“…When assessing the benefits of working toward voluntary participation in HVPs and the advantages of providing agency for the horse, valuable information can be sourced from several sectors including zoological institutions, small animal veterinary practice, and paediatric medicine [ 41 ]. These sectors have all made substantial changes in recent decades to more fully embrace the need to reduce fear, stress, and anxiety during health care procedures [ 37 , 40 , 82 , 83 , 84 , 85 , 86 , 87 ]. This includes changes to improve patient agency, provide the patient with predictability where possible, provision of appropriate positive distractions during procedures, and having a familiar caregiver present in a supporting role during the procedure [ 37 , 44 , 82 , 84 , 85 , 88 , 89 , 90 , 91 ].…”