Project ITCH: cross-sectional surveys to understand residential vector control attitudes and practices across New England.

Objective: To understand the attitudes and prevalence of peridomestic vector control across New England, and to identify factors associated with self-reported residential vector control uptake. Methods: An online-based survey captured 4855 responses from households across New England in 2023 and 2024. Multivariable Poisson regression was used to quantify factors, including attitudes towards ticks and mosquitoes, motivations for vector control and property characteristics, that are associated with total household residential vector control practices. Results: The majority of respondents reported using at least one household-level vector control intervention in 2023 (88%) and 2024 (93%). Overall, higher levels of concern for ticks, mosquitoes and mosquito-borne disease showed a gradient response and were associated with statistically significant increasing rates of peridomestic vector control; however, concern for tick-borne disease was not associated with vector control usage (p values >0.05). After adjustment for socio-economics, yard size, property type and levels of concern, Maine and Vermont both had lower incidence rates of total vector control interventions compared with the rest of New England ((adjusted incidence rate ratio (aIRR)=0.89; 95% CI 0.84 to 0.93; p value=<0.001), (aIRR=0.89, 95% CI 0.82 to 0.96; p value=0.002), respectively). Finally, protecting the health of family members had a strong association with peridomestic vector control uptake. Conclusions: This study reveals factors associated with increased uptake of peridomestic vector control, including levels of concern, state of residence and primary motivation for vector control use. Results support previous evidence and fill in gaps in geographical spread and the vector control interventions assessed. Future theory-based programming can help close gaps and increase uptake of peridomestic vector control.