A Comprehensive Travel Health Education for Tour Guides in Bali, Indonesia

NCT04961983 | Unknown

• 1 other identifier: 2021.03.1.0515
• Study Type: interventional
• Target: 152
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a field trial with a randomized pre-test post-test control group design. This trial is the second phase of an exploratory mixed methods research. Prior to this trial, a qualitative study through in-depth interviews to tour guides from 11 language divisions and also policy makers of Indonesian Tour Guide Association Bali branch (HPI Bali). The education model for tour guides were developed based on the integration of theory of planned behavior (TPB) and identity theory. This educational model is expected to improve the behavior of tour guides in providing travel health information to tourists they serve, which is currently still lacking. However, due to the COVID-19 pandemic, the measurement of behavior can not be conducted. Therefore, this trial aims to test the efficacy of the comprehensive education model to improve the indirect and direct determinants of the behavior namely attitude, subjective norms, perceived behavioral control, role identity, actual behavioral control and behavioral intention. The research hypothesis are:

1. 1.The comprehensive travel health education model improves the attitude of tour guides towards providing travel health information to tourists?
2. 2.The comprehensive travel health education model improves the subjective norms of tour guides towards providing travel health information to tourists?
3. 3.The comprehensive travel health education model improves the perceived behavioral control of tour guides in providing travel health information to tourists?
4. 4.The comprehensive travel health education model improves the role identity of tour guides as a travel health promoter for tourists?
5. 5.The comprehensive travel health education model improves the actual behavioral control of tour guides in providing travel health information to tourists?
6. 6.The comprehensive travel health education model improves the intention of tour guides to provide travel health information to tourists?

Conditions

Behavior, Health; Travel-Related Illness

Keywords

travel health; health promotion; tour guides

Outcome Measures

Primary Outcomes (6)

• Mean score of attitude

  Attitude is a psychological tendency expressed by tour guides towards the behavior of providing travel health information to tourists. Attitude will be measured through a self-administered questionnaire developed based on the TPB questionnaire development guideline. The data measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale.

  3 months

• Mean score of subjective norm

  Subjective norm is the perception of tour guides on the extent to which the behavior of providing health information to tourists is a behavior that is expected by the tourists, by their employers, HPI, and the community. Subjective norms will be measured through a self-administered questionnaire which was developed based on TPB questionnaire development guideline. The measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale.

  3 months

• Mean score of perceived behavioral control

  Perceived behavioral control is the confidence of tour guides in their ability to carry out the behavior of providing information to tourists regarding prevention and first aid of health problems. Perceived behavioral control will be measured through a self-administered questionnaire which was developed based on the TPB questionnaire development guideline. The measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale.

  3 months

• Mean score of actual behavioral control

  Actual behavioral control is tour guide's knowledge about the prevention of travel health problems and first aid to tourists who experience health problems. Actual behavioral control will be measured through a self-administered questionnaire. The measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale. Knowledge measurement scale is interval. The correct answer for each knowledge question will get a score = 1, while the question with the wrong answer or do not know gets a score = 0. Data will be analysed in interval scale.

  3 months

• Mean score of role identity

  Role identity is tour guide's perception of the extent to which the provision of information related to the prevention and first aid of tourism health problems to tourists is a part of the tour guide's role. Role identity will be measured through a self-administered questionnaire.The measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale.

  3 months

• Mean score of behavioral intention

  Behavioral intention is the willingness of tour guides to convey information related to the prevention and first aid of travel health problems to the tourists they serve. Intention will be measured through a self-administered questionnaire which was developed based on the TPB questionnaire development guideline. The data measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disinterested, 2 = not intending; 3 = lack of intention, 4 = neutral, 5 = somewhat intend, 6 = intend; 7 = very intend). Data will be analysed in interval scale.

  3 months

Study Arms (2)

Intervention group

EXPERIMENTAL

Tour guides who will receive a comprehensive travel health education model.

Behavioral: Comprehensive Travel Health Education Model

Control group

NO INTERVENTION

Tour guides who will receive no intervention.

Interventions

Comprehensive Travel Health Education Model BEHAVIORAL

The comprehensive travel health education model consists of: 1. Online training: 10 hours (2 days) online education via Zoom. The topics that will be delivered during the training includes: * The potential roles of tour guides in tourists' health, * The importance of travel health information for tourists, * Assessment of tourist's health risks, * Prevention and first aid of various travel health problems Topics related to tour guides will be delivered by the tourism experts, while topics related to travel health will be provided by travel medicine experts, Faculty of Medicine, Udayana University. Participants will also receive a travel health guide book. 2. Weekly travel health Information sharing through WhatsApp group for 2 months.

Intervention group

Eligibility Criteria

• Age: 20 Years - 54 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Active members of HPI Bali,
• Age less than 55 years old,
• Have worked as a tour guide for one year or more,
• Have a smart phone or laptop that equipped with Zoom and WhatsApp application,
• Familiar with Zoom meeting,
• Using WhatsApp actively.

You may not qualify if:

• Holding a structural position at HPI Bali,
• Unwilling to work as a tour guide after the re-opening of tourism,
• Have a formal health education background,
• Unwilling to participate in this study.

Sponsors & Collaborators

• Udayana University: lead

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MeSH Terms

Conditions

Health Behavior; Travel-Related Illness

Condition Hierarchy (Ancestors)

Behavior; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Ni Made Sri Nopiyani, MD, MPH

  Udayana University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ni Made Sri Nopiyani, MD, MPH

CONTACT

+6281236327788; sri.nopiyani@unud.ac.id

I Md Ady Wirawan, MD, MPH, Ph.D

CONTACT

+6281239394465; ady.wirawan@unud.ac.id

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, MPH

Model Details: Participants will be assigned to two groups (intervention and control groups) in parallel for the duration of the study. The allocation of participants into the intervention and control groups will be carried out using permuted block randomization technique.

Study Record Dates

• First Submitted: July 9, 2021
• First Posted: July 14, 2021
• Study Start: September 1, 2021
• Primary Completion: December 31, 2021
• Study Completion: January 31, 2022
• Last Updated: July 21, 2021

Record last verified: 2021-07

Data Sharing

• IPD Sharing: Will not share