A recent study from Cornell University suggests that current approaches to public health messaging and research concerning tick-borne illnesses are insufficient, despite rising case numbers nationwide. The research, published in BMC Public Health, found that over 1,000 questions from more than 30 tick prevention surveys largely fail to ask individuals why they do not adopt preventative measures, such as using repellents, performing tick checks, or wearing protective clothing.
Study Details
- Focus: The multidisciplinary team examined over 30 years of knowledge, attitudes, and practices (KAP) surveys related to tick bite prevention.
- Findings: Surveys primarily focused on what people know and what they do, with limited attention to the underlying reasons for their behavior.
- Methodology: Researchers identified 36 KAP studies from the U.S., Canada, and Europe, extracting 1,016 questions. These questions were mapped against established theories of behavior change, particularly the Health Belief Model.
- Key Imbalance: Most questions concentrated on indirect factors like awareness of tick-borne diseases or prior bites. Few addressed psychological and practical factors crucial for behavior change, such as belief in preventive action efficacy, confidence in performing actions, affordability, social acceptability, or cues to action.
- Risk Perception: "Risk perception" dominated survey questions, while "cues to action" appeared in only 11 out of over 1,000 questions analyzed.
Implications
Lead author Emily Mader stated that many questions measured background information rather than decision-making factors. Senior author Amelia Greiner Safi emphasized that understanding why people do not act is more important than knowing if they perceive a risk, as fear alone rarely sustains long-term behavior change.
Senior author Amelia Greiner Safi emphasized that understanding why people do not act is more important than knowing if they perceive a risk, as fear alone rarely sustains long-term behavior change.
Tick-borne diseases account for over 75% of reported vector-borne illnesses in the U.S., with Lyme disease alone incurring an estimated $700 million to $1.3 billion annually in medical costs and lost productivity. Despite these figures, prevention adoption rates remain low.
Public health agencies rely on KAP surveys to guide resource allocation and campaign design. If surveys overlook key drivers of behavior, interventions may be misdirected. The authors advocate for improved, theoretically grounded surveys rather than an increase in the number of surveys.