Daily Activity Survey

Daily Activity Survey: Day 7, Tuesday, June 20th

Please answer the following questions about the outdoor activity of each person in your household
today. You will take the survey once for each person in your household. For example, if you have 4
people in your household, you will take the survey 4 times.
This is the only time during the 4-year study that we will ask you to take this survey. You will
receive a gift card for $55 if you answer all 7-nights of the survey for all members of your
household. The gift card will be sent to you within one week of completing the last night of the
survey.
The information we gather will truly help us to better understand where people are encountering
ticks. Thank you so much for your time and help!

* 1. Please enter your household BITM Study ID#. If you do not remember your ID#, please enter
your street address, city, and state, or contact your State BITM Study Coordinator to obtain the
number. For CT, contact Rayda Krell, [email protected], 203-837-8835; for RI,
contact Steve Engborg, [email protected], 401-874-2607.

* 2. Please enter the first and last initial and age of the person for whom you are answering the
survey.

3. Did this person spend time in your household in the past 24-hours?
Yes
Yes, but this person did not spend any time outside today (e.g., did not even walk to mailbox, did not take garbage to curb, etc.)
No, this person was away from the household for the past 24 hours.
Please clarify, if needed.

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 4. How much time did this person spend in the wooded area of your property today? (Please
enter your answer as a whole number between 0-59 for minutes and 0-24 for hours. If this
person did not spend any time in this area, please enter 0 for each. If you do not know if this
person spent time in this area, please try to find out. If you cannot find out, please enter "?" for
each.)
Minutes
Hours

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* 5. How much time did this person spend within 10-ft of the wooded area of your property
today? (Please enter your answer as a whole number between 0-59 for minutes and 0-24 for
hours. If this person did not spend any time in this area, please enter 0 for each.If you do not
know if this person spent time in this area, please try to find out. If you cannot find out, please
enter "?" for each.)
Minutes
Hours

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* 6. How much time did this person spend outside in your yard 10-ft or more away from the
wooded area of your property today? (Please enter your answer as a whole number between 059 for minutes and 0-24 for hours. If this person did not spend any time in this area, please
enter 0 for each.If you do not know if this person spent time in this area, please try to find out. If
you cannot find out, please enter "?" for each.)
Minutes
Hours

* 7. Did this person spend time in a vegetable garden in your yard today?
Yes
No
Don't know
No vegetable garden in my yard.
Prefer not to answer

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 8. How much time did this person spend in a vegetable garden in your yard? (Please enter your
answer as a whole number between 0-59 for minutes and 0-24 for hours.)
Minutes
Hours

Pachysandra and Myrtle

* 9. Did this person spend time in groundcover vegetation such as pachysandra or myrtle in your yard today?
Yes
No
Don't know
Not applicable to my yard.
Prefer not to answer
Comments (optional)

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 10. How much time did this person spend in groundcover vegetation? (Please enter your
answer as a whole number between 0-59 for minutes and 0-24 for hours.)
Minutes
Hours

* 11. Did this person spend time in other ornamental vegetation such as flower gardens, perennial plantings, or other
non-lawn areas in your yard today?
Yes
No
Don't know
Not applicable to our yard.
Prefer not to answer
Comments (optional)

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 12. How much time did this person spend in other ornamental vegetation such as flower
gardens, perennial plantings, or other non-lawn areas in your yard? (Please enter your answer
as a whole number between 0-59 for minutes and 0-24 for hours.)
Minutes
Hours

* 13. Did this person spend time hiking in a wooded area today (state park, town greenspace, etc.)?
Yes
No
Don't know
Prefer not to answer
Comments (optional)

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 14. How much time did this person spend hiking in a wooded area today? (Please enter your
answer as a whole number between 0-59 for minutes and 0-24 for hours.)
Minutes
Hours

* 15. Did this person spend time in outdoor locations other than your yard or a wooded hiking trail today (e.g.,
someone else's yard, town park, golf course, soccer field, etc.)?
Yes
No
Don't know
Prefer not to answer
Comments (optional)

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 16. How much time did this person spend in other outdoor locations besides your yard or a
wooded hiking trail (e.g., someone else's yard, town park, golf course, soccer field, etc.)?
(Please enter your answer as a whole number between 0-59 for minutes and 0-24 for hours.)
Minutes
Hours

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 17. Did this person find any ticks crawling on his/her body today?
Yes
No
Don't know
Prefer not to answer

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Daily Activity Survey: Day 7, Tuesday, June 20th

18. How many ticks did this person find crawling on his/her body?
1
2
3
4
5
6
7
8
9
10
More than 10
Don't know
Prefer not to answer

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 19. Did this person find any ticks attached to his/her body today?
Yes
No
Don't know
Prefer not to answer

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Daily Activity Survey: Day 7, Tuesday, June 20th

20. How many ticks did this person find attached to his/her body?
1
2
3
4
5
6
7
8
9
10
More than 10
Don't know
Prefer not to answer

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Daily Activity Survey: Day 7, Tuesday, June 20th

Please answer the following questions about any tick prevention measures used by
this person today.
* 21. Did this person take a shower or bath today?
Yes
No
Don't know
Prefer not to answer

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Daily Activity Survey: Day 7, Tuesday, June 20th

22. What time did this person bathe or shower? Please enter the time that this person bathed or
showered followed by AM or PM. If he/she bathed or showered more than once today, separate
each time with a comma (Example: 7:30 AM, 6:45 PM).

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 23. Did this person use a repellent product today?
Yes
No
Don't know
Prefer not to answer

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Daily Activity Survey: Day 7, Tuesday, June 20th

24. Please select the name of the product and the percentage of active ingredient or enter it the text box. (Example:
Cutter Backwoods, 25% DEET).

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 25. Did this person place the clothes he/she wore into the dryer immediately after being outside
today?
Yes
No
This person was not outside today.
Don't know
Prefer not to answer

* 26. Did this person perform a bodily tick check today?
Yes
No
Don't know
Prefer not to answer
Comments (optional)

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Daily Activity Survey: Day 7, Tuesday, June 20th

27. Do you have another person in your household?
Yes
No

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Daily Activity Survey: Day 7, Tuesday, June 20th

* 28. If you or someone in your household had ticks crawling on, or attached to your body today,
did you or a household member submit a photo of the tick(s) to Tickspotters
(tickspotters.org/BITM)?
Yes
No
No one in our household had crawling or attached ticks today.
Don't know
Prefer not to answer

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Daily Activity Survey: Day 7, Tuesday, June 20th

29. How many ticks did you report on Tickspotters today?

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Daily Activity Survey: Day 7, Tuesday, June 20th

30. Why didn't you submit any ticks to the Tickspotters website?

Comments

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Daily Activity Survey: Day 7, Tuesday, June 20th

Please click the link below to answer the questions for the next member
of your household.
Take survey for next person in household.

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Daily Activity Survey: Day 7, Tuesday, June 20th

31. Is there anything else you would like to tell us about your household's experience with ticks
today?

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Daily Activity Survey: Day 7, Tuesday, June 20th

Thank you so much for your time in answering these questions. We
hope these data will help us learn more about how to prevent
tickborne disease.

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