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A Comprehensive Travel Health Education for Tour Guides in Bali, Indonesia

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ClinicalTrials.gov Identifier: NCT04961983
Recruitment Status : Not yet recruiting
First Posted : July 14, 2021
Last Update Posted : July 21, 2021
Sponsor:
Information provided by (Responsible Party):
Ni Made Sri Nopiyani, Udayana University

Brief Summary:

This is a field trial with a randomized pre-test post-test control group design. This trial is the second phase of an exploratory mixed methods research. Prior to this trial, a qualitative study through in-depth interviews to tour guides from 11 language divisions and also policy makers of Indonesian Tour Guide Association Bali branch (HPI Bali). The education model for tour guides were developed based on the integration of theory of planned behavior (TPB) and identity theory. This educational model is expected to improve the behavior of tour guides in providing travel health information to tourists they serve, which is currently still lacking. However, due to the COVID-19 pandemic, the measurement of behavior can not be conducted. Therefore, this trial aims to test the efficacy of the comprehensive education model to improve the indirect and direct determinants of the behavior namely attitude, subjective norms, perceived behavioral control, role identity, actual behavioral control and behavioral intention.

The research hypothesis are:

  1. The comprehensive travel health education model improves the attitude of tour guides towards providing travel health information to tourists?
  2. The comprehensive travel health education model improves the subjective norms of tour guides towards providing travel health information to tourists?
  3. The comprehensive travel health education model improves the perceived behavioral control of tour guides in providing travel health information to tourists?
  4. The comprehensive travel health education model improves the role identity of tour guides as a travel health promoter for tourists?
  5. The comprehensive travel health education model improves the actual behavioral control of tour guides in providing travel health information to tourists?
  6. The comprehensive travel health education model improves the intention of tour guides to provide travel health information to tourists?

Condition or disease Intervention/treatment Phase
Behavior, Health Travel-Related Illness Behavioral: Comprehensive Travel Health Education Model Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 152 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Participants will be assigned to two groups (intervention and control groups) in parallel for the duration of the study. The allocation of participants into the intervention and control groups will be carried out using permuted block randomization technique.
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: A Comprehensive Travel Health Education Improving Attitude, Subjective Norm, Perceived Behavioral Control, Role Identity, Actual Behavioral Control, and Intention to Provide Travel Health Information of Tour Guides in Bali
Estimated Study Start Date : September 1, 2021
Estimated Primary Completion Date : December 31, 2021
Estimated Study Completion Date : January 31, 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Intervention group
Tour guides who will receive a comprehensive travel health education model.
Behavioral: Comprehensive Travel Health Education Model

The comprehensive travel health education model consists of:

  1. Online training: 10 hours (2 days) online education via Zoom. The topics that will be delivered during the training includes:

    • The potential roles of tour guides in tourists' health,
    • The importance of travel health information for tourists,
    • Assessment of tourist's health risks,
    • Prevention and first aid of various travel health problems Topics related to tour guides will be delivered by the tourism experts, while topics related to travel health will be provided by travel medicine experts, Faculty of Medicine, Udayana University. Participants will also receive a travel health guide book.
  2. Weekly travel health Information sharing through WhatsApp group for 2 months.

No Intervention: Control group
Tour guides who will receive no intervention.



Primary Outcome Measures :
  1. Mean score of attitude [ Time Frame: 3 months ]
    Attitude is a psychological tendency expressed by tour guides towards the behavior of providing travel health information to tourists. Attitude will be measured through a self-administered questionnaire developed based on the TPB questionnaire development guideline. The data measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale.

  2. Mean score of subjective norm [ Time Frame: 3 months ]
    Subjective norm is the perception of tour guides on the extent to which the behavior of providing health information to tourists is a behavior that is expected by the tourists, by their employers, HPI, and the community. Subjective norms will be measured through a self-administered questionnaire which was developed based on TPB questionnaire development guideline. The measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale.

  3. Mean score of perceived behavioral control [ Time Frame: 3 months ]
    Perceived behavioral control is the confidence of tour guides in their ability to carry out the behavior of providing information to tourists regarding prevention and first aid of health problems. Perceived behavioral control will be measured through a self-administered questionnaire which was developed based on the TPB questionnaire development guideline. The measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale.

  4. Mean score of actual behavioral control [ Time Frame: 3 months ]
    Actual behavioral control is tour guide's knowledge about the prevention of travel health problems and first aid to tourists who experience health problems. Actual behavioral control will be measured through a self-administered questionnaire. The measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale. Knowledge measurement scale is interval. The correct answer for each knowledge question will get a score = 1, while the question with the wrong answer or do not know gets a score = 0. Data will be analysed in interval scale.

  5. Mean score of role identity [ Time Frame: 3 months ]
    Role identity is tour guide's perception of the extent to which the provision of information related to the prevention and first aid of tourism health problems to tourists is a part of the tour guide's role. Role identity will be measured through a self-administered questionnaire.The measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disagree, 2 = disagree; 3 = disagree, 4 = neutral, 5 = somewhat agree, 6 = agree; 7 = strongly agree). Data will be analysed in interval scale.

  6. Mean score of behavioral intention [ Time Frame: 3 months ]
    Behavioral intention is the willingness of tour guides to convey information related to the prevention and first aid of travel health problems to the tourists they serve. Intention will be measured through a self-administered questionnaire which was developed based on the TPB questionnaire development guideline. The data measurement scale is ordinal which is expressed on a Likert scale (1 = strongly disinterested, 2 = not intending; 3 = lack of intention, 4 = neutral, 5 = somewhat intend, 6 = intend; 7 = very intend). Data will be analysed in interval scale.



Information from the National Library of Medicine

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Ages Eligible for Study:   20 Years to 54 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. Active members of HPI Bali,
  2. Age less than 55 years old,
  3. Have worked as a tour guide for one year or more,
  4. Have a smart phone or laptop that equipped with Zoom and WhatsApp application,
  5. Familiar with Zoom meeting,
  6. Using WhatsApp actively.

Exclusion Criteria:

  1. Holding a structural position at HPI Bali,
  2. Unwilling to work as a tour guide after the re-opening of tourism,
  3. Have a formal health education background,
  4. Unwilling to participate in this study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04961983


Contacts
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Contact: Ni Made Sri Nopiyani, MD, MPH +6281236327788 sri.nopiyani@unud.ac.id
Contact: I Md Ady Wirawan, MD, MPH, Ph.D +6281239394465 ady.wirawan@unud.ac.id

Sponsors and Collaborators
Udayana University
Investigators
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Principal Investigator: Ni Made Sri Nopiyani, MD, MPH Udayana University
Publications:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Ni Made Sri Nopiyani, MD, MPH, Udayana University
ClinicalTrials.gov Identifier: NCT04961983    
Other Study ID Numbers: 2021.03.1.0515
First Posted: July 14, 2021    Key Record Dates
Last Update Posted: July 21, 2021
Last Verified: July 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Ni Made Sri Nopiyani, Udayana University:
travel health
health promotion
tour guides
Additional relevant MeSH terms:
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Travel-Related Illness