The study participants attended the 2024 Bison Worker Safety & Herd Health Roundtable hosted by the Central States Center for Agricultural Safety and Health (CS-CASH) and the InterTribal Buffalo Council (ITBC). The meeting occurred on July 24–25, 2024, at the Winnavegas Casino Resort in Sloane, Iowa. The participants included bison workers, herd managers, Indigenous community leaders, wildlife biologists, health professionals, and researchers. Representatives from all Tribal Nations who have or hope to have buffalo restored to their lands are invited through collaborations with the ITBC. Thus, this information serves as a preliminary assessment of knowledge and attitudes regarding ticks and tick-borne diseases.

This research was deemed as non-Human Subjects Research by the University of Nebraska Medical Center Institutional Review Board Committee. No personally identifiable information was collected, and the purpose of these responses were for programmatic evaluation.

The Nebraska One Health system supports integrated training, research, extension, and outreach opportunities. Hosted under this organizational structure is Tick Tag Go, led by Dr. Louise Lynch-O’Brien, and is focused on educating the public on the impacts of ticks and TBDs. Tick Tag Go has a diverse variety of resources for educational outreach (13). In conjunction with Tick Tag Go, we selected, crafted, and disseminated educational materials to present and share with attendees using culturally appropriate language and targeting areas of concern expressed by Tribal herd workers over the last 6 years of collaborative work with these communities. Educational material was built around perceptions, knowledge, and preventative practices for TBDs.

In-presentation questions were formulated to prompt participants to raise their hands and/or provide verbal responses. The questions were both asked verbally and written on the corresponding presentation slide. Total counts and verbal responses were recorded.

Following the presentation, a short, post-presentation questionnaire was administered to gauge the impact of the presentation material, understand how behaviors regarding tickborne diseases may change following the presentation, and identify areas of improvement for future educational outreach events. This questionnaire consisted of 11 questions. Eight of the 11 questions were Likert scale questions where participants reported if they “agree,” are “neutral,” or “disagree.” The remaining three questions were short answer responses.

Questions were required to adhere to non-Human Subject Research IRB requirements focused on the scope of programmatic evaluation. However we aligned, where possible, with questions that assess knowledge, behavior, and traditional knowledge regarding vector-borne diseases in Indigenous communities. This first step in assessing perceptions will guide future interventions aimed at improving health outcomes for Indigenous people in North America. Further, this is the first step in developing a comprehensive approach to OneHealth initiatives that are culturally appropriate and both needed as well as requested by the community, increasing the utility of the training and discussion (14–18).

Descriptive analysis was performed based on the participant’s perceptions of ticks, tickborne diseases, and preventative measures. The data was presented as numbers and percentages for the categorical data.

Participants were asked about their immediate thoughts and perceptions surrounding ticks entering into the presentation. Responses included they believe ticks to be “creepy,” “disgusting,” and “not sure why they exist.” Consistent with their occupations as predominantly outdoor, agricultural workers, almost all participants (n = 31, 91.2%; Table 1) reported working in a wooded area, tall grass, or pasture consistent with tick habitat (19). Nearly all the participants (n = 32, 94.1%; Table 1) reported that they have found a tick on themselves. Participants were informed where ticks are found in these habitats and how they seek for hosts, during which five participants (14.7%; Table 1) reported they were taught the misconception that ticks jump or fall off trees to find a new host.

The participants were shown a picture of four tick “look-alikes” and one tick. When asked to identify a picture of a tick, 88% (n = 30; Table 1) identified the tick correctly. Two participants (5%) incorrectly identified a bed bug as a tick and two participants (5%) incorrectly identified an ant as a tick. The other two pictures shown were a louse and a beetle, and no participants incorrectly selected those options. The group knew different types of ticks existed but expressed that they knew little about the individual types. In one of the open-ended responses following the presentation, one participant suggested “more identification information on the most common species.” However, a majority of participants (77.8%; Table 2) did state they felt more confident about identifying different species of ticks with the resource materials given.

Although identification and knowledge regarding what environments ticks may be found is crucial, active implementation of best practices to avoid tick bites is key to preventing TBDs (20). Participants provided responses on which preventative measures were currently being used to prevent tick bites. The most common answer was “bug spray.” Several participants stated they were tucking pants into socks and shirts into pants. One participant stated that they were using garlic as a tick prevention method, which has been shown to be a deterrent, albeit weak (21). Besides preventative practices when entering or working in tick habitat, participants were surveyed for their use of tick checks on their bodies after returning from the field. Only approximately a third of participants (n = 11, 32.4%; Table 1) reported doing tick checks. Of these participants, three (11.1%) reported doing tick checks for 5–10 min, and two (7.4%) reported checking for 10-plus minutes.

Of the 34 respondents, 33 (97%; Table 1) had previously learned or heard about Lyme disease. Curious about their knowledge of emerging, non-infectious TBDs, we surveyed regarding Alpha-gal syndrome or sometimes called the “red meat allergy.” About half of the respondents (n = 16, 47.1%; Table 1) were familiar with Alpha-gal syndrome, consistent with other survey reports on this emerging tick-associated allergy, including within physicians (22). All participants (100%; Table 1) knew that both animals and humans are susceptible to TBDs. When surveyed about the capacity of ticks to transmit diseases, several participants correctly noted verbally to the group that not all ticks are responsible for Lyme disease or other TBDs. Additional resources were provided (e.g., Center for Disease Control and Prevention websites) for continued learning. 92.6% of participants agreed that these materials provided them with adequate resources to find information on tick-borne diseases (Table 2).

This theme of the presentation engaged the most participation. Participants asked for additional details regarding TBDs and whether ticks can serve as vectors for other diseases. For example, one participant asked if ticks can transmit the infectious prions that cause Chronic Wasting Disease (CWD). Additional follow-up questions regarding incubation periods, symptoms, and treatments for the different TBDs were asked. Additional interest in our line of research was also observed with participants inquiring if we have contracted Lyme disease due to our research with ticks.

To identify the perceived reception/impact of these materials, we administered a post-presentation questionnaire which 27/34 (79.4%) participants completed. Generally, the majority of participants responded “agree” for each of the questions asked (Table 2). After the presentation, the respondents responded in the short answer section that they felt: interested, helped, informed, aware, armed, more cautious, not scared anymore, and confident.

Additionally, over the course of the two-day training event, we received additional colloquial feedback. We have historically found with this community that informal feedback can be preferred rather than through structured surveys. Participants provided statements such as “This was extremely helpful and I want to know if there is more I can do,” “This aligns well with our goals to educate and be aware regarding diseases workers may get,” and “Please contact me further and find a way to talk to the rest of my tribe.” These statements align with the survey results that the presentation content was relevant to their needs (n = 20, 70.4%) and an interest in having individualized programs in their communities (n = 12, 44.4%) (Table 2).

Participants agreed that they would be more likely to implement preventative practices (n = 19, 70.4%; Table 2). On the second day of the Roundtable event, participants traveled to a buffalo pasture. Several participants brought tick removal kits that we provided, some asked if certain “bugs” found on themselves were ticks, and one participant did identify and remove a tick from themself while in the field after performing a tick check.