Comparison of tick surveillance approaches: utilizing trailhead tick-check stations to support tick surveillance and community education.

Introduction: Rising tick-borne disease (TBD) cases and the geographical expansion of tick populations underscore the need for effective surveillance and public education regarding local risk. This study assessed the effectiveness of tick-check stations-self-service trailhead stations that provide tick and TBD information while allowing visitors to report trail use, tick encounters, and submit collected ticks-as a tool for tick surveillance and public education. Methods: To assess the effectiveness of tick-check stations for surveillance, we evaluated station engagement and compared tick density estimates, species composition, and sex- and life-stage distributions with those obtained through concurrent active surveillance. In addition, we compared submission numbers, and tick species, sex, and life stages to those collected through a mail-in submission system conducted by the Colorado Department of Public Health and Environment (CDPHE). To quantify feasibility, we estimated effort per tick and compared effort across simulated sampling scenarios. Finally, in-person knowledge, attitudes, and practices (KAP) interviews were conducted at trailheads to assess baseline tick KAP and to evaluate differences between sites with and without tick-check stations. Results: Engagement with tick-check stations was sustained throughout the study. Tick-check stations yielded 80 ticks, compared with 28 ticks collected through active surveillance and 28 ticks submitted through the CDPHE mail-in program. Tick-check station yield increased with underlying active-surveillance density ( Conclusion: Tick-check stations can provide tick density estimates comparable to active surveillance while requiring less effort in many scenarios, particularly in low-density settings. Our findings also highlight opportunities for targeted outreach to address gaps in TBD knowledge. As both a surveillance and educational tool, tick-check stations offer a sustainable approach for expanding tick monitoring in resource-limited settings.