Baseline assessment of Tick-borne disease risk in Indiana

Background: Despite monumental advances in the control of ticks and tick-borne diseases within the past century, ticks continue to flourish and expand geographically, while tick-borne diseases continue to threaten human and animal health globally. Particularly among high risk groups in Indiana (rural dwellers, urban/suburban homeowners living in close proximity of grassy areas and woodlands, park employees and outdoor workers in close proximity of tick habitat), the nature and acceptability of tick control interventions for tick-borne disease risk reduction is poorly understood.

A critical need therefore exists to determine tick and TBD awareness, knowledge, attitudes, beliefs, personal protective behaviors, and tick-borne disease risks of Indiana residents.  This is necessary for, 1) quantifying their tick-borne disease risk, 2) informing effective tick-borne disease prevention policy for Indiana residents, and 3) developing tailored and targeted interventions, such that at-risk individuals/groups are enabled to, i) make more informed decisions about TBD health risks, ii) avoid tick exposure, iii) decide whether to attempt tick control, and iv) determine how to conduct such controls if necessary. Three specific aims guide this particular project, 1) To determine the psychosocial and behavioral risk factors for tick exposure, 2) To determine the density and distribution of host seeking ticks of public health importance at residential places in South/Central Indiana, and 3) To identify clusters of TBDs in Indiana. This ecological study used various sampling methods for data collection, including cross-sectional online survey,2 snowball sampling with cold-calling,3 field tick collection using drags and Carbon dioxide traps.4 This project provided opportunity to mentor and co-author manuscripts with four graduate level students of the School of Public Health, Indiana University Bloomington

Validation of a self-report scale to assess tick exposure and tick-borne disease risk in residential places

Background: In many parts of the U.S., people can be counseled to avoid tick-infested recreational areas. However, this is difficult when the tick-infested area is the residential property. As novel tick-borne pathogens are discovered in residential properties, it is important that we be able to measure the risk of tick exposure and TBD using an assessment scale.

Spurred on by these observations and the pressing need for residential home owners/occupiers to have practical help in identifying tick exposure and TBD risk, my research goal in this area is to develop a self-report scale to access tick exposure and TBD risk. The specific aims of this project include, 1) Identify key predictive socio-ecological variables for tick exposure at residential homes in Indiana, 2) Identify key predictive psychosocial variables for tick-borne pathogen antibody sero-prevalence among residents of Indiana, and, 3) Validate a new tick exposure and tick-borne disease risk assessment scale for residential property in Indiana. Especially with scare resources, our ability to predict tick exposure and TBD in residential places has important implications for developing target tick control and TBD prevention interventions.

Integrated tick exposure and tick-borne disease risk management – experiment in risk communication

Background: As TBD prevention efforts begin to focus on behavior change, two barriers to change arise. First, a majority of at-risk populations show little perceived risk or personal involvement with TBDs. The second barrier lies in our ability to use mass media to educate a large audience of at-risk populations. Answers to questions such as, “What message characteristics are most effective?” and “How do characteristics of the message interact with characteristics of the population?” are important for the success of media-based interventions. Even though the evidence is strong for the association between tick exposure and TBD at residential places, there are currently no media-based interventions designed to increase the adoption of integrated residential tick control programs. Additionally, as a leading School of Public Health, there is a need for Indiana University Bloomington to have readily available online resources for Hoosiers seeking tick exposure and TBD prevention/control information.

The overall objective of the current project is to determine the effectiveness of media-based interventions in increasing tick exposure prevention behavior within a 90-day period among homeowners and outdoor workers. Two specific aims guiding this project include, 1) To determine the effectiveness of media-based interventions in inducing behavior change for tick exposure prevention, and 2) Identify components of a media-based intervention predictive of behavioral intention and tick exposure preventive behavior among at-risk populations in Indiana. If tested and found to be effective, these media-based messages will form part of an online tick health resource center at the Indiana University Bloomington, School of Public Health. These resources will be useful for engaging, training, and empowering various at risk communities both in the Hoosier State and beyond to take action proactively for tick exposure and TBD risk reduction.

Pilot-trial of ecosystem-based tick exposure elimination and prevention of re-colonization in residential property

Background: Although ticks transmit more pathogens to humans than any other known arthropods, and more tick-borne diseases are acquired from places of primary residence than any other location, no ecosystem-based tick exposure elimination and prevention of recolonization intervention has been evaluated in residential property. As the risk of human exposure/contact with ticks are elevated, a critical need exists to evaluate the effectiveness of ecosystem-based measures which involve biological control, habitat manipulation, and behavior modification in the long-term elimination and prevention of subsequent recolonization of ticks in residential property.

The overall objective of the current project is to test the effectiveness of an ecosystem-based intervention in eliminating and preventing tick re-colonization at residential property in Indiana. The specific aims of this project are, 1) Determine the effect of integrated tick-management practices on tick density and entomological risk index on residential homes in Indiana, 2) Determine the effect of tick health education on tick exposure among residents of eco-system treated residential property, and 3) Determine the incidence of tick-borne infections among residents of eco-system treated residential property.