Business, Management and Accounting (all); Arts and Humanities (all); Social Sciences (all); Psychology (all); Economics, Econometrics and Finance (all)
Abstract :
[en] Today, wellness tourism has become a thriving industry. In wellness tourism, the tourists travel to relieve the pressures of ordinary life and become refreshed with no medicinal intervention. In wellness tourism, tourists seldom have any specific physical illnesses; rather, they are interested in enjoying the healing properties of certain regions. In this non-experimental research, a structural equation model was used to analyze the data to explore various aspects of well-being and identify the variables that influence wellness tourism. The statistical population included 237,415 tourists who visited the tourist attractions of Sarab County in Iran. The sample size was determined 384 subjects. The results showed that destination location in terms of climate, positive image of the region, excellent food, as well as physical, traditional, and historical appeals of the region, were the factors that had the highest effect on determining the destination of wellness tourism. In general, this study contributed to the development of wellness tourism in the world including Iran. The practical steps were taken based on the strategies, and approaches presented to reduce stress which enhances well-being during the COVID-19 outbreak.
Disciplines :
Agriculture & agronomy
Author, co-author :
Esfandyari, Hossein; Department of Agricultural Extension and Education, Tarbiat Modares University, Tehran, Iran
Choobchian, Shahla ; Department of Agricultural Extension and Education, Tarbiat Modares University, Tehran, Iran
Momenpour, Yadgar; Department of Agricultural Extension and Education, Tarbiat Modares University, Tehran, Iran
Azadi, Hossein ; Université de Liège - ULiège > TERRA Research Centre > Modélisation et développement
Language :
English
Title :
Sustainable rural development in Northwest Iran: proposing a wellness-based tourism pattern using a structural equation modeling approach
Abbaspour F, Soltani S, Tham A (2021) Medical tourism for COVID-19 post-crisis recovery? Anatolia 32(1):140–143
Agnoletti M, Manganelli S, Piras F (2020) Covid-19 and rural landscape: the case of Italy. Landsc Urban Plan 204:103955
Asadi A, Kalantari K, Choobchian S (2013) Structural analysis of factors affecting agricultural sustainability in Qazvin Province, Iran. J Agric Sci Technol 15(1):11–22
Asem Asl R (2008) Hot and mineral springs of East Azerbaijan province. Geol Train 14(1)
Assaf AG, Oh H, Tsionas MG (2016) Unobserved heterogeneity in hospitality and tourism research. J Travel Res 55(6):774–788
Bagozzi RP, Yi Y, Nassen KD (1998) Representation of measurement error in marketing variables: review of approaches and extension to three-facet designs. J Econ 89(1–2):393–421
Barbier EB, Burgess JC (2020) Sustainability and development after COVID-19. World Dev 135:105082
Bone K (2013) Spiritual retreat tourism in New Zealand Tour Recreation Res 38(3):295–309 10.1080/02508281.2013.11081755 DOI: 10.1080/02508281.2013.11081755
Bou-Llusar JC, Escrig-Tena AB, Roca-Puig V, Beltrán-Martín I (2009) An empirical assessment of the EFQM excellence model: evaluation as a TQM framework relative to the MBNQA model. J Oper Manag 27(1):1–22
Buckley R (2020) Nature tourism and mental health: parks, happiness, and causation. J Sustain Tour 28(9):1409–1424
Büyüközkan G, Mukul E, Kongar E (2020) Health tourism strategy selection via SWOT analysis and integrated hesitant fuzzy linguistic AHP-MABAC approach. Socio-Econ Plan Sci. https://doi.org/10.1016/j.seps.2020.100929
Charak NS (2019) Role of spa resorts in promoting India as a preferred wellness tourism destination—a case of Himalayas Int J Spa Wellness 2:53–62 10.1080/24721735.2019.1668672 DOI: 10.1080/24721735.2019.1668672
Chen KH, Chang FH, Wu C (2013) Investigating the wellness tourism factors in hot spring hotel customer service. Int J Contemp Hosp Manage 25(7):1092–1114. 10.1108/IJCHM-06-2012-0086 DOI: 10.1108/IJCHM-06-2012-0086
Cheraghi S, Choobchain S, Abbasi E (2019) Factors affecting decision-making process in renewable energies investment in agricultural sector, Iran. J Agric Sci Technol 21:1673–1689. https://jast.modares.ac.ir/article-23-25769-en.pdf
Chi CGQ, Qu H (2008) Examining the structural relationships of destination image, tourist satisfaction, and destination loyalty: an integrated approach. Tour Manag 29(4):624–636
Chiwona-Karltun L, Amuakwa-Mensah F, Wamala-Larsson C, Amuakwa-Mensah S, Hatab AA, Made N, Bizoza AR (2021) COVID-19: from health crises to food security anxiety and policy implications. Ambio 50(4):794–811
Chlachula J (2019) Geo-tourism perspectives in East Kazakhstan Geogr Environ Sustain 12(2):29–43. 10.24057/2071-9388-2018-78 DOI: 10.24057/2071-9388-2018-78
Choi Y, Kim J, Choong-Ki L, Benjamin H (2015) The role of functional and wellness values in visitors’ evaluation of spa experiences Asia Pac J Tour Res 20:263–279. 10.1080/10941665.2013.877044 DOI: 10.1080/10941665.2013.877044
Civelek ME (2018) Essentials of structural equation modeling. Lulu.com. This work is licensed under a Creative Commons Attribution 4.0 International License. https://doi.org/10.13014/K2SJ1HR5
Cohen M, Bodeker G (2008) Understanding the global spa industry: spa management. Elsevier, London
Corbet S, Hou Y, Hu Y, Oxley L, Xu D (2021) Pandemic-related financial market volatility spillovers: evidence from the Chinese COVID-19 epicenter. Int Rev Econ Finance 71:55–81. 10.1016/j.iref.2020.06.022 DOI: 10.1016/j.iref.2020.06.022
Cvikl D (2022) Forest therapy and well-being tourism literature review—with assessment of potential for Slovenia. Acad Tur-Tour Innov J 15(1):1–17
De Bloom J, Nawijn J, Geurts S, Kinnunen U, Korpela K (2017) Holiday travel, staycations, and subjective well-being. J Sustain Tour 25(4):573–588
Deng A, Junyang L, Zhengyuan Z (2020) Rural destination revitalization in China: applying evolutionary economic geography in tourism governance. Asia Pac J Tour Res https://doi.org/10.1080/10941665.2020.1789682
Dillette A, Douglas A, Martin D (2018) Do vacations make us happier? exploring the relationships between wellness tourism, happiness and quality of life. J Tour Hosp 7(355):2167–0269
East Azerbaijan Tourism Department (2019) Central Travel Coordination Office, Statistics and Information Committee. Available at https://eachto.ir/ (in Persian)
East Azerbaijan Cultural Heritage and Tourism Development Organization (2021) Central Travel Coordination Office, Statistics and Information Committee. Available at: https://eachto.ir/, https://neshan.org/maps/places/bf511a22e417eb731d98888b1144c95f (in Persian)
Esfandiari H, Choobchian S (2020) Designing a wellness-based tourism model for sustainable rural development. Res Sq 2020. https://doi.org/10.21203/rs.3.rs-63947/v1
Esiyok B, Çakar M, Kurtulmuşoğlu FB (2017) The effect of cultural distance on medical tourism. J Destin Mark Manag 6(1):66–75
Fennell DA, Bowyer E (2020) Tourism and sustainable transformation: a discussion and application to tourism food consumption. Tour Recreation Res 45(1):119–131. 10.1080/02508281.2019.1694757 DOI: 10.1080/02508281.2019.1694757
Fornell C, Larcker DF (1981) Evaluating structural equation models with unobservable variables and measurement error. J Mark Res 39–50. 10.2307/3151312. https://www.jstor.org/stable/3151312
Gan LL, Frederick JR (2011) Medical tourism facilitators: patterns of service differentiation. J Vacation Mark 17(3):165–183
Garjan HS, Paydar MM, Divsalar A (2023) A sustainable supply chain for a wellness tourism center considering discount and quality of service. Expert Syst Appl 211:118682
Gaski J (2017) Common latent factor: confirmatory factor analysis. http://statwiki.kolobkreations.com/index.php?title=Confirmatory_Factor_Analysis&redirect=no#Common_Laten_Factor. Accessed 15 Mar 2018
Ghasemi M, Nejad MG, Aghaei I (2021) Knowledge management orientation and operational performance relationship in medical tourism (overview of the model performance in the COVID-19 pandemic and post-pandemic era). Health Serv Manag Res 34(4):208–222
Gössling S, Scott D, Hall CM (2021) Pandemics, tourism, and global change: a rapid assessment of COVID-19. J Sustain Tour 29(1):1–20
Hall CM (2011) Health and medical tourism: a kill or cure for global public health? Tour Rev 66(1/2):4–15
Hanna P, Wijesinghe S, Paliatsos I, Walker C, Adams M, Kimbu A (2019) Active engagement with nature: outdoor adventure tourism, sustainability, and wellbeing. J Sustain Tour 27(9):1355–1373
Harman HH (1976) Modern factor analysis, 3rd edn. University of Chicago Press, Chicago
Hoang TTH, Van Rompaey A, Meyfroidt P et al. (2020) Impact of tourism development on the local livelihoods and land cover change in the Northern Vietnamese Highlands. Environ Dev Sustain 22:1371–1395. 10.1007/s10668-018-0253-5 DOI: 10.1007/s10668-018-0253-5
Huang L, Xu H (2018) Therapeutic landscapes and longevity: wellness tourism in Bama. Soc Sci Med 197:24–32. 10.1016/j.socscimed.2017.11.052 DOI: 10.1016/j.socscimed.2017.11.052
Huijbens EH (2011) Developing wellness in Iceland. Theming wellness destinations the Nordic Way. Scand J Hosp Tour 11(1):20–41. 10.1080/15022250.2011.525026 DOI: 10.1080/15022250.2011.525026
Hunt CA, Harbor LC (2019) Pro-environmental tourism: lessons from adventure, wellness, and eco-tourism (AWE) in Costa Rica. J Outdoor Recreation Tour 28. https://doi.org/10.1016/j.jort.2018.11.007
Kabir S, Papadopoulos Y (2019) Applications of Bayesian networks and Petri nets in safety, reliability, and risk assessments: a review. Saf Sci 115:154–175
Kalantari Kh (2013) Data processing and analysis in socio-economic research. Sharif, Tehran, 392 pp (in Persian)
Kangas M (2010) Creative and playful learning: learning through game co-creation and games in a playful learning environment. Think Skills Creativity 5(1):1–15
Kaushal V, Srivastava S (2021) Hospitality and tourism industry amid COVID-19 pandemic: perspectives on challenges and learnings from India. Int J Hosp Manag 92:102707. 10.1016/j.ijhm.2020.102707 DOI: 10.1016/j.ijhm.2020.102707
Khan SAR, Yu Z, Belhadi A, Mardani A (2020) Investigating the effects of renewable energy on international trade and environmental quality. J Environ Manag 272:111089
Khaola P, Coldwell D (2019) Explaining how leadership and justice influence employee innovative behaviors. Eur J Innov Manag 22(1):193–212. 10.1108/EJIM-08-2017-0103 DOI: 10.1108/EJIM-08-2017-0103
Kock N (2021) Harman’s single factor test in PLS-SEM: checking for common method bias. Data Anal Perspect J 2(2):1–6
Koncul N (2012) Wellness: a new mode of tourism. Econ Res-Ekon Istraž 25(2):525–534
Korolev A, Safarian A (2018) Evaluation of the natural recreation system of the perm region Geogr Environ Sustain 11(4):24–38. 10.24057/2071-9388-2018-11-4-24-38 DOI: 10.24057/2071-9388-2018-11-4-24-38
Koval V, Mykhno Y, Antonova L, Plekhanov D, Bondar V (2019) Analysis of environmental factors’ effect on the development of tourism. J Geol Geogr Geoecol 28(3):445–456
Krejcie RV, Morgan DW (1970) Determining sample size for research activities. Educ Psychol Meas 30:607–610
Kühnel J, Sonnentag S (2011) How long do you benefit from vacation? A closer look at the fade‐out of vacation effects. J Organ Behav 32(1):125–143
Kumar MP, Kumara NM (2020) Market capitalization: pre and post-COVID-19 analysis. Mater Today: Proc. https://doi.org/10.1016/j.matpr.2020.08.493
Lee J-Y, Podsakoff NP (2003) Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol 88(5):879
Lee K (2019) The art of economic catch-up: Barriers, detours and leapfrogging in innovation systems. Cambridge University Press. https://doi.org/10.20396/rbi.v18i2.8657255
Li M, Cai LA (2012) The effects of personal values on travel motivation and behavioral intention. J Travel Res 51(4):473–487
Lim YJ, Kim HK, Lee TJ (2015) Visitor motivational factors and level of satisfaction in wellness tourism: comparison between first-time visitors and repeat visitors. Asia Pac J Tour Res 21(2):137–156
Lunt N, Carrera P (2011) Systematic review of web sites for prospective medical tourists. Tour Rev 66(1/2):57–67
Luo Y, Lanlung C, Kim E, Tang LR, Song SM (2018) Towards quality of life: the effects of the wellness tourism experience. J Travel Tour Mark 35(4):410–424
Machida K, Tsukamoto H, Mkrtchyan H, Duan L, Dynnyk A, Liu HM,.. Lai MMC (2009) Toll-like receptor 4 mediates synergism between alcohol and HCV in hepatic oncogenesis involving stem cell marker Nanog. Proc Natl Acad Sci 106(5):1548–1553
Mangwane J, Ntanjana A (2020) Wellness tourism in South Africa: development opportunities. In: Rocha Á, Abreu A, de Carvalho J, Liberato D, González E, Liberato P (eds) Advances in tourism, technology and smart systems. Smart innovation, systems and technologies, vol 171. Springer, Singapore
Manthiou A, Kuppelwieser VG, Klaus P (2022) Reevaluating tourism experience measurements: An alternative Bayesian approach. Current Issues in Tourism 1–17
McCormick K, Salcedo J (2017) IBM SPSS Modeler essentials: Effective techniques for building powerful data mining and predictive analytics solutions. Packt Publishing Ltd
MPO (Management and Planning Organization of Iran) (2015) East Azerbaijan development plan. Management and Planning Organization of Iran
NajafiNasab M, Agheli L, Andrade MV, Sadeghi H, Faraji Dizaji S (2018) Determinants of medical tourism expansion in Iran: structural equation modeling approach. Iran J Econ Stud 7(2):169–189. 10.22099/ijes.2018.30739.1485 DOI: 10.22099/ijes.2018.30739.1485
Norouzi AM, Gluyas J, Babaei M (2022) CO2-plume geothermal in fluvial formations: A 2D numerical performance study using subsurface metrics and upscaling. Geothermics 99:102287
NWI (National Wellness Institute) (n.d.) NWI History. Accessed 17 July 2017. www.nationalwellness.org/?page=History.nwi@nationalwellness.org
OECD (2020) iLibrary, O. Tourism Policy Responses to the Coronavirus (COVID-19) Available at: https://www.oecd.org/coronavirus/policy-responses/tourism-policy-responses-to-the-coronavirus-covid-19-6466aa20/
Ozturk I, Sharif A, Godil DI, Yousuf A, Tahir I (2023) The dynamic nexus between international tourism and environmental degradation in top twenty tourist destinations: new insights from quantile-on-quantile approach. Eval rev 47(3):532–562
Perkumienė D, Pranskūnienė R (2019) Overtourism: between the right to travel and residents’ rights. Sustainability 11(7):2138
Perles-Ribes JF, Moreno-Izquierdo L, Torregrosa T, Such-Devesa MJ (2020) The relationship between satisfaction and tourism expenditure in ‘sun and beach destinations: a structural equation modeling approach. Curr Issues Tour 1–15
Podsakoff PM, MacKenzie SB, Podsakoff NP (2012) Sources of method bias in social science research and recommendations on how to control it. Annu Rev Psychol 63(1):539–569. 10.1146/annurev-psych-120710-100452 DOI: 10.1146/annurev-psych-120710-100452
Prayag G (2009) Tourists’evaluations of destination image, satisfaction, and future behavioral intentions—the case of Mauritius. J Travel Tour Mark 26(8):836–853
Prentice C, Hsiao A (2021) Travel deterrents to regional destinations. J Retail Consum Serv 58:102292. 10.1016/j.jretconser.2020.102292 DOI: 10.1016/j.jretconser.2020.102292
Prokopy LS, Gramig BM, Bower A, Church SP, Ellison B, Gassman PW, Ulrich-Schad JD (2020) The urgency of transforming the Midwestern U.S. landscape into more than corn and soybean. Agric Hum Values 37(3):537–539. 10.1007/s10460-020-10077-x DOI: 10.1007/s10460-020-10077-x
Roldán JL, Sánchez Franco MJ (2012) Variance-based structural equation modeling: guidelines for using partial least squares in information systems research. https://doi.org/10.4018/97821246662017926.ch010
Romão J, Machino K, Nijkamp P (2018) Integrative diversification of wellness tourism services in rural areas—an operational framework model applied to east Hokkaido (Japan). Asia Pac J Tour Res 23(7):734–746
Romeo RR, Leonard JA, Robinson ST, West MR, Mackey AP, Rowe ML, Gabrieli JD (2018) Beyond the 30-million-word gap: Children’s conversational exposure is associated with language-related brain function. Psychol Sci 29(5):700–710
Seongsoo J, Jinwon K (2022) Enhancing exercise visitors’ behavioral engagement through gamified experiences: a spatial approach. Tour Manag ume 93(2022):104576. 10.1016/j.tourman.2022.104576 DOI: 10.1016/j.tourman.2022.104576
Serrano Archimi C, Reynaud E, Yasin HM, Bhatti ZA (2018) How perceived corporate social responsibility affects employee cynicism: the mediating role of organizational trust. J Bus Ethics 151(4):907–921
Shahyad S, Mohammadi MT (2020) Psychological impacts of Covid-19 outbreak on the mental health status of society individuals: a narrative review. J Mil Med 22(2):184–192. 10.30491/JMM.22.2.184 DOI: 10.30491/JMM.22.2.184
Singh S, Bhat JA, Shah S, Pala NA (2021) Coastal resource management and tourism development in Fiji Islands: a conservation challenge. Environ Dev Sustain 23:3009–3027
Sirgy MJ, Kruger PS, Lee D-J, Yu GB (2011) How does a travel trip affect tourists’ life satisfaction? J Travel Res 50(3):261–275
Soltani A, Dashti A, Babaei E, Ghazaie M (2015) Evaluation of Mashhad Religious Tourism Services from the perspective of tourists. Armanshahr Archit Urban Dev 7(13):333–342. http://www.armanshahrjournal.com/article_33456.html
Statistics Center of Iran (2019) Statistical yearbook of east Azarbaijan Province, 2016, 2011, 2006, 1996, 1986. https://www.amar.org.ir
Taghizadeh Yazdi M, Barazandeh H (2016) Identifying and ranking health tourism development barriers in Iran using fuzzy VIKOR method. Asian Soc Sci 12, 10.5539/ass.v12n5p54
Tahanisaz S (2020) Evaluation of passenger satisfaction with service quality: a consecutive method applied to the airline industry. J Air Transp Manag 83:101764
Tharakan YG (2014) A comprehensive model for development of sustainable health and wellness tourism destination at Manipal. Int J Hosp Tour Syst 7(1):12–26. http://www.publishingindia.com/ijhts/24/298/2014/
Tikunov VS, Belozerov VS, Antipov SO, Cui W, Purevjav D (2017) Geoinformation technologies in the promotion of tourist destinations in the zone of the Great Silk Road Geogr Environ Sustain J 10(1):44–52. 10.24057/2071-9388-2017-10-1-44-52 DOI: 10.24057/2071-9388-2017-10-1-44-52
Tucker H (2020) Coronavirus bankruptcy tracker. These major companies are failing amid the shutdown. Forbes. https://www.forbes.com/sites/hanktucker/2020/05/03/coronavirus-bankruptcy-tracker-these-major-companies-are-failing-amid-the-shutdown/#5649f95d3425
Turner AJ, Kim J, Fitzmaurice H, Newman C, Worthington K, Chan K, Cohen RC (2020) Observed impacts of COVID‐19 on urban CO2 emissions. Geophys Res Lett 47(22):e2020GL090037
Uğur NG, Akbıyık A (2020) Impacts of COVID-19 on global tourism industry: a cross-regional comparison. Tour Manag Perspect 36:100744. 10.1016/j.tmp.2020.100744 DOI: 10.1016/j.tmp.2020.100744
Valaei M, Zivari-Kazempour A, Bodaghi A (2021) Jordan amenability of banach algebras. Math Slovaca 71(3):721–730
Watthayu W, Peng Y (2004) A Bayesian network based framework for multi-criteria decision making. In: Proceedings of the 17th international conference on multiple criteria decision analysis
WHO (World Health Organization) (2018) A state of complete physical mental and social well-being and not merely the absence of disease or infirmity. Constitution of the World Health Organization Basic Documents, Forty-fifth edition, Supplement. https://www.who.int/about/governance/constitution#:~:text=Health%20is%20a%20state%20of,belief%2C%20economic%20or%20social%20condition
WHO (World Health Organization) (2020) Coronavirus (COVID-19). World Health Organization. https://covid19.who.int/region/emro/country/ir
Wilkinson A (2020) Local response in health emergencies: key considerations for addressing the COVID-19 pandemic in informal urban settlements. Environ Urbanization 32(2):503–522
World Health Organization (2018) What quantitative and qualitative methods have been developed to measure community empowerment at a national level? vol 59. World Health Organization
World Tourism Organization (2019) Iran, Islamic Republic of Country-specific: Basic indicators (Compendium) 2013–2017. https://www.e-unwto.org
Wu GC, Baleanu D (2014) Discrete fractional logistic map and its chaos. Nonlinear Dynamics 75:283–287
Yan X, He S (2020) The co-evolution of therapeutic landscape and health tourism in Bama longevity villages, China: an actor-network perspective. Health Place 66:102448. 10.1016/j.healthplace.2020.102448 DOI: 10.1016/j.healthplace.2020.102448
Yao H, Chen JH, Xu YF (2020) Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry 7:e21. 10.1016/S2215-0366(20)30090-0 DOI: 10.1016/S2215-0366(20)30090-0
Yin L (2020) Forecast without historical data: objective tourist volume forecast model for newly developed rural tourism areas of China. Asia Pac J Tour Res 25(5):555–571. 10.1080/10941665.2020.1752755 DOI: 10.1080/10941665.2020.1752755
Zabihkhah M, Afshar S (2015) Health village design with health tourism development approach. Master Thesis, Soura University, Faculty of Architecture
Zhao X, Zhang R, Qiao S, Wang X, Zhang W, Ruan W,.. Gao GF (2022) Omicron SARS-CoV-2 neutralization from inactivated and ZF2001 vaccines. N Engl J Med 387(3):277–280
