NCCEH Student Project Award 2016 - A Kata

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NCCEH Student Project Award 2016 - A Kata

Time is ticking: A needs assessment for Lyme disease health promotion

A Kata
University of Waterloo - Master of Public Health


  • Tick submissions to Brant County Health Unit have increased over recent years, possibly indicating a tick population being established. One type of tick— the blacklegged tick— can spread Lyme disease (LD), a bacterial infection caused by Borrelia burgdorferi.
  • As part of a needs assessment around LD health promotion for the Health Unit, a literature review was conducted.


  • The literature search focused on how LD information can best be communicated to the general public, priority groups, and physicians, and what types of health promotion activities are delivered to these groups.


  • Few resources are available on LD health promotion. Most are single studies that measure the knowledge, practices, or perceptions of LD in the general public or among healthcare practitioners.
  • Studies suggest a lack of general LD knowledge among physicians.
  • Levels of LD knowledge in the general public vary, but the amount of knowledge does not predict if a person uses tick-prevention behaviours. Behaviours are more likely to be performed if their benefits are seen as outweighing their inconvenience.
  • The importance of local context was a key theme in the literature. Different settings influence the public’s perception of LD risk and their likelihood of performing prevention behaviours.

Discussion & Conclusion

  • A community’s particular beliefs around risk levels and attitudes toward prevention behaviours will determine the effectiveness of LD promotion efforts. Determining the local epidemiological setting and local contexts are necessary in order to effectively tailor public health campaigns.
  • Chronic Lyme disease is a current controversy that should be noted in any promotional campaigns. Advocacy groups disagree with established diagnosis and treatment guidelines, and may promote unscientific information. It is important to point to scientific and authoritative sources of information.
  • The body of evidence on LD health promotion is small and not necessarily generalizable. Additional work will need to be done at the local level, and should incorporate greater consideration of behavioural change theories.