Knowledge, Attitudes, and Practices Regarding Tick-Borne Diseases in a Non-Lyme-Endemic County in Southeastern Ohio:...

Tick-borne diseases (TBDs) are a significant public health problem and are expanding to formerly naive areas of the United States, such as the lower Midwest. To counter TBDs, many researchers apply the Knowledge, Attitudes, Practices (KAP) model to identify human-level factors that can be activated in campaigns to prevent tick-bites. These studies are, however, almost exclusively conducted in Lyme disease endemic areas of the US. We sought to outline KAPs among residents of a naïve County in southeast Ohio to provide baseline data to inform future educational and communication campaigns.

To identify KAPs before Lyme disease and other TBDs become endemic, we conducted a cross-sectional survey to collect data on exposure to ticks and to examine KAPs regarding TBDs in a non-Lyme-endemic county in Ohio that borders a Lyme-endemic county in West Virginia.

Two hundred thirty-one people completed the survey. Most participants reported time spent in places where ticks are common and about half reported having a tick on themselves, but low levels of concern that they would be bitten or contract a TBD. Participants reported high levels of awareness of Lyme disease but low levels of awareness of other TBDs. The perceived seriousness of TBDs was low. Participants reported suboptimal adoption of all TBD-prevention behaviors. The most common barriers were forgetting to perform a preventive practice or not being aware of a preventive practice.

These gaps in KAPs provide clear targets for public health communication messages to prevent tick-bites, particularly in non-Lyme-endemic counties in the US.