TXHC-"S.W.A.T" Mosquito-borne Illnesses Survey 2020

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1. Please check where you live:

Bloomington (Zip code: 77951)

Inez (Zip code: 77968)

McFadden (Zip code: 77973)

Nursery (Zip code: 77976

Placedo (Zip code: 77977

Telferner (Zip code: 77988)

Victoria (Zip code: 77901)

Victoria (Zip code: 77902)

Victoria (Zip code: 77904)

Victoria (Zip code: 77905)

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2. How many people are in your household?

1-2

3-4

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3. How many children (if any) are in:

*Enter a number in the field (use 0 if none)

Pre-K (0-4)

Elementary School (K-5th)

Middle School (6th-8th)

High School (9th-12th)

None

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4. Which diseases do you think are spread by mosquitoes in Texas? (check all that apply)

Zika Virus

West Nile Virus

Dengue Fever

Chikungunya Virus

Lyme Disease

Malaria

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5. Is mosquito control an important issue to you?

Yes

Don't know

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6. In the last 30 days, have you or a member of your household used mosquito repellent?

Yes

Don't know

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7. If you answered no to question #6, why?

Do not have access to mosquito repellent

Cannot afford repellent

Forget to use repellent

Do not need repellent

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8. Do you have any of the following in your yard or by your house? (check all that apply)

Birdbath

Old tires or barrels

Buckets and potted plant trays/dishes or other containers

Standing water like in puddles and pools

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9. Please rank in order from 1-6 (1 being the best), trusted sources of mosquito-borne disease information:

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10. What can you do to protect yourself from mosquito-borne diseases? (select all that apply)

Use a mosquito repellent

Cover up (wear long-sleeve shirts and pants when possible)

Keep mosquitoes outside

Repair holes in screens to keep mosquitoes outside

Keep grass cut short

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11. To protect yourself from mosquito-borne diseases, how often should you apply insect repellent?

Every 30 minutes

Every hour

It depends on the percentage of active ingredient in the product

Insect repellent does not protect against mosquito-borne diseases

TXHC-"S.W.A.T" Mosquito-borne Illnesses Survey 2020

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* 1. Please check where you live:

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* 2. How many people are in your household?

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* 3. How many children (if any) are in:*Enter a number in the field (use 0 if none)

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* 4. Which diseases do you think are spread by mosquitoes in Texas? (check all that apply)

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* 5. Is mosquito control an important issue to you?

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* 6. In the last 30 days, have you or a member of your household used mosquito repellent?

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* 7. If you answered no to question #6, why?

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* 8. Do you have any of the following in your yard or by your house? (check all that apply)

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* 9. Please rank in order from 1-6 (1 being the best), trusted sources of mosquito-borne disease information:

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* 10. What can you do to protect yourself from mosquito-borne diseases? (select all that apply)

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* 11. To protect yourself from mosquito-borne diseases, how often should you apply insect repellent?

1. Please check where you live:

2. How many people are in your household?

3. How many children (if any) are in:

*Enter a number in the field (use 0 if none)

4. Which diseases do you think are spread by mosquitoes in Texas? (check all that apply)

5. Is mosquito control an important issue to you?

6. In the last 30 days, have you or a member of your household used mosquito repellent?

7. If you answered no to question #6, why?

8. Do you have any of the following in your yard or by your house? (check all that apply)

9. Please rank in order from 1-6 (1 being the best), trusted sources of mosquito-borne disease information:

10. What can you do to protect yourself from mosquito-borne diseases? (select all that apply)

11. To protect yourself from mosquito-borne diseases, how often should you apply insect repellent?