Global TravEpiNet: Global Travelers' Health Surveillance, Applications, and Cons

描述（由申请人提供）：国际旅行不仅可能增加个人旅行者的感染风险，还可能导致感染的全球传播。更好地了解这一在流行病学上具有重要意义的人群，可以改进干预措施，促进国际旅行者的健康，并减少感染在其家乡社区内的传播。这个更新应用程序的重点是Global travelepinet——一个提供旅行前健康建议的诊所联盟。在travelepinet中，旅行者的数据是通过一种新颖的网络工具收集的，该工具同时收集数据，并帮助医疗保健从业者提供必要的建议。自2009年开始收集数据以来，已收集了11,000多次美国国际旅行的信息，并正在对高风险旅行者的子集、干预措施和成本分析进行分析。我们建议在更新申请中以此为基础。具体来说，我们现在提出四个具体目标。在具体目标#1中，我们建议(a)维护、改进和更新全球旅行网网络工具，重点优化其作为(i)最新的交互式黄皮书实践指导工具和（ii）数据收集监测系统的功能，（iii）整合医疗保健提供者的响应以协助实践指导，(b)评估旅行网网络工具和系统的影响，以促进最佳实践。(c)与疾病预防控制中心合作，最大限度地利用旅行前后监测数据系统的比较。在具体目标#2中，我们建议(a)收集和分析全球国际旅行者的数据，包括旅行人口统计数据和预防策略，特别关注高风险旅行者；(b)通过基于网络的交互式调查系统评估国际旅行者的疾病风险。在具体目标#3中，我们建议(a)维持、改进和扩大全球旅行网联盟，尤其侧重于扩大向VFR旅行者、高风险旅行者、学生和当地卫生部门提供护理的诊所的成员，以及(b)扩大对旅行网网络工具的访问，以指导联盟成员之外的最佳实践，特别是在初级保健提供者和非专业从业人员中。在具体目标#4中，我们建议开发新的方法来增加高风险旅行者在旅行前寻求医疗保健的行为，具体来说，我们建议开发、测试、部署和评估一个面向旅行者的网络工具，以告知旅行者潜在的旅行相关健康风险，并促进国际旅行者与他们的医疗保健提供者的互动。

DESCRIPTION (provided by applicant): International travel may not only increase the risk of infection for an individual traveler, but may also contribute to the global spread of infections. A better understanding of this epidemiologically important population could lead to improved interventions to promote the health of international travelers, and to diminish the spread of infections within their home communities. This renewal application focuses on Global TravEpiNet -- a consortium of clinics providing pre-travel health advice. In TravEpiNet, data on travelers are collected via a novel web-tool that simultaneously collects data, and aids health care practitioners in providing essential recommendations. Since beginning data collection in 2009, information regarding more than 11,000 U.S. international trips has been collected, and analyses focusing on subsets of high-risk travelers, interventions, and cost-analyses are ongoing. We propose to build upon this foundation in this renewal application. Specifically, we now propose four Specific Aims. In Specific Aim #1, we propose to (a) maintain, improve, and update the Global TravEpiNet web-tool, focusing on optimizing its ability to function as (i) an up-to-date interactive Yellow Book practice guidance tool and (ii) data collection surveillance system that (iii) integrates health care provider responses to assist practice guidance, (b) assess the impact of the TravEpiNet web-tool and system to facilitate optimal practice, and (c) work with CDC to maximize utility of comparisons of pre and post-travel surveillance data systems. In Specific Aim #2, we propose to (a) collect and analyze data on global international travelers, including travel demographics and preventative strategies, particularly focusing on high-risk travelers, and (b) assess the risk of illness in international travelers through an interactive web-based survey system. In Specific Aim #3, we propose to (a) maintain, improve and expand the Global TravEpiNet Consortium, especially focusing on expanding membership of clinics providing care to VFR travelers, high-risk travelers, students, and local health departments, and (b) expand access to the TravEpiNet web-tool to guide optimal practice beyond consortium membership, especially among primary care providers and non-expert practitioners. In Specific Aim #4, we propose to develop new approaches to increase pre-travel health-care seeking behavior by high-risk travelers, specifically, we propose to develop, test, deploy, and assess a traveler- oriented web-tool to inform travelers of potential travel-related health risks, and to facilitate interaction of international travelers with their health care providers. PUBLIC HEALTH RELEVANCE: International travel may not only increase the risk of infection for an individual traveler, but may also contribute to the global spread of infections. This renewal application focuses on Global TravEpiNet -- a consortium of clinics providing pre-travel health advice, and uses a novel web-tool that simultaneously collects data, and aids health care practitioners in providing essential recommendations. We propose to build upon the foundation provided by TravEpiNet to (1) maintain, enhance, expand access to, and assess impact of the TravEpiNet web-tool and consortium, (2) develop and assess a web-tool to assess risks of international travel, especially among high-risk travelers, (3) develop and assses a traveler-oriented web-tool to minimize health risks associated with international travel, and (4) analyze and communicate data to inform public health recommendations for international travelers, particularly regarding high-risk travelers, with the goal of preserving and advancing the health of the American public.