Comparing the effect of a leaflet and a movie in preventing tick bites and Lyme disease in The Netherlands.
Lyme disease (LD) has become the most common vector borne illness in the Northern hemisphere. Prevention relies predominantly on fostering protective behaviors (e.g., avoiding tick areas, using protective clothing and repellent, and doing routine tick checks post-exposure). The objective of this study was to evaluate the effectiveness (in terms of knowledge, perceived severity and susceptibility, self-efficacy, response efficacy, intention, and behavior over time) and appreciation of a leaflet and a movie as tools for informing the public in the Netherlands about ticks and LD protective behaviors.



Participants (1,677 at t1 and 361 extra at t2) were members of a representative Internet panel (adults aged 18 years and above). A four group randomized controlled design was used to test the effect of an information leaflet and a movie (two intervention groups), compared to a control group and a follow-up only control group. Data were collected over two periods: July 15-29, 2013 (t1) and at follow-up 4 weeks later, August 16-31, 2013 (t2).



Post-intervention results show all respondents in all groups possess good general basic knowledge of ticks and LD. Respondents in both the leaflet and movie groups knew more than respondents in the control group, and had greater awareness of best practices after a tick bite. Intention to perform protective behavior in future was stronger among respondents in the intervention groups. While respondents generally appreciated both the movie and the leaflet, they found the movie ran too long. Follow-up revealed no lasting positive effects from either the leaflet or the movie.



Our results suggest that both the movie and the leaflet are valued and effective intervention tools for improving knowledge about tick bites and strengthening self-efficacy and intentions to perform protective behavior against ticks and LD . Achieving lasting effects, however, calls for more action.
Centre for Infectiou Disease Control National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. desiree.beaujean@rivm.nl.
Desirée Jacqueline Mathieu Angélique
DJ
Beaujean
Department of Health Promotion, Maastricht University, CAPHRI School for Public Health and Primary Care, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Rik
R
Crutzen
Centre for Infectiou Disease Control National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
Fedor
F
Gassner
Department of Environmental Health, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
Caroline
C
Ameling
Department of Statistics, Informatics, and Mathematical Modeling, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
Albert
A
Wong
Centre for Infectiou Disease Control National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.|Leiden University Medical Centre, Centre for Infectious Diseases, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
James Everard
JE
van Steenbergen
Department of Health Services Research, Maastricht University, CAPHRI School for Public Health and Primary Care, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Dirk
D
Ruwaard
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008193:Lyme Disease / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010174:Pamphlets; D011481:Protective Clothing / Q000706:statistics & numerical data; D020377:Self Efficacy; D064927:Tick Bites / Q000517:prevention & control*; D013987:Ticks; D014741:Video Recording; D055815:Young Adult
Communication interventions; Educational interventions; Lyme disease; Ticks