Factors Leading Municipal Authorities to Implement Preventive Interventions for Lyme Disease

Willingness and ability of existing mosquito control and public health agencies in New Jersey to assume responsibilities for management of ticks and tick-borne disease

We conducted surveys of New Jersey mosquito control and public health agencies to determine their willingness and ability to expand or create and maintain publicly funded tick and tick-borne disease (T/TBD) management programs. Nearly all (86%) of 21 county mosquito control agencies (MCAs) completed the survey, while only 25% of the 102 health departments (HDs) responded, probably reflecting traditional agency responsibilities. Although few of either group had formal programs, many were engaged in T/TBD-related activities. Many MCAs rated their ability to assume T/TBD responsibilities as high or moderate, while most HDs rated their capabilities as low. With the exceptions of lack of sustainable funding and possible legal constraints, the groups differed regarding perceived barriers to program creation and maintenance. Both groups envisioned comprehensive programs emphasizing public education, but program priorities differed between the groups. MCAs were willing to include most program activities, while HDs felt that some activities should be the responsibility of other agencies. MCAs were generally more familiar than HDs with tick control methods and while both groups would include control in a comprehensive program, both would limit control to public lands. Estimated program costs varied widely, probably reflecting responding agency size and complexity of envisioned programs. These results in a state with a system of existing agencies staffed by highly competent professionals suggest that more than simply additional funding (e.g., established guidelines for tick control and surveillance) is needed to create a network of practice necessary to address the growing incidence of TBD.

Intention to vaccinate for Lyme disease using the Health Belief Model

AIMS

Lyme disease (LD) cases in the United States are estimated to be approaching 500,000 annually. Protective measures, such as repellent use and wearing protective clothing are recommended by public health officials. However, no protective measure has been proven to be consistently effective, partly because they require consistent and persistent behaviour change. While safe and effective vaccines are in development, it is unclear what factors influence the intention to vaccinate against LD. This study uses the Health Belief Model (HBM) framework to determine key drivers associated with vaccine intention. The HBM is widely applied in public health research and uses the following constructs: perceived susceptibility and severity of disease, perceived benefits and barriers to disease prevention, and cues to action for disease prevention to predict health behaviours. To date, the HBM framework has not been applied to vaccination intention for LD.

METHODS AND RESULTS

Data were collected from 874 adults and 834 caregivers of children residing in US states endemic to LD. Sampling adults and caregivers allows us to explore how the intention to vaccinate differs among those at-risk. Estimates from structural equation modelling (SEM) show that the HBM constructs explain much of the variation in intention to vaccinate against LD. Both adult and caregiver intentions to vaccinate are positively influenced by cues to action, perceived susceptibility of LD, and perceived benefits to vaccination. However, there is variation in the influence of constructs across the samples. Caregiver's intention to vaccinate is positively influenced by the perceived severity of LD and negatively influenced by safety concerns about the vaccine, whereas adult intention is negatively influenced by perceived barriers to vaccination.

CONCLUSION

A strong relationship of cues to action on vaccine intention in samples of adults and caregivers suggests the importance of a recommendation from a healthcare provider or the Centers for Disease Control and Prevention (CDC).

Factors predicting self-care behavior of cardiovascular patients during the COVID-19 epidemic

BACKGROUND

The COVID-19 virus has had wide-ranging effects on all healthcare systems and a direct impact on all areas of human life in all countries around the world. Therefore, it is necessary to take preventive actions to reduce the prevalence and severity of the complications associated with this disease. The purpose of this study was to explain the dimensions of adopting general self-care behaviors (mask-wearing, social distancing, hand hygiene, and home quarantine) for preventing COVID-19 based on the theory of planned behavior (TPB) in cardiovascular patients.

METHODS

This was a descriptive-analytical study conducted with the participation of 420 patients referring to health and treatment centers of Ahvaz, southwest of Iran, in 2022. Sampling was done using a non-random (convenience) method. The data collection tool was a questionnaire containing items addressing demographic characteristics, questions related to the TPB, and questions dealing with the adoption of everyday self-care behaviors against contracting COVID-19. Data were analyzed using descriptive and inferential statistical methods (prevalence, mean, standard deviation, Pearson's correlation coefficient, and linear regression) in SPSS version 25.

RESULTS

The results of this study showed that the rate of adoption of self-care behaviors against COVID-19 among cardiovascular patients was moderate. The results also showed that among the constructs of the TPB, Perceived behavioral control, Subjective norms, and Perceived behavioral intention were the most important predictors of adopting self-care behaviors among cardiovascular patients with a change variance of 46%.

CONCLUSIONS

The results of the present study have implications for health and treatment policy makers as well as planners of educational and behavioral interventions aimed at promoting the adoption of self-care behaviors against COVID-19. In this respect, managing and institutionalizing desirable behaviors among cardiovascular patients could be beneficial from economic, social, and health-related aspects.

Collaborative Modeling of the Tick-Borne Disease Social-Ecological System: A Conceptual Framework

Hard-bodied ticks have become a major concern in temperate regions because they transmit a variety of pathogens of medical significance. Ticks and pathogens interact with hosts in a complex social-ecological system (SES) that influences human exposure to tick-borne diseases (TBD). We argue that addressing the urgent public health threat posed by TBD requires an understanding of the integrated processes in the forest ecosystem that influence tick density and infection prevalence, transmission among ticks, animal hosts, and ultimately disease prevalence in humans. We argue that collaborative modeling of the human-tick SES is required to understand the system dynamics as well as move science toward policy action. Recent studies in human health have shown the importance of stakeholder participation in understanding the factors that contribute to human exposure to zoonotic diseases. We discuss how collaborative modeling can be applied to understand the impacts of forest management practices on ticks and TBD. We discuss the potential of collaborative modeling for encouraging participation of diverse stakeholders in discussing the implications of managing forest ticks in the absence of large-scale control policy.

Integrated human behavior and tick risk maps to prioritize Lyme disease interventions using a 'One Health' approach

Lyme disease (LD) risk is emerging rapidly in Canada due to range expansion of its tick vectors, accelerated by climate change. The risk of contracting LD varies geographically due to variability in ecological characteristics that determine the hazard (the densities of infected host-seeking ticks) and vulnerability of the human population determined by their knowledge and adoption of preventive behaviors. Risk maps are commonly used to support public health decision-making on Lyme disease, but the ability of the human public to adopt preventive behaviors is rarely taken into account in their development, which represents a critical gap. The objective of this work was to improve LD risk mapping using an integrated social-behavioral and ecological approach to: (i) compute enhanced integrated risk maps for prioritization of interventions and (ii) develop a spatially-explicit assessment tool to examine the relative contribution of different risk factors. The study was carried out in the Estrie region located in southern Québec. The blacklegged tick, Ixodes scapularis, infected with the agent of LD is widespread in Estrie and as a result, regional LD incidence is the highest in the province. LD knowledge and behaviors in the population were measured in a cross-sectional health survey conducted in 2018 reaching 10,790 respondents in Estrie. These data were used to create an index for the social-behavioral component of risk in 2018. Local Empirical Bayes estimator technique were used to better quantify the spatial variance in the levels of adoption of LD preventive activities. For the ecological risk analysis, a tick abundance model was developed by integrating data from ongoing long-term tick surveillance programs from 2007 up to 2018. Social-behavioral and ecological components of the risk measures were combined to create vulnerability index maps and, with the addition of human population densities, prioritization index maps. Map predictions were validated by testing the association of high-risk areas with the current spatial distribution of human cases of LD and reported tick exposure. Our results demonstrated that social-behavioral and ecological components of LD risk have markedly different distributions within Estrie. The occurrence of human LD cases or reported tick exposure in a municipality was positively associated with tick density and the prioritization risk index (p < 0.001). This research is a second step towards a more comprehensive integrated LD risk assessment approach, examining social-behavioral risk factors that interact with ecological risk factors to influence the management of emerging tick-borne diseases, an approach that could be applied more widely to vector-borne and zoonotic diseases.

Perceived vulnerability for Lyme disease questionnaire: A social science tool for understanding tick-borne disease attitudes

Lyme disease has emerged as a growing epidemic across the U.S., with tick populations spreading north because of a plethora of human-induced factors. As the scope of this problem grows, there is a need to understand how vulnerable the public perceives themselves to be and how perceived vulnerability as a psychological construct influences public behavior. A growing body of literature has explored individual risk perceptions and individual preventative behaviors toward Lyme disease, but there remains a notable research gap regarding the concept of vulnerability. This empirical study establishes the first questionnaire for perceived vulnerability towards Lyme disease, modified from pre-existing infectious disease literature. This novel instrument was tested and compared with individual factors relating to preventative behaviors and source credibility of major information sources about Lyme disease in the state of Maine. Recent increases in black-legged tick (Ixodes scapularis) populations have affected the state of Maine in dramatic ways. This research specifically surveyed homeowners to explore their perceived vulnerability, source credibility, and individual protective intentions related to ticks and Lyme disease in Maine. Results from this study validate a modified perceived vulnerability scale for Lyme disease and highlight how understanding the relationships between these perceptions of vulnerability, individual behaviors, and sources of information can improve outreach and communication efforts about tick-borne diseases.

Using the Theory of Planned Behavior to Predict the Adoption of Heat and Flood Adaptation Behaviors by Municipal Authorities in the Province of Quebec, Canada

The aim of this study is to identify which psychosocial factors of the theory of planned behavior better predict and explain the adoption of heat and flood adaptation behaviors by municipal authorities in the Province of Quebec, Canada, and to explore the cognitive structures motivating municipal officers to adopt adaptation behaviors. The results of structural equation analyses showed that municipal authorities’ attitude toward the adoption of adaptation behaviors (i.e., the degree to which the performance of an adaptive behavior is positively or negatively valued by municipal officers) and perceived control (barriers) over adaptation behaviors significantly contributed to the prediction of readiness to adopt the behavior.

Some at Risk for COVID-19 Are Reluctant to Take Precautions, but Others Are Not: A Case From Rural in Southern Iran

Little is known about the evaluative and cognitive foundations for adopting preventive measures to reduce the spread of COVID-19. Recognizing the existence of a gap in the knowledge describing the intention and behavior of participating in health measures, this study investigated the drivers that contribute to the intention to take health protective measures among 305 rural youth from the Dashtestan Region, Bushehr Province, and southern Iran, reached through an online survey. Protection motivation theory (PMT) served as the theoretical framework for the study. It was able to forecast variation in intentions and behaviors with accuracies of 39 and 64%, respectively. Furthermore, the variables of response efficiency, perceived severity, and self-efficacy had a positive and significant effect on protective intentions. Additionally, perceived severity, self-efficacy, and intention produced a positive and significant impression on behaviors, with most of the behavioral variance being accounted for by intention, as was hypothesized. In conclusion, it is suggested that health development including training measures that take account of both the concrete issues of health resources and technologies and of more abstract ones, such as mindset readiness, are important for engagement in positive health care behaviors. Accordingly, training-based interventions for rural youth should be contemplated, with the object of changing their intentions.