Ignite Creation Date:
2024-05-06 @ 4:22 PM
Last Modification Date:
2024-10-26 @ 2:09 PM
Study NCT ID:
NCT04961983
Status:
UNKNOWN
Last Update Posted:
2021-07-21
First Post:
2021-07-09
Brief Title:
A Comprehensive Travel Health Education for Tour Guides in Bali Indonesia
Sponsor:
Udayana University
Organization:
Udayana University
Study Overview
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
Status:
UNKNOWN
Status Verified Date:
2021-07
Last Known Status:
NOT_YET_RECRUITING
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
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
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
Detailed Description:
1 Study design 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
2 Study setting Data collection will be conducted in Bali Indonesia started from September 2021 to February 2022
3 Study population The target population in this study are all general tour guides in Bali Indonesia The accessible population are general tour guides who are registered as members of HPI Bali who can be reached during the data collection period
4 Sample size The calculation of the minimum sample size in this study was carried out with the assistance of the WHO Sample Size Determination software using the hypothesis test formula for the mean difference of two populations one-sided
Based on the sample size calculation with the above formula the minimum sample size for each group is 69 tour guides Taking into account the drop-out rate of 10 the number of samples for each group is 76 tour guides Thus the total number of samples for intervention and comparison groups in this study is 152 tour guides
5 Sample selection The sample selection was carried out with disproportionate stratified random sampling using a sampling frame namely the list of tour guides who are registered as the members of Indonesian Guides Association HPI Bali Branch from 11 language divisions The number of samples in each division for intervention and control group ranged from 5 to 8 subjects
6 Sample allocation Permuted block randomization
7 Study variables
1 Dependent variable is comprehensive travel health education model
2 Intermediate variables are
attitude towards providing travel health information to tourists
subjective norms towards providing travel health information to tourists
perceived behavioral control of providing travel health information to tourists
role identity
actual behavioral control
3 Dependent variable is intention to provide travel health information to tourists
4 Controll variables are
Controlled by design
history of formal health education
ownership of a smartphone or laptop with WhatsApp and Zoom application
familiarity with Zoom usage
familiarity with WhatsApp usage
Controlled by analysis
age
sex
education
length of work
employment status
tourists country of origin
type of tourism activities
employers policy
8 Research instrument
The instrument that will be used in this study is a questionnaire The measurement using questionnaire will be conducted before the intervention pre-test and after the intervention post-test The developed questionnaire consists of several parts namely the identity or socio-demographic characteristics of the subjects job characteristics characteristics of tourists served attitudes subjective norms perceived behavioral control role identity actual behavior control and behavioral intentions
The questionnaire was developed based on the guidelines for developing a questionnaire for TPB-based interventions and the results of the qualitative study The assessment for each statement item on the attitude subjective norm perceived behavioral control and role identity uses a Likert scale consisting of seven scales namely 1 strongly disagree 2 disagree 3 disagree 4 undecided 5 somewhat agree 6 agree 7 strongly agree
The questionnaire on the actual behavior control section consists of questions related to knowledge about prevention and first aid for tourism health problems Questions to measure knowledge were developed based on the material provided during the intervention The correct answer for each knowledge question will get a score 1 while the wrong or do not know answer will be given a score 0
The questionnaire on the behavioral intention section is also written in statement format The assessment for each statement item uses a Likert scale consisting of seven scales namely a scale of 1 strongly not intending 2 not intending 3 lack of intention 4 undecided 5 somewhat intend 6 intend 7 very intent
The validity and reliability of the questionnaire will be tested before it being used in data collection Twenty tour guides will be involved in the pilot test of the questionnaire If necessary improvements will be made to the questionnaire based on the test results The questionnaire is self-administered and will be given to the subjects in digital format
9 Data analysis
1 Descriptive statistic Quantitative data obtained from the questionnaire will be analyzed descriptively by calculating the frequency distribution for data on a categorical scale and by calculating the total value mean median standard deviation and range of values from minimum to maximum on continuous scale data On the variables of attitude subjective norm perceived behavioral control and role identity a positive statement will get a score of 1 strongly disagree 1 strongly disagree 2 disagree 3 disagree 4 doubtful 5 somewhat agree 6 agree 7 strongly agree As for negative statements the score given is the opposite namely a score of 7 strongly disagree 6 disagree 5 disagree 4 doubtful 3 somewhat agree 2 agree 1 strongly agree The actual behavioral control score was 1 for correct answer and 0 for wrong answer and do not know answer
2 Chi square test Comparison of sample characteristics in the intervention and control groups in terms of control variables age gender education length of work employment status tourists country of origin type of tourism activities and employers policy was also carried out using the chi square test Through this test it will be known whether there are differences in the two groups based on these variables If the p value 005 the two groups are the same comparable whereas if p value 005 then the two groups are different in terms of the variables tested Variables that have a p value 005 will be tested in multivariate analysis
3 Normality test Data normality test is conducted to determine whether or not the data on attitude subjective norms perceived behavioral control actual behavior control role identity and behavioral intentions scores are normally distributed as a prerequisite for being able to perform parametric statistical tests Based on the sample size the normality test will be carried out using the Kolmogorov-Smirnov test If the normality test produces a p value 005 then the data distribution is normally distributed On the other hand the data is not normally distributed if the p 005
4 Homogeneity test The purpose of the homogeneity test is to find out whether the two groups to be compared have the same variance According to the sample size homogeneity test will be carried out using Levenes test If the results of the homogeneity test show a p value 005 then the variance between groups is homogeneous On the other hand if the p value 005 the variance of the two groups is not homogeneous
5 Mean comparison test The mean comparison test will be conducted to determine whether there is a difference in the mean between the intervention and the control group difference in the mean of two independent samples The mean comparison procedure used in this study is the independent samples t test However testing with independent samples t test is a parametric test which assumes the data is normally distributed and both groups have the same variance The interpretation of the test results is that Ho is accepted if the p value 005 or the zero value lies within the confidence interval for the difference in the mean on the other hand Ho is rejected if the p value 005 or the zero value lies outside the confidence interval for the mean difference of the two groups If the data is not normally distributed the data will be transformed Furthermore if the transformation cannot make the data normally distributed the data will be analyzed by non-parametric statistical tests namely the Mann Whitney U test
In addition to the comparison of the mean between the intervention and comparison groups a comparison test of the means was also carried out for the control variables For categorical-scale control variables with two categories a t-test was performed such as a comparative analysis of the mean for the intervention and control groups Meanwhile for control variables that have more than two categories an analysis of variance ANOVA test will be carried out If the assumptions for the parametric statistical test are not met the Kruskal-Wallis test is performed
6 Multivariate analysis After the bivariate analysis a multivariate analysis was carried out which aims to control the inter-correlation between the variables under study In multivariate analysis all dependent variables are tested simultaneously If the assumptions for parametric statistical analysis are met the statistical test used is multivariate analysis of variance MANOVA MANOVA is chosen because there is more than one continuous-scale dependent variable to be tested and more than one categorical-scale independent variable with two or more categories If the assumptions are not met then a non-parametric MANOVA statistical test is performed
2 Study setting Data collection will be conducted in Bali Indonesia started from September 2021 to February 2022
3 Study population The target population in this study are all general tour guides in Bali Indonesia The accessible population are general tour guides who are registered as members of HPI Bali who can be reached during the data collection period
4 Sample size The calculation of the minimum sample size in this study was carried out with the assistance of the WHO Sample Size Determination software using the hypothesis test formula for the mean difference of two populations one-sided
Based on the sample size calculation with the above formula the minimum sample size for each group is 69 tour guides Taking into account the drop-out rate of 10 the number of samples for each group is 76 tour guides Thus the total number of samples for intervention and comparison groups in this study is 152 tour guides
5 Sample selection The sample selection was carried out with disproportionate stratified random sampling using a sampling frame namely the list of tour guides who are registered as the members of Indonesian Guides Association HPI Bali Branch from 11 language divisions The number of samples in each division for intervention and control group ranged from 5 to 8 subjects
6 Sample allocation Permuted block randomization
7 Study variables
1 Dependent variable is comprehensive travel health education model
2 Intermediate variables are
attitude towards providing travel health information to tourists
subjective norms towards providing travel health information to tourists
perceived behavioral control of providing travel health information to tourists
role identity
actual behavioral control
3 Dependent variable is intention to provide travel health information to tourists
4 Controll variables are
Controlled by design
history of formal health education
ownership of a smartphone or laptop with WhatsApp and Zoom application
familiarity with Zoom usage
familiarity with WhatsApp usage
Controlled by analysis
age
sex
education
length of work
employment status
tourists country of origin
type of tourism activities
employers policy
8 Research instrument
The instrument that will be used in this study is a questionnaire The measurement using questionnaire will be conducted before the intervention pre-test and after the intervention post-test The developed questionnaire consists of several parts namely the identity or socio-demographic characteristics of the subjects job characteristics characteristics of tourists served attitudes subjective norms perceived behavioral control role identity actual behavior control and behavioral intentions
The questionnaire was developed based on the guidelines for developing a questionnaire for TPB-based interventions and the results of the qualitative study The assessment for each statement item on the attitude subjective norm perceived behavioral control and role identity uses a Likert scale consisting of seven scales namely 1 strongly disagree 2 disagree 3 disagree 4 undecided 5 somewhat agree 6 agree 7 strongly agree
The questionnaire on the actual behavior control section consists of questions related to knowledge about prevention and first aid for tourism health problems Questions to measure knowledge were developed based on the material provided during the intervention The correct answer for each knowledge question will get a score 1 while the wrong or do not know answer will be given a score 0
The questionnaire on the behavioral intention section is also written in statement format The assessment for each statement item uses a Likert scale consisting of seven scales namely a scale of 1 strongly not intending 2 not intending 3 lack of intention 4 undecided 5 somewhat intend 6 intend 7 very intent
The validity and reliability of the questionnaire will be tested before it being used in data collection Twenty tour guides will be involved in the pilot test of the questionnaire If necessary improvements will be made to the questionnaire based on the test results The questionnaire is self-administered and will be given to the subjects in digital format
9 Data analysis
1 Descriptive statistic Quantitative data obtained from the questionnaire will be analyzed descriptively by calculating the frequency distribution for data on a categorical scale and by calculating the total value mean median standard deviation and range of values from minimum to maximum on continuous scale data On the variables of attitude subjective norm perceived behavioral control and role identity a positive statement will get a score of 1 strongly disagree 1 strongly disagree 2 disagree 3 disagree 4 doubtful 5 somewhat agree 6 agree 7 strongly agree As for negative statements the score given is the opposite namely a score of 7 strongly disagree 6 disagree 5 disagree 4 doubtful 3 somewhat agree 2 agree 1 strongly agree The actual behavioral control score was 1 for correct answer and 0 for wrong answer and do not know answer
2 Chi square test Comparison of sample characteristics in the intervention and control groups in terms of control variables age gender education length of work employment status tourists country of origin type of tourism activities and employers policy was also carried out using the chi square test Through this test it will be known whether there are differences in the two groups based on these variables If the p value 005 the two groups are the same comparable whereas if p value 005 then the two groups are different in terms of the variables tested Variables that have a p value 005 will be tested in multivariate analysis
3 Normality test Data normality test is conducted to determine whether or not the data on attitude subjective norms perceived behavioral control actual behavior control role identity and behavioral intentions scores are normally distributed as a prerequisite for being able to perform parametric statistical tests Based on the sample size the normality test will be carried out using the Kolmogorov-Smirnov test If the normality test produces a p value 005 then the data distribution is normally distributed On the other hand the data is not normally distributed if the p 005
4 Homogeneity test The purpose of the homogeneity test is to find out whether the two groups to be compared have the same variance According to the sample size homogeneity test will be carried out using Levenes test If the results of the homogeneity test show a p value 005 then the variance between groups is homogeneous On the other hand if the p value 005 the variance of the two groups is not homogeneous
5 Mean comparison test The mean comparison test will be conducted to determine whether there is a difference in the mean between the intervention and the control group difference in the mean of two independent samples The mean comparison procedure used in this study is the independent samples t test However testing with independent samples t test is a parametric test which assumes the data is normally distributed and both groups have the same variance The interpretation of the test results is that Ho is accepted if the p value 005 or the zero value lies within the confidence interval for the difference in the mean on the other hand Ho is rejected if the p value 005 or the zero value lies outside the confidence interval for the mean difference of the two groups If the data is not normally distributed the data will be transformed Furthermore if the transformation cannot make the data normally distributed the data will be analyzed by non-parametric statistical tests namely the Mann Whitney U test
In addition to the comparison of the mean between the intervention and comparison groups a comparison test of the means was also carried out for the control variables For categorical-scale control variables with two categories a t-test was performed such as a comparative analysis of the mean for the intervention and control groups Meanwhile for control variables that have more than two categories an analysis of variance ANOVA test will be carried out If the assumptions for the parametric statistical test are not met the Kruskal-Wallis test is performed
6 Multivariate analysis After the bivariate analysis a multivariate analysis was carried out which aims to control the inter-correlation between the variables under study In multivariate analysis all dependent variables are tested simultaneously If the assumptions for parametric statistical analysis are met the statistical test used is multivariate analysis of variance MANOVA MANOVA is chosen because there is more than one continuous-scale dependent variable to be tested and more than one categorical-scale independent variable with two or more categories If the assumptions are not met then a non-parametric MANOVA statistical test is performed
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None