Using participatory epidemiology to understand differences in tick-borne disease perceptions from homeowners in the Ohio River Valley

Tick-borne diseases are the most common vector-borne diseases reported annually in the United States. Lyme disease, caused by the spirochetal bacteria Borrelia burgdorferi sensu stricto (s.s) affects an estimated 476,000 people each year and is transmitted by the Ixodes scapularis tick. People residing in endemic areas are likely to possess differences in knowledge and protective behaviors compared to people living in newly emerging areas. To better understand behavioral differences and perspectives of Lyme disease and other tick-borne diseases in these areas, homeowners were surveyed from a Lyme endemic area (southwestern Pennsylvania) and an emerging area (eastern Ohio). The survey covered three main areas of interest: perceived risk of tick exposure and tick-borne disease health risks, personal protection methods used to prevent or reduce exposure to tick bites, and protection methods to reduce tick presence on homeowner properties. The results of our study suggest that residents in endemic regions may be more educated and aware of tick-borne disease risk and prevention methods based on their belief that tick-borne disease pose at least a minor health risk. Additionally, more Pennsylvania residents used tick prevention methods while outdoors on their property. Residents in Ohio were unlikely to make any changes to protect themselves or their property from ticks, which may be a result of a lack of education or lack of motivation to change their behaviors. The findings from this study can inform public health education and interventions to increase awareness and reduce the risk of tick-borne diseases in endemic and emerging areas.