Understanding Lyme disease: Illness experience, prevention, and the health belief model

Lyme disease is the most common vector-borne disease in the United States and is endemic in the Northeast. The aims of this research were to examine how people living in an area endemic for Lyme disease attempt to prevent catching the disease, and why they choose certain prevention measures over others. This dissertation research had three goals. The first was to examine what people who live in Storrs/Mansfield Connecticut and Block Island, Rhode Island knew about the disease, what kinds of illness experiences they have had, what types of prevention measures they used, and what they thought of prevention measures in terms of effectiveness and practicality. The second goal was to see whether variables in the Health Belief Model (perceived severity of disease, perceived susceptibility to disease, benefits to prevention and barriers to prevention) could predict level of prevention effort. The third goal was to examine whether experiences with the disease influenced levels of perceived severity and susceptibility. Overall, the participants in the study were very aware of Lyme disease, though they knew more about early onset symptoms than late stage complications. Perceived susceptibility and perceived severity levels were high. Informants recognized risky environments and almost universally took some type of precaution. The most common precaution was checking for ticks. Conversely, use of chemical bug sprays was infrequent, and many informants were concerned about the health risks of insecticide. Most, if not all, of the participants either knew someone who had been with ill Lyme disease, or had suffered from it personally. Knowing someone who suffered from Lyme, or having contracted it oneself were significant predictors of perceived susceptibility. Knowing someone who had suffered from a severe case of Lyme, or having suffered oneself were significant predictors of perceived severity. Perceived severity, seeing barriers to prevention and questioning the effectiveness of prevention were significant predictors of prevention effort. The use of tick checks, DEET sprays and wearing long pants and socks when outdoors were associated with high perceived effectiveness and low perceived barriers for these methods.