This was a community-based, cross-sectional questionnaire survey applying to visitors attending to the Taiwan International Travel Fair in May 2019. The questionnaire was self-administered and anonymous. The completion and return of the questionnaire represented the subject agreed to participate.
The including criteria were aged over 20 years old, willing, and able to complete the questionnaire. The study was approved by the Institutional Review Board at National Taiwan University Hospital in Taiwan (201902070W) before the study was conducted.
The four-part questionnaire included questions on socio-demographical characteristics, knowledge towards travel-related disease and vaccine, attitudes, awareness and willingness towards travel medicine clinic, and travel insurance. The questionnaire was pretested for face validity by a committee of ten physicians. The members of the committee were from National Taiwan University Hospital (NTUH) and Centers for Disease Control (CDC), Taiwan who were experienced in the clinical practice of travel medicine. A literature review and consensus opinion from three physicians at NTUH and CDC, Taiwan, were also conducted to test the content validity of the questionnaire.
The socio-demographical characteristics included sex, age, education level, occupation, medical history, and special activities during travel. The other three parts of the questionnaire included the following components:
Knowledge towards travel-related disease: 10 questions about vaccination, malaria, yellow fever, cholera, measles, hepatitis B, rabies, meningococcus, and influenza. Each question was scored 1 point for a correct response, with a total score of 10 points. The questions tested the respondents’ knowledge regarding the epidemiology, medication, and vaccine of travel-related disease.
Attitude towards travel medicine clinic and travel insurance: This part examined the subjects’ perceptions regarding to the importance of travel medicine clinic and travel insurance as follows: (1) travel medicine clinic, (2) pre-travel vaccination, (3) accidental death and disablement insurance, (4) accidental medical reimbursement, (5) overseas sickness coverage, (6) 24 hours of emergency assistance, (7) travel inconvenience insurance. The scoring system used a five-point Likert Scale, ranging from “very unimportant” (1 point) to “unimportant” (2 points), “no comment” (3 points), “important” (4 points), and “very important” (5 points). Higher scores indicated positive attitudes regarding the need of certain services.
Awareness and willingness towards travel medicine clinic and travel insurance: This part sought the information on whether people had heard about the above mentioned five different kinds of travel insurance and travel clinic and whether they will use the service or not.
Data were presented as means (SDs) for continuous variables and numbers (percentage) for categorical variables. Chi-square test was used to compare the proportions of the willing to buy travel insurance between different socio-economic variables. One-way ANOVA and independent t test were used to clarify the relation between knowledge for travel medicine and socio-economic variables. A p value less than 0.05 was considered statistically significant. Statistical analysis was carried out using the statistical software SPSS 19.0 (version: 19.0, IBM Corp., Armonk, NY, USA, 2017).