Survey of U.S. Army Soldiers' Knowledge, Attitudes, and Practices Regarding Personal Protection Measures to Prevent Arthropod-Related Diseases and Nuisance Bites

Abstract
This study examined U.S. Army soldiers' knowledge, attitudes, and practices regarding personal protection measures (PPMs) to prevent arthropod-related diseases and nuisance bites. Soldiers attending 1 of 13 U.S. Army training courses either completed a written questionnaire (N = 1,007) or participated in a group interview (N = 65). Respondents primarily used repellents to prevent nuisance insect bites (55%) rather than to prevent disease (38.7%). Less than one-third correctly identified the military-issue repellents to be used on skin (31.7%) or clothing (26.1%). More than half (57.6%) thought that commercial products were better than military-issue repellents, but most (74.2%) reported that they did not have enough or any information about the U.S. military's system of PPMs. Soldiers have poor knowledge of U.S. military doctrine regarding PPMs and still prefer to use commercial products. A focused strategy to ensure the appropriate use of PPMs by service members should be developed, implemented, and evaluated.