Rocky Mountain spotted fever (RMSF) transmitted by the brown dog tick (Rhipicephalus sanguineus sensu lato) has emerged as a significant public health risk on American Indian reservations in eastern Arizona. During 2003–2012, more than 250 RMSF cases and 19 deaths were documented among Arizona's American Indian population. The high case fatality rate makes community-level interventions aimed at rapid and sustained reduction of ticks urgent. Beginning in 2012, a two year pilot integrated tick prevention campaign called the RMSF Rodeo was launched in a ∼600-home tribal community with high rates of RMSF. During year one, long-acting tick collars were placed on all dogs in the community, environmental acaricides were applied to yards monthly, and animal care practices such as spay and neuter and proper tethering procedures were encouraged. Tick levels, indicated by visible inspection of dogs, tick traps and homeowner reports were used to monitor tick presence and evaluate the efficacy of interventions throughout the project. By the end of year one, <1% of dogs in the RMSF Rodeo community had visible tick infestations five months after the project was started, compared to 64% of dogs in Non-Rodeo communities, and environmental tick levels were reduced below detectable levels. The second year of the project focused on use of the long-acting collar alone and achieved sustained tick control with fewer than 3% of dogs in the RMSF Rodeo community with visible tick infestations by the end of the second year. Homeowner reports of tick activity in the domestic and peridomestic setting showed similar decreases in tick activity compared to the non-project communities. Expansion of this successful project to other areas with Rhipicephalus-transmitted RMSF has the potential to reduce brown dog tick infestations and save human lives.
Data from the 1995 National Survey of Family Growth have previously shown greater risk of inconsistent contraceptive pill use among Hispanicwomen. We used the same data to test a culturally based model of pill use among the subsample of Hispanicwomen. Hierarchical logit analyses revealed that primary use of Spanish, negative attitudes aboutwomen in theworkplace, two or more recent sex partners, and recent pill adoption were factors that increased the odds of inconsistent use. Living alone or with non-kin was associated with more consistent use, as were showing preference for a stay-at-home model of motherhood, frequent church attendance, and frequent sexual intercourse. Our findings suggest that the strong effects of behavioral variables (e.g., duration of pill use, number of sex partners) are mediated by cultural indicators (e.g., primary use of Spanish, attitudes about sex roles). The extent to which programs address important cultural dimensions of health behaviors could enhance effectiveness.
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