Farm-animal-assisted interventions
: A systematic scoping review, realist synthesis, and realist evaluation

  • Suzanne Johnston

Student thesis: Doctoral ThesisDoctor of Philosophy


Farm-animal-assisted interventions (FAAIs) are a complex intervention in which human/livestock encounters are operationalized to improve human well-being. This intervention has been understudied, therefore this thesis reports three studies contributing novel insights about FAAIs.

A systematic scoping review investigated the reported uses and impacts of FAAIs on human health. To develop understanding of the mechanisms by which FAAIs improve human health, and for whom; a realist synthesis was conducted. A realist evaluation explored in which circumstances FAAIS are adopted by the NHS in Northern Ireland.

Thirty-six publications were identified via the scoping review. Positive results associated with physical and mental health were reported amongst nine participant groups. Sixty-five sources were synthesized within the realist synthesis to develop theory which suggests that FAAIs improve mental health by facilitating disorientation from stigmatizing social identities. One hundred and thirty sources including 25 interviews were synthesized within the realist evaluation. Diffusion of adoption of FAAIs amongst referral agents was incapacitated in many circumstances since information disseminated did not demonstrate FAAI compatibility and relative advantage.

In appropriate circumstances, FAAIs facilitate well-being. Further studies must explore the experiences of FAAI participants using appropriate methods to refine results reported herein.

Thesis embargoed until 31 December 2024
Date of AwardDec 2021
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SponsorsDepartment of Agriculture, Environment and Rural Affairs
SupervisorGeorge Hutchinson (Supervisor), Michael Donnelly (Supervisor) & Judith Stephens (Supervisor)


  • Realist evaluation
  • realist synthesis
  • scoping review
  • social farming
  • farm-animal-assisted interventions
  • animal assisted interventions
  • mental health
  • diffusion of innovation theory

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