The Tick App: Changing Behaviors With Educational Messaging

The Use of Ecological Momentary Assessments to Assess Tick-borne Disease Risk

The goal of this work is to evaluate the use of ecological momentary assessments as a tool to assess risk and risk factors for tick encounters and tick-borne diseases. This study will be conducted across the United States, with a focus the upper Midwest and Northeast and with a focus on Wisconsin and will enroll up to 1000 people.

Study Overview

• Status: Recruiting
• Conditions: Tick Bites
• Intervention / Treatment: Other: Educational Materials delivered via the Tick App

Detailed Description

In the United States, several online and smart-phone apps are available to ID a tick (TickID app, North Carolina State University), submit a picture of a tick (TickSpotters.org, an outreach tool within the larger TickEncounter resource center by the University of Rhode Island) or submit a tick for testing (among other public health agencies, TickReport.com by the University of Massachusetts Amherst). Although these tools are accessible throughout the U.S., they focus on the Northeast. In addition, they do not assess human behavior and tick encounters nor do these tools evaluate prevention and education strategies. A recent study in the Netherlands evaluated the use and effectiveness of a preventative and educational tick app ("Tekenbeet"). This app was well-appreciated, well-used, and improved the user's intention to implement preventative measures. This also illustrates the move of information acquisition from in-hand leaflets to information provision through smartphones.

In this study, data on human behavior regarding tick encounters and tick prevention measures will be obtained from a smartphone application using momentary assessments methodology to assess real time behavior and movement. Ecological momentary assessments are a methodological tool for gathering quantitative behavioral data in real-time, or within the framework of a participant's daily routine.

The daily logs feature provides researchers information about what the participant's activity, location, tick encounters, and prevention measures used. This study will analyze participants who complete 7 daily logs. Their daily logs will be analyzed against the types of educational messaging presented to them within the Tick App.

During a portion of the year the opening screen will contain a prevention message and daily log reminder instead of the home screen. The screen will provide a tick check reminder, a link to the daily log and for half the users the screen will also include a reminder about another prevention behavior (for example bathing/showering). Users will be randomly assigned to the two groups to assess if the additional prevention message increases prevention behavior (tick checks and showering/bathing) and the number of tick encounters.

• Study Type: Interventional
• Enrollment (Estimated): 3500
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Cassie Halvorsen; Phone Number: 608-265-4741; Email: chalvorsen2@wisc.edu

Study Locations

• United States
  • Illinois
    • Urbana, Illinois, United States, 61801
      • Recruiting
      • University of Illinois
      • Sub-Investigator: Becky Smith
  • Michigan
    • East Lansing, Michigan, United States, 48824
      • Recruiting
      • Michigan State University
      • Contact: Phone Number: 517-353-1737; Email: tsao@msu.edu
      • Sub-Investigator: Jean Tsao
  • New York
    • New York, New York, United States, 10027
      • Recruiting
      • Columbia University
      • Principal Investigator: Maria Diuk-Wasser
      • Sub-Investigator: Heather Kopsco
  • Washington
    • Pullman, Washington, United States, 99164
      • Recruiting
      • Washington State University
      • Principal Investigator: Pilar Fernandez

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Will to participate in 7 days worth of daily activity logs within the Tick App.
• be able and willing to provide informed consent

Exclusion Criteria:

• Completes less than 7 days worth of daily logs or completes 7+ daily logs but not within 12 months.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Tick App Educational Materials	Other: Educational Materials delivered via the Tick App; Education about tick bite prevention
No Intervention: No Educational Messaging

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in number of tick prevention behaviors	A goal of the intervention is to see an increase in tick prevention behaviors (tick checks and showering). To measure this, the change in number of tick prevention behaviors will be compared between groups. Data collected when participant completes 7 daily logs in app within 12 months.	up to 12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in number of self-reported tick encounters	A goal of the intervention is to see a decrease in self-reported tick encounters. To measure this, the change in number of self-reported tick encounters will be compared between groups. Data collected when participant completes 7 daily logs in app within 12 months.	up to 12 months

Collaborators and Investigators

• Sponsor: University of Wisconsin, Madison
• Collaborators: Columbia University; University of Illinois at Chicago; Washington State University; Centers for Disease Control and Prevention; Michigan State University
• Investigators: Principal Investigator: Susan Paskewitz, University of Wisconsin, Madison; Principal Investigator: Lyric Bartholomay, University of Wisconsin, Madison

Publications and helpful links

Helpful Links

• The Tick App

Study record dates

Study Major Dates

• Study Start (Actual): March 31, 2020
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): July 1, 2027

Study Registration Dates

• First Submitted: March 11, 2025
• First Submitted That Met QC Criteria: March 11, 2025
• First Posted (Actual): March 18, 2025

Study Record Updates

• Last Update Posted (Actual): May 26, 2026
• Last Update Submitted That Met QC Criteria: May 21, 2026
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Keywords: behavior change; tick education; tick bite prevention
• Additional Relevant MeSH Terms: Wounds and Injuries; Chemically-Induced Disorders; Poisoning; Bites and Stings; Tick Bites
• Other Study ID Numbers: 2018-0084; A073600 (Other Identifier: UW Madison); 1U01CK000651-01-00 (Other Grant/Funding Number: Centers for Disease Control and Prevention); 1U01CK000651-01 (U.S. NIH Grant/Contract); Protocol Version 9/11/25 (Other Identifier: UW Madison)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data collected during the trial, after the deidentification will be available to researchers for independent verification of study outcome or to conduct subsequent clinical research, whose proposed use of the data has been approved by an independent review committee identified for this purpose.
• IPD Sharing Time Frame: Beginning 9 months after publication of primary outcomes and ending 2 years after that date.
• IPD Sharing Access Criteria: Proposals should be directed to Susan Paskewitz, smpaskew@wisc.edu or Maria Diuk Wasser, mad2256@columbia.edu. If approved after review by regulatory counsel, requestors will enter into a formal data sharing agreement. Data will be shared via encrypted single-user file transmission protocol.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No