Extending the theory of planned behaviour to foreign students’ perceptions of traditional Chinese medical tourism
Vol 9, Issue 1, 2024, Article identifier:
VIEWS - 479 (Abstract) 243 (PDF)
Abstract
Medical tourism is becoming an increasingly important component of the international tourism industry, and Chinese medical tourists make up a big percentage of this growing tourism market segment. Most previous studies on Chinese medical tourism have focused on Chinese outbound medical tourism, but there has little research undertaken as yet, on foreign tourists’ perception towards traditional Chinese medical tourism. Specifically, most of the previous studies utilized the measurement scale of destination image in medical tourism research, resulting in a limited representation of the nature of medical tourism. This study aims to examine the relationship between attitude, subjective norm (SN), perceived behavioural control (PBC), familiarity, perceived ease of visa application (PEVA) and intention toward traditional Chinese medical tourism. A quantitative approach was used, adopting a survey methodology involving 344 foreigners which was followed by subsequent empirical testing of the postulated hypotheses. The results suggested that attitude, PBC, familiarity and PEVA positively influence intention. PEVA positively influences attitude, PBC and intention respectively. Results also demonstrated that familiarity influenced attitude and PBC, and SN positively influenced familiarity. This study expands the existing knowledge on how PEVA and familiarity influenced visitation in medical tourism literature which can benefit key stakeholders in the tourism industry.
Keywords
Full Text:
PDFReferences
1. Cham TH, Lim YM, Sia BC, et al. Medical tourism destination image and its relationship with the intention to revisit: A study of Chinese medical tourists in Malaysia. Journal of China Tourism Research 2021; 17(2): 163–191. doi:10.1080/19388160.2020.1734514
2. Chia KW, Liao YM. An exploratory study of factors influencing Chinese outbound medical tourism. Journal of China Tourism Research 2021; 17(3): 376–394. doi:10.1080/19388160.2020.1780177
3. Berdine G. Medical tourism. The Southwest Respiratory and Critical Care Chronicles 2019; 7(28): 53–54. doi:10.12746/swrccc.v7i28.546
4. Park G, Chung K, Oh J, Kim W. A study on Chinese travelers' behavior on selection attributes of Korean medical tourism. Indian Journal of Science and Technology 2016; 9(1): 1–7. doi:10.17485/ijst/2016/v9iS(1)/109906
5. Soni V, Gupta M, Shukla R. Medical tourism in India. Test Engineering and Management 2020; 82: 2511–2515.
6. Yu J, Seo J, Hyun SS. Attributes of medical tourism destination brands: Case study of the Korean medical tourism market. Journal of Travel & Tourism Marketing 2021; 38(1): 107–121. doi:10.1080/10548408.2021.1875104
7. Khan MJ, Chelliah S, Haron MS, Ahmed S. Role of travel motivations, perceived risks and travel constraints on destination image and visit intention in medical tourism. Sultan Qaboos University Medical Journal 2017; 17(1): 11–17. doi:10.18295/squmj.2016.17.01.003
8. Zarei A, Feiz D, Minbashrazgah MM, Maleki F. Factors influencing selection of medical tourism destinations: A special niche market. International Journal of Healthcare Management 2020; 13(sup1): 192–198. doi:10.1080/20479700.2018.1492764
9. Mehdi I, Bahrani BJA. Medical tourism in Oman. Cancer Reports and Reviews 2020; 4: 1–5. doi:10.15761/CRR.1000212
10. Habibi A, Mousavi M, Jamali SM, Ale Ebrahim N. A bibliometric study of medical tourism. Anatolia 2022; 33(3): 415–425. doi:10.1080/13032917.2021.1954042
11. Cheng KM. Medical tourism: Chinese maternity tourism to Hong Kong. Current Issues in Tourism 2016; 19(14): 1479–1486. doi:10.1080/13683500.2015.1042359
12. Lam CC, du Cros H, Vong TN. Macao's potential for developing regional Chinese medical tourism. Tourism Review 2011; 66(1/2): 68–82. doi:10.1108/16605371111127242
13. Ren X, Zhang N. Private hospitals rise on back of FDI. Available online: http://www.chinadaily.com.cn/business/2017-10/09/content_33012993.htm (accessed on 12 October 2023).
14. Ying T, Wen J, Tan X. Does traditional Chinese medicine attract inbound tourists to China? An investigation from Russian tourists’ perspectives. Anatolia 2020; 31(4): 662–665. doi:10.1080/13032917.2020.1742170
15. Ormond M, Sulianti D. More than medical tourism: Lessons from Indonesia and Malaysia on South—South intra-regional medical travel. Current Issues in Tourism 2017; 20(1): 94–110. doi:10.1080/13683500.2014.937324
16. China Daily. Traditional Chinese medicine in China. Available online: http://www.chinadaily.com.cn/kindle/2016-12/07/content_27601954.htm (accessed on 12 October 2023).
17. American College of Traditional Chinese Medicine. What is Chinese medicine? 2021. Available online: https://www.actcm.edu/chinese-medicine (accessed on 12 October 2023).
18. Zhang D, Duan L, Zhou N. Market survey on traditional medicine of the third month fair in Dali Prefecture in Yunnan Province, South West China. African Journal of Traditional, Complementary, And Alternative Medicines 2014; 11(2): 377–401. doi:10.4314/ajtcam.v11i2.25
19. Wen J, Wang CC, Kozak M. Post-COVID-19 Chinese domestic tourism market recovery: Potential influence of traditional Chinese medicine on tourist behaviour. Anatolia 2021; 32(1): 121–125. doi:10.1080/13032917.2020.1768335
20. Ni L, Zhou L, Zhou M, et al. Combination of western medicine and Chinese traditional patent medicine in treating a family case of COVID-19. Frontiers of medicine 2020; 14(2): 210–214. doi:10.1007/s11684-020-0757-x
21. Cyranoski D. Why Chinese medicine is heading for clinics around the world. Nature 2018; 561: 448–450. doi:10.1038/d41586-018-06782-7
22. Ulker-Demirel E, Ciftci G. A systematic literature review of the theory of planned behavior in tourism, leisure and hospitality management research. Journal of Hospitality and Tourism Management 2020; 43: 209–219. doi:10.1016/j.jhtm.2020.04.003
23. Wang L, Wong PPW, Elangkovan NA, Chee WM. Green hotel selection of Chinese consumers: A planned behavior perspective. Journal of China Tourism Research 2019; 15(2): 192–212. doi:10.1080/19388160.2018.1553743
24. Paul J, Modi A, Patel J. Predicting green product consumption using theory of planned behavior and reasoned action. Journal of Retailing and Consumer Services 2016; 29: 123–134. doi:10.1016/j.jretconser.2015.11.006
25. Wang L, Wong PPW. Marketing of environmentally friendly hotels in China through religious segmentation: A theory of planned behaviour approach. Tourism Review 2021; 76(5): 1164–1180. doi:10.1108/TR-08-2019-0327
26. Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes 1991; 50(2): 179–211. doi:10.1016/0749-5978(91)90020-T
27. Wang L, Wong PPW, Zhang Q. Travellers’ destination choice among university students in China amid COVID-19: Extending the theory of planned behaviour. Tourism Review 2021; 76(4): 749–763. doi:10.1108/TR-06-2020-0269
28. Yuzhanin S, Fisher D. The efficacy of the theory of planned behavior for predicting intentions to choose a travel destination: A review. Tourism Review 2016; 71(2): 135–147. doi:10.1108/TR-11-2015-0055
29. Soliman M. Extending the theory of planned behavior to predict tourism destination revisit intention. International Journal of Hospitality & Tourism Administration 2021; 22(5): 524–549. doi:10.1080/15256480.2019.1692755
30. Nimri R, Patiar A, Kensbock S, Jin X. Consumers’ intention to stay in green hotels in Australia: Theorization and implications. Journal of Hospitality & Tourism Research 2019; 44(1): 149–168. doi:10.1177/1096348019862602
31. Marvi MH, Minbashrazgah MM, Zarei A, Baghini GS. Knowledge foundation in green purchase behaviour: Multidimensional scaling method. Cogent Business & Management 2020; 7(1): 1773676. doi:10.1080/23311975.2020.1773676
32. Wang L, Zhang Q, Ding YY, Wong PPW. The effect of social and personal norm on intention to patronize green hotels: Extension of theory of planned behavior. Journal of China Tourism Research 2023; 19(2): 311–334. doi:10.1080/19388160.2022.2070567
33. Nawi NBC, Mamun AA, Nasir NAM, et al. Brand image and consumer satisfaction towards Islamic travel packages: A study on tourism entrepreneurship in Malaysia. Asia Pacific Journal of Innovation and Entrepreneurship 2019; 13(2): 188–202. doi:10.1108/APJIE-02-2019-0007
34. Sutikno V, Indarini, Margaretha S. Young consumer’s purchase intention toward environmentally friendly products in Indonesia: Expanding the theory of planned behavior. Advances in Economics, Business and Management Research 2020; 115: 36–40. doi:10.2991/aebmr.k.200127.008
35. Wang L, Fu CF, Wong PPW, Zhang Q. The impact of tourists’ perceptions of space-launch tourism: An extension of the theory of planned behavior approach. Journal of China Tourism Research 2022; 18(3): 549–568. doi:10.1080/19388160.2021.1900972
36. Wang L, Tan XF, Wang ZX, Wong PPW. Factors influencing students' cheating behaviours: An empirical evidence from China. International Journal of Education, Science, Technology, and Engineering 2023; 6(1): 10–20. doi:10.36079/lamintang.ijeste-0601.475
37. Ateş H. Understanding students’ and science educators’ eco-labeled food purchase behaviors: Extension of theory of planned behavior with self-identity, personal norm, willingness to pay, and eco-label knowledge. Ecology of Food and Nutrition 2021; ahead-of-print: 1–19. doi:10.1080/03670244.2020.1865339
38. Ngah AH, Halim MR, Aziz NA. The influence of electronic word of mouth on theory of reasoned action and the visit intention to the world monument fund site. Indian Journal of Public Health Research and Development 2018; 9(11): 1277–1282. doi:10.5958/0976-5506.2018.01632.7
39. Patharia I, Rastogi S, Vinayek R, Malik S. A fresh look at environment friendly customer's profile: Evidence from India. International Journal of Economics and Business Research 2020; 20(3): 310–321. doi:10.1504/IJEBR.2020.110425
40. Kim S, Lehto X, Kandampully J. The role of familiarity in consumer destination image formation. Tourism Review 2019; 74(4): 885–901. doi:10.1108/TR-10-2018-0141
41. Stylidis D, Woosnam KM, Ivkov M, Kim SS. Destination loyalty explained through place attachment, destination familiarity and destination image. International Journal of Tourism Research 2020; 22(5): 604–616. doi:10.1002/jtr.2359
42. Tan WK, Wu CE. An investigation of the relationships among destination familiarity, destination image and future visit intention. Journal of Destination Marketing & Management 2016; 5(3): 214–226. doi:10.1016/j.jdmm.2015.12.008
43. Chi HK, Huang KC, Nguyen HM. Elements of destination brand equity and destination familiarity regarding travel intention. Journal of Retailing and Consumer Services 2020; 52: 101728. doi:10.1016/j.jretconser.2018.12.012
44. Smith WW, Li X, Pan B, et al. Tracking destination image across the trip experience with smartphone technology. Tourism Management 2015; 48: 113–122. doi:10.1016/j.tourman.2014.04.010
45. Kastenholz E. ‘Cultural proximity’ as a determinant of destination image. Journal of Vacation Marketing 2010; 16(4): 313–322. doi:10.1177/1356766710380883
46. Ju G, Liu J, He G, et al. Literary destination familiarity and inbound tourism: Evidence from mainland China. Journal of Social Computing 2021; 2(2): 193–206. doi:10.23919/JSC.2021.0013
47. Wang L, Zhang Q, Wong PPW. Impact of familiarity and green image on satisfaction and loyalty among young green hotels’ guests—A developing country’s perspective. Frontiers in Psychology 2022; 13: 899118. doi:10.3389/fpsyg.2022.899118
48. Baloglu S. Image variations of Turkey by familiarity index: Informational and experiential dimensions. Tourism Management 2001; 22(2): 127–133. doi:10.1016/S0261-5177(00)00049-2
49. Murphy L, Benckendorff P, Moscardo G. Destination brand personality: Visitor perceptions of a regional tourism destination. Tourism Analysis 2007; 12(5–6): 419–432. doi:10.3727/108354207783227948
50. Bianchi C, Milberg S, Cúneo A. Understanding travelers' intentions to visit a short versus long-haul emerging vacation destination: The case of Chile. Tourism Management 2017; 59: 312–324. doi:10.1016/j.tourman.2016.08.013
51. Tsai SP. Place attachment and tourism marketing: Investigating international tourists in Singapore. International Journal of Tourism Research 2012; 14(2): 139–152. doi:10.1002/jtr.842
52. Wang L, Shao YX, Heng JY, et al. A deeper understanding of attitude and norm applicable to green hotel selection. Journal of Quality Assurance in Hospitality & Tourism 2023; ahead-of-print: 1–33. doi:10.1080/1528008X.2023.2165594
53. Whyte B. Visa-free travel privileges: An exploratory geographical analysis. Tourism Geographies 2008; 10(2): 127–149. doi:10.1080/14616680801999984
54. Song H, Lee CK, Reisinger Y, Xu HL. The role of visa exemption in Chinese tourists’ decision-making: A model of goal-directed behavior. Journal of Travel & Tourism Marketing 2017; 34(5): 666–679. doi:10.1080/10548408.2016.1223777
55. Neumayer E. Visa restrictions and bilateral travel. The Professional Geographer 2010; 62(2): 171–181. doi:10.1080/00330121003600835
56. Li S, Song H. Economic impacts of visa restrictions on tourism: A case of two events in China. Annals of Tourism Research 2013; 43: 251–271. doi:10.1016/j.annals.2013.07.007
57. Yudhistira MH, Sofiyandi Y, Indriyani W, Pratama AP. Heterogeneous effects of visa exemption policy on international tourist arrivals: Evidence from Indonesia. Tourism Economics 2021; 27(4): 703–720. doi:10.1177/1354816619897150
58. Han H, Lee S, Lee CK. Extending the theory of planned behavior: Visa exemptions and the traveller decision-making process. Tourism Geographies 2011; 13(1): 45–74. doi:10.1080/14616688.2010.529930
59. Saunders M, Lewis P, Thornhill A. Research methods for business students, 5th ed. Pearson Education; 2011.
60. Wang L, Zhang Q, Wong PPW. Purchase intention for green cars among Chinese millennials: Merging the value–attitude–behavior theory and theory of planned behavior. Frontiers in Psychology 2022; 13: 786292. doi:10.3389/fpsyg.2022.786292
61. Wang L, Wang ZX, Zhang Q, et al. Consumers’ intention to visit green hotels – A goal-framing theory perspective. Journal of Sustainable Tourism 2022; 30(8): 1837–1857. doi:10.1080/09669582.2021.1977937
62. Global Times. How many foreigners are there in China? Available online: https://baijiahao.baidu.com/s?id=1660411896633066139&wfr=spider&for=pc (accessed on 12 October 2023).
63. China Youth Daily. How many foreigners are there in Guangzhou now? Which countries are they mainly from? The official figures. Available online: https://baijiahao.baidu.com/s?id=1663812116289374807&wfr=spider&for=pc (accessed on 12 October 2023).
64. Evans JR, Mathur A. The value of online surveys. Internet Research 2005; 15(2): 195–219. doi:10.1108/10662240510590360
65. Tabachnick BG, Fidell LS. Using Multivariate Statistics, 6th ed. Allyn & Bacon/Pearson Education; 2012.
66. Kline RB. Principles And Practice of Structural Equation Modeling, 4th ed. Guilford; 2015.
67. Hulland J, Baumgartner H, Smith KM. Marketing survey research best practices: Evidence and recommendations from a review of JAMS articles. Journal of the Academy of Marketing Science 2018; 46: 92–108. doi:10.1007/s11747-017-0532-y
68. Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology 2003; 88(5): 879–903. doi:10.1037/0021-9010.88.5.879
69. Green SB, Salkind NJ. Using SPSS for Windows And Macintosh: Analyzing And Understanding Data. Prentice Hall Press; 2010.
70. Hair Jr JF, Sarstedt M, Hopkins L, Kuppelwieser VG. Partial least squares structural equation modeling (PLS-SEM). European Business Review 2014; 26(2): 106–121. doi:10.1108/EBR-10-2013-0128
71. Hair Jr JF, Black WC, Babin BJ, Tatham RL. Multivariate Data Analysis: A Global Perspective, 7th ed. Pearson Prentice Hall; 2010.
72. Byrne BM. Structural Equation Modeling With AMOS: Basic Concepts, Applications, And Programming. Routledge; 2016.
73. Meyers LS, Gamst G, Guarino AJ. Applied Multivariate Research: Design And Interpretation. Sage; 2006.
74. Wang L, Zhang Q, Cao MR, Wong PPW. Use and perceptions of electronic cigarettes among young Chinese generation: Expanding the theory of planned behaviour. International Journal of Humanities, Management, and Social Science 2022; 5(1): 26–39. doi:10.36079/lamintang.ij-humass-0501.339
75. Bahl P, Kumar S. Green purchase behaviour among young generation: Meditating role of purchase intention. Think India Journal 2019; 22(10): 5262–5283.
76. Liu MT, Liu Y, Mo Z. Moral norm is the key: An extension of the theory of planned behaviour (TPB) on Chinese consumers' green purchase intention. Asia Pacific Journal of Marketing and Logistics 2020; 32(8): 1823–1841. doi:10.1108/APJML-05-2019-0285
77. Lepp A, Gibson H. Tourist roles, perceived risk and international tourism. Annals of Tourism Research 2003; 30(3): 606–624. doi:10.1016/S0160-7383(03)00024-0
78. Casali GL, Liu Y, Presenza A, Moyle CL. How does familiarity shape destination image and loyalty for visitors and residents? Journal of Vacation Marketing 2020; 27(2): 151–167. doi:10.1177/1356766720969747
79. Cheng SJ, Jia HX, Wong PPW, Wang L. Factors influencing consumers’ purchase intention on organic foods via a theory of planned behaviour approach. Journal of Tourism, Culinary and Entrepreneurship 2023; 3(1): 98–116. doi:10.37715/jtce.v3i1.3681
DOI: https://doi.org/10.54517/esp.v9i1.1861
(479 Abstract Views, 243 PDF Downloads)
Refbacks
- There are currently no refbacks.
Copyright (c) 2023 Lei Wang, Hao-Xiang Jia, Su-Juan Cheng, Philip Pong Weng Wong
License URL: https://creativecommons.org/licenses/by/4.0/