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Epidemiology and Society Health Review| ESHR 
 

Vol 2 No1 2020 
 

9 

Research Article 
 
Traveler’s Knowledge and Attitudes to Access Tourism 
Health Centre at Gunungkidul: Case Study at Indrayanti 
Beach 
 
Noval Ali Lating1 and Liena Sofiana1* 
 
1Faculty of Public Health, University of Ahmad Dahlan, Yogyakarta, Indonesia 
 
* Correspondence: liena.sofiana@ikm.uad.ac.id. Tel: +6285875555584 
Received 09 January 2020; Accepted 30 March 2020; Published 05 May 2020 

 

ABSTRACT 
 
Background: Indrayanti beach located at Gunungkidul district, Yogyakarta. The number of 
tourists visited this beach has increased each year, meaning that it increases the health risks 
for the tourist and people involved such as infectious diseases, blisters, lost, injured by 
objects or marine animals, seawater irritation. However, according to the previous study, a 
traveler who is accessing the Tourism Health Centre is low. This research aimed to identify 
the relationship between knowledge and attitude of the travelers in Indrayanti Beach to the 
traveler’s access to the Tourism Health Centre. 
Method: Quantitative analytical approach with a cross-sectional study design was applied in 
this study. Of 106 travelers was participate in this study that was recruited through accidental 
sampling. A tested questionnaire contained knowledge, and attitude was asked to the 
Indrayanti visitor. A Chi-square test was used to analyze the result. 
Results: There is a significant association between knowledge level (p=0.027) and attitude 
(p = 0.000) to the willingness to access the Tourism Health Centre.  
Conclusion: Knowledge and attitude are the primary aspects of the willingness to access 
the Tourism Health Centre. 

 
Keywords: Knowledge, Attitude, Travelers, Usage, Tourism Health Centre 
 

INTRODUCTION 

Tourism is each tour activity supported by facilities and services provided by the public, 
employers, government, and local government (1). Tourism in Indonesia is part of a social-
economic activity. Indrayanti beach is one of the famous tourist destinations in the 
Yogyakarta Special Region, both for the domestic and foreign visitors. This beach located in 
Gunungkidul district, in the east of Yogyakarta. According to the Tourism Statistics from 
Yogyakarta Tourism Office, the number of visitors to Gunungkidul is increasing since 2016 
with 1.9 million visits or equal with 160,000 visitors per month, and it continues the year 
after. In 2017, recorded 2,2 million visitors or 180,000 people per month (2),(3). 
 
Today, the development of tourist sectors prioritizes the comfort and safety of the visitors. 
Along with the increasing number of tourists, it is followed by a rising of health risks, 
although it depends on the physical condition of the tourists (4).  Hence, attention to 
facilities, in particular, the health facilities or called Tourism Health Centre is needed. 



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Information about this facility is essential to guide the visitor on seeking help when they have 
a problem in a particular resort.  
 
Several factors could be influencing a person's behavior on accessing service in the tourism 
health center. According to the Health Behavior Model of Health Services Utilization, there 
are three factors that influence the utilization of health services: predisposing and enabling 
need (5). Predisposing is a factor that facilitates one's interaction, such as knowledge, 
attitudes, traditions and beliefs, value systems, educational levels, socioeconomic and 
enabling is a factor that allows behavior including the availability of infrastructure or health 
facilities for the community.  Previous studies stated, there is a relationship between 
knowledge and attitudes of domestic and foreign tourists with tourism health center 
utilization (6). In addition, it was known that there was a relationship between knowledge and 
utilization of health services also the association between level of emergency travel 
knowledge with the utilization of tourism health center (7),(8). Considering the importance of 
the topic, this research aimed to analyze the association between knowledge and attitudes 
of Indrayanti visitor to the usage of Indrayanti tourism health center, which is provided by the 
district government of Gunungkidul.  

 

METHODS 

This study carried out at Indrayanti beach, Gunungkidul, by using an observational study 
with a cross-sectional approach (9). Accidental sampling was applied to recruit the 
respondent. The samples were travelers who were in Indrayanti Beach with minimum hold 
senior high school educations. The sample size was 106 respondents based on a sample 
calculation with an unknown population. The independent variable in this study is the 
knowledge and traveler attitudes, while the dependent variable is the utilization of 
Gunungkidul Tourism Health Centre. We used a questionnaire that had previously been 
tested for validity and reliability—respondents filled in the questionnaires by themselves. 
Data was administered with cleaning, editing, coding, and entering the software for the Chi-
square test. 
 

RESULTS 

Respondent characteristic is presented by gender, age, education, and occupation (Table 1). 
The majority of the respondents are female (n = 67; 63.2%). Eighty respondents or (75.5%) 
of respondents come from outside of Gunungkidul. As to education, more than half of the 
respondents belong to the age group of 17-25 years old (n = 54; 50.9%. More than 40% of 
respondents are students (n = 47; 44.3%). Most of the respondent (n = 65, 61.3%) hold 
university educations.  
 
Chi-square test between the level of knowledge to the utilization of Gunungkidul Tourism 
Health Centre obtains p-value = 0.027 with PR = 1.237 (95% CI= 1.027–1.490), meaning 
that the significant associated. Visitors who have good knowledge have 1.237 times as likely 
to use the Tourism Health Centre compared to people who have insufficient knowledge. 
While for attitude, we found p = 0.000 with PR= 1.549 (95% CI= 1.206–1.989), meaning that 
the people who have a positive attitude, they have 1.5949 times as likely to use the Tourism 
Health Centre compared to people with negative attitudes (Table 2). 
 
 
 
 
 



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Table 1. Demographic Characteristics of the Respondents 
 

Characteristics Frequency Percentage (%) 
Gender 

Male 39 36.8 
Female 67 63.2 

Age 
17-25  54 50.9 
26-35  33 31.1 
36-45  19 17.9 

Address 
Gunungkidul 26 24.5 
Outside of Gunungkidul 80 75.5 

Education 
High School 41 38.7 
University 65 61.3 

Occupation 
Government employees 13 12.3 
Private employees 21 19.8 
Entrepreneur 11 10.4 
Labour 14 13.2 
Student 47 44.3 

Total 106 100 
        Source: Primary Data, 2019 

 
Table 2. Correlation between Level of Knowledge, Attitudes and the Utilization of 

Tourism Health Centre 
 

Variables 
Utilization of Tourism 

Health Centre PR 
(95% CI) P-value Yes No 

n % n % 
Knowledge 

High 
Low 

 
43 
42 

 
50.6 
49.4 

 
5 

16 

 
23.8 
76.2 

 
1.237 

(1.027-1.490) 
0.027 

Attitude 
Positive 
Negative 

 
59 
26 

 
69.4 
30.6 

 
4 

17 

 
19 
81 

 
1.549 

(1.206-1.989) 
0.000 

 

DISCUSSIONS 

The level of people's knowledge and behavior is influenced by the level of education. In this 
study, most of the respondents hold university education (61.3%). Levels of education is an 
external factor that influences a person's knowledge level. Travelers who have high 
education will have a good knowledge level (10). Low levels of education are more likely to 
not access health services because of the lack of understanding about the benefits of health 
services when conditions are emergency (11). These results are in line with previous 
research stated there is a relationship between community knowledge and health care 
utilization (PHC) (12). A person's knowledge is related to education and age; in this 
research, several respondents aged between 17-25 years, which is a period of taking 
education. The age of someone may affect the mindset of information acceptance (10).  



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Our results are consistent with previous studies that said there are relationships between 
knowledge and utilization of health services (7),(13). The results of this study were 
consistent with the theory of behavior model of health services utilization, that knowledge is 
one of the predisposing factors that affect a person in the use of health services (5). People 
who have not used health services at tourist sites can be caused by a lack of information 
regarding the existence of these health service locations. Simply and accurate information 
are needed to inform the visitor about the presence of these health services. The information 
form can be various media, both print, and electronic media, that provide health information 
and health services (14).  
 
The attitude is the driving force to perform or not a particular behavior, and attitude is more 
to an individual's awareness process. A good attitude influences the actions in the utilization 
of the Tourism Health Centre. Traveler attitude in this study belongs to the category quite 
well; this is good for the tourist administrators to increase the media to inform the existence 
of the Tourism Health Centre (15). Knowledge relates to a person's attitude in the utilization 
of health services after people know the importance of health services; a good attitude will 
be formed. Such as, people agreeing to use health services or even giving advice to others 
to be able to use health services when needed (15). 
 
The travel environment also affects the visitor’s attitude. Visitors generally susceptible to 
microorganisms because they visit a new area. Environmental hygiene is an essential 
aspect of visitors. The cleanliness tourist spot is the most important thing for the visitor 
because it affects their health. It corresponds to the theory that all the conditions surrounding 
people is affecting the development and attitudes. Through mutual interaction will affect the 
practice of someone on hygiene sanitation (16). 
 
Having a high level of knowledge and a positive attitude may indicate the level of compliance 
with the use of the Tourism Health Centre is excellent. Thus, tourists expected to be able to 
recognize potential hazards in the tourist destination and able to understand what they 
should do to protect the health and minimize the risk of accidents when traveling especially 
coastal tourism. 
 
The satisfaction of foreign tourists to visit tourist sites is also influenced by the quality of 
services provided, such as the presence of health services at tourist sites. The better quality 
of medical services leads the higher tourist satisfaction (17). The presence of clinics or 
health services, search and rescue teams (SAR), and proper infrastructure is influencing 
visitor satisfaction (18)-(20). 
 

CONCLUSIONS 

Based on the results of this study concluded that there is a relationship between the level of 
knowledge and attitudes to the use of the Tourism Health Centre at Indrayanti beach, 
Gunungkidul. 
 

Authors Contribution 

NAL contributed to the data collection and analysis of the data. LS contributed to the data 
analysis and manuscript preparations.  

Funding 



Epidemiology and Society Health Review| ESHR 
 

Vol 2 No1 2020 
 

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This research does not receive external funding. 

Conflict of interest 

There is no conflict of interest. 

 

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