Predictors of protective behaviour against ticks in the UK: a mixed methods study.

The objective of this research was to determine the most appropriate protective behaviours to promote in order to protect members of the public from Lyme borreliosis, to identify the drivers and barriers for these behaviours, and to determine the strongest predictors of tick-protective behaviour. We used a mixed methods study with qualitative interviews and a quantitative web survey. Interviews with topic experts and members of the public suggested that predictors of tick checking included perceived disease likelihood and severity as well as overall awareness of ticks and tick-borne disease. Twenty-four percent of participants regularly checked for ticks after walking in a tick-endemic area. The strongest predictors of checking for ticks were greater levels of knowledge, perceived likelihood of being bitten, self-efficacy about tick removal, and lower levels of disgust about ticks. Barriers to checking included forgetfulness and lacking time. At-risk members of the UK public require information to increase awareness of ticks and protective behaviours, particularly tick checking. Information may be most effective if it focuses on increasing self-efficacy while also reducing disgust.