Abstract
Background
Public green spaces are important for human health, but they may expose visitors to ticks and tick-borne pathogens. We sought to understand risk and drivers of tick-preventative behavior in three popular parks on Staten Island, NY, USA by integrating tick hazard and park visitors’ behaviors.
Methods
From 20 May to 19 August 2019, ticks were collected via drag cloth sampling in multiple parks, sites, and habitats to estimate tick density. Human behavior was assessed by observing usage (time spent and activity type) in each site and habitat. To evaluate risk of tick exposure, we compared park usage by demographics across sites and compared individual exposure time per site and habitat. To assess visitors’ tick prevention behaviors, a knowledge, attitude, and practices (KAP) survey was administered.
Results
Three tick species (Ixodes scapularis, Amblyomma americanum and Haemaphysalis longicornis) were collected. The density of nymphs was heterogenous across parks, with the greatest density in unmaintained herbaceous habitats and trails. The fewest people entered the highest tick risk park and within-park locations. The KAP survey revealed that most respondents (N= 190) could not identify a nymphal stage tick when shown examples of various arthropods. Interviewees identified parks as the main location for tick exposure, but most believed they themselves had minimal risk for tick encounter. Consequently, many visitors did not conduct tick checks. People were most likely to practice tick checks if they knew multiple prevention methods and perceived a high likelihood of tick encounter.
Conclusions
By integrating acarological indices and park visitor behaviors we found a mismatch between the areas with higher tick densities and areas more frequently used by park visitors. However, this exposure risk varied among demographic groups and the type of activities. Moreover, the use of preventative measures was associated with the perceived probability of tick encounter and knowledge of tick habitat, which would modify the ultimate risk of tick encounter and disease given exposure. Our research is a first step towards identifying visitor risk, attitudes, and practices that could be targeted by optimized messaging strategies for tick bite prevention among park visitors.