title: Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia.
abstract: BACKGROUND
  Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia.
  
  
  METHODS
  In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history.
  
  
  RESULTS
  A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8). Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P < 0.0001). Overall, students reported low risk perception of travel threats and a low corresponding concern for these threats.
  
  
  CONCLUSIONS
  Our study highlights the need to educate students about the risk associated with travel and improve preventative health-seeking and uptake of precautionary health measures in this highly mobile young adult population. Although immunisation is not an entry requirement to study at Universities in Australia, large tertiary institutions provide an opportunity to engage with young adults on the importance of travel health and provision of vaccines required for travel, including missed childhood vaccines.
authors.affiliation: School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia.
authors.forename: Anita E
authors.initials: AE
authors.lastname: Heywood
authors.forename: Meng
authors.initials: M
authors.lastname: Zhang
authors.forename: C Raina
authors.initials: CR
authors.lastname: MacIntyre
authors.forename: Holly
authors.initials: H
authors.lastname: Seale
mesh_terms: D000328:Adult; D000818:Animals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009517:New South Wales; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013334:Students; D011795:Surveys and Questionnaires; D014195:Travel; D014495:Universities; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult