title: International travellers from New Jersey: piloting a travel health module in the 2011 Behavioral Risk Factor Surveillance System survey.
abstract: BACKGROUND
  In 2011, the Centers for Disease Control and Prevention and the New Jersey Department of Health used the New Jersey Behavioral Risk Factor Survey (NJBRFS), a state component of the national Behavioral Risk Factor Surveillance System (BRFSS) to pilot a travel health module designed to collect population-based data on New Jersey residents travelling internationally. Our objective was to use this population-based travel health information to serve as a baseline to evaluate trends in US international travellers.
  
  
  METHODS
  A representative sample of New Jersey residents was identified through a random-digit-dialing method and administered the travel health module, which asked five questions: travel outside of USA during the previous year; destination; purpose; if a healthcare provider was visited before travel and any travel-related illness. Additional health variables from the larger NJBRFS were considered and included in bivariate analyses and multiple logistic regression; weights were assigned to variables to account for survey design complexity.
  
  
  RESULTS
  Of 4029 participants, 841 (21%) travelled internationally. Top destinations included Mexico (10%), Canada (9%), Dominican Republic (6%), Bahamas (5%) and Italy (5%). Variables positively associated with travel included foreign birth, ≥$75 000 annual household income, college education and no children living in the household. One hundred fifty (18%) of 821 travellers with known destinations went to high-risk countries; 40% were visiting friends and relatives and only 30% sought pre-travel healthcare. Forty-eight (6%) of 837 responding travellers reported travel-related illness; 44% visited high-risk countries.
  
  
  CONCLUSIONS
  Approximately one in five NJBRFS respondents travelled internationally during the previous year, a sizeable proportion to high-risk destinations. Few reported becoming ill as a result of travel but almost one-half of those ill had travelled to high-risk destinations. Population-based surveillance data on travellers can help document trends in destinations, traveller type and disease prevalence and evaluate the effectiveness of disease prevention programmmes.
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA and uyn2@cdc.gov.
authors.forename: Rhett J
authors.initials: RJ
authors.lastname: Stoney
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA and.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Kozarsky
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Roberd M
authors.initials: RM
authors.lastname: Bostick
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA and.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sotir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001444:Bahamas; D040343:Behavioral Risk Factor Surveillance System; D002170:Canada; D004293:Dominican Republic; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D038622:Internationality; D007558:Italy; D016015:Logistic Models; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009515:New Jersey; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014195:Travel / Q000639:trends*; D055815:Young Adult
keywords: BRFSS; New Jersey; US international travel; population-based surveillance; travel epidemiology; travellers’ health