Streaming data from a smartphone application: A new approach to mapping health during travel

Background: New research methods offer opportunities to investigate the influence of environment on health during travel. Our study uses data from a smartphone application to describe spatial and environmental patterns in health among travellers. Methods: A prospective cohort of travellers to Thailand used a smartphone application during their trips to 1) answer a daily questionnaire about health behaviours and events, and 2) collect streaming data on environment, itinerary, and weather. Incidence of health events was described by region and trip type. The relationship between environmental factors and health events was modelled using a logistic mixed model. Results: The 75/101 (74.3%) travellers that completed the study answered 940 questionnaires, 796 (84.7%) of which were geolocated to Southeast Asia. Accidents occurred to 20.0% of participants and were mainly in the Thai islands, while self-rated “severe” mental health events (21.3%) were centred in Bangkok. The odds of a health event were higher in Chiang Mai (2.34, 95% CI: 1.08, 5.08) and on rainy days (1.86, 95% CI: 1.03, 3.36). Conclusions: Distinct patterns in spatial and environmental risk factors emerged in travellers to Thailand. Location based tracking could identify “hotspots” for health problems and update travel advice to target specific risk groups and regions.