International travellers are a primary factor in the spread of infectious diseases across borders and have been instrumental in spreading SARS-CoV-2 around the world. Diasporic people who travel back to their countries of origin to visit friends and relatives (VFR travellers) are at increased risk of acquiring a range of infectious diseases during travel, compared to other travellers. Pre-travel assessment and advice is an important opportunity to address VFR issues regarding health beliefs, health behaviours, current health status and pre-existing conditions.

General Practitioners (GPs) are an important source of pre-travel advice for travellers. An Australian population-based survey found that almost 90% of travellers used their general practitioner for travel health advice (1). Despite this, there has been little published research on the practice of travel medicine in primary care in Australia or internationally(2, 3) and few address the provision of travel medicine advice to migrant Australians travelling to visit friends and relatives (4). A 2012 study of GPs in migrant-rich suburbs of Sydney found a lack of awareness of the need for pre-travel health assessment of migrant Australians, particularly among migrant GPs (4). Further research is needed to identify barriers to care among a more generalisable sample of Australian GPs.

Traveller behaviour may differ in the post-COVID era and the practice of travel medicine is likely to change. Understanding GP knowledge, and perception of travel risks and barriers to the provision of advice is important, with previous research indicating a need for directed education and awareness of the need for opportunistic targeting of VFR travellers (5). 

A cross-sectional survey of GPs practicing in Australia will be conducted. GPs will be sampled from the AMA Medical Directory of Australia database. Depending on contact details, GPs will be emailed a link to an online survey or posted a hard-copy survey and invited to participate.

Project Status

Current Projects

Team

A/Professor Anita Heywood, Toby Morgan (ILP student), Professor Mark Harris, Dr Abela Mahimbo

Aims of Project

  1. To examine barriers and facilitators impacting delivery of routine immunisation (NIP) in General Practice, including patient communication, and the provision of vaccine information in the COVID-19 era.

  2. Explore perceived barriers and challenges of the rollout of the COVID-19 immunisation program through General Practice.
  3. Explore information and training needs to support General Practice to effectively communicate with patients about immunisation.

Student Role

The student will undertake a review of literature of the main aspects surrounding this topic. Based on the literature review, the student will develop a survey for recording relevant and appropriate questions for the study aims. An anonymous electronic survey will be created using Survey Monkey. GPs listed on the Medical Directory of Australia database will be sourced. Introductory letters will be sent to GPs explaining the purpose of the research, and seeking their cooperation in conducting the study and a link to the online survey.

The ILP student will be responsible for developing and maintaining an online survey through surveymonkey.com. While the survey is live, the student will complete their literature review and will write up their methods section of the report. The student will have the opportunity to attend School journal clubs and other seminars.

At conclusion of the data collection the student will set up a database and clean the data – coding and data checking the responses. The student will analyse the data. Categorical data analysis will include undertaking statistical testing to determine associations between demographic and other factors and the anticipated outcomes using the chi-squared test. Final analysis will include a multiple logistic regression model.

Students will write-up and submit the final report and a paper for publication.

Learning outcomes: The student will learn the elements involved with undertaking a study using a survey including how to develop appropriate questions, implementation, coding, analysis and report writing. Students will undertake categorical data analysis. The survey will include both closed and open-ended questions - so the student will gain experience in analysing and reporting both types. 

References

  1. Zwar N, Streeton CL, Travel Health Advisory Group. Pretravel advice and hepatitis A immunization among Australian travelers. J Travel Med. 2007;14(1):31-6.
  2. Leggat PA, Seelan ST. Resources Utilized by General Practitioners for Advising Travelers from Australia. Journal of Travel Medicine. 2003;10(1):15-8.
  3. Leggat PA, Heydon JL, Menon A. A survey of general practice policies on travel medicine. J Travel Med. 1998;5(3):149-52.
  4. Heywood AE, Forssman BL, Seale H, MacIntyre CR, Zwar N. General practitioners' perception of risk for travelers visiting friends and relatives. J Travel Med. 2015;22(6):368-74.
  5. Heywood AE, Zwar N. Improving access and provision of pre-travel healthcare for travellers visiting friends and relatives: a review of the evidence. J Travel Med. 2018;25(1):doi: 10.1093/jtm/tay010.

Methods

Structured in-depth interviews undertaken with General Practitioners (GPs) and Practice Nurses who provide immunisation services in their practices.  Interview questions have been developed based on the available literature. Questions will be asked exploring key areas of interest:

  • Impact of COVID-19 on immunisation service delivery in general practice
  • Attitudes towards COVID-19 vaccine
  • Sources of information used
  • Perceived issues/barriers
  • Future perceptions

We aim to recruit 15-20 currently practising GPs and Practice Nurses to take part in interviews either in person in their practice, via telephone or Zoom.  The interviews will be audio-recorded using a digital recorder Audio recordings will be transcribed and analysed using NVivo.

Progress

 Interviews have been completed and are now being analysed for report and publication.

Contact

Email: cphce@unsw.edu.au

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Project stream
Prevention and Management of Long Term Conditions
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