Departments of Recreation, Park, and Tourism Studies (Dr Omodior) and Epidemiology and Biostatistics (Dr Kianersi and Ms Luetke), School of Public Health, Indiana University Bloomington, Bloomington, Indiana.
J Public Health Manag Pract. 2021;27(6):E210-E219. doi: 10.1097/PHH.0000000000001070.
To determine the prevalence of risk and protective factors for tick exposure and tick-borne disease (TBD) based on gender and living in urban or rural areas (urbanicity) among a cross section of Indiana adults.
Data were collected from 3003 adults (81% response rate) spread across all 92 Indiana counties. Study participants were recruited from existing online panels maintained by Qualtrics. We calculated prevalence ratio (PR) and 95% confidence interval (CI) of 8 primary outcomes for 2 different exposures: (1) gender (male/female) and (2) urbanicity.
Female participants were 10% less likely to find a tick on themselves than male participants (PR = 0.90; 95% CI, 0.74-0.99) and significantly more likely to worry about their health and safety because of ticks, whereas males avoided the outdoors less because of worry about ticks. Female participants were significantly more likely to adopt various personal protective measures, specifically because of concern for ticks. Female participants were also less likely to have been told by a health care provider that they have a TBD (PR = 0.53; 95% CI, 0.38-0.75). Rural participants were significantly more likely to report seeing a tick at their residential property (PR = 2.40; 95% CI, 2.11-2.76), report finding ticks on themselves (PR = 1.90; 95% CI, 1.68-2.23), and report finding a tick on a child at their residential property within the past 6 months than urban dwellers (PR = 1.37; 95% CI, 1.06-1.77). In addition, we found that 62% of participants have very high trust in government sources of information on TBD and tick prevention.
In Indiana, the area around people's residences may constitute an important source of tick exposure for humans. Being exposed to ticks is most prevalent in those living in rural areas of Indiana. Finally, risk factors for TBD are higher among males than among females.
基于印第安纳州成年人的性别和居住在城市或农村地区（城市性），确定与蜱虫暴露和蜱传疾病（TBD）相关的风险和保护因素的流行率。
数据来自分布在印第安纳州 92 个县的 3003 名成年人（81%的回复率）。研究参与者是从 Qualtrics 维护的现有在线小组中招募的。我们计算了 8 个主要结果的 2 种不同暴露情况（1）性别（男性/女性）和（2）城市性的患病率比（PR）和 95%置信区间（CI）。
与男性参与者相比，女性参与者身上发现蜱虫的可能性低 10%（PR = 0.90；95%CI，0.74-0.99），且因蜱虫而担心自身健康和安全的可能性明显更高，而男性因担心蜱虫而较少避免户外活动。女性参与者更有可能采取各种个人保护措施，特别是因为担心蜱虫。女性参与者也不太可能被医疗保健提供者告知患有 TBD（PR = 0.53；95%CI，0.38-0.75）。农村参与者报告在其住宅物业上看到蜱虫的可能性明显更高（PR = 2.40；95%CI，2.11-2.76），报告发现自己身上有蜱虫的可能性更高（PR = 1.90；95%CI，1.68-2.23），报告在过去 6 个月内在住宅物业上发现孩子身上有蜱虫的可能性更高（PR = 1.37；95%CI，1.06-1.77）。此外，我们发现 62%的参与者非常信任政府提供的 TBD 和蜱虫预防信息来源。
在印第安纳州，人们居住的周围地区可能是人类接触蜱虫的重要来源。在印第安纳州农村地区，接触蜱虫的情况最为普遍。最后，TBD 的风险因素在男性中比女性中更高。
