Reviewer response for version 1

Abstract

Tuberculosis remains a large global health threat, including increasing cases in generally low-incidence areas of the United States. However, the knowledge, attitudes, and practices regarding tuberculosis in these low-incidence areas are underexplored, precluding planning for effective health communication in these areas regarding travel to high-incidence areas or potential future outbreaks in currently low-incidence areas. Using Health Belief Model as a theoretical framework, we developed a Knowledge, Attitudes, and Practices (KAP) survey to assess public perceptions of tuberculosis in Colorado, a currently low-incidence area. We collected complete responses from n=225 adults. We found that participants had higher self-assessed knowledge than actual knowledge about tuberculosis. We also found that while participants recognized tuberculosis as a global health threat, they were not personally worried about contracting tuberculosis. However, a portion of participants indicated that they would feel shame if they did contract tuberculosis. Providing further messaging in low-incidence areas on actual public health burden of tuberculosis could help right-size public knowledge and risk perception about tuberculosis. Additionally, providing health communication to focus on emotion management and reducing stigma about the disease would be important to promote healthcare-seeking and treatment compliance in case of a future outbreak.