title: Adaptation and Evaluation of a Multi-Criteria Decision Analysis Model for Lyme Disease Prevention.
abstract: Designing preventive programs relevant to vector-borne diseases such as Lyme disease (LD) can be complex given the need to include multiple issues and perspectives into prioritizing public health actions. A multi-criteria decision aid (MCDA) model was previously used to rank interventions for LD prevention in Quebec, Canada, where the disease is emerging. The aim of the current study was to adapt and evaluate the decision model constructed in Quebec under a different epidemiological context, in Switzerland, where LD has been endemic for the last thirty years. The model adaptation was undertaken with a group of Swiss stakeholders using a participatory approach. The PROMETHEE method was used for multi-criteria analysis. Key elements and results of the MCDA model are described and contrasted with the Quebec model. All criteria and most interventions of the MCDA model developed for LD prevention in Quebec were directly transferable to the Swiss context. Four new decision criteria were added, and the list of proposed interventions was modified. Based on the overall group ranking, interventions targeting human populations were prioritized in the Swiss model, with the top ranked action being the implementation of a large communication campaign. The addition of criteria did not significantly alter the intervention rankings, but increased the capacity of the model to discriminate between highest and lowest ranked interventions. The current study suggests that beyond the specificity of the MCDA models developed for Quebec and Switzerland, their general structure captures the fundamental and common issues that characterize the complexity of vector-borne disease prevention. These results should encourage public health organizations to adapt, use and share MCDA models as an effective and functional approach to enable the integration of multiple perspectives and considerations in the prevention and control of complex public health issues such as Lyme disease or other vector-borne and zoonotic diseases.
authors: Research Group on Epidemiology of Zoonoses and Public Health, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada; Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.
authors: Cécile
authors: C
authors: Aenishaenslin
authors: Laboratoire d'Eco-Épidémiologie, Institut de Biologie, Université de Neuchâtel, Neuchâtel, Suisse.
authors: Lise
authors: L
authors: Gern
authors: Research Group on Epidemiology of Zoonoses and Public Health, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada; Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Saint-Hyacinthe, Quebec, Canada.
authors: Pascal
authors: P
authors: Michel
authors: Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.
authors: André
authors: A
authors: Ravel
authors: Research Group on Epidemiology of Zoonoses and Public Health, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada; Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.
authors: Valérie
authors: V
authors: Hongoh
authors: Group for Research in Decision Analysis (GERAD), Montreal, Quebec, Canada.
authors: Jean-Philippe
authors: JP
authors: Waaub
authors: Institut national de santé publique du Québec, Longueuil, Quebec, Canada.
authors: François
authors: F
authors: Milord
authors: Research Group on Epidemiology of Zoonoses and Public Health, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada; Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.
authors: Denise
authors: D
authors: Bélanger
mesh_terms: D056810:Acaricides; D000818:Animals; D025065:Borrelia burgdorferi / Q000472:pathogenicity / Q000502:physiology; D003661:Decision Support Techniques; D062665:Epidemiological Monitoring; D006801:Humans; D018884:Ixodes / Q000382:microbiology*; D008193:Lyme Disease / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D015233:Models, Statistical; D011634:Public Health; D011792:Quebec / Q000453:epidemiology; D013557:Switzerland / Q000453:epidemiology; D013983:Tick Control / Q000191:economics / Q000379:methods*; D015047:Zoonoses / Q000517:prevention & control*
chemical_list: D056810:Acaricides