P., standing with Pat Mullins, HHRF Advisory Council member, holding his 2008 NARHA James Brady Award.

HHRF board members present – Molly Sweeney, Octavia Brown, Michael Kaufmann and Judy Lightfoot – also networked and enjoyed the conference experience.  We made a concerted effort to take time to share and learn from board members and executive directors of every national and international association that we could connect with.  These meetings included officers/representatives from EFMHA, AHA, NARHA and FRDI.  We discussed many aspects of research and specifically addressed future collaborative possibilities and needs related to developing research that will further the industry.  We were really excited to be discussing partnering on an international basis – and we are looking forward to talking to the many other national and international associations who may also interested. 

We hope to establish an international research symposium in the not too distant future to further our collaborative efforts in these areas. 

We’d love to hear from people with ideas and interests in this direction.

Please e-mail me to share ideas, or leave comments on the blog!

KC Henry

HHRF Executive Director

KCHenry@HorsesandHumans.org

www.HorsesandHumans.org

In the Summer 2008 edition of the HHRF Newsletter, we printed this headline: Benefits of Hippotherapy Proven By Washington University Research Team.  

This headline provoked responses such as this:

When I first read the subject line, the social scientist in me winced 
at the word “proven” – it goes against all my training in research 
methods to claim proof of anything in the laboratory of life. If that 
was the first reaction of someone who believes in & supports your work 
wholeheartedly, what would be the reaction of skeptics?

Thank you - thank you!  I promise this poorly placed word came from the exuberance of the HHRF administrative staff (yes – that would include me – a self proclaimed administrator-NON researcher) – NOT from any of our scientific committee members.  I am sure they, too, winced upon reading that word!  Thank you for your gentle reminder.  Even before your reminder we had other similar suggestions  – and have hopefully upgraded our entire website to better words – like “validate” – I don’t know how I let this headline slip by!

                                                      KC Henry – Executive Director 

                                                      KCHenry@HorsesandHumans.org

www.HorsesandHumans.org

The design did not include equines but rather a proxy. My thought would be to replicate the study including horses, knowing full well the difficulties inherent in such work.

First and foremost, we emphasize that our grants are awarded on a competitive basis.  If an application uses our criteria to describe a highly qualified project with a rigorously developed scientific methodology, it still may not be selected.  Multiple applications impress our scientific advisors and are enthusiastically received by our board, but we select the project(s) that, in our opinion, will most benefit this field.

While we receive many excellent applications in each grant cycle, there are still many that do not follow our guidelines thoroughly enough to qualify for funding consideration.  One recurring shortcoming in many applications is the area of pilot studies.  Some applicants have not completed a pilot study.  Some report a pilot study that is not relevant enough to the research project being presented for funding.  Other pilot studies do not go far enough verifying the critical areas, such as the reliability, validity or sensitivity of their select measurement tools.

It will be helpful to applicants to carefully study all the criteria on the Research page of our website.  All areas of the application should be complete and thorough, leaving no question or doubt in the mind of reviewers of the intent of the research team.

In the Spring 2008 edition of the our newsletter, Renee Casady of our scientific advisory council wrote an article, Take off with a Pilot Study, on the importance an original pilot study.

Here are some excerpts from her article.

“A pilot study may be designed to provide a preliminary test of the presumed hypothesis and an investigation of the feasibility of a larger protocol.”

In order to be considered for funding, Horses and Human Research Foundation needs to know research will yield results.  A pilot study gives our advisory council a sample of your research plan, investigational experience, and indication toward the success of a larger scale project.

“Validate the scientific approach and methods to investigate a research question.  Present relevant findings from the pilot in any research proposal.”

Our advisory council is seeking results from your original pilot study.  Results from someone else’s pilot study, or from someone else’s research, could yield different results, and may not be accepted.

To read Renee’s full article on page 2 of the recent HHRF newsletter, click here.

To view the HHRF application guidelines, click here.

We are hosting a blog here at the Horses and Humans Research Foundation website.

Many questions and comments related to EEA/T research are directed to our office. The answers, ideas and comments will be posted here – and also our invitation for further input from our colleagues in this field.

Our board of directors, staff, scientific advisors and advisory council will provide input and seek additional advise from others in the field as needed. Stay tuned to our blog for updates, insights and commentary, so we can all pursue the mission of validating and furthering best practices in EEA/T.