Tick Free NH: A Grass-Roots Lyme Disease Prevention Campaign in New Hampshire

Background: An estimated 200,000-400,000 people in the United States (US) contract Lyme disease each year, although only ~35,000 are reported. Incidence has been increasing in both the US and New Hampshire (NH). NH has the second highest incidence rate of Lyme disease in the country. Almost 40% of NH adults do not think they have a high or moderate risk of becoming infected with Lyme disease, 42% cited incorrect tick removal methods.  Awareness of the risks, prevention methods, removal and symptoms are key to reducing incidence of Lyme disease.

Program background:  JSI worked with the NH Charitable Foundation via a private funder to review existing research around the economic burden of Lyme disease and developed a range of potential research methodologies for assessing the burden in NH.  JSI purchased ten questions on the University of New Hampshire Granite State Poll to understand knowledge, attitudes, barriers and beliefs around ticks and tick prevention as well as conducted key informant interviews with relevant professionals. JSI then created a social marketing and grass roots media campaign, Tick Free NH, to educate the public about how to prevent tick encounters (and potentially contracting Lyme disease) by changing behaviors around preparation for outside activity and checking for ticks. The campaign was focus group tested; targets are: parents of children aged 2 to 13 and recreational outdoors enthusiasts. The campaign includes a PSA, multi-media, social media, print materials, www.TickFreeNH.org, and representation at events. Throughout the process JSI has convened stakeholders who are on the front line of tick encounter prevention, such as: state and local health departments, summer camps, childcare facilities, schools, and parks.

Evaluation Methods and Results:  JSI tracked the distribution, placement, and reach of physical materials, traditional, digital and mobile advertisements, and social media campaigns. Additionally, JSI collected survey responses in Spring 2016, a follow-up survey in late Fall 2016, and will collect via survey in late Fall 2017 after Tick Free NH runs again in 2017. Fall 2016 results found: 62% of respondents believe they are at a high (27%) or moderate (35%) risk of becoming infected with Lyme disease, similar to assessments made in the Spring 2016. The number of respondents who say they always check their body for ticks after being in a wooded, grassy or brushy area grew slightly from Spring 2016 but is substantially greater than in the previous Summer 2008 survey.

Conclusions:  The combination of social marketing and grass-roots dissemination was effective at the beginning to reach a resistant population with new information. 77% of those who saw Lyme disease prevention messaging took appropriate steps/additional steps to protect themselves from tick bites. There still is reluctance to use insect repellant in certain populations – interventions should be repeated annually.

Implications for research and/or practice:  A social marketing and grassroots education campaign that leverages partnerships with state and local organizations, traditional, and non-traditional partners, to educate and protect the New Hampshire public about Lyme disease prevention and avoiding a tick encounter can be effective and has implications for future practice.