International travellers from New Jersey: piloting a travel health module in the 2011 Behavioral Risk Factor Surveillance System survey

• Published in: Journal of travel medicine 2016-01, Vol.23 (1), p.tav015
• Main Authors: Stoney, Rhett J., Kozarsky, Phyllis, Bostick, Roberd M., Sotir, Mark J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bahamas; Behavioral Risk Factor Surveillance System; Canada; Dominican Republic; Female; Health Knowledge, Attitudes, Practice; Humans; Internationality; Italy; Logistic Models; Male; Mexico; Middle Aged; New Jersey; Risk Factors; Surveys and Questionnaires; Travel - trends; Young Adult
• ISSN: 1195-1982; 1708-8305
• DOI: 10.1093/jtm/tav015

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.