Tools for Addressing Bed Bugs in Rural Alaska

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Introduction

Environmental health programs from Alaska’s regional tribal health corporations have seen rural Alaskans struggle to deal with bed bugs over the last 5+ years. Access to pest control professionals, treatment equipment, prevention supplies and bed bug expertise, coupled with a high prevalence of shared community spaces make rural Alaskan communities particularly vulnerable to bed bug infestations. BBAHC and TCC staff have been providing outreach to communities in their respective regions of southwestern and interior Alaska to mitigate bed bugs by using an integrated pest management (IPM) approach. Unavailability of tools to carry out IPM efforts has remained a barrier to effective bed bug management. In 2015 BBAHC and TCC secured EPA funding to provide tools for bed bug eradication to rural Alaskans statewide, with an aim to determine the viability of this approach and remaining knowledge gaps.

BBAHC_2_inch_color_logoOEH-TCC Logo

Methods

Homeowner “toolkits” were developed by BBAHC and TCC with input from an advisory board comprised of pest management professionals, rural Alaska community members, and public health professionals who were in frequent contact with rural Alaskans dealing with bed bugs issues. Research based efficacy and practicality were key factors behind selection of toolkit items.

Toolkit Items:
•Caulk sealant
•Mattress encasements
•Passive monitoring devices
•CimeXa desiccant dust
•Bellows hand duster
•N-95 masks
•Nitrile gloves
•Extra large trash bags
•Flashlight

Each toolkit included educational materials about bed bugs and IPM along with instructions for using each toolkit item safely and effectively. Toolkits were shipped directly to households upon completion of a pre-outreach survey, which was developed to capture Knowledge, Attitudes, and Practices (KAP) of toolkit recipients before receiving a toolkit and several months after employing toolkit items and IPM efforts. Analysis of pre-and post-outreach KAP surveys will be completed at the end of the project.

Results

111 toolkits were distributed to homes across 36 rural Alaska communities. Preliminary survey results indicate increased knowledge of eliminating infestations through application of IPM method and increased knowledge or reliable resources for bed bug management information.

BB toolkit by village
Map of villages with residents that received toolkits.

Participants identified most useful tools within the kit as mattress encasements and the desiccant dust.

Discussion

People living in rural areas generally have very limited resources, making it more difficult to manage a bed bug problem than the average homeowner.

•For most participants the toolkits were the only source of assistance received to mitigate bed bug issues
•Survey results indicate that approximately 40% of homes participating did not own a vacuum cleaner.
•After receiving toolkits, participants appeared emboldened and were no longer as cautious to discuss bed bugs with project team or fellow community members. Some became the local “bed bug expert” by disseminating sound IPM advice
•A small number of participants did not properly utilize toolkit items and did not have the financial resources to replace them, which likely resulted in a prolonged battle with their bed bug infestation

Providing a materials list and stocking tools locally or regionally could be beneficial to other homeowners dealing with bed bug infestations in tribal communities. Education is important, but lack of tools is a major challenge. The project was limited by the amount of funding provided. Similar projects should consider the inclusion of vacuum cleaners within the toolkit; vacuums are an important tool for homeowner IPM efforts against bed bugs.

The project noted that bed bugs remain a taboo subject for many rural Alaskan villages, and this can work to exacerbate bed bug infestations throughout a community. Incorporating peer education via local “experts” might be an important component of future toolkit outreach. Future projects should consider some in-person education regarding how to specifically utilize each item within the toolkit to prevent misinformation about utilizing tools effectively.

Conclusions/Recommendations

Toolkit recipients have reported increased success in combatting bed bug infestations and preventing future infestations. Successful bed bug management depends on a combination of IPM efforts and behavior change. Behavior change is difficult to affect and assess. This project removed some of the barriers to behavior change by putting necessary tools in homeowners’ hands.

Recommendations for similar projects:
•Consider how the method of distributing toolkit items (postal delivery versus in-person) will impact how participants use the toolkit
•Ensure education will properly address how to use toolkit items. More frequent follow-up with participants may be necessary
•Determine need for other tools, such as vacuums
•Include capacity-building efforts, such as peer education, to support prevention and mitigation efforts community-wide

The next steps for this project include evaluating pre-and post-outreach KAP survey data to determine most useful tools and remaining knowledge gaps regarding IPM. Year 2 of the project also includes development of village action plans to guide community-wide prevention and mitigation efforts. In Year 2 we will also provide a limited number of mobile heat treatment rooms to assist selected communities in applying thermal treatment to homes and large pieces of furniture.

IPM remains the best approach for preventing and eliminating bed bugs, and the provision of tools to carry out these measures is an important component in areas of the country where resources are limited or non-existent.

Contributed by Katie Bante (TCC), Racheal Lee (TCC), Mary Schneider (ANTHC) and Jennifer Skarada (BBAHC).

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