title: Knowledge, attitudes, and practices of US practitioners who provide pre-travel advice.
abstract: BACKGROUND
  As international travel increases, many health care professionals are being asked to provide pre-travel advice. We designed an anonymous web-based survey to assess the extent to which primary care providers (PCPs) provide travel medicine advice and how their understanding and delivery of itinerary-specific advice and management compare with that of travel medicine specialists.
  
  
  METHODS
  We surveyed randomly selected US PCPs registered in the Pri-Med Institute (now pmiCME) database and US travel medicine specialists from the International Society of Travel Medicine (ISTM), American Society of Tropical Medicine and Hygiene (ASTMH), and Centers for Disease Control and Prevention (CDC) yellow fever (YF) vaccine provider mailing lists. SAS software (SAS Institute, Cary, NC, USA) was used for all analyses.
  
  
  RESULTS
  Of 14,932 e-mails sent to valid e-mail addresses, 902 yielded complete or partially completed surveys (6.0% response rate). Eighty percent of respondents personally provided pre-travel advice (95% of travel medicine specialists versus 73% of PCPs). About two thirds of PCPs (68%) providing pre-travel consultations saw <50 travelers per year whereas 30% of travel medicine specialists saw <50 travelers per year. More travel medicine specialists (59%) than PCPs (18%) saw >500 travelers per year. Familiarity with travel-specific vaccines (YF, Japanese encephalitis) and provision of written educational materials increased as volume of travelers increased. Familiarity with antimalarial side effects and malaria resistance patterns, and knowledge scores based on brief pre-travel scenarios were higher in travel medicine specialists, ASTMH or ISTM certificate holders, and respondents who saw more pre-travel patients.
  
  
  CONCLUSIONS
  Many PCP survey participants provided pre-travel advice, but most saw few travelers. Volume of travelers and holding an ASTMH or ISTM certificate had the greatest influence on knowledge of travel medicine and provision of appropriate advice and recommendations. Creating easily accessible travel medicine education programs for US providers from a wide range of disciplines is needed to improve the management of travelers.
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Kogelman
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Barnett
authors.forename: Lin H
authors.initials: LH
authors.lastname: Chen
authors.forename: Emily
authors.initials: E
authors.lastname: Quinn
authors.forename: Emad
authors.initials: E
authors.lastname: Yanni
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wilson
authors.forename: Christine
authors.initials: C
authors.lastname: Benoit
authors.forename: Adolf W
authors.initials: AW
authors.lastname: Karchmer
authors.forename: Winnie W
authors.initials: WW
authors.lastname: Ooi
authors.forename: Emily S
authors.initials: ES
authors.lastname: Jentes
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
mesh_terms: D000328:Adult; D003141:Communicable Diseases / Q000208:ethnology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014195:Travel; D057236:Travel Medicine / Q000379:methods*; D014330:Tropical Medicine / Q000379:methods*; D014481:United States / Q000453:epidemiology; D055815:Young Adult