Project Summary

I haven't talk about my project much. Therefore, I am going to write a summary about my whole experience in this blog.

What is my project about?

The incidence of infectious diseases occurs in many tourist destinations and is increasingly imported by tourists due to increase in global travel. For example, dengue disease is the most common arboviral (insect-borne) disease in travelers (Other than the fact that mosquito can carry diseases, they are the most annoying thing in Thailand too). However, with the lack of intervention and research focusing on tourists, the infection rate of dengue and infectious diseases among tourists remains high and is growing (A lot of people thought dengue is transmitted by food and water. Some people thought there is a vaccine against dengue). The purpose of this study is to assess the knowledge and behavior of tourists about disease and prevention. The study will be conducted through cross-sectional survey of tourists using one stage cluster sampling in the area of Ko Chang, Trat, Thailand, where dengue is endemic. Through Likert-scale, multiple-choice and open-ended questions, I will assess disease prevention knowledge, perceived disease susceptibility and severity, level of compliance, and the knowledge of dengue specific information, including, means of transmission, signs and symptoms, prevention methods and their level of compliance. I will attempt to survey 500 tourists that enter the island of Ko Chang with a milieu of tourists from various parts of the world. Inclusion criteria will be those who are over 18, speak English or Thai, mentally stable, and can give verbal consent. Those who are under 18, cannot understand English or Thai, mentally altered and are unable to give consent will be excluded (I ended up with 400+ surveys. I had to throw out 50+ surveys because it was not complete). The results of this study can potentially inform intervention strategies and health policy change for disease prevention among global travelers.

First day

I decided that recruiting people to complete a survey is not my favorite thing to do. However, it is the majority of work for this project. Initially, I interviewed the participants one by one. The process was too slow. At this rate, I would not finish the project on time. Also, the rejections was a bit of a shock for me. I realized that not everybody would complete the survey. I also know that I will get reject. Regardless, to get reject in a row was a sad situation. Later on, I learned to let go and did not take the rejection personally.

Later days

Later on, I developed a recruiting technique. The technique was a success. I finished 500 surveys as expected. Basically, I would pass the survey out before tourists walked into the boat (I asked for their consent first. Or else, it wouldn't pass the IRB, right?) Then I would give them incentive when they finished the survey (I walked around the ferry to collect the survey).

It was easier to survey people on their way back from the island than on their way to the island. My theory is that they are less excited about leaving. Therefore, they tend to have more time to complete the survey.

Something to keep in mind/interesting facts

- There are a lot of Russian tourists. However, they came in a big group and refused to speak English. Therefore, I could not get enough representatives from this group. To my surprise, they could speak perfect English when they hit on a girl(Maybe life is not so bad for global health women after all.) In order for the tour guide to identify the russians apart, they put a little round sticker on their shirt, which was also how I tell them apart. I would spend less time recruiting this group of people (i would first ask them if they speak English.)

- In the questionnaire design, I overlooked repeated traveler. They usually get vaccination for their previous trips. Therefore, for this particular trip, they do not get any vaccination. Something to keep in mind for my other project.

- I pre-tested the questionnaire with 10 people from the state before I came to Thailand. However, I realized now that pre-testing with the exact population I will be working with is important. Not only for questionnaire improvement but also for the recruiting technique. There are a few questions I would change, but it was too late to resubmit the IRB. So I decided to stick to the original questionnaire.

- Data input was a pain. Initially, I wanted to use iPad as a survey tool. So I wouldn't have to input the data by hand. However, the program was expensive. With iPad, I can only survey 1 person at a time. It would be impossible to complete 500 surveys in that amount of time. Therefore, I decided to go with a traditional (paper) method. (Also, the iPad survey program is extremely expensive.) Someone please develop a student version!! After inputting all the data, I have to recheck them again because there were a few errors....must be from looking at too many numbers for too long. Next time, I will hire someone to do it.....

To sum it up - - -

Ko Chang is not as underdeveloped as I expect it to be. However, Ko Chang is facing bigger problems many tourist destinations face in second and third world countries. The development is going up too fast without a good plan. There is no affordable clinic on the island, no sewage system, no clean water for the public, no trash management system, and no development plan. I think the whole island need to act quickly on these issues before this tropical paradise turns into another one of those ugly tourist spot in Thailand. I truly want to stay longer and work on those issues but my time here is up. I have to pack and get ready for my flight.

See you back in California...