Development and validation of a behavioral index for adaptation to lyme disease.

BACKGROUND: Recent evidence suggests that climate change and other factors are leading to the emergence of Lyme disease in the province of Quebec, where it previously did not exist. As risk areas expand further north, the population can adopt specific preventive behaviors to limit chances of infection. The objectives of this study were to (1) create an index of Lyme disease prevention behaviors (LDPB), and (2) use the theory of planned behavior (TPB) to explain the decision-making process of people who choose to adopt LDPB. METHODS: A sample of 1959 adults living in a Lyme disease risk area completed a questionnaire by phone (n = 1003) or on the Web (n = 956). The questionnaire measured whether they did or did not adopt the LDPB proposed by public health officials. It also measured some TPB variables, including their attitude or perceived social norms regarding LDPB. RESULTS: Our findings led to the creation of a Lyme disease prevention index consisting of 10 behaviors, down from the 19 behaviors initially considered for inclusion in the index. Rates of adoption of each behavior varied tremendously, from 4.30 to 83.80%. All variables of the TPB model (attitude, social norms, and perceived control) were significantly associated with intention to adopt preventive behaviors. Intention itself was significantly associated with adoption of LDPB. Likewise, risk perception was positively correlated with the adoption of LDPB. CONCLUSIONS: This study led to the creation of a Lyme disease prevention index that can be used by public health agencies, researchers, and professionals to monitor the evolution over time of individuals' LDPB adoption rates. It also showed the usefulness of the TPB in understanding the adoption of LDPB and how intention to adopt such behaviors is formed.

Telephone versus web panel National Survey for monitoring adoption of preventive behaviors to climate change in populations: a case study of Lyme disease in Québec, Canada.

BACKGROUND: To monitor the adoption of climate change adaptive behaviors in the population, public health authorities have to conduct national surveys, which can help them target vulnerable subpopulations. To ensure reliable estimates of the adoption of these preventive behaviors, many data collection methods are offered by polling firms. The aim of this study was to compare a telephone survey with a web survey on Lyme disease with regard to their representativeness. METHODS: The data comes from a cross-sectional study conducted in the Province of Québec (Canada). In total, 1003 people completed the questionnaire by telephone and 956 filled in a web questionnaire. We compared the data obtained from both survey modes with the census data in regard to various demographic characteristics. We then compared the data from both samples in terms of self-reported Lyme disease preventive behaviors and other theoretically associated constructs. We also assessed the measurement invariance (equivalence) of the index of Lyme disease preventive behaviors across the telephone and web samples. RESULTS: Findings showed that neither the telephone nor the web panel modes of data collection can be considered more representative of the target population. The results showed that the proportion of item non-responses was significantly higher with the web questionnaire (5.6%) than with the telephone survey (1.3%), and that the magnitude of the differences between the two survey modes was nil for 19 out of the 30 items related to Lyme disease, and small for 11 of them. Results from invariance analyses confirmed the measurement invariance of an index of adaptation to Lyme disease, as well as the mean invariance across both samples. CONCLUSIONS: Our results suggested that both samples provided similar estimates of the level of adaptation to Lyme disease preventive behaviors. In sum, the results of our study showed that neither survey mode was superior to the other. Thus, in studies where adaptation to climate change is monitored over time, using a web survey instead of a telephone survey could be more cost-effective, and researchers should consider doing so in future surveys on adaptation to climate. However, we recommend conducting a pretest study before deciding whether to use both survey modes or only one of them.

Factors Leading Municipal Authorities to Implement Preventive Interventions for Lyme Disease.

The aim of this study is to document climate change adaptation interventions targeting Lyme disease at the municipal level in the province of Quebec (Canada). This exploratory study relies on the theory of planned behavior and certain constructs from the health belief model to identify the factors leading municipal authorities to implement preventive interventions for Lyme disease (PILD). Data were obtained from an online survey sent, during the summer of 2018, to municipal officers in 820 municipalities in Quebec, in all health regions where the population is at risk of contracting Lyme disease (response rate = 36%). The questionnaire was used to measure the implementation of PILD, the intention to implement these interventions, attitudes, perceived social pressure, perceived control (levers and barriers) over interventions, perceived effectiveness of preventive measures, risk, and perceived vulnerability. Results of structural equation analyses showed that attitudes were significantly associated with municipal authorities' intention to implement PILD, while the intention to implement PILD was a significant predictor of the implementation of PILD. Additional analyses showed that perceived barriers added a moderating effect in the intention-implementation relationship. The prediction of behaviors or practices that municipal authorities could implement to prevent Lyme disease will enable the evaluation over time of the evolution of Quebec municipalities' adaptation to Lyme disease. Moreover, the examination of the associations of specific psychosocial factors revealed important implications for the design of effective behavior-change interventions, which would allow health officials doing awareness work to create personalized interventions better suited to municipal officers and their specific contexts.

Safety of dietary conjugated α-linolenic acid (CLNA) in a neonatal pig model.

The aim of the present study was to perform a short-term safety evaluation of dietary mono-conjugated α-linolenic acid isomers (CLNA; c9-t11-c15-18:3+c9-t13-c15-18:3) using a neonatal pig model. CLNA diet was compared with three other dietary fats: (1) conjugated linoleic acid (CLA; c9-t11-18:2+t10-c12-18:2), (2) non-conjugated n-3 PUFA and (3) n-6 PUFA. Thirty-two piglets weaned at 3 weeks of age were distributed into four dietary groups. Diets were isoenergetic and food intake was controlled by a gastric tube. Mono-CLNA diet did not significantly change body or organ weight, carcass composition and most biochemical parameters including; glucose, cholesterol, triglycerides, creatinine, blood urea nitrogen, hepatic enzymes and electrolytes levels in blood (P⩾0.09). Conversely, the n-3 PUFA composition of the brain, liver and heart decreased by 6-21% in the CLNA-fed group compared to animals fed nonconjugated n-3 PUFA (P<0.01). Responses to dietary treatments were tissue-specific, with the liver and the brain being the most deprived in n-3 PUFA. Our results support that short-term intake of mono-CLNA is safe in neonatal pigs but n-3 PUFA reduction in tissues deserves to be further investigated before using long-term nutritional supplementation in pigs and other animal models and before moving to clinical trials.

Dietary conjugated α-linolenic acid did not improve glucose tolerance in a neonatal pig model.

PURPOSE: There is an increased interest in the benefits of conjugated α-linolenic acid (CLNA) on obesity-related complications such as insulin resistance and diabetes. The aim of the study was to investigate whether a 1% dietary supplementation of mono-CLNA isomers (c9-t11-c15-18:3 + c9-t13-c15-18:3) improved glucose and lipid metabolism in neonatal pigs. METHODS: Since mono-CLNA isomers combine one conjugated two-double-bond system with an n-3 polyunsaturated fatty acid (PUFA) structure, the experimental protocol was designed to isolate the dietary structural characteristics of the molecules by comparing a CLNA diet with three other dietary fats: (1) conjugated linoleic acid (c9-t11-18:2 + t10-c12-18:2; CLA), (2) non-conjugated n-3 PUFA, and (3) n-6 PUFA. Thirty-two piglets weaned at 3 weeks of age were distributed among the four dietary groups. Diets were isoenergetic and food intake was controlled by a gastric tube. After 2 weeks of supplementation, gastro-enteral (OGTT) and parenteral (IVGTT) glucose tolerance tests were conducted. RESULTS: Dietary supplementation with mono-CLNA did not modify body weight/fat or blood lipid profiles (p > 0.82 and p > 0.57, respectively) compared with other dietary groups. Plasma glucose, insulin, and C-peptide responses to OGTT and IVGTT in the CLNA group were not different from the three other dietary groups (p > 0.18 and p > 0.15, respectively). Compared to the non-conjugated n-3 PUFA diet, CLNA-fed animals had decreased liver composition in three n-3 fatty acids (18:3n-3; 20:3n-3; 22:5n-3; p < 0.001). CONCLUSIONS: These results suggest that providing 1% mono-CLNA is not effective in improving insulin sensitivity in neonatal pigs.