In one survey of state parks across Oklahoma, researchers identified that the potential tick encounter rate varied from 32.1 ticks per hour at one park in May to less than one per hour at another park during the peak summer season. Among the various settings where exposure to zoonotic agents (tick, mosquitoes, fleas) occurs, spaces for public outdoor recreation are notable among visitors and personnel alike, and the risk associated with recreational tick encounters varies dramatically based on tick abundance as well as temporal and spatial factors. Ticks are prevalent across all 48 contiguous states, and the geographic range of tick distribution continue to expand. Over the past fifteen years, reports of tick-borne diseases have grown across the United States (U.S.), with the decade from 2007 to 2017 representing a near-doubling in total reported tick-borne diseases. Online, user-generated trail reviews have the potential to serve as rich data sources for identifying recreational trails, where 1) the risk of tick exposure is great, 2) more robust active tick and tick-borne pathogen surveillance may be warranted, and 3) tailored prevention interventions are needed. Content of user reviews indicated several behaviors employed to prevent tick encounters, particularly Repellent Application and Recreational Deterrence 25% included a behavior Recommendation to others. Subsequent results of a negative binomial regression model indicated that Southern Indiana State Region, Federal and Private Land Management Type, and Elevation Gain were factors significantly associated with Tick Presence Reviews. Results of Ļ 2 tests indicated significant associations between Tick Presence Reviews and (a) State Region and (b) Land Management Type Mann-Whitney U tests detected significant differences in Tick Presence Reviews based on Trail Length and Elevation Gain. Hot spot analysis revealed statistically significant clusters of Tick Presence Reviews on trails in the Southern Indiana State Region. Tick Presence was recorded at 10% ( nā=ā65) of trails and occurred most frequently in May. Finally, negative binomial regression evaluated the strength of the association between the number of Tick Presence Reviews and several trail characteristics. Pearson chi-square tests of independence evaluated whether tick presence was associated with several trail characteristics. We used hot spot (Getis-Ord Gi*) analysis to test the hypothesis of whether there are clusters in the number of Tick Presence Reviews. Reviews were evaluated to determine Tick Presence/Absence, the total number of Tick Presence Reviews per trail, and multiple trail and user behavioral characteristics. We reviewed 26,016 user comments left on for 697 Indiana trails. Based on online user reviews and comments, the purpose of this study was to determine risk factors and behavioral recommendations associated with tick encounters ( Tick Presence) on recreational trails in the state of Indiana, U.S. Although online reviews represent a rich source of user information, they have rarely been used in determining the risk of tick exposure during recreational trail use. Recreational trails abound across the United States and represent high risk areas for tick exposure.
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