As part of a TickNET collaboration we evaluated the knowledge, attitudes, and behaviors related to tick-borne disease (TBD) prevention among persons living in endemic areas of Connecticut (CT) and Maryland (MD). Up-to-date information on the use of various prevention methods, as well as attitudes toward available and potential prevention options, is critical for effective promotion of recommended behaviors.

During 2016–2017, printed invitations were mailed via the post office to 27,029 households requesting participation in an online survey regarding knowledge of TBD, risk perceptions, and prevention behaviors. Prevention behaviors included tick checks, showering/bathing, insect repellents, pet tick control, and chemical or natural pesticide use on residential properties. Associations of sociodemographic characteristics and knowledge and attitude variables with prevention behaviors were assessed in unadjusted analyses and multivariable models to calculate adjusted odds ratios (aOR). Participants were also asked if they would be willing to get a Lyme disease (LD) vaccine, if one becomes available.

Overall, 1883 (7%) persons completed the survey. Participants reported using preventive behaviors most of the time or always as follows: pet tick control (83%), tick checks (58%), showering/bathing (42%), insect repellent (31%), and chemical (23%) or natural (15%) pesticides on property. Self-rated knowledge of LD, perceived prevalence of LD, perceived severity of LD, and perceived likelihood of contracting LD or another TBD were significantly (p < 0.05) associated with performing a tick check [aOR 2.5, aOR 1.71, aOR 1.36, aOR 1.83, respectively]. Female gender and perceived prevalence of LD were significantly associated with applying insect repellent [aOR 1.56, aOR 1.64, respectively]. Perceived prevalence of LD was significantly associated with showering or bathing, insect repellents, and pet tick control [aOR 1.42, aOR 1.64, aOR 1.92, respectively]. Income > $100,000 was significantly associated with applying a chemical or natural pesticide to one’s property [aOR 1.29, aOR 1.40, respectively]. A majority of respondents (84%) reported that they were very likely or somewhat likely to get a LD vaccine if one were available.

Few behaviors (tick checks and pet tick control) were reported to be practiced by more than half of the respondents living in LD endemic areas. Perceived prevalence of LD was the only factor associated with performing most of the prevention behaviors (tick checks, showering/bathing, use of insect repellents, and pet tick control). Use of chemical or natural pesticides appears to be driven by income. Greater efforts are needed to encourage use of prevention behaviors in endemic areas, and this may be facilitated by increasing awareness of local prevalence.

作为 TickNET 合作的一部分，我们评估了居住在康涅狄格州 (CT) 和马里兰州 (MD) 流行地区的人们与蜱传疾病 (TBD) 预防相关的知识、态度和行为。有关使用各种预防方法的最新信息，以及对现有和潜在预防方案的态度，对于有效促进推荐行为至关重要。

2016 年至 2017 年期间，通过邮局向 27,029 个家庭邮寄了印刷版邀请函，要求他们参与有关 TBD 知识、风险认知和预防行为的在线调查。预防行为​​包括蜱虫检查、淋浴/沐浴、驱虫剂、宠物蜱虫控制以及在住宅物业使用化学或天然杀虫剂。在未经调整的分析和多变量模型中评估社会人口特征以及知识和态度变量与预防行为的关联，以计算调整后的比值比（aOR）。参与者还被问及如果有莱姆病（LD）疫苗，他们是否愿意接种。

总体而言，1883 人（7%）完成了调查。参与者报告大部分时间或总是使用以下预防行为：宠物蜱虫控制（83%）、蜱虫检查（58%）、淋浴/沐浴（42%）、驱虫剂（31%）和化学物质（23%）或财产上的天然（15%）杀虫剂。自评的 LD 知识、感知的 LD 患病率、感知的 LD 严重性以及感知的感染 LD 或其他 TBD 的可能性与执行蜱虫检查显着相关 (p < 0.05) [aOR 2.5、aOR 1.71、aOR 1.36、aOR分别为1.83]。女性性别和感知的 LD 患病率与使用驱虫剂显着相关 [分别为 aOR 1.56、aOR 1.64]。 LD 的感知患病率与淋浴或沐浴、驱虫剂和宠物蜱控制显着相关 [分别为 aOR 1.42、aOR 1.64、aOR 1.92]。收入> $100,000 与对财产使用化学或天然杀虫剂显着相关[分别为 aOR 1.29、aOR 1.40]。大多数受访者 (84%) 表示，如果有 LD 疫苗，他们很可能或在一定程度上可能会接种。

据报道，生活在 LD 流行地区的受访者中有一半以上没有采取任何行为（蜱虫检查和宠物蜱虫控制）。感知的 LD 患病率是与执行大多数预防行为（蜱虫检查、淋浴/沐浴、使用驱虫剂和宠物蜱虫控制）相关的唯一因素。化学或天然农药的使用似乎是由收入驱动的。需要加大力度鼓励在流行地区采取预防行为，提高对当地流行情况的认识可能会促进这一点。