Preventive behaviors and knowledge of tick-borne illnesses: results of a survey from an endemic area.
BACKGROUND
Lyme disease (LD) is the most commonly reported vector-borne illness in the United States. With physically and economically burdensome effects, it is a concern of public health officials.


OBJECTIVE
To assess knowledge and preventive behaviors of individuals in the endemic area of Martha's Vineyard, Massachusetts, to better understand how sociodemographic data and knowledge correlate with preventive behaviors, and to update previous island studies.


METHODS
A 30-item paper-based anonymous survey in either English or Portuguese based on language preference.


METHODS
The island of Martha's Vineyard and the ferry between island and mainland.


METHODS
A total of 946 participants were recruited at 1 of 4 island locations. The majority of participants were traveling by ferry to and from Martha's Vineyard. To reach 2 populations potentially at high risk, that is, youths and outdoor workers, 3 additional venues included the island high school, an English-as-a-Second-Language class, and a local Brazilian church.


METHODS
Four specific preventive behaviors as well as an overall composite prevention score.


RESULTS
Participants' knowledge of tick-borne illnesses was poor, and the frequency of practicing preventive behaviors was low; the most commonly reported behavior was checking one's skin for ticks (45%). Approximately one-third of respondents (37%) stated that they did not know the late symptoms of untreated LD, nor did they know early LD treatment options (49%). The 2 high-risk groups reported little participation in preventive measures. In multivariate analyses, only 4 characteristics-older age, confidence in telling deer tick from wood tick, seeing tick-borne illness as a serious threat, and certainty in ability to identify LD symptoms-attained significance associated with preventive behavior as an overall composite score.


CONCLUSIONS
Public health interventions focusing on accurately communicating risk, improving knowledge both of LD symptoms and of ticks that carry the disease, as well as teaching preventive behaviors may help reduce tick-borne illness rates.
Department of Family Medicine and Community Health (Dr Cashman and Ms Savageau), University of Massachusetts Medical School (Ms Valente and Messrs Wemple and Ramos), Worcester.
Sara L
SL
Valente
Daniel
D
Wemple
Sebastian
S
Ramos
Suzanne B
SB
Cashman
Judith A
JA
Savageau
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007303:Insect Vectors / Q000472:pathogenicity*; D008193:Lyme Disease / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013987:Ticks