A national survey of risk perceptions and practices to prevent tick-borne Lyme disease and mosquito-borne viral encephalitis

Abstract

Behavioral epidemiology has become an increasingly important science of inquiry for the examination of health-related behaviors in populations, the association of these behaviors with well-being, morbidity, and mortality, and the discovery of techniques for predicting, improving, and sustaining healthy behaviors. Thematic areas common to health behavior theories were used to design this study and examine the results observed. A 55-item survey instrument was successfully administered to 1489 adults in the U.S. and an over-sample of 261 adults in six states in the Northeast (CT, DE, NJ, NY, PA, RI) regarding ticks and tick-borne Lyme disease and mosquitoes and mosquito-borne viral encephalitis. Index measures for tick and mosquito bite prevention were created. Among U.S. adults, perceived harm to self about being bitten by ticks appeared to be the most robust predictor of behavioral action to prevent tick bites (OR = 8.3; 95% CI = 6.3, 11.1). Respondents from the Northeastern states over-sample who knew someone with Lyme disease were significantly more likely (OR = 22.1; 95% CI = 3.6, 136.5) to take action to prevent tick bites. Moreover, respondents from the Northeastern sample, but not the U.S. sample, who stated they recently took action to prevent tick bites were 2.9 times more likely to choose tweezers (vs. the erroneous choice of a hot match) to remove an embedded tick when compared with respondents who stated they did had not recently take action to prevent tick bites. Pet ownership (OR = 2.1; 95% CI = 1.3, 3.6) was also a statistically significant predictor of the adoption of precautions by U.S. adults to prevent tick bites. Regarding mosquitoes, analyses revealed that being concerned about being bitten by mosquitoes, believing that staying indoors in late afternoon and evening was protective, that mosquito repellent is not harmful to health, owning dogs and/or cats as pets, being married, and being between 18-44 years of age were statistically significant predictors of the mosquito bite prevention index. Among U.S. adults perceived harm to self about being bitten by mosquitoes appeared to be the most robust predictor of behavioral action to prevent mosquito bites (OR = 7.3; 95% CI = 4.3, 12.2).