title: Methodologies for measuring travelers' risk perception of infectious diseases: A systematic review.
abstract: Numerous studies in the past have stressed the importance of travelers' psychology and perception in the implementation of preventive measures. The aim of this systematic review was to identify the methodologies used in studies reporting on travelers' risk perception of infectious diseases. A systematic search for relevant literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. There were 39 studies identified. In 35 of 39 studies, the methodology used was that of a knowledge, attitude and practice (KAP) survey based on questionnaires. One study used a combination of questionnaires and a visual psychometric measuring instrument called the 'pictorial representation of illness and self-measurement" or PRISM. One study used a self-representation model (SRM) method. Two studies measured psychosocial factors. Valuable information was obtained from KAP surveys showing an overall lack of knowledge among travelers about the most frequent travel-associated infections and associated preventive measures. This methodological approach however, is mainly descriptive, addressing knowledge, attitudes, and practices separately and lacking an examination of the interrelationships between these three components. Another limitation of the KAP method is underestimating psychosocial variables that have proved influential in health related behaviors, including perceived benefits and costs of preventive measures, perceived social pressure, perceived personal control, unrealistic optimism and risk propensity. Future risk perception studies in travel medicine should consider psychosocial variables with inferential and multivariate statistical analyses. The use of implicit measurements of attitudes could also provide new insights in the field of travelers' risk perception of travel-associated infectious diseases.
authors.affiliation: Aix Marseille Université, Emerging Tropical and Infectious Disease Unit (URMITE), Faculty of Medicine, 27 Bd Jean Moulin, 13005 Marseille, France.
authors.forename: Shruti
authors.initials: S
authors.lastname: Sridhar
authors.affiliation: Aix Marseille Université, CNRS, LPC UMR 7290, 13331, Marseille, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Régner
authors.affiliation: Aix Marseille Université, Emerging Tropical and Infectious Disease Unit (URMITE), Faculty of Medicine, 27 Bd Jean Moulin, 13005 Marseille, France; Assistance Publique Hôpitaux de Marseille, Institut Méditerranée Infection, Infectious Diseases and Tropical Medicine Unit, North Hospital, Chemin des Bourrelys, 13915, Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Brouqui
authors.affiliation: Aix Marseille Université, Emerging Tropical and Infectious Disease Unit (URMITE), Faculty of Medicine, 27 Bd Jean Moulin, 13005 Marseille, France; Assistance Publique Hôpitaux de Marseille, Institut Méditerranée Infection, Infectious Diseases and Tropical Medicine Unit, North Hospital, Chemin des Bourrelys, 13915, Marseille, France. Electronic address: philippe.gautret@club-internet.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
mesh_terms: D000328:Adult; D003140:Communicable Disease Control / Q000379:methods*; D003141:Communicable Diseases; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010465:Perception; D012306:Risk; D011795:Surveys and Questionnaires; D014195:Travel / Q000523:psychology*
keywords: Infectious diseases; Methodology; Risk perception; Traveler