Chikungunya Disease Awareness Among U.S. Travelers to Caribbean Destinations

Introduction: This study investigated chikungunya disease awareness and its predictors, the level of adoption of recommended personal protective behaviors against chikungunya, and the health information-seeking behavior of U.S. travelers to Caribbean destinations. Methods: A cross-sectional retrospective online survey of 653 adult U.S. international travelers who visited any one of 34 Caribbean destinations was conducted in October 2015. Study participants were recruited through Amazon® Mechanical Turk. Travelers who met the inclusion criteria and gave informed consent were subsequently redirected to complete the survey which was domiciled in Qualtrics®. Results: Results regarding health information-seeking behavior indicated that 51% of study participants had never sought information about chikungunya or any vector-borne illnesses. Only thirty percent of study participants reported having heard of chikungunya disease before participating in this study. After adjusting for the presence of other variables in a logistic regression model, gender of female, higher levels of education, more time spent at the destination, and a higher number of hours spent engaging in outdoor activities were factors significantly associated with chikungunya disease awareness. Study results also showed that twenty-two percent of study participants did not engage in any of the three recommended personal protective behaviors under investigation. Conclusion: Study findings highlighted a gap in existing approaches to health information dissemination vis-à-vis adoption of recommended personal protective behaviors, especially for U.S. travelers at risk for chikungunya and other emerging mosquito-borne infectious diseases in Caribbean destinations.