Table 2.
Barriers to accessing pre-travel care for travellers visiting friends and relatives (VFRs) reported in the travel medicine literature compared with those identified during focus groups held in Minnesota and New York with West African immigrants
| Barrier reported in literature | Source | Supported in present study |
|---|---|---|
| Don’t go to travel clinics | 14–16 | No |
| More likely to seek care if travelling with children | 7 | Yes |
| Travel clinics aren’t culturally appropriate/comfortable | 3a,17,18a | No |
| Long wait times for appointments make scheduling difficult | 6 | Sometimes |
| Underinsured or not insured, and specialty travel care is often not covered | 2a,3a,15a | Sometimes |
| Cost is #1 barrier both to seeking pre-travel care and to following advice and recommendations | 7,18a | Yes |
| More likely to visit primary care than specialty travel clinic pre-travel | 2a,3a,19 | Yes |
| Scepticism about training of healthcare practitioners who ‘read about malaria in a book’ | 6,7 | Yes |
| More likely to make last-minute trips and get incomplete pre-travel advice because of separate medical records in different health systems | 6 | No |
| Lots of last-minute trips and don’t have time to seek pre-travel advice | 2a,7,17 | Sometimes |
| Language barriers preventing access to care | 2a,3a,16a,18a | No |
| Overseas trips are ‘routine’ and don’t warrant pre-travel care | 2a,3a | Rarely |
| Don’t access pre-travel care because of fear of immigration authorities | 2a,18a | No |
| Novel barriers identified in present study | ||
| Negative healthcare experiences in the past, dissuading them from seeking pre-travel care | ||
| Competing priorities and pre-travel tasks, which sometimes take precedence over scheduling pre-travel appointments (purchasing gifts for family, travel logistics, coordinating schedules, etc.) | ||
a
Anecdotal barrier noted in publication which was not based on authors’ primary research results.