Baseline Survey on Lyme Disease and Other Tick-Borne Diseases
Executive Summary

Baseline Survey on Lyme Disease and Other Tick-Borne Diseases
Final Report

Prepared for Health Canada
Supplier name: Phoenix Strategic Perspectives Inc.
September 2021

This public opinion research report presents the results of an online survey conducted with 1,872 panellists at least 18 years of age who (at the time of the fieldwork) resided in areas across Canada of higher risk of Lyme disease and other tick-borne diseases and who spent time outdoors. This included: parents of children under 15 years of age, outdoor enthusiasts, people with occupational exposure, those living in rural areas and people with pets. The fieldwork was conducted August 4 through August 15, 2021.

This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from Health Canada. For more information on this report, please contact Health Canada at:

hc.cpab.por-rop.dgcap.SC@canada.ca or at:

Communications and Public Affairs Branch
Health Canada
200 Eglantine Driveway, Jeanne Mance Building
AL 1915C, Tunney's Pasture
Ottawa, Ontario K1A 0K9

Catalogue number:

H14-384/2021E-PDF

International Standard Book Number (ISBN):
ISBN 978-0-660-40347-2

Related publications (registration number: POR 019-21):
Catalogue number (Final report, French) H14-384/2021F-PDF
ISBN 978-0-660-40348-9

^© Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2021.

Cette publication est aussi disponible en français sous le titre : Sondage de référence sur la maladie de Lyme et autres maladies transmises par les tiques

Executive Summary

Health Canada commissioned Phoenix Strategic Perspectives (Phoenix SPI) to conduct a baseline survey of Canadians to measure awareness and knowledge of Lyme disease and other tick-borne diseases.

1. Research purpose and objectives

Lyme disease is one of the most rapidly emerging infectious diseases in Canada and the most commonly reported vector-borne disease in North America. The Public Health Agency of Canada (PHAC) developed a national tick and Lyme disease education and awareness campaign, in collaboration with partners. The purpose of this research was to provide evidence-based data and key insights to guide the development of the upcoming three-year marketing strategy to educate Canadians. The research objectives were to a) assess general knowledge, attitudes, prevention methods, perceptions and behaviours towards tick bite prevention, Lyme disease and other tick-borne diseases; and b) gather information on how best to inform and communicate with populations in areas at risk of contracting Lyme disease.

2. Methodology

A 15-minute online survey was administered to 1,872 adults (Footnote 1) aged 18 and older who reside in areas of higher risk of Lyme disease and other tick-borne diseases (Footnote 2) and who spend time outdoors, including: parents of children under the age of 15, outdoor enthusiasts (Footnote 3), people with occupational exposure (Footnote 4), those living in rural areas (Footnote 5), and people with pets (a cat and/or a dog). This was a non-probability sample drawn from a commercial online panel; therefore, no inferences can be made to the greater population. The fieldwork was conducted August 4 to August 15, 2021.

3. Key Findings

A large majority have heard of Lyme disease.

Almost nine in 10 (89%) respondents said they have heard of Lyme disease. Awareness of Lyme disease was higher among rural dwellers (94%), pet owners (91%), and those considered outdoor enthusiasts (91%). Among those who have heard of Lyme disease, most heard about it on the local news (53%) and through family and friends (40%).

Respondents are moderately knowledgeable about Lyme disease and ticks.

When asked in an open-ended manner how they think people get Lyme disease, approximately two-thirds (65%) of respondents correctly said that Lyme disease is contracted through a tick bite. One in five (20%) did not know how Lyme disease is contracted.

The vast majority of respondents believe visiting an outdoor venue puts someone at risk of getting bitten by a tick (91%), even within urban and suburban areas (86%). Additionally, two-thirds of those surveyed believe that ticks can be found in their area (67%). Overall, outdoor enthusiasts, rural dwellers, and pet owners were generally more knowledgeable about where ticks can be found.

While many respondents claimed to know how Lyme disease is contracted and majorities knew where ticks can be found, fewer than half (47%) would know what to do if they, or someone they know, is bitten by a tick. Those who live in a rural area of the country (59%) and those who are outdoor enthusiasts (49%) were among those most likely to say they would know what to do in the event of a tick bite.

Those who said they would know how to handle a tick bite were asked, in an open-ended manner, what actions they would take. A large proportion (45%) said they would seek medical attention. Following this, similar proportions said they would remove the tick or pull it off (27%) or remove it using tweezers (25%). When later asked to identify the best way to remove a tick, seven in 10 (70%) said the best method is to use tweezers.

Many are at least moderately concerned about contracting Lyme disease and believe that the topic is an important issue.

Two-thirds (67%) of respondents said they are at least moderately concerned about contracting Lyme disease. Concern about contracting Lyme and other tick-borne diseases was higher among those at risk of workplace exposure (76%), parents (75%), dog owners (74%), and outdoor enthusiasts (69%).

Underscoring concern, nine in 10 (91%) view the topic of Lyme and tick-borne diseases as an important issue for Canadians and six in 10 (60%) believe that Lyme disease does not receive enough attention. Respondents who live in rural areas were more likely to say that Lyme and other tick-borne diseases is an important topic of discussion for Canadians (94% versus 90% of those living in urban areas).

Many believe they know how to protect themselves from being bitten by a tick.

When it comes to prevention, six in 10 (60%) said they know how to help protect themselves from being bitten by a tick. Knowledge of protective measures was higher among rural dwellers, pet owners, and outdoor enthusiasts.

Approximately nine in 10 respondents identified at least one precaution they take to protect themselves from tick bites. The preventative measures most frequently mentioned include wearing pants (70%), avoiding areas with ticks (69%), checking their body for ticks (65%), and wearing long-sleeved shirts (63%). Among those who use insect repellent to prevent tick bites (n=984), the majority (62%) use DEET. The most common areas to apply insect repellent is to the legs (89%), arms (87%), neck (77%), and hands (67%).

There are few barriers, moreover, to taking action to prevent tick bites. Half (51%) of those who do not take preventative measures said there is no reason—they simply have not done anything to reduce the chance of being bitten by a tick. Those who pointed to specific reasons, or barriers, noted a lack of information (24%) and the cost of purchasing appropriate outdoor clothing (3%). Others said they do not think there are ticks where they live (12%), do not view ticks as a threat (7%), or trust themselves not to get bitten (5%).

Close to half (44%) have looked for information on Lyme disease.

Forty-four percent of respondents have looked for information on Lyme disease or other tick-borne diseases and an additional 12% have not done so but plan to in the coming weeks. Those at risk of workplace exposure (58%), pet owners (49%), rural dwellers (48%), and outdoor enthusiasts (46%) were more likely to have looked for information on Lyme disease or other tick-borne diseases. Among those who have looked for this type of information, three-quarters (75%) have looked for symptoms of Lyme disease or other tick-borne diseases. Smaller, and similar proportions said they have looked for information on the following topics: prevention (63%), treatment (61%) as well as areas where ticks are found (60%).

Respondents hold generally positive impressions of the advertising materials.

The vast majority of respondents agreed somewhat or strongly that the information in the pamphlet is easy to understand (94%), that the design is attention-catching (89%), and that the information is personally relevant (88%). Additionally, after having seen the information pamphlet, nine in 10 (91%) said they felt more confident about how to protect themselves from tick bites. Turning to the web banner ad, eight in 10 agreed somewhat or strongly that the information is relevant (80%) and that the design and text is attention-catching (79%). Nearly three-quarters (73%) said they want to learn more about ticks and Lyme disease after having seen the ad. There was no consensus when it came to the Instagram Stories, although the fourth Instagram Story ('socks') was preferred by the single largest proportion—34%.

4. Limitations of the research

Surveys, like this one, that use samples drawn from online panels cannot be described as statistically projectable to the target population and no estimates of sampling error can be calculated because the sample is based on those who initially self-selected for participation in the panel.

5. Use of the results

The results of this research will be used by the Government of Canada to better understand the knowledge, attitudes, barriers, and motivations that influence tick-prevention behaviours. This will help to inform and validate the national tick and Lyme disease education and awareness campaign's direction, messaging, and products, as well as preferred communication channels and tactics.

6. Political Neutrality Certification

I hereby certify, as a Senior Officer of Phoenix Strategic Perspectives, that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Communications Policy of the Government of Canada and Procedures for Planning and Contracting Public Opinion Research. Specifically, the deliverables do not contain any reference to electoral voting intentions, political party preferences, standings with the electorate, or ratings of the performance of a political party or its leader.

Signed:
Alethea Woods, President
Phoenix Strategic Perspectives Inc.

7. Contract value

The contract value was $73,980.14 (including HST).

Footnotes

Footnote 1
The target sample size was n=2,000. The fieldwork ended early due to the 44th general election.

Footnote 2
This was determined based on postal codes. Health Canada provided a list of postal codes located in higher risk areas.

Footnote 3
This includes people who garden, hike, trail run, play sports outdoors, or camp three or more times in a typical year.

Footnote 4
This includes people whose work requires them to spend most or all of the day outdoors.

Footnote 5
This includes rural areas (less than 1,000 people) and small population centres (1,000 to 29,999 people).