Predicting Chikungunya disease personal protective behaviors: Results of a cross-sectional survey of US-Caribbean travelers

Abstract

Background: Incidents of vector-borne disease have recently tripled in the United States. Chikungunya disease is a particularly common disease in the Caribbean, posing a threat to international tourists. However, the relationship between psychological variables derived from the protection motivation theory (PMT), and adoption of protective behaviors against the disease, is uncertain. This study sought to identify the psychological predictors of travelers’ protective health behaviors, specifically (1) appropriate clothing use, and (2) indoor spatial repellent use. Methods: An online, retrospective survey of U.S. international travelers to Caribbean destinations measured the five constructs of the PMT in the context of Chikungunya disease: Perceived severity, perceived vulnerability, perceived response efficacy, perceived self-efficacy, and knowledge. Hierarchical logistic regression analyzed whether these five theoretical constructs predicted the two protective behaviors in respondents who met study criteria (n = 184). Results: Results suggest that the interaction between chikungunya knowledge and perceived chikungunya severity predicts both appropriate clothing use (odds ratio [OR]: 1.95, CI: 1.18-3.25, P=0.010) and indoor spatial repellent use (OR: 1.55, CI: 1.05-2.29, P=0.029). In the cases of appropriate clothing use, the interaction between perceived chikungunya severity and perceived vulnerability was also a significant predictor (OR: 9.67, CI:1.23-75.80, P=0.031). Additionally, indoor spatial repellent use was also predicted by the interaction of chikungunya knowledge and perceived vulnerability (OR: 1.88, CI:1.18-3.02, P=0.009). Conclusion: Two-pronged educational approaches may be most efficacious in increasing protective health behaviors. Such efforts could reduce incidents of chikungunya disease and other vectorborne diseases in travel destinations featuring high exposure risks.

Application of the health belief model to explain public perceptions, travel intentions and actions during COVID-19: a sequential transformative design

“…These studies confirm earlier research that stipulates a positive relationship between self-efficacy and individual self-protection during travel (e.g. Anderson et al, 2020;Wang et al, 2019). Therefore, we propose:…”

“…Zheng et al (2021) show that people who consider themselves self-efficacious will experience reduced travel fear and are motivated to protect themselves during travel. These studies confirm earlier research that stipulates a positive relationship between self-efficacy and individual self-protection during travel (e. g. Anderson et al, 2020, Wang et al, 2019. Therefore, we propose: H3a: Perceived self-efficacy will increase willingness to travel domestically.…”

Career resilience of the tourism and hospitality workforce in the COVID-19: The protection motivation theory perspective

“…Finally, the study's findings provide further empirical support for PMT ( Floyd et al, 2000 ) by lending credence to the role of cognitive processes, comprising perceptions towards the pandemic and perceived efficacy, in facilitating protective behavior (i.e., health risk preventative behavior) and in turn career resilience. PMT has been applied predominantly to common health risk behaviors such as disease prevention ( Anderson et al, 2020 ) or vaccination uptake ( Ling, Kothe, & Mullan, 2019 ) and rarely to protective behaviors in a pandemic setting ( Nguyen-Phuoc, Oviedo-Trespalacios, Nguyen, Dinh, & Su, 2022 ; Tang, Chen, Lin, & Feng, 2021 ; Zheng et al, 2021 ). Our study applies this theory not only to a pandemic context but also to the tourism sector.…”

An integrated human behavioral model for mosquito-borne disease control: A scoping review of behavior change theories used to identify key behavioral determinants

“…Thirteen of the 28 included studies originated from Africa, including West Africa [ 19 ] and ten specified countries: Ethiopia [ 20 , 21 ], Kenya [ 22 ], Madagascar [ 18 ], Malawi [ 23 ], Mali [ 18 ], Nigeria [ 18 , 24 , 25 ], Rwanda [ 26 ], Uganda [ 27 ], and Tanzania [ 28 ]. Ten studies came from the Americas, of which 6 were conducted in the United States [ [29] , [30] , [31] , [32] , [33] , [34] ], and one each in Canada [ 35 ], Mexico [ 36 ], French-Guiana [ 37 ], and the Caribbean Island Curacao [ 38 ]. Three studies were conducted in Malaysia [ [39] , [40] , [41] ], one in the border region of Myanmar with Thailand [ 42 ] and another in Australia [ 43 ].…”

“…Three studies which formed one record, focused solely on women with children under five years old [ 18 ]. Three studies focused on US travelers, outside of the US in general [ 31 ], and in Caribbean destinations in particular [ 29 , 32 ]. One study specifically examined adults with a confirmed chikungunya infection [ 38 ].…”