modeling insect-repellent use for chikungunya disease prevention among us-caribbean travelers

Introduction: this study examined the relationship between specific psychosocial variables and the use of insect repellents on skin or clothing as a preventive behavior for chikungunya fever among us travelers to caribbean destinations. methods: a crosssectional retrospective online survey method was adopted. us residents who travelled to one of 34 caribbean destinations within the past 12 months and expressed an awareness of chikungunya fever were invited to participate in this study. sociodemographic variables, perceived response efficacy, perceived selfefficacy, perceived chikungunya severity and susceptibility, and selfreported use of insect repellents were investigated. results: results of direct logistic regression analysis revealed a significant association between higher levels of education and the odds of selfreported use of insect repellent on skin or clothing among study participants. among the proximal chikungunyarelated variables, hierarchical binary logistic regression revealed a significant association between scores on perceived response efficacy, perceived selfefficacy, and perceived severity of selfreported use of insect repellents. these results support the existence of a hierarchical relationship between the more proximal chikungunyarelated variables and selfreported use of insect repellents as a personal protective measure (ppm). conclusion: the findings of the current study have important implications for health communication messaging aimed at reducing the spread of chikungunya among us travelers to caribbean destinations. it seems essential to establish the use of insect repellent on skin and clothing as a personal preventive measure against chikungunya disease within an educational context, framed along the lines of chikungunya severity, response efficacy, and selfefficacy, for us travelers to destinations with a high risk of exposure to chikungunya diseasecarrying mosquitoes.