Travel medicine and mHealth technology: a study using smartphones to collect health data during travel

Background: mHealth methodology such as smartphone applications offers new opportunities to capture the full range of health risks during travel in real time. Our study aims to widen the scope of travel health research in tropical and subtropical destinations by using a smartphone application to collect detailed information on health behaviours, clinical symptoms, accidents and environmental factors during travel.

Methods: We enrolled travel clinic clients in Zurich and Basel ≥18 years of age travelling to Thailand for <5 weeks. Sociodemographic, clinical and risk behaviour information was collected pre-travel. Participants were equipped with a smartphone and an application that (1) actively administers a daily self-report questionnaire on the health risks, behaviours and symptoms the traveller encountered, and (2) passively collects information on the traveller's location and environmental conditions by transformation of raw GPS data.

Results: A prospective cohort of 101 travellers planning travel to Thailand between January and June 2015 was recruited. Of the 101 enrolled travellers, 75 (74.3%) answered at least one questionnaire during travel, 10 (9.9%) had technical difficulties and 16 (15.8%) dropped out. Those who completed questionnaires were a median of 27.0 years old (range 18-57). Travellers filled out a median of 12.0 questionnaires during their trip (range 1-30), corresponding to a median completion rate of 85.0% days of travel. The typical example of a healthy female traveller shows that many and diverse health issues arise during a trip that clusters on certain days. The rich data on behaviour and local environment may be used to explain the occurrence and clustering of health issues.

Conclusions: Use of a smartphone app to collect health information is technically feasible and acceptable amongst a traveller population, minimizes recall bias and greatly increases the quality and quantity of data collected during travel. mHealth technology shows great potential for innovation in travel medicine.