Phenomenological analysis of going home in Caribbean-American international travelers

BACKGROUND In travel health risk assessments visiting friends and relatives (VFR) travel status is often used as an indicator for high-risk travel behavior. VFR travelers have been associated with increased risk of travel-associated illnesses due to poor adherence to travel guidelines and lack of pre-travel health consultations. For travelers to dengue endemic regions, guidelines include compliance with mosquito avoidance practices (MAP). The goal of this study is to understand the meaning of travel experiences to the home country for immigrant and first generation American VFR travelers in the United States (US). METHODS A phenomenology study was conducted on VFR travelers to identify social and physical environmental factors associated with travel health behaviors, and determine how 'going home' influences compliance with recommendations for dengue prevention. Purposive sampling identified participants for semi-structured interviews on travel behavior with iterative collection and analysis until data reached saturation. RESULTS Interviews revealed five themes that defined the experience of going home: connectedness; control of the experience; two different experiences at home; seeing what home has to offer; and there is no place like home. Moreover, risk perception of health and disease risks in the travel destination influenced travel behavior and compliance with guidelines. CONCLUSIONS VFR travel status does not fully capture the experience of international travel. Behavior was associated with the emergent concept of Cultural Embeddedness when traveling home and to new destinations. More research on improving terminology for travel health risk assessments is needed to improve prevention strategies in VFR travelers.