Research & Program Evaluation
Connected Horse recognizes the importance of measuring the impact our work has on the people, horses, and communities we serve. Our commitment to research-derived programming began in 2015, when we launched a research project with Stanford University’s Alzheimer’s Disease and Research Center and the Red Barn Leadership program, and continued in 2016 with a three-year study alongside the UC Davis Alzheimer’s Disease Research Center and Center for Equine Health— looking closely at the impact of equine-assisted services on the relationship between people living with dementia and their care partners. Since then, our research has expanded into peer-reviewed publication, international conference presentations, community based partnerships evaluating benefits and our current acceptance as a community based organization studying social prescribing with Kaiser Permanente’s pilot research project on how social prescribing programs impact wellbeing and health outcomes.
”Connected Horse programs counter the isolation so often experienced by people living with dementia and their care partners through research-informed equine programs. From our founding pilot study through our current work in community programs, social prescribing support, and our participation in the Kaiser Permanente Pilot Study, measuring impact and research has always guided how we build and expand our programs.
Paula HertelCo-Founder, Connected Horse
Foundational Research: The Equine-Guided Support Pilot Study
The Equine-Guided Support Pilot Study, conducted in partnership with Stanford University and UC Davis, measured the effectiveness of Connected Horse’s equine-guided workshops on stress reduction and quality of life for people affected by early-stage dementia and their care partners. Connected Horse was the first program of its kind to support people with early-stage dementia and their care partners together.
Why it Mattered
Over 55 million people live with dementia worldwide, including more than 6 million people in the United States—a number projected to rise to nearly 13 million by 2050. Family caregiving remains the most common form of care both in the U.S. and around the world, yet research consistently shows that stress, anxiety, and depression typify the caregiving experience. Few programs exist that address the needs of people living with dementia and their caregivers together.
The Pilot
Conducted over Fall 2016 and Spring 2017, the study brought 26 participants (13 pairs) to a Bay Area equine facility for an introductory session followed by two five-hour workshops. Activities were designed to teach non-verbal communication between care partners and people living with dementia, including observing herd behavior, grooming, leading, and connecting with horses over the fence. Trained facilitators led discussion groups that invited reflection on each pair’s experience with the horses.
The Results
Using a pre/post-test design with standardized measures of stress, burden, mood, and social support, the study found a significantly increased positive perception of social support, along with greater reciprocity, awareness, and appreciation between pairs. Every participant, facilitator, and researcher involved reported a more positive mood after interacting with the horses.
Meet the Research Team
University of California, Davis (2016-2018)
Sarah Tomaszewski Farias, PhD — Principal Investigator, Professor of Neurology, Davis Medical Center, Alzheimer’s Disease Research Center.
Claudia Sonder, DVM — Director, School of Veterinary Medicine, Center for Equine Health.
Liz Williams, MA — Lead Facilitator, Connected Horse Workshops and curriculum development.
Elke Tekin — Community Outreach Coordinator and Connected Horse Board Member, specializing in case management and education for elders and families.
Paula Hertel, MSW — Program Director and Connected Horse Co-Founder/Board Member, specializing in programs supporting older adults, care partners, and professionals.
Nancy Schier Anzelmo, MSG — Education Director, dementia care practitioner, and Connected Horse Co-Founder/Board member, specializing in programs that support person-centered care for those living with dementia.
Elizabeth Landsverk, MD — Research Study Medical Advisor and geriatrician specializing in dementia care, adjunct professor at Stanford University and founder of Elder Consult Geriatric Medicine.
Stanford University (2015-2016)
Dolores Gallagher Thompson, PhD — Principal Investigator and Professor of Research, Department of Psychiatry and Behavioral Sciences, Stanford University.
Nusha Askari, PhD — Project Coordinator and Academic Program Professional, Stanford ADRC, Department of Neurology and Neurological Sciences, Stanford University.
Ann Choryan Bilbrey, PhD — Assistant Project Coordinator and Postdoctoral Research Fellow, Department of Psychiatry and Behavioral Sciences, Stanford University.
Jacqueline Hartman — Curriculum Developer & Lead Facilitator, co-founder of the Stanford University Red Barn Leadership Program and curriculum/program developer for equine-guided leadership.
Elizabeth Landsverk, MD — Research Study Medical Advisor and geriatrician specializing in dementia care, adjunct professor at Stanford University and founder of Elder Consult Geriatric Medicine.
Elke Tekin — Community Outreach Coordinator and Connected Horse Board Member, specializing in case management and education for elders and families.
Paula Hertel, MSW — Program Director and Connected Horse Co-Founder/Board Member, specializing in programs supporting older adults, care partners and professionals.
Nancy Schier Anzelmo, MSG — Education Director, dementia care practitioner and Connected Horse Co-Founder/Board member, specializing in programs that support person-centered care for those living with dementia.
”All participants, facilitators and researchers reported experiencing a more positive mood and affect after interacting with the horses in the equine guided support workshops.
Published & Peer-Reviewed Research
Our pilot findings have gone on to inform peer-reviewed publications that extend the reach of our work into the broader research community, including:
Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association — findings from the Connected Horse equine-guided support project for people living with early-stage dementia and their care partners.
The Gerontologist — “Equine Guided Workshops for People Affected by Dementia,” examining research outcomes from our program.
Innovation in Aging, a publication of The Gerontological Society of America — additional findings from our equine-guided workshop model.
Conference Presentations
Connected Horse has shared its program impact and research with the global dementia and aging community at some of the field’s most prominent gatherings:
37th Alzheimer’s Disease International Conference, Lyon, France, 2026 — our most recent findings, showing increased engagement, confidence, and activation for both care partners and people living with memory loss.
National Innovations in Alzheimer’s Caregiving Award, Family Caregiver Alliance, San Francisco, CA 2024 — presenting our sensory engagement and social connection data and accepting the award.
Gerontological Society of America, Innovations in Aging, New Orlena, LA, 2017 — presenting continued findings on the impact of our program.
Alzheimer’s Association International Conference (AAIC), Toronto, Canada 2016 — our founding pilot data was presented to the world’s largest dementia research conference.
Current Research: Kaiser Permanente Social Prescribing Pilot
Connected Horse is proud to participate as a Community-Based Organization in the Kaiser Permanente Social Prescribing Pilot, a research project measuring the impact of social connection on older adults experiencing memory loss, depression, caregiving burden, and other stressors. This work is helping inform not just Connected Horse’s programming, but the broader field’s understanding of how community-based social connection can improve health outcomes.
What’s Next: Our 2026/27 Research Vision
With the support of our donors and grant partners, Connected Horse is deepening our commitment to measuring the impact of our programs across three areas:
- Social Connection — measuring our impact on reducing isolation and withdrawal.
- Confidence & Self-Agency — examining how individuals make choices about their own future.
- Wellbeing & Health Outcomes — tracking measurable improvements to health and quality of life.
Thank you to our current research and program evaluation funders: Three Valleys Community Foundation and Upjohn (San Francisco)
Facts on Dementia and Caregiving
Dementia describes a group of symptoms including memory and mental processing changes, Alzheimer’s Disease is one cause of dementia.
Approximately 1 in 9 people ages65 and older (11%) has Alzheimer’s
Almost two-thirds of Americans with Alzheimer’s are women.
Older Black Americans are about twice as likely to have Alzheimer’s or other dementias as older White Americans
Nearly 13 million Americans provide unpaid care for people with Alzheimer’s or other dementias
In 2025, unpaid caregivers provided more than 19 billion hours of care valued at more than $446 billion
More than 7 million Americans have Alzheimer’s, with an estimated 7.4 million Americans age 65 and older
Participation in activities that are meaningful and “maintaining a sense of self identity and relationships to others” are key factors identified by the Alzheimer’s Association for improving quality of life for affected people and care partners.
Data from the Alzheimer’s Association publication, Alzheimer’s Facts and Figures, 2026
