Ticking all the boxes? a systematic review of education and communication interventions to prevent tick-borne disease

Fiona Mowbray*, Richard Amlot, G. James Rubin

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    38 Citations (Scopus)


    Tick-borne disease has become increasingly prevalent across Europe. Despite the effectiveness of protective behaviors, relatively few people adopt them when in areas where ticks are known to be present. In this systematic review we identified studies that assessed the impact of any educational or behavioral interventions intended to encourage the widespread use of protective behaviors against tick-borne disease. An extensive search of electronic databases returned a total of only nine such studies. Only two of these were fully randomized controlled trials, with the remaining studies using weaker designs and often relying solely on self-reports to assess behavior. The majority of research in this area has not explicitly noted the consideration of any formal psychological theory on how best to promote behaviors that protect health. Nonetheless, the results show that both knowledge of and attitudes towards tick-borne disease are amenable to change, although the stability of these changes over time has not yet been determined. Not all intervention strategies have proved effective, with some producing detrimental effects. More theory-based, methodologically-robust studies are urgently required if we are to gain a better understanding of the most effective strategies for encouraging members of the public to adopt behaviors known to protect against tick-borne disease.

    Original languageEnglish
    Pages (from-to)817-825
    Number of pages9
    JournalVector-Borne and Zoonotic Diseases
    Issue number9
    Publication statusPublished - 1 Sept 2012


    • Behavior change
    • Communication interventions
    • Educational interventions
    • health belief model
    • tick-borne disease


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