Risk perception related to communicable disease among international college students: A mixed method study

Background: Emerging and re-emerging communicable diseases pose a rising global health threat to developing and industrialized countries. Universal and selective intervention efforts have been ineffective in controlling communicable disease transmission due to a combined lack of factual knowledge, inaccurate perception of individual vulnerability, and inadequate adherence to recommended prevention guidelines. Purpose: This study examined the variables of knowledge, understanding, risk perception, attitude, and behaviors among international college students related to non-sexually transmitted communicable diseases. Methods: A parallel descriptive (quantitative-qualitative) mixed method study examined risk variables using the Risk Perception of Infectious Diseases Questionnaire and an individual semi-structured interview guide. The sample included 109 international students from Africa, Asia, the Middle Ease, Pacific Rim, and South America, who were currently attending seven U.S. universities. Analysis: Quantitative data analyses using descriptive and inferential statistics were performed. Qualitative interviews were conducted and analyzed using Interpretive Phenomenological Analysis. Findings: Quantitative results identified the most important information needed during an outbreak as infection prevention (49%) and disease transmission (28%) and recognition of symptoms (10%). Preferred sources of information during an outbreak were the internet (60%), TV (14%), government agencies (9%) and physicians (6%). Qualitative analysis provided unique insights into the quantitative results. Mixed method data analysis revealed behavioral, cognitive, cultural, and psychological conceptual categories related to prevention of communicable disease. Conclusions: Risk perception among international college students is related to a number of individual and sociocultural factors that must be understood to develop preventive interventions with a greater likelihood of student adherence.