Prevention of Lyme Disease in Dutch Children: Analysis of Determinants of Tick Inspection by Parents

Background. This study examined factors that discriminate between parents who regularly inspect their children for ticks and those who do not do so. Methods. Knowledge, cognitive and emotional attitudes, social influences, and self-efficacy expectations were assessed in 230 parents living in high endemic regions. Results. Regression analysis showed that moral norms, emotional attitude, anticipated regret, role models, and stress self-efficacy were positively associated with inspection behavior. Conclusions. Health education programs not only need to stimulate parental knowledge and discuss the health effects of tick bite prevention, they also need to stress the emotional benefits of tick bite prevention for children and parents and induce positive norms toward inspecting others. Furthermore, they need to stimulate openness about inspection behaviors, since the modeling examples of partners, relatives, and grandparents and the behavior of friends discriminate between inspecting and noninspecting parents. Finally, education programs should clearly indicate how tick inspection works, how the need for it should be communicated to the children, and how to take enough time to do it.