A structured framework for the development of knowledge, attitudes, and practices surveys addressing brown dog tick-associated Rocky Mountain spotted fever

Rocky Mountain spotted fever (RMSF) is a severe tick-borne disease with high fatality rates in endemic regions, particularly where brown dog ticks proliferate. This study proposes a structured framework for developing surveys addressing knowledge, attitudes, and practices (KAP) related to preventive measures in RMSF. Systematic review. We searched major scientific databases using MeSH/DeCS terms and keywords related to “health knowledge, attitudes, practice” and “Rocky Mountain spotted fever”, combined with relevant synonyms and Boolean operators, for studies published between 2003 and 2024 in English, Spanish, and Portuguese. Following PRISMA guidelines, eight eligible studies were identified and assessed with the AXIS tool. While existing studies offered valuable insights, our assessment revealed four significant biases that compromised their methodological quality and the reliability of their findings. To address these limitations, we propose a novel, structured framework for developing future RMSF KAP surveys. This framework integrates: (a) comprehensive risk assessment, (b) a primary prevention stratification pyramid, and (c) a robust logic model. Applying this proposed framework is anticipated to improve the methodological rigor, validity, and reliability of future KAP studies concerning RMSF preventive measures, ultimately enhancing public health interventions.