Perceptions of travel-related health risks and pre-travel health-seeking behaviour among students: A qualitative analysis.

BACKGROUND: The impact of the COVID-19 pandemic on travel risk perceptions and pre-travel healthcare attendance is unknown. We aimed to explore barriers and enablers to engagement in and uptake of pre-travel advice (PTA) among university students, a recognised at-risk group for travel-related morbidity and poor PTA uptake. Additionally, we aimed to explore whether the COVID-19 pandemic has influenced attitudes towards future PTA. METHODS: Semi-structured interviews were conducted with university students (October-December 2021). Thematic analysis of the data was conducted using the Health Belief Model (HBM) framework. RESULTS: We interviewed 18 students (11 male, median age 24). Students' risk perceptions relating to travel-related illnesses were influenced by past experiences, travel destination, vaccination status and knowledge. Barriers to seeking PTA included a lack of perceived need and concerns about accessibility/availability, whereas potential benefits included reduced health risks, vaccine-induced protection, and knowledge gain. Cues to seeking future PTA were perceived risks of travel-related illness, perceived high-risk destination, itinerary-related vaccine requirements, perceived benefits of advice and concerns about COVID-19 infection. COVID-19 risk perceptions did not consistently align with those of other travel-related illness. We used findings to inform recommendations. CONCLUSION: The current COVID-19 pandemic offers an opportunity to increase students' risk awareness and promote preventive travel health behaviours. Recommendations to improve students' future engagement in PTA include: 1) increasing awareness of risks associated with travel, 2) emphasising PTA benefits, and 3) ensuring PTA is convenient, accessible and affordable.

University students' travel risk perceptions and risk-taking willingness during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Student travellers are recognised as a group at high risk of travel-related morbidity, but few previous studies have evaluated students' perceptions of or willingness to take risks during travel. Individual risk propensities may influence travellers' engagement in pre-travel healthcare and can therefore inform strategies in pre-travel risk communication. This study aimed to describe the factors influencing risk-taking willingness, risk perceptions and future health-seeking intention among student travellers. METHOD: We conducted a cross-sectional online survey (June-August 2021) among students enrolled at Monash University, Melbourne, Australia. Primary outcomes were travel-related risk-taking willingness and risk perceptions, measured using the health/safety items of the validated Domain-Specific Risk-Taking (DOSPERT) scale. RESULTS: Four hundred and eighteen students completed the survey. The mean age of respondents was 25.61 years, 78% were female and 46% were born outside Australia. Greater willingness to take risks was predicted by younger age (<25 years), being Australian-born, greater travel experience (3+ trips), having previously sought PTA, and perceiving oneself at low risk of severe COVID-19. We found no significant predictors of risk perception. Increased intention to seek pre-travel advice in the future was associated with greater risk perception, younger age, and perceiving oneself at high risk of severe COVID-19. CONCLUSION: These findings support the rationale for a greater role of risk communication in travel medicine promotion strategies. We recommend that this could be achieved through 1) increasing risk perception by emphasising potential travel-associated risks, 2) personalising information about travel risks, 3) addressing perceived benefits of engaging in risky behaviours, and 4) reinforcing self-efficacy.