Predictors of pretravel consultation in tourists from Quebec (Canada)

Background: Although many tourists from Quebec (Canada) each year visit des tinations at risk for infectious diseases, only a few of them seek travel h ealth advice. To identify the determinants of travel health consultation, w e conducted a study among Quebec's tourists visiting two popular sun destin ations. Methods; A conceptual model based on psychosocial determinants of human beh avior was constructed. A cross-sectional survey was carried out, from Janua ry to April 1999, on two samples of travelers planning to visit Mexico and the Dominican Republic. One sample was composed of people who did not consu lt a travel clinic (cluster sampling in seven flights), and the other sampl e was one of clients of travel clinics (purposive selection of 13 specializ ed clinics located in Quebec). A 34-item self-administered bilingual questi onnaire was distributed to travelers. Statistical analysis included a multi variate approach (logistic regression). Results: A total of 2,242 travelers were surveyed (response rate in flight 75% and in clinics 99%). We present only results reported by French-speakin g tourists: 1,152 who did not consult a travel clinic and were reached in f light, and 449 who were reached in clinics. Multivariate analyses indicated that travel agent recommendation was the most important predictor of consu ltation among travelers (OR 8.0, 95% CI 5.1-13), especially among those und er 45 years of age and those who never sought pretravel consultation before (OR 21, 95% CI 11-41). Other important predictors were: traveling for the first time, traveling with children, previous consultation, perception abou t efficacy of immunization, risk perception, and information from travel ag ent, family doctor, and pharmacist. Conclusion: Despite its limitations, this study provides data that should h elp improve public health interventions aimed at encouraging travelers to g et a pretravel consultation.