JMIR Publications

ABSTRACT

Background:

Tourists are at risk of experiencing health problems during their travel. However, despite the fact that tour guides have the potential to become travel health promoters, their participation has not been optimal.

Objective:

This study aims to develop a comprehensive travel health education model to help tour guides improve health information delivery to tourists.

Methods:

This is an exploratory sequential mixed-methods research. The first phase is a qualitative study with an informed grounded theory design. In-depth interviews were carried out with tour guides from all language divisions and policymakers of the Indonesian Tour Guide Association Bali Branch or Himpunan Pramuwisata Indonesia Daerah Bali (HPI Bali). The interview guidelines were developed based on the theory of planned behavior (TPB) and identity theory. Qualitative data were analyzed thematically. In the interim phase, a travel health education model and questionnaire were developed based on the qualitative findings. The initial model and its instruments are then consulted with travel medicine, health promotion and tour guiding experts. Furthermore, the validity and reliability of the questionnaire will be tested on 20 tour guides. The model is refined based on the pilot testing results. The second phase is a quantitative study with a randomized pre-test post-test control group design. Seventy-six tour guides in the intervention group will receive comprehensive travel health education, while 76 guides in the control group receive no specific intervention. The measurement of outcome variables (i.e., attitudes, subjective norms, perceived behavioral control, actual behavioral control, role identity, and behavioral intention) will be conducted at baseline (T0), after the online training (T1), before information sharing via WhatsApp (T2), and two months after WhatsApp intervention (T3). The mean difference of each outcome variable before and after the intervention will be compared between the intervention and control groups. The quantitative and qualitative findings will be integrated in a joint display afterwards.

Results:

This study is currently ongoing. The qualitative phase has been conducted through in-depth interviews with twenty-one informants of tour guides and policymakers from HPI Bali. The education model, educational materials, and questionnaire have been developed based on the qualitative findings. The education model consists of online training and information sharing through WhatsApp. This study is currently in the interim phase that the educational materials are consulted with the experts before proceeding to the next phase.

Conclusions:

This study is expected to produce a comprehensive, relevant and effective travel health education model for tour guides. Moreover, this study can expand the amount of scientific evidence to optimize the involvement of actors in the tourism industry in travel health promotion. Clinical Trial: This study has been registered in ClinicalTrials.gov (NCT04961983).