Evaluating knowledge of ticks and tick-borne diseases among Indiana healthcare professionals

Ticks and tick-borne disease (TBD) risks are increasing in Indiana and North America. The successful prevention, diagnosis, and treatment of TBDs requires healthcare professionals be well-informed and prepared. This study reports the findings of a 2020 online survey of 465 Indiana healthcare professionals, designed to assess their knowledge of ticks and TBDs and identify factors influencing total knowledge scores. The survey included 24 discrete/ordinal questions and one open-ended question. Statistical analyses, including ANOVA, t-tests, and the Boruta algorithm, were conducted in R. Indiana healthcare professionals scored 30.8% for tick- and 57.9% for disease-related questions. Professionals scored higher on most disease-related questions, including (i) the importance of prompt tick removal to reduce TBD transmission risk, (ii) that not all Lyme disease cases present with bull's-eye rash, and (iii) the signs and symptoms of TBDs. They scored lower on tick-related questions, including (i) the tick species capable of transmitting diseases to humans, (ii) TBDs considered endemic, (iii) the distribution of Ixodes scapularis (deer tick), and (iv) regions considered higher risk for Lyme disease transmission in Indiana. Knowledge scores varied across demographic categories, with the use of online resources identified as the most important predictor of total knowledge scores. These findings highlight the importance of increasing awareness of existing resources, expanding online educational materials to cover TBDs beyond Lyme disease, and promoting self-guided learning. Achieving these goals will require collaboration among state and public health agencies, healthcare professionals, research institutions, and community outreach partners.