Journal of Creativity in Mental Health

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The Effects of Animal-Assisted Activities on College

Students Before and After a Final Exam

JoAnn Jarolmen & Gunjan Patel

To cite this article: JoAnn Jarolmen & Gunjan Patel (2018) The Effects of Animal-Assisted
Activities on College Students Before and After a Final Exam, Journal of Creativity in Mental Health,
13:3, 264-274, DOI: 10.1080/15401383.2018.1425941

To link to this article: https://doi.org/10.1080/15401383.2018.1425941

Published online: 21 Feb 2018.

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JOURNAL OF CREATIVITY IN MENTAL HEALTH
2018, VOL. 13, NO. 3, 264–274
https://doi.org/10.1080/15401383.2018.1425941

The Effects of Animal-Assisted Activities on College Students

Before and After a Final Exam
JoAnn Jarolmen and Gunjan Patel
Kean University, Department of Social Work, Union, NJ

ABSTRACT KEYWORDS
Final exams at colleges and universities have proven to be a time of Human-animal bond;
animal-assisted activities;
anxiety and stress for students. This paper contains an exploration
animal-assisted therapy;
the effects of Animal-Assisted Activities (AAA) on exam anxiety therapy dogs; exam stress;
through the use of blood pressure readings before and after inter- gender differences; creativity
acting with therapy dogs. A comparison of the experimental and in counseling
control groups interacting with therapy dogs has shown statistical
significance for the reduction of blood pressure for those students
who will or have taken a final exam. Having owned a pet, as well, as
the age of the participant were not significant predictors of whether
or not therapy dogs would reduce blood pressure.

Final examinations continue to be a source of student anxiety and although solutions have
been sought, the anxiety persists. A newer, more promising, and alternative approach to
alleviating this distress is the use of companion animals. This paper contains an explora-
tion the effects of Animal-Assisted Activities (AAA) on exam anxiety through the use of
blood pressure readings before and after interacting with therapy dogs. The authors
propose the following research question: Does interacting with a therapy dog lower
blood pressure and reduce anxiety for students who have taken or will take a final exam?

Human-Animal Bonds
The human-animal bond construct has been studied since the 1970’s and 1980’s. The work
of Konrad Lorenz laid much of the foundation of this concept as we know it today. From a
forum honoring Lorenz on his 80th birthday, Bustard referred to Lorenz’s words concern-
ing the human-animal bond:
The wish to keep an animal usually arises from a general longing for a bond with nature. . .
This bond is analogous with those human functions which go hand in hand with the
emotions of love and friendship in the purest and noblest forms. (Bustad, 1986)

Community programs and media coverage contributed to the human-animal bond, which
resulted in the bond gaining public knowledge and awareness (Hines, 2003). According to
the American Veterinary Medical Association (AVMA):

CONTACT JoAnn Jarolmen jjarolme@kean.edu Department of Social Work, Kean University, 1000 Morris Avenue,
Union, NJ 07083
JoAnn Jarolmen, Department of Social Work, Kean University; Gunjan Patel, Department of Social Work, Kean University.
© 2018 Taylor & Francis
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 265

Table 1. Descriptives on variables assessed.

N Minimum Maximum Mean Std. Deviation
Age 86 2.00 9.00 2.8140 1.30620
Pets 86 1.00 9.00 1.6628 1.48412
Petspast 86 1.00 9.00 1.5233 1.49294
Gender 86 1.00 9.00 1.9767 1.42232
Valid N (listwise) 86

Table 2. Experimental group- (1 = systolic before/after; 2 = diastolic before/after).

Paired Differences
95% Confidence
Interval of the
Std. Std. Error Difference
Mean Deviation Mean Lower Upper t df Sig. (2-tailed)
Pair 1 systolicbefore - systolicaft 3.04167 10.56494 1.24509 .55903 5.52431 2.443 71 .017
Pair 2 diastolicbefo - diostolicaft 3.88732 10.76708 1.27782 1.33880 6.43585 3.042 70 .003

Table 3. Control group (1 = systolic before/after; 2 = diastolic before/after).

Paired Differences
95% Confidence
Std. Interval of the
Std. Error Difference
Mean Deviation Mean Lower Upper t df Sig. (2-tailed)
Pair 1 systolicbefore - systolicafter −1.85714 11.31953 3.0252 −8.39285 4.67856 −.614 13 .550
Pair 2 diastolicbefore - diostolicafter −3.57143 12.84053 3.4317 −10.98533 3.84247 −1.041 13 .317

Table 4. ANOVA-blood pressure and gender for experimental group.

Sum of Squares df Mean Square F Sig.
Systolic/before Between Groups 1691.081 2 845.541 4.435 .015
Within Groups 13155.238 69 190.656
Total 14846.319 71
Systolic/after Between Groups 1639.739 2 819.869 5.240 .008
Within Groups 10795.372 69 156.455
Total 12435.111 71
Diastolic/before Between Groups 498.784 2 249.392 1.428 .247
Within Groups 12048.091 69 174.610
Total 12546.875 71
Diastolic/after Between Groups 1729.578 2 864.789 7.927 .001
Within Groups 7418.816 68 109.100
Total 9148.394 70

Table 5. ANOVA-age and blood pressure.

Sum of Squares df Mean Square F Sig.
Systolic/before Between Groups 928.653 2 464.326 2.302 .108
Within Groups 13917.667 69 201.705
Total 14846.319 71
Systolic/after Between Groups 675.022 2 337.511 1.980 .146
Within Groups 11760.089 69 170.436
Total 12435.111 71
Diastolic/before Between Groups 628.837 2 314.418 1.820 .170
Within Groups 11918.038 69 172.725
Total 12546.875 71
Diastolic/after Between Groups 444.909 2 222.455 1.738 .184
Within Groups 8703.485 68 127.992
Total 9148.394 70
266 J. JAROLMEN AND G. PATEL

Table 6. ANOVA for pet ownership.

Sum of Squares df Mean Square F Sig.
Systolic/before Between Groups 8.810 1 8.810 .042 .839
Within Groups 14837.510 70 211.964
Total 14846.319 71
Systolic/after Between Groups 107.302 1 107.302 .609 .438
Within Groups 12327.810 70 176.112
Total 12435.111 71
Diastolic/before Between Groups 204.004 1 204.004 1.157 .286
Within Groups 12342.871 70 176.327
Total 12546.875 71
Diastolic/after Between Groups 6.384 1 6.384 .048 .827
Within Groups 9142.011 69 132.493
Total 9148.394 70

Table 7. ANOVA-pet ownership in the past.

Sum of Squares df Mean Square F Sig.
Systolic/before Between Groups 330.042 1 330.042 1.592 .211
Within Groups 14516.278 70 207.375
Total 14846.319 71
Systolic/after Between Groups 85.630 1 85.630 .485 .488
Within Groups 12349.481 70 176.421
Total 12435.111 71
Diastolic/before Between Groups 100.042 1 100.042 .563 .456
Within Groups 12446.833 70 177.812
Total 12546.875 71
Diastolic/after Between Groups 39.177 1 39.177 .297 .588
Within Groups 9109.217 69 132.018
Total 9148.394 70

The human-animal bond is a mutually beneficial and dynamic relationship between people
and animals which is influenced by behaviors that are essential to the health and well-being of
both. This includes, but is not limited to, emotional, psychological, and physical interactions
of people, animals, and the environment.

Animal-Assisted Activities and Therapies

Chandler’s definition of AAA suggests that it is informal human–animal interaction, such
as play and care (2005). There are no treatment goals involved in AAA and it is not
necessary to develop a plan of care. However, Animal-Assisted Therapy (AAT) assumes
goals which are developed and executed as part of a person’s treatment plan. The goals for
AAT are assessed regularly and registered in the client’s treatment files (D’Arcy, 2011).
AAT therapy dogs must possess certain characteristics in order to qualify as a therapy dog.
These characteristics include friendliness and non-aggression. The dog must also be
confident, patient, calm, gentle, and amenable to training. It must get along with people
and other dogs and go through a rigorous training program in order to qualify as a
therapy dog (Lucidi, Bernabo, Panunzi, Dalla Villa, & Mattioli, 2005).
Much is said of the animal presence relieving anxiety and providing support. Ernst
reports that animal interaction with people provides a feeling of calm and joy (2012).
The author explains that the interaction may reduce heart rate and blood pressure, as
well as reduce anxiety and lower levels of neurohormones (Ernst, 2012). Researchers
have called for rigorous quantitative and qualitative investigations in order to better
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 267

understand the use of animals in the therapeutic process (Beck & Katcher, 1984;
Melson, 1990). It is incumbent upon the researcher to question the efficacy of the
pet-related intervention and to challenge the concept rather than to work from the
assumption that therapy with pets will be effective. Some studies showed a positive
response to the use of animals in a therapeutic environment. These positive responses
included improvement in self-esteem, locus of control, and depression (Lukasa, n.d.).
Gender differences and pet therapy interventions are other critical areas to investigate.
According to Melson’s article, four dimensions of pet attachment were reviewed:
interest in and affect toward, knowledge of, time spent with and behavior toward the
attachment object, which would be a pet in this case (1990). The review found that
caring for pets is “gender-neutral” and is an excellent venue for developing nurturing
characteristics in boys. That is, both males and females have a similar, positive response
to nurturing and caring for their own pets (Melson, 1990).
AAA have a soothing and stress relieving effect on many populations (e.g., the elderly,
college students, and those with disabilities.) According to Friedmann, Thomas, Cook,
Chai-Chan, and Picot (2007), the use of AAA has also accounted for blood pressure
reduction: “In a study of older adults with pre- to mild hypertension, participants had to
sit quietly, then talk, then sit quietly again (2 minutes for each session), with or without
an unfamiliar, friendly dog present.” Reduced blood pressure (BP) was associated with
the presence of a dog during the study stated above (Friedmann et al., 2007). According
to this research, it seems that the presence of a therapy dog acted as a buffer against the
anxiety produced when faced with adversity (Barker, Knisely, McCain, Schubert, &
Pandurangi, 2016). In another study conducted by Wilson (1991), similar results were
found. The study showed that interacting with an unknown dog reduced blood pressure
and lowered anxiety levels. Stewart, Dispenza, Parker, Chang, and Cunnien (2014) found
that anxiety and loneliness were alleviated for college students through the presence of
therapy dogs on campus.

AAA and College Students

According to Reynolds & Rabschutz (2011), college students are excellent participants in
this type of study as they are not as susceptible to disease or as erratic as young children.
The American College Health Association (ACHA) reported in 2016 that nearly 50% of
college students seeking counseling were suffering from some form of anxiety, and
another 33% of students reported stress that impacted academic performance (ACHA,
2016). ACHA also reported that the number of college counselors had not increased
despite the increased number of students exhibiting symptoms (2016).
Barker et al. (2016) recently conducted a study on college students the week before
final exams. Their findings concluded that animal-assisted activity is helpful and cost
effective, and could be used in the future around exam time (2016). Their study
involved completing several surveys and analyses of saliva sample Nerve Growth
Factor (sNGF) for measuring the nerve growth factor and salivary Alpha Amylase
(sAA). sNGF deals with the immune system regulation, and these tests are non-
invasive measures of stress (2016). In this study, there were 78 participants, and it
was both a control and comparison group study using pre-and post-test measures. No
significance was found in the sAA test between or within intervention and those in the
268 J. JAROLMEN AND G. PATEL

control groups. sNGF was not detectable and therefore not assessed. However, there
was significance found in the Stress Visual Analog Scale (SVSS), a scale that measures
the intensity or frequency of a symptom. Despite these findings, Barker et al. (2016)
recommended the need for further studies measuring physiological changes around
therapy dog intervention during peri-exam periods. Additionally, the idea that activ-
ities with unknown dogs can be significantly affected by prior or present pet ownership
was assessed by Schneider and Harley (2006). In their study, many of the student
participants who were living on campus and said that they missed their pet at home,
while the older participants who commuted had more access to their family pets
(Schneider & Harley, 2006). However, pet ownership had little effect on the response
of the participants (Schneider & Harley, 2006). Furthermore, in the Schneider and
Harley research, attitudes towards therapists were assessed by the presence or absence
of an unknown dog; Therapists with dogs were looked upon more favorably (2006).

Important Considerations
Blood pressure
The issue of systolic and diastolic blood pressure is important to understand. According to
Cushman (2000), as early as 1974, systolic blood pressure was found to be a greater
predictor of risk than diastolic pressure. He concluded that systolic blood pressure is a
more significant predictor of coronary heart disease and hypertension than diastolic
pressure (Cushman, 2000). Normal blood pressure range is considered any number less
than120/80 (systolic is the top number and diastolic is the bottom number) (Taylor, 2011).

Pet Qwnership
The impact of pet ownership as opposed to non-pet ownership is a question posed in
some articles. For example, Schneider and Harley looked at this relationship when
clients were responding to a pet that was present (2006). They hypothesized that people
would be more generally satisfied and willing to disclose sensitive information if a pet
accompanied the therapist. These hypotheses were supported (2006). Prato-Previde,
Fallani, and Valsecchi (2006) investigated whether or not gender had an impact on
affiliation with their dogs. In Hart’s (1995) investigation concerning age of humans and
their relationship to dogs, the findings suggest that regardless of age, people living
alone were more attached to their dogs than those in families or those who had greater
social interactions. Also, the time spent with their pets had a significant effect on the
attachment noted (Hart, 1995). Prato-Previde et al. (2006) observed men and women
interacting with their dogs, at play and with affiliative behavior, and sought to under-
stand whether there was a gender difference in pet attachment. It was found that pet
attachment was not different between genders, but women, more so than men, talked
to their pets in a child-like, affectionate way (Prato-Previde et al., 2006). Additionally,
social support theory lends itself to the relationships between humans and animals.
Katcher and Beck (2003) reported physiological and psychological benefits of interac-
tion with companion animals, including its reductions in aggression and other aberrant
behaviors and the lowering of blood pressure.
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 269

Current Study
These authors aim to assess the relationship between AAA and blood pressure levels in
students before and after an academic final examination. As stated previously, similar
research was done in the past and this research intends to build on the existing body of
knowledge with assessment of students’ blood pressure prior to, or subsequent to, an
academic examination. Zhang, Su, Peng, Yang and Chang (2011) found a significant
relationship between blood pressure and anxiety level in college students during the
peri-exam period. Zhang et al. focused on heart rate and blood pressure three days before
and three days after the final examinations (2011). However, the BP readings were not
done immediately before and after exposure to therapy dogs, as in this study. 50% percent
of college students noted that final exams were the most stressful academic experience
(Anderson & Cole, 1988). Indeed, a simple web search reveals that there are 500,000
websites providing help on how to handle examination stress (Reynolds & Rabschutz,
2011). Daltry and Mehr (2015) examined the inclusion of therapy dogs in campus
counseling centers but not during stressful examination periods. The goals of their
program were to provide stress relief for students and allow them to interact with
counselors outside of the office setting, and positive student feedback was indicated
(Daltry & Mehr, 2015).

Hypotheses
The following null hypotheses were chosen for this study for two reasons: (a) 50% of
college students are seeking counseling for anxiety; and (b) past research findings used
blood pressure to determine anxiety in clients and college students (Barker, Barker,
McCain, & Schubert, 2010; Ernst, 2012; Zhang et al., 2011).

Hypothesis 1. There is no significant difference in systolic and diastolic blood pressure

for those in the experimental group exposed to therapy dogs in AAA and those who were
in the control group.

Hypothesis 2. There is no significant difference in systolic and diastolic blood pressure

for those interacting with therapy dogs in AAA in different age categories.

Hypothesis 3. There is no significant difference in systolic and diastolic blood pressure

for those of different gender interacting in AAA with therapy dogs.

Hypothesis 4. There is no significant difference in systolic and diastolic blood pressure

before and after interacting with therapy dogs for those who presently have pets.

Hypothesis 5. There is no significant difference in systolic and diastolic blood pressure

before and after AAA for those who have had pets in the past.
270 J. JAROLMEN AND G. PATEL

Method
Sample and Participant Selection
This study was exploratory in nature and was submitted then accepted by the
Institutional Review Board of Kean University. Under the direction of the principal
author, the masters of social work department at Kean University scheduled a four-
day event for AAA during the final exam week at the end of the 2016 Spring
semester. The students’ center was the venue for this event, and students were
solicited to attend through a college wide email blast. The email blast asked students
if they wanted to participate in this research study on the effects of animal-assisted
activities on blood pressure and anxiety. The information they received told them
that they would be asked to fill out a short survey, have a blood pressure reading
before and after interacting with the therapy dogs, and that their participation
depended on having an exam that day, either before or after, participation in the
activity. Approximately 30 students responded to this email and made formal
appointments for attendance. Since the venue was in the student center near the
cafeteria, many walk-ins were also invited to participate. A total of 86 students
agreed to participate, some in the control group and some in the experimental group.

Assessments
Those in the control group were asked to sit behind a privacy screen for a 15-minute
interval, which was the time allotted for active participation. These intervals were
timed by a “clock” phone app. Their blood pressure was screened before and after this
15-minute interval. The principal researcher did the blood pressure readings. The
machine used was a portable, automatic blood pressure monitor called, “ReliOn.”
The students were then permitted to play with the therapy dogs. The experimental
group followed the same protocol, except they were permitted to interact with the
therapy dogs between blood pressure readings. The students were observed while they
all touched, spoke to, and sat on the floor next to the dogs. Some students even played
with dog toys (i.e., a ball) with some of the dogs. After participation, students were
given a debriefing statement thanking them for participating and recapping the
process.
Each student was permitted to talk to, pet, and play with the dogs. The project ran
from 10 AM to 4 PM, from Monday through Thursday of final exam week. The ages
of students ranged from 18 to 39 years old. Most of the participants (50%) were in
the 21–29 year age range. 58 participants (67.4%) were female, 24 (27.9%) were male,
and 1 reported as other. Student helpers participated in these procedures to alleviate
any wait time. The therapy dogs were secured through Bright and Beautiful Dog
Therapies, Inc. NJ (Golden, 2016). This organization provides training, evaluation,
and certification for therapy dogs. Dog owners are given primary accident and
liability insurance for work within the US. The dogs and their owners came to
campus on their own and there was no fee for this service. 11 dogs were involved
in the 4-day activity. Most of the dogs were from pedigree backgrounds and large
and small breeds were represented.
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 271

Analysis and Results

Quantitative analysis was conducted using frequencies and descriptives for age, gender,
and “having a companion animal now and in the past (Table 1).” A paired sample t-test
was conducted to evaluate the impact of the pre-post-test intervention for both those in
the experimental and control groups. There was a statistically significant decrease in both
systolic and diastolic blood pressure for the experimental group: systolic blood pressure
(M = 3.04 mm. of mercury, SD = 10.56); t = 2.44, p < .017 (two-tailed). For the diastolic
pressure in the experimental group the results were as follows: (M = 3.89, SD = 10.77),
t = 3.04, p < .003 (two-tailed) (Table 2). This statistical analysis was chosen since data were
collected pre- and post- exposure to the therapy dogs. Both the participants in the
experimental and control group were assessed using this measurement. For the control
group, there was no significant change in blood pressure for systolic pressure before and
after (M = 1.85, SD = 11.31), t = -.614, p < .55 (two-tailed) or for the diastolic pressure in
the control (M = 3.57, SD = 12.84), t = 1.04, p < .317 (two-tailed) (Table 3) . A one-way
analysis of variance was conducted for blood pressure and gender for those in the
experimental group. There was a significant difference in the systolic blood pressure
before (p < .032) and after (p < .013) (Table 4). In the diastolic blood pressure readings
for gender there was no difference in the pressure before (p < .103), but there was
significance in the diastolic pressure after (p < .001). These were found in the between
groups. A one-way analysis of variance was done for age and blood pressure (for those in
the experimental group) and no significance was found (Table 5). This procedure was also
followed for having a pet now and in the past and there was no significance noted in either
(Table 6 and 7).

Results of Hypotheses
Result of Hypothesis 1
A significant difference was found among the experimental group both in systolic and
diastolic blood pressure. No statistical significance difference was found for those in the
control group. It should be noted that there was significance in the before groups
(experimental and control) for systolic pressure. The null hypothesis was not supported.

Results of Hypothesis 2
Using an ANOVA statistical analysis, the null hypothesis is not true for those in the
systolic before group but in the systolic after, diastolic before and after the null hypothesis
is true.

Results of Hypothesis 3
The null hypothesis is not true for gender and before and after systolic blood pressure and
for the diastolic blood pressure after but is true for the diastolic blood pressure before.

Results of Hypothesis 4
This null hypothesis was proven true. Interpreting this finding shows that the reaction to
the therapy dogs had no influence on present pet ownership.
272 J. JAROLMEN AND G. PATEL

Results of Hypothesis 5
This null hypothesis was proven true. There is no significant difference for systolic and
diastolic blood pressure for those who participated in AAA with therapy dogs on pet
ownership in the past.

Discussion and Procedure

The current study was designed to assess the relationship of AAA to blood pressure levels
in students before and after having a final academic examination on their participation
day. Blood pressure was viewed as an indication of anxiety level in the participants.
Similar research was done in the past and this study aimed to build on the current
body of knowledge. A total of 86 students participated in this study. 75 were part of the
experimental study participants, and 11 were part of the control group. During the
research, blood pressure was screened before and after a 15-minute interval for the control
group, after which they were permitted to play with the therapy dogs. The experimental
study participants were allowed to play with the therapy dogs between blood pressure
readings. All of the participants reported enjoying their interaction time with the dogs.
Some of the participants commented that they were feeling relaxed and less anxious after
interacting with the dogs. Some of the therapy dogs attracted the attention of students
passing through the venue where the study was taking place. These students then became
participants of the study. All students who participated signed a consent form and
followed the study protocol. Overall, there was a positive reaction from student partici-
pants. Some of the findings suggested that a significant difference was found among the
experimental group both in systolic and diastolic blood pressure, but no statistically
significant difference was found for the control group. There was no significant difference
found in systolic and diastolic blood pressure in different age categories, but significant
difference was found between genders. Pet ownership did not affect the participants’
reactions to the therapy dogs. This study also showed that the reaction to the therapy
dogs had no influence on present or past pet ownership.

Limitations
There were some limitations to this study. In the survey given to participants, one of
the questions was as follows: “Do you have any companion animal?” Many participants
did not understand that question and asked the researcher what was meant by
“companion animal.” Another limitation was that the group was self-selected, which
limits the validity of the results as opposed to it being a random sample. Also, in the
study, the ratio between control and the experimental participant was significantly
skewed. This led the researcher to expand the control group to allow for a more
balanced statistical analysis. In regard to language, future studies can pretest questions
so as to eliminate any language difficulties. In addition, the ratio between gender
(male/female) was also skewed. The null hypothesis was not true for gender, before
and after systolic blood pressure, or for the diastolic blood pressure after, but the null
hypothesis was true for the diastolic blood pressure before. Future study focusing on
gender can eliminate the difference in ratio in order to get an equal result within both
the control and the experiential group. As stated in the procedure section, 86 students
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 273

participated in the study. However, when the initial email was sent out via the
university email blast system, only 30 people signed up and made an appointment to
take part in the study. Because of the student center venue, more students showed
interest and participated in the study. Future studies may promote the project and
invite students by using university social media accounts. University social media can
assist in spreading and distributing information about the study and when the therapy
dogs will be on campus.

Conclusion
The significance of these findings would be beneficial to universities and colleges as
they assess the need for lowering anxiety among students before and/or after final
exams. This method is cost effective and might contribute to better mental health and
academic outcomes. Overall, important information was gleaned from this study. The
use of therapy dogs in AAA does have a significant impact on lowering the blood
pressure of students on the actual day of final examinations. This, in turn, would
suggest that anxiety levels would also be ameliorated making this intervention a simple
and cost-efficient remedy for stress-relief.

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