Risk communication, behaviour change and tick-borne disease in the UK

Student thesis: Doctoral ThesisDoctor of Philosophy


Tick-borne disease represents a growing problem in the UK. While some communications materials exist which encourage members of the public to adopt precautionary behaviours when in tick affected areas, these have not been informed by empirical evidence as to what factors promote uptake of protective behaviours and have not had their effectiveness formally tested.

This research:

 Identified knowledge and perceptions of risk concerning tick-borne disease in the UK that were associated with uptake of health protective behaviours

 Designed new communications materials promoting the uptake of health protective behaviours

 Tested whether the effect of these new materials was improved by also incorporating messages designed to reduce the emotion of disgust

Qualitative interviews allowed understanding of the thought processes of experts and the public with regards to the risk posed by ticks and tick-borne disease. Tick checking emerged as the most effective and accepted protective behaviour. A quantitative survey with members of London-based outdoor groups provided data showing that knowledge, perceived likelihood of being bitten, self-efficacy about tick removal and lower levels of disgust were the strongest predictors of checking behaviour. Both the qualitative and quantitative data fed into the design of communication materials that served as interventions against tick-borne disease risks. These were tested in a pilot randomised controlled trial where members of the public were sent one of three versions of the intervention, one including disgust reduction messages, one with messages based on behaviour change techniques developed from conventional models within health psychology and one with existing messages. The intervention based on conventional theories of health psychology proved most effective at increasing the uptake of tick checking behaviour and disgust reduction appeared to decrease behavioural engagement. Future research is needed to investigate the role of disgust as a driver of behaviour change, while policy makers need to be aware of the importance of engaging with the public and incorporating elements of health psychology theory into intervention design.

Date of Award2014
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorJames Rubin (Supervisor) & Richard Amlôt (Supervisor)

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