Travel Medicine and Infectious Disease (2015) 13, 426e427

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CORRESPONDENCE

Do travel health researchers need to get out more?

Dear Editor, The majority of research in travel health and medicine is clinical or medical. However, health is more than just medicine, and health research more than just medical research. Vast areas in travel health remain un-researched due to 1) a reluctance by researchers to join travellers at their destinations and 2) the specialty’s unfamiliarity with a wide range of established and validated research methods, the application of which would fill considerable gaps in its current body of knowledge. Ten out of 70 original articles (15%) published in the Journal of Travel Medicine in 2013/2014 studied travellers (though not necessarily tourists) on location. Within the same timeframe, five out of 76 original research papers (6%) published in Travel Medicine and Infectious Disease collected data on location; none on tourists. With these few exceptions, travellers are studied in medical settings either in person (as prospective travellers or patients post-travel) or via their medical records. However, the greater part of travellers will not come near a health facility, and a large number of people, who could contribute to exploring important travel health topics, are lost to science. Therefore, researchers also need to study travellers where they are (on travels) not just before or after a trip. Joining the travelling public independently or through commercially organised trips (cruises, climbing holidays or other organised activities) not only gives access to the study population but lets the researcher experience the context in which the researched topic takes place. The most obvious focus of research at destinations centres on what travellers actually do while away, information that cannot be obtained by studying patients. Investigating planned behaviour pre-travel or self-reported behaviour after a trip is, noticeably, fraught with bias and, so, of limited value. Only on location can real behaviour be recorded to inform travel health advice. Potential topics range from food/drink, appropriate clothing, or any risktaking behaviour to health topics linked to activities (e.g. night clubbing, climbing volcanoes) or to specific groups of travellers (e.g. children, wheelchair-users, or trekkers with

http://dx.doi.org/10.1016/j.tmaid.2015.08.003 1477-8939/ª 2015 Elsevier Ltd. All rights reserved.

visual impairment [1]). Additionally, the rationale for people’s (risk) behaviour can be studied, travellers’ perceptions of health issues as they emerge on location, or their views on the relevance of received travel health advice, similar to suggestions for research at destination airports [2]. Research on location will require a wider range of methods that are not typically utilised in a surgery. To ensure high-quality research, travel health researchers need to be skilled in established research techniques, such as different types of observations or interviews, including a command of appropriate qualitative approaches where the topic demands them. However, methods that are less known to health professionals but highly appropriate in some situations and for some topics should be included in the toolkit, such as simple rank ordering [3] to gain insight, for example, in people’s rationale for their behaviour or visual methodologies that provide information that is, at this point, completely inaccessible to travel medicine. More complex topics should be studied in multidisciplinary cooperation with scientists from disciplines where the most appropriate research methods are utilised routinely. Traditional medical research is but a small part of the entire realm of scientific research. Academic journals could facilitate the crucial expansion of research topics in travel health not only by the inclusion of papers on appropriate research methodologies and methods, but also by editorial boards and reviewers familiarising themselves with such content. Readers and researchers should have the opportunity to learn about other approaches, not only to peruse published research in a cognisant manner, but also to employ such techniques in their own investigations. Travel health professionals’ credibility suffers when they give travel health advice without experiencing travel to challenging destinations themselves. It also prevents them from identifying and experiencing potential research topics, issues and challenges. Understanding those, rather than building advice on second-hand information (from a book) and assumptions, is crucial for high quality travel health care. As the next step, research on location informs travel medicine on many areas, especially those that cannot be studied in a surgery or clinic. In order to learn more about the health of travellers, yes, travel health researchers do need to get out more; they need to go where the travellers are.

Correspondence

Conflict of interest None.

Funding source None.

References [1] Bauer I. Contact lens wearers’ experiences while trekking in the Khumbu Region/Nepal. Travel Med Infect Dis 2015;13: 178e84.

427 [2] Bauer I. Airport surveys at travel destinations e underutilized opportunities in travel medicine research? J Travel Med 2015; 22:124e9. [3] Bauer I. Bridging the conceptual gap between researcher and respondent by using simple rank ordering: an example from the Peruvian Andes. Int J Interdiscip Soc Sci 2007;2:157e67.

Irmgard L. Bauer Division of Tropical Health and Medicine, College of Healthcare Sciences, Discipline of Nursing, Midwifery & Nutrition, James Cook University, Townsville, QLD 4811, Australia E-mail address: [email protected] 8 April 2015

Do travel health researchers need to get out more?

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