International Journal of Applied Engineering Research ISSN 0973-4562 Volume 13, Number 1 (2018) pp.

651-661
© Research India Publications. http://www.ripublication.com

Wellness tourism: What motivates tourists to participate?

Dr. Demet Tuzunkan

Sol International Hotel & Foodservice Department,
Woosong College, Daejeon, South Korea.

Abstract history and indicated economic benefits. One of the possible

reasons is that wellness tourism is relatively a new niche in
Wellness tourism could add to the existing job opportunities
the tourism industry in a professional manner (Medina,
in destinations, and with its economic impact it could create
larger economic benefits to the society. Despite its long Munoz & Medina-Munoz, 2012; Smith & Kelly, 2006).
history and economic benefits, relatively less attention is Although studies are limited on this subject, they adopted
different conceptualization of wellness tourism in which it is
given to the wellness tourism in the literature. In particular,
generally confused with medical tourism. It is important to
there are limited studies analyzing the factors that motivates
differentiate the medical tourism from wellness tourism.
tourists to participate in wellness tourism in the United States
(US), where the wellness tourism sector has been growing Medical tourism is closely related to wellness tourism.
exponentially. The purpose of this study is to explore However, it is worth noting that medical tourism and wellness
domestic tourists’ motivations to participate in wellness tourism are not identical. Some of the studies considered
tourism in the US. A survey is conducted in the US to collect wellness tourism as a segment of health tourism (e.g. Dinu,
data from potential wellness tourism participants. The results Zbuchea, & Cioaca, 2010; Muller & Kaufman, 2001), other
showed that keeping up with fashion and spiritual health were considered spa tourism as a tourism segment (e.g. Mak, Wong,
significnat predictors of behavioral intention to participate in & Chang, 2009), and some of the studies treated health
wellness tourism. There were no differences in terms of tourism as a whole without further segmentation (e.g. Bennett,
behaviroal intention to participate among different age groups, King & Milner, 2004). Carrera and Bridges (2006) categorize
suggesting that wellness tourism doesn’t primarily identify health and wellness tourism as a sub-category of medical
with any age groups. Theoretical and practical implications tourism, whereas Connell (2013) suggests that medical
are discussed. tourism is a purpose of travel with stronger care and
procedure, relative to health and wellness tourism. Chen,
Keywords: wellness tourism, motivation, intention, push and
Prebensen, and Huan (2008), and Huijbens (2011)
pull factors
differentiate the wellness tourism from health and medical
tourism. Also, Bookman and Bookman (2007) suggest that
INTRODUCTION people travel for three different types of medical treatment:
invasive, diagnostic, and lifestyle. This paper follows
People have been traveling to different places that have Bookman and Bookman (2007), Chen, Prebensen, and Huan
specific natural resources since early historical ages with (2008) and Huijbens (2011), who differentiated wellness
desire of relaxation (Goodrich, 1993). Relaxation might infer tourism from medical tourism and described it as a category
to wellness or well-being spiritually, mentally, or physically. of health tourism. Consequently, yoga, acupuncture, thermal
Relaxation is one of the motives of tourists among others swimming pools, body massages, various baths, beauty
while taking a vacation (Crompton, 1979; Pearce & Lee, treatments (Goodrich, 1993; Mueller & Kaufmann, 2001;
2005). Growing needs of relaxation and hence wellness need Chen, Prebensen, & Huan, 2008), spa (Spivack, 1998;
of tourists increased the demand of tourists in wellness Williams, et al., 1996; Chen, Prebensen, & Huan, 2008; Mak,
purposes, and created a new niche in tourism industry. Wong, & Chang, 2009; Medina-Muñoz & Medina-Muñoz,
According to World Tourism Organization (2007), 225 2012), rest and mediation, fitness, and beauty care (Mueller &
million tourists traveled for miscellaneous reasons including Kaufmann, 2001; Chen, Prebensen, & Huan, 2008) are
health and wellness in 2006. As an important component of considered major wellness tourism activities.
wellness tourism, health spa experienced rapid growth in the
past three decades. According to the International Spa Though a variety of studies have been conducted on
Association’s (ISPA) report, the number of spa locations in motivational factors of tourists on many niches in tourism
United States has grown from 4,140 in 1999 to 19,900 in 2010; industry (Baloglu & Mangaloglu, 2001; Dann, 1981; Gnoth,
and the spa visit number has grown from 90.7 million to 150 1997; Jenkins, 1999; Kozak, 2002), there are limited research
million at the same period. Although wellness tourism has its focusing on the relationship between tourists’ motivation and
root in tourism, it is an emerging niche that offers great their behavioral intention to participate in wellness tourism
growth opportunities to existing destinations and on creating destinations. The main objective of this study is to explore
new destinations (Hume & DeMicco, 2007). domestic visitors’ motivations to participate in wellness
tourism in the United States because rarely have researchers
However, relatively less attention is given to the wellness studied on wellness tourism over the country where a growing
tourism in the literature despite wellness tourism’s long number of people have interest on it. In this study, we

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analyze the motivational factors in the wellness tourism of fitness. For the sake of rigorous results, this study defines
context and tourists’ intention to participate in wellness health and wellness tourism as destinations focused on pure
tourism. Exclusively, the purpose of this study is to analyze health and wellness activities and featured with just health and
the “push and pull” factors of tourists’ motivation in wellness wellness facilities and products, for instance spa center.
tourism context, and their effects on tourists’ intention to
Some researchers have studied the perception of wellness
participate in wellness tourism. As a relatively new topic in
seekers. Mueller and Kaufmann (2001) conducted a study on
academic tourism research, the study will provide useful
tourists’ perception about wellness tourism using Importance-
implications for the marketing strategies, management and Performance Analysis (IPA). Further the visitors were
operation of wellness tourism destinations, thus improving clustered as demanding health guests, independent
wellness seekers’ experience and attracting more wellness
infrastructure users, care-intensive cure guests, and
tourists.
undemanding recreation guests. Suresh, Ganesan, and
Specifically, the study intends to investigate the following Ravinchandran (2007) examined consumers’ service
questions: expectations, attitudes toward wellness services, and the
clusters of clients in five wellness centers in Bangalore, India.
1) What are the motivational factors of people in the US to
Based on the behavioral characteristics of clients, three
participate in wellness tourism?
clusters were identified: occupational ailment prevention
2) How likely is it for people in the US to participate in a seekers and regular weekend clients, heredity ailment
wellness tourism activity during vacation? prevention seekers and new clients, and anti-aging, spirituality
3) What is the role of motivational factors in predicting seekers and strong reviewers.
wellness seeker's behavioral intention? Bennett, King and Milner (2004) conducted an attribute
4) What is the influence of past experience on tourist's analysis on the health and wellness tourism destinations in
motivation and behavioral intention to visit a health and Australia. They developed a four-quadrant model: 1)
wellness destination? mainstream and tourism focus, 2) alternative and wider
tourism focus, 3) medical treatment and mainstream focus, 4)
alternative and medical treatment focus. The four quadrants
LITERATURE REVIEW were labeled as leading market, which takes up the largest
proportion in industry, emerging market, conventional and
An increasingly intensified academic attention has been paid niche market. The results provide implications for marketing
to this niche tourism in recent years (Smith, Kelley, 2006), segmentation of wellness tourism from supply side. Tourism
however, the study on wellness tourism remains in an market segmentations are usually based on demographic
exploratory stage, and the discussions of health and wellness characteristics, psychographic profiles, geographical
tourism have particularly focused on health tourism as a boundaries, buying behavior characteristics and benefits that
market and product (Dimanche, & Dimanche, 2010). Current tourists desire (Hudson, 2008). The market of health and
research interests include definition (e.g. Mueller & wellness tourism has two segmentation approaches: health and
Kaufmann, 2001) and scope (e.g. Bushell, & Sheldon, 2009) income (Goodrich, 1993), some destinations target at people
of wellness tourism; wellness tourists’ motivations (Chen, with certain health care needs, as different people have
Prebensen, & Huan , 2008; Mak, Wong, & Chang, 2009, different health problems; and some other destinations can
etc. ), behaviors (Suresh, Ganesan, and Ravinchandran, 2007), provide luxury health service and treatment for the high-end
perceptions (Mueller & Kaufmann, 2001); wellness tourism consumers as a result of income segmentation. The cluster
resources and destinations (Spivack, 1998; Bennett, King & analysis in Mueller and Kaufmann (2001) and Suresh et al.
Milner, 2004); as well as market segmentation (Goodrich, (2007)’s study segmented the wellness tourism market
1993; Voigt, & Laing, 2010, etc. ) and demand and supply according to the behavioral characteristics of wellness tourists.
analyses (Joppe, 2010; Spivack, 1998). Voigt and Laing (2010) provided a new approach of market
To date, there is still a lack of consistency in the definition of segmentation: characteristics of health and wellness tourism
wellness tourism across the literature but most of the providers, which are different from the traditional approaches
researchers tend to agree that wellness tourism, together with that are based on the perspective of consumers. As business
medical tourism, belongs to the realm of health tourism providers can always keenly perceive even a tiny consumption
(Joppe, 2010; Smith, & Puczko, 2009; Mueller, & Kaufmann, trend in the market.
2001). For the scope of wellness tourism, according to the Studies on health and wellness tourism have diversified on
authors of “Wellness and Tourism: Mind, Body, Spirit, Place”, motivation factors (Konu & Laukkanen, 2009), expenditures
wellness tourism can be divided into six categories based on determinants (Medina-Munoz and Medina-Munoz, 2012),
tourist’s motivations and product purpose and benefits. They analysis of retreat operators (Kelly, 2010) destination
are medical, health, sport/ fitness, adventure, wellbeing and development (Huijbens, 2011). Nonetheless, it is important to
transformation (Bushell, & Sheldon, 2009). Beeton (2010) concentrate on the motivation studies to generate insight to the
concluded that generally wellness tourism include: traveling emerging concepts in tourism (Crompton, 1979). Motivation
for medical reasons (Connell, 2006; Henderson, 2003), is an important factor of individuals that explains tourist
traveling for mental and physical rejuvenation (Mueller, & behavior (Prebensen and Kleiven, 2006), needs (Backman et
Kaufmann, 2001; Smith, & Puczkó, 2009) and traveling for al., 1995), and expectations (Yoon and Uysal, 2005).
physical activities that require and/or encourage certain levels Motivation has an important background in tourism literature,

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and various models have been developed to explain water resources with high quality of chemical composition
motivation. Beard and Ragheb (1983) introduced the leisure and appropriate temperature. These features improve
motivation scale. They suggest that intellectual, social, Romania’s potential for attracting an increasing number of
competence mastery, and stimulus avoidance are motives that foreign visitors (Dinu, Zbuchea, & Cioaca, 2010). A case
drive people for travel. Crompton (1979) developed a tourist study on the evolution of health and wellness tourism within
typology in motivation context that includes push and pull Byron Bay, Australia, shows that because of its location,
factors. Push factors are internal individual needs whereas pull unique geographic formation, natural assets, and wide range
factors are external factors such as attributes of a destination of health and wellness facilities such as yoga and spiritual
that drives tourists to participate in a vacation (Crompton retreats, the area is appealing to a large number of foreign
1979). Researchers on tourists’ motivation context have taken visitors and domestic residents (Wray, Laing, & Voigt, 2010).
several approaches. Leisure motivation scale (Beard &
Although motivational factors explain the reasons of why
Ragheb, 1983), push and pull factors (Crompton, 1979), and
visitors’ participate in wellness tourism, understanding
travel career ladder (Pearce & Lee, 2005) are some of the
tourists’ behavioral intention to visit a destination is critically
tourists’ motivation models. Motivation is an important important for destination managers and marketing
construct explaining wellness tourists’ behavior, needs, and organizations. Studies on behavioral intentions mostly focused
expectation, where push and pull factors model allows this
on the topic of behavioral intention as a consequence variable.
study to investigate tourists’ motivation in wellness tourism
Widely accepted theories related with behavioral intention
both internally and externally. In this study, push and pull
include the Theory of Reasoned Action (Fishbein, & Ajzen,
factors model are used to test tourists’ motivation on wellness
1975, 1980) and the Theory of Planned Behavior (Azjen, 1985,
tourism 1991). In tourism context, researchers have found that
Health or wellness tourism has become a rapid growing destination image (Chen & Tsai, 2007), subjective
industry, where people travel to gain health-related effects norm/interpersonal influence (Hsu, Kang & Lam, 2006),
(Garcia-Altaes 2005). In this particular tourism industry, constraints (Hubbard & Mannell, 2001), service quality
products are designed to meet tourists’ health-related needs, (Alexandris, Dimitriadis, & Markata, 2002), and tourist
so that tourists can recover and improve their quality of life. satisfaction (González, Comesaña, & Brea, 2007) are
Tourism products such as spa, massage, fitness classes, and important factors in predicting of travelers’ behavioral
body treatment (pampering), health gourmet meals, fitness intentions. However, very few studies have explored
classes and clinical treatments are developed to attract tourists motivation as a predictor in explaining behavioral intention.
who travel for healthy activities (Chen, Prebensen, & Huan, Jang and Feng (2007) try to explain the role of one motivation
2008). The motivation of health and wellness tourism has factor “novelty seeking” in tourist’s temporal destination
been discussed by a number of tourism researchers. And the
revisit intention. Konu and Laukkanen (2009, 2010)
‘push and pull’ model is widely adopted in tourist motivation
conducted two consecutive studies to identify the relationship
research, which also applies to health and wellness tourism
between wellness tourists’ motivation factors and their
arena.
intentions to make wellbeing holiday in Finland. Results show
Crompton (1979) identified seven socio-psychological that motivations of participating physical activities, getting in
motives considered as ‘push’ factors, including escape from a better shape and promoting and enhancing health have
perceived mundane environment, exploration and evaluation positive effects on tourist’s intentions to make a wellbeing trip,
of self, relaxation, prestige, regression, enhancement of while motivations like visiting new areas and places, viewing
kinship relationships, and facilitation of social interaction. the scenery and experiencing the nature etc. are not so
Based on Crompton’s study, Mak, Wong, and Chang (2009) relevant with intentions to make wellbeing trips. Previous
conducted a focus group survey to spa participants and found experience of wellbeing holidays is confirmed having the
other new motivations for going to spa, namely pampering strongest predictive effect in behavioral intention. Based on
oneself, rewarding oneself for working hard, seeking mental Konu and Laukkanen’s (2009, 2010) studies, the motivation
peacefulness, and getting away from the pressures of work items are limited to those are closely related to wellness
and social life. In the study conducted in Taiwan, by Chen, tourism, such as enhancing mental wellbeing, relaxation, etc.
Prebensen, and Huan (2008), the findings show that in the
The summary of literature review revealed that scant attention
ranking of importance of motivation by wellness tourism
has been given to the motivation in wellness tourism context.
participants, relaxation takes the priority, followed by
The explanation might be in the nature of wellness tourism as
pursuing multiple activities, recreation, and experiencing
being a new niche in tourism literature. On the other hand,
nature, respectively (Chen, Prebensen, & Huan 2008). Mostly, different perspectives of previous studies on the topic might
the various studies on the “push” motivational factors share a be another explanation to this issue. Most of the current
common result that relaxation is one of the most important
studies are exploratory and descriptive in nature, which are
factors that drives tourists going for wellness destinations.
still in an initial research stage. More in-depth studies and a
Apart from the ‘push’ factors that source from tourists wider range of research perspectives are needed. There are
themselves, the ‘pull’ factors are identified as the destinations’ only a few studies on the motivational factors of health and
attributes and their attractions (Mak, Wong, & Chang, 2009). wellness tourists, especially those studying motivation as an
Therefore, the features of destination itself can be a driving explaining variable for tourists’ behavioral intention. Aiming
force of tourists’ visits. A research on health tourism in at examining the motivational factors of health and wellness
Romania spa industry found that Romania has various natural tourists in the United States, further using motivation as an

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explanatory variable, this paper is expected to test the effect wellness tourism. Current consumers are those who have had
that tourists’ motivations have on their behavioral intentions the experience of being to wellness destination or
to participate in wellness tourism. participating in wellness tourism activities, while potential
customers are those who have no such experience, but have
the intention to take part in. At the beginning of the survey, a
METHODOLOGY screening question, “have you experienced wellness tourism
Research Design activities before? ‘Yes’ or ‘No’”, is set to help separate two
different types of customers. The questionnaires were
In this paper, a survey research approach is adopted to explore completed by street intercepts, emails and mails. Street
the motivational factors of tourists who participate in health intercepts took place in Charleston, SC on the weekends of
and wellness tourism, and to further examine the influence of December 2015. An email with a web link for the survey were
motivational factors on tourists’ willingness and intention to also sent to randomly to potential respondents. When the data
participate in health and wellness tourism in the United States. gathering stage ended, the variables were coded and the data
A quantitative structured questionnaire is developed based on were recorded directly in SPSS, the statistical package used in
the literature review to collect the data. the analyses.

Measurement EMPIRICAL RESULTS

The questionnaire mainly consists three parts: health and Summary Statistics
wellness tourism motivation, including push and pull factors,
respondents’ intention to participate health and wellness 124 questionnaires were collected during the entire data
tourism in the United States, and the demographic information collection process. However, only 91 out of 124
of respondents. The first section of survey questions collects questionnaires were complete and usable. A descriptive
information about the “push and pull” factors influencing analysis is conducted on the demographic profiles of the
tourists’ motivation on wellness tourism. The two dimensions respondents (See Table 1). The majority of the interviewees
are asked separately. Push factors concerning tourists’ own were female (56.0%), whereas male accounted for 42.9% of
psychological driving forces to travel wellness tourism the respondents. Most of the interviewees are 20 to 29 years
destination, while pull factors explore destination attributes old (72.5%). With respect to education, some college,
that attract tourists (Crompton, 1979). The basic framework of bachelor's degree and master degree accounted for 39.6%,
the measurement of the “push and pull” factors on wellness 24.2% and 24.2% respectively. 46.2% reported that their
seekers’ motivation come from the study of Chen, J., annual household income in 2012 before tax is $20,000 or
Prebensen, N., and Huan, T. (2008). This framework was under and 19.8% earn $20,001-$35,000 annually. As for
supplemented and improved based on other related literatures. employment status, majority of the respondents are student
The list of 15 push factors was derived from those studies (53.8%). Those who employed accounted for 39.6%. All
relating to tourists’ motivation of visiting wellness destination respondents except two missing data traveled for at least an
developed by Chen, Prebensen, and Huan (2008), Mak, Wong, overnight stay in the past 12 months. 29.7% traveled five time
and Chang (2009). And those15 items relating to attributes of or above.
wellness destinations considered as “pull” factors were
developed by Konu and Laukkanen (2009), Medina-Muñoz
and Medina-Muñoz (2012). And the second section contains 7 Factor analysis
items measuring the intention of tourists to participate in Principle analysis was adopted to extract the main dimensions
wellness tourism including loyalty, willingness to pay more, of tourists’ wellness tourism motivation items in both push
and willingness to switch. This scale is derived from Zeithaml, factors and pull factors. For push factors, a KMO & Bartlet’s
Berry, and Parasuraman (1996)'s five-dimension framework test of sphericity is conducted before exploratory factor
for behavioral intention measurement. A 5-point Likert-type analysis. Results (KMO=0.684, p=0.000 <0.001) showed that
scale where 1 = Not at all important, 5 = Extremely important the data were suitable for further analysis. Varimax method
is applied to assess respondents’ motivational factors, and was adopted in the principle component analysis, and factor
another 5-point Likert-type scale where 1 = strongly disagree, loadings greater than 0.4 should be remained (Nunnally, 1978;
5 = strongly agree is employed to test respondents’ intentions Steven, 1992), as a result, no item was eliminated. Four
to participate in wellness tourism. The third section asks about principle factors were extracted, and most of the items have a
respondents' demographic information which considered factor loading higher than 0.5. The cumulative variance
instrumental for future market segmentation analysis. explained by the four factors is 60.39%, which means the four
factors account for 60.39% of the total variance. According to
the items fall into each dimension, the first factor focuses on
Sample the mentality of being in the health and wellness fashion trend,
The target sample of the study was the college students, who and of being seen as nice and fit, thus is labeled as “Keeping
are likely to participate in wellness tourism. The age required up with fashion”. The second factor incorporates mental items
for respondents is 18-year-old and above. A total of 200 like mental and spiritual therapy, thus is labeled as “Spiritual
copies of questionnaires were distributed to targeted two types health”. The third factors clearly state relaxation and stress
of consumers, namely current and potential consumers for relief, thus it is named as “Stress relaxation”. The last factor

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has a high factor loading on “Enhancing my quality of life” internal consistency of each set of items as a group.
and “Experiencing something new”, respondents are Cronbach's α of the first two factors are greater than 0.7,
expecting an improvement through health and wellness which means the internal consistency is acceptable; while the
activities, and thus it is labeled as “life improvement”. A last two factors are poor in internal consistency with an
reliability analysis is run through each factor to test the Cronbach's α falls between 0.5 and 0.6(Kline, 1999).

Table 1: Demographic Characteristics

Characteristics Number Percentage

Gender Female 51 56.0%
Male 39 42.9%
Age 19 and under 15 16.5%
20-29 66 72.5%
30-39 8 8.8%
40-49 1 1.1%
50-59 1 1.1%
60 and older 0 0%
Level of education High school or less 4 4.4%
Some college 36 39.6%
Associate degree 2 2.2%
Bachelor’s degree 22 24.2%
Master Degree 22 24.2%
Doctorate degree 5 5.5%
Annual household income $20,000 or under 42 46.2%
$20,001 - $35,000 18 19.8%
$35,001 - $50,000 7 7.7%
$50,001 - $70,000 5 5.5%
$75,001 - $100,000 8 8.8%
$100,001 or more 6 6.6%
Employment status Employed 36 39.6%
Unemployed 2 2.2%
Student 49 53.8%
Retired 1 1.1%
Others 3 3.3%
Travel frequency One 11 12.1%
Two 18 19.8%
Three 18 19.8%
Four 15 16.5%
Five or above 27 29.7%

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Table 2. KMO and Bartlett's Test for Push Factors

Kaiser-Meyer-Olkin Measure of Sampling Adequacy .684
Bartlett's Test of Sphericity Approx. Chi-Square 422.078
df 105
Sig. .000

Table 3. Factor analysis of push factor motivations of wellness seekers

Factors Factor loading Eigenvalue % of Variance Cumulative % Cronbach's α
F1-Keeping up with fashion 2.98 19.86% 19.86% .74
To be seen fashionable .81
Weight lose activities .77
Healthy life style .69
Participating in physical activities .58

F2-Spiritual health 2.53 16.88% 36.746% .71

Mental therapy .72
Aging prevention .62
Spiritual therapy .59
Health consciousness .59
Improvement of overall health .51
Being alone .42
F3-Releasing stress 1.77 11.83% 48.58% .53
Relaxation .79
Stress relieving .75
F4-Life improvement 1.77 11.81% 60.39% .56
Enhancing my quality of life .75
Experiencing something different .69
Engagement in refreshing activities .63
Note:
1) Extraction Method: Principal Component Analysis.
2) Rotation Method: Varimax with Kaiser Normalization.
3) Rotation converged in 8 iterations.
largest variance of why a tourist comes. The second and the
third dimension depict the intangible features of the site,
For pull factors, again the KMO & Bartlet’s test of sphericity
including the accessibility, the availability, the environment,
is conducted first to test the fitness of the data to run factor
the atmosphere, the climate, as well as the popularity of the
analysis. Results (KMO=0.758, p=0.000 <0.001) show that
destination. Further, the three principle factors extracted from
the data are suitable for factor analysis. Three principle factors
are extracted after the dimension reduction, and the pull factor motivations are labeled respectively as “Core
cumulative variance explained by the three factors is 50.35%, products provided by destination”, “Accessibility of
destination” and “Reputation of destination”. The reliability
which means the three factors account for 60.39% of the total
analysis results show that Factor 1(α=0.793) and Factor
variance. The items fall into the first factor focuses are mainly
2(α=0.713) have an acceptable level of internal consistency,
concerning the products, service and facilities provided by the
destination, which constitute the core product of a health and and Factor 3(α=0.569) has a relatively poor reliability.
wellness tourism destination. This dimension explains the

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Table 4. KMO and Bartlett's Test for Pull Factors

Kaiser-Meyer-Olkin Measure of Sampling Adequacy .75
Bartlett's Test of Sphericity Approx. Chi-Square 395.83
df 120
Sig. 0.00

Table 5. Factor analysis of pull factor motivations of wellness seekers

Factor Eigenvalue % of Cumulative % Cronbach's α
Factors
loading Variance
F1-Core products provided by 3.39 21.19% 21.19% .793
destination
Balanced and healthy diet options .768
Range of wellness treatments offered in
.739
destinations
Length of treatment programs: the longer
.719
the better
Length of treatment programs: the shorter
.651
the better
Sport facilities in destination .566
Yoga facilities .559
Option for the packaged services .528
F2- Accessibility of destination 2.66 16.67% 37.87% .713
Easy access at the destination .724
Destination climate .719
Accessibility and availability of destination .714
Gastronomy supply .607
Spa facilities .412
F3-Reputation of destination 1.99 12.47% 50.35% .569
Environment, atmosphere, and decoration
.676
of destination
Availability of multiple activities in
.652
destinations
Word of mouth of the destination .614
Popularity of the destination .541
Note:
1) Extraction Method: Principal Component Analysis.
2) Rotation Method: Varimax with Kaiser Normalization.
3) Rotation converged in 6 iterations.

Univariate Analysis account for the variances of respondents’ willingness to

A T-test analysis is employed to test the difference of recommend health and wellness tourism. Further, the 2-tailed
willingness to recommend health and wellness tourism to significance value for equality of means is 0.505, which is
higher than 0.05, meaning that there is no difference between
other people between male and female respondents. From
male and female respondents regarding their willingness to
Levene’s Test for Equality of Variances, the significance is
recommend health and wellness tourism to their families and
0.051 (>α=0.05, at the confidence interval percentage 95%),
friends.
which implies that male and female respondents equally

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Table 6. Independent sample T test

Levene's Test for Equality of Variances t-test for Equality of Means
F Sig. t df Sig. (2-tailed) Mean
Equal variances assumed 4.142 .051 -.675 28 .505 3.30
Equal variances not assumed -.580 12.681 .572 3.60

An Oneway analysis of Variance (ANOVA) is applied to test Multiple regression analysis

whether there are differences among 5 age groups (19 or We further conducted multiple regression analysis to test the
under, 20-29, 30-39, 40-49, 50-59) on the perception of
hypothesis of the study. The findings of the regression
importance of the motivational factor “healthy life style”
analysis revealed that the model is overall significant, and the
driving them to health and wellness tourism. However, the
independent variables predict 27.7% of the dependent variable.
ANOVA test result displays that the significance between
We investigated whether factors generated from the dataset,
groups is 0.986 (>α=0.05, at the confidence interval reputation of destination, core products provided by
percentage 95%), which indicates that there is no significant destination, accessibility of destination, releasing stress, life
difference on the perception of “healthy lifestyle” among
improvement, spiritual health, and keeping up with fashion
different age groups.
are able to predict the behavioral intention to visit a health and
wellness tourism destination. If we look at the coefficients
Table 7. Results from ANOVA Analysis table we can see that only keeping up with fashion and
spiritual health is significant predictors of dependent variable,
Sum of Squares df Mean Square F Sig. namely I will visit health and wellness destination in the next
Between Groups .465 4 .116 .088 .986 few years at the 5% significant level. Remaining variables,
however, appears to be insignificant in predicting the
Within Groups 113.491 86 1.320 dependent variable. Keeping up with fashion has beta
Total 113.956 90 coefficient of .318 and spiritual health has beta coefficient
of .290.

Table 8. Regression Results

Unstandardized Standardized
Coefficients Coefficients

B Std. Error Beta t Sig.

(Constant) 3.053 .116 26.207 .000

Keeping up with fashion .318 .149 .271 2.132 .036
Spiritual health .290 .145 .242 2.005 .049
Releasing stress .183 .120 .159 1.520 .133
Life improvement -.153 .125 -.134 -1.225 .225
Core products provided by destination .136 .161 .118 .844 .401
Accessibility of destination .188 .131 .158 1.435 .155
Reputation of destination .203 .126 .177 1.612 .111
R-Square 0.27
Adj-R-square 0.21

Dependent Variable: I will visit health and wellness destination in the next few years

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