Comparing the effect of a leaflet and a movie in preventing tick bites and Lyme disease in The Netherlands

Desiree Jacqueline Mathieu Angelique Beaujean*, Rik Crutzen, Fedor Gassner, Caroline Ameling, Albert Wong, James Everard van Steenbergen, Dirk Ruwaard

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Lyme disease (LD) has become the most common vector borne illness in the Northern hemisphere. Prevention relies predominantly on fostering protective behaviors (e.g., avoiding tick areas, using protective clothing and repellent, and doing routine tick checks post-exposure). The objective of this study was to evaluate the effectiveness (in terms of knowledge, perceived severity and susceptibility, self-efficacy, response efficacy, intention, and behavior over time) and appreciation of a leaflet and a movie as tools for informing the public in the Netherlands about ticks and LD protective behaviors. Methods: Participants (1,677 at t1 and 361 extra at t2) were members of a representative Internet panel (adults aged 18 years and above). A four group randomized controlled design was used to test the effect of an information leaflet and a movie (two intervention groups), compared to a control group and a follow-up only control group. Data were collected over two periods: July 15-29, 2013 (t1) and at follow-up 4 weeks later, August 16-31, 2013 (t2). Results: Post-intervention results show all respondents in all groups possess good general basic knowledge of ticks and LD. Respondents in both the leaflet and movie groups knew more than respondents in the control group, and had greater awareness of best practices after a tick bite. Intention to perform protective behavior in future was stronger among respondents in the intervention groups. While respondents generally appreciated both the movie and the leaflet, they found the movie ran too long. Follow-up revealed no lasting positive effects from either the leaflet or the movie. Conclusions: Our results suggest that both the movie and the leaflet are valued and effective intervention tools for improving knowledge about tick bites and strengthening self-efficacy and intentions to perform protective behavior against ticks and LD. Achieving lasting effects, however, calls for more action.
Original languageEnglish
Article number495
JournalBMC Public Health
Publication statusPublished - 10 Jun 2016


  • Communication interventions
  • Educational interventions
  • Ticks
  • Lyme disease

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