TABLE 3
Behaviors Section From the Survey to Assess Knowledge, Attitudes, and Behaviors Regarding Tickborne Diseases
Statement
Almost Never
Rarely
Often
Almost Always
Does Not Apply
I avoid places where ticks live when they are more likely to be looking for food. I participate in outdoor activities in places where ticks occur. I use products containing permethrin to pretreat clothing before being in places where ticks live. I use a repellent containing DEET when in places where ticks live. I use a repellent containing natural oils when in places where ticks live. I wear long pants when in places where ticks live. I wear a hat when in places where ticks live. I tuck my pants into socks or boots when in places where ticks live. I thoroughly check my body for ticks after being in places where ticks live. I have someone check my head for ticks after being in places where ticks live. I shower immediately after being in places where ticks live. If bitten by a tick, I apply disinfectant at the site of the bite after the tick is removed. If I find a tick attached to my body, I burn it off. I apply a substance, such as fingernail polish, to suffocate the tick to aid in removing it. I check my pets for ticks when they come inside after being in places where ticks live.
Note. Survey takers are instructed to indicate their agreement with the following statements and select only one answer for each statement. DEET = N,N-Diethyl-m-toluamide.
Several participants stated that they would select “no opinion” on questions that were unclear or that they were not sure how to answer. Others said they chose a random answer if they did not understand the ques- tion or did not know the correct answer: “See that’s sort of why I kind of had to guess on these questions. I was like wait a second, this sounds familiar, but I don’t know exactly what it is. I assume it’s this or something.” Recommendations for the Attitudes Section Participants recommended changing wording or the organization of questions to make them clearer and easier to understand. Some individ- uals said that using more known brand names (e.g., OFF!) could help individuals identify specific repellents. Another recommendation was using numbers instead of letters, because the letter association with the answer choice confused many participants, especially with
questions that were on a 5-point Likert scale of strongly agree to strongly disagree: “I think this is probably dumb, but the fact that I was circling for agree it was a ‘D’ did kind of throw me o a little bit. I feel like it’s a stupid thing to say, but if it was numbers and not letters, because it was just weird to me.” “I think numbers are better. I kind of like the numbers better just because the letters have weird connections.” Furthermore, participants stated that add- ing questions about the environment and the prevalence of tick bites in their geographic area was needed. They also felt that the sur- vey should include questions asking if the participant is from another country, as this information could influence the knowledge a participant would have about ticks in the U.S. Participants also discussed that wearing long sleeves in the summer was not an option, es- pecially in areas where the weather gets very
hot. They stated that wearing a hat for tick prevention, however, was acceptable.
Knowledge Themes Participants expressed that a person’s over- all knowledge of tick-related considerations would be influenced by personal experiences with ticks in addition to other factors includ- ing preventive measures, knowledge of tick removal techniques, and information learned from others. Some participants identified that a common but incorrect method of tick removal is to use tweezers and a lighted match: “It’s like a lighted match and tweezers. The tweezers are like already holding on to [the tick] as closest to the head, well to the skin, as possible and then it’s like touch the match and immediately yank it out is what we’ve done.” Other participants said they learned in- formation about ticks through schools and camping trips or from peers:
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November 2024 • Journal of Environmental Health
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