Research on Influencing Factors of Chinese Medicine Health Tourism

Choice Intention of Tourists Based on ETPB Theory

Biao Zhang

Chunyan Xu

, and Jiancheng Liu

School of Economics and Management, Jiangxi University of Chinese Medicine, Nanchang, China

College of Chinese Medicine, Jiangxi University of Chinese Medicine, Nanchang, China

Keywords: TPB Theory, Chinese Medicine Health Tourism, Visitors Will.

Abstract: This paper analyzes the influencing factors and the relationship between tourists' behavior choice of Chinese

medicine recreation tourism. Based on the authoritative theory in the field of behavior research --- Planned

Behavior Theory, this paper builds a behavioral choice model of Chinese medicine recreation tourism by

adding individual attributes and scenic spot attributes. The structural equation model test of 551 valid sample

data shows that professional background, convenience, natural resources and accommodation ticket cost have

the most obvious influence on tourists' behavior choice. The influence of personal pressure is greater than that

of social pressure. Meanwhile, family income, self-interested attitude and educational background also have

certain influence on tourists' behavior choice.

1 INTRODUCTION

With the rapid development of economy, tourism is

shifting from popular tourism to personalized and

healthy tourism. In this context, as a kind of tourism

activity with the purpose of health preservation and

meeting the high demand of modern people in pursuit

of a healthy body and mind, health tourism emerged

at the historic moment. Due to the professional

knowledge of tourism and medical health, people's

choice of health tourism is often inconsistent with

traditional views. The traditional view is that as long

as the destination has a good reputation, good scenery

and a large number of tourists, the tourists will come,

but the actual situation is not the case for health

tourism. In order to understand the reasons, based on

the existing behavioral choice questionnaire, the

author found out the factors influencing tourists'

choice of Chinese medicine health tourism by

modifying the questionnaire, and put forward

targeted solutions.

Jiancheng Liu 20220285 Terahertz wave data detection of

ordered structure field generator

2 OVERVIEW OF CHINESE

MEDICINE HEALTH TOURISM

2.1 Connotation

Before the term "health tourism" was put forward in

China, there were similar concepts in foreign

countries, such as "health tourism", "health tourism"

and "medical tourism". Foreign scholars believe that

health tourism mainly includes two types of health

tourism and medical tourism (MARION, 2011),

which is a kind of tourism mode for disease

prevention and treatment. In China, "health tourism"

refers to the sum of all kinds of tourism activities that

make people achieve a natural and harmonious state

in body, mind and spirit through various ways, such

as nourishing skin and body, nourishing diet, self-

cultivation and caring for the environment. As Ren

Xuanyu pointed out, recreation tourism is a tourism

mode to relax body and mind, pursue happiness and

improve tourists' happiness (

Ren, 2016). Li Peng

believes that health tourism is a kind of tourism mode

that meets the needs of one's body, spirit, health and

relaxation, and finally achieves a benign interaction

with society and environment (

Li, 2020). The author

Zhang, B., Xu, C. and Liu, J.

Research on Inﬂuencing Factors of Chinese Medicine Health Tourism Choice Intention of Tourists Based on ETPB Theory.

DOI: 10.5220/0012042200003620

In Proceedings of the 4th International Conference on Economic Management and Model Engineering (ICEMME 2022), pages 699-706

ISBN: 978-989-758-636-1

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

699

believes that Chinese medicine health tourism is a

kind of tourism in which tourists enjoy natural

climate resources and use Chinese medicine therapy,

Chinese medicine recipes and other Chinese

medicine health preservation methods in combination

with time and their own conditions to achieve

physical and mental cultivation and promote health.

2.2 Development History

There is no special discussion on health tourism in

Chinese medicine. From the concept of fuzziness, it

belongs to the categories of "outing", "climbing" and

"traveling". It has been recorded in the literature

thousands of years ago. Nssi is not timely, an excuse

for xianglanyun. Think out of the tour orchid, can

cultivate one's morality for pleasure; According to the

medical monograph Huangdi Neijing, "Spring brings

forth weather... Spring outing and slow steps...

Cultivate Yang Dao." Spring outing can raise Yang.

Until today, the level of people's demand for health

has been increasing, and the state has formulated and

introduced relevant policies, which has led to the

development of health tourism. The CPC Central

Committee and The State Council issued the outline

of "Healthy China 2030" on October 25, 2016,

integrating into all aspects of the construction of a

healthy China, which will bring huge space for the

development of health tourism. Despite the fact that

the value of Chinese medicine health tourism has

been recognized by more and more tourists, the

number of tourists who truly practice Chinese

medicine health tourism is still small and their

willingness to travel is not high. The author believes

that the reason lies in the lack of awareness of health

tourism. Specifically, it is closely related to natural

resources, human resources, infrastructure and basic

costs. In order to verify the above conjecture, this

paper introduces scenic area attribute variables such

as natural resources, human resources, infrastructure

and basic costs on the basis of TPB theory, thus

forming the theory of expansion planning behavior,

and carrying out in-depth discussion on related

issues.

3 THEORETICAL BASIS AND

RESEARCH HYPOTHESIS

3.1 Theory

After the emergence of rational planning behavior

(TRA), researchers found that individual choice is not

a completely voluntary behavior, and individual

ability and conditions also affect behavioral choice,

namely individual behavioral control (Gao, 2020).

Therefore, the Theory of Planned Behavior (TPB)

appears in the field of view of researchers. TPB

theory mainly includes attitude, subjective norms and

perceived behavior control, which can effectively

affect individual behavior. As an influential basic

theory in the study of individual behavior, TPB theory

is widely used to explain the generation of various

behaviors (Qiu, 2016). At present, in the aspect of

behavior research, many scholars have confirmed the

prediction of individual will and behavior by this

theory. However, when reviewing the literature, it is

found that the application of this theory is rarely seen

in the study of tourism intention, let alone in the

aspect of health tourism.

As a theory in the field of behavioral research, this

theory provides a new perspective for in-depth

research on the influencing factors of Chinese

medicine health tourism intention. However, it is

worth noting that are three aspects of TPB theory:

attitude, subjective norm and perceptual behavioral

control. If we only discuss from these three aspects,

it will be more subjective and less objective.

However, the intention of health tourism involves the

relationship between objective influence variables,

subjective psychological variables and actual

behavior. Therefore, in order to accurately and

objectively express the relationship between the

influencing factors and the choice of Chinese

medicine recreation tourism, the theory of Extended

planning Behavior (ETPB) was formed by adding the

objective influencing variables of scenic spot

attributes, and the research hypothesis was made on

this basis.

3.2 Research Hypothesis

3.2.1 Attitude and Behavior

In TPB theory, attitude refers to the subject's positive

or negative views on a specific behavior, which

reflects the subject's preference for the

implementation of the behavior (Zhang, 2014) and

has an important influence on the generation of

behavioral intention. Individuals' attitude towards

health tourism is beneficial to themselves. When

individuals choose health tourism, they will have a

positive attitude and form their willingness to choose

health tourism, which will then be transformed into

practical behaviors. The author believes that tourists

mainly have self-interested attitude towards health

tourism, that is, the acquisition of self-benefit.

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Therefore, the following hypotheses are proposed in

this paper:

H1: Self-interested attitude has significant

influence on behavioral choice of tourist destination

3.2.2 Subjective Norms and Behavior

Subjective norms include social pressure and

personal pressure. This paper mainly focuses on

social pressure. Social pressure refers to the pressure

or influence of important individuals or organizations

around them on their behaviors. For the willingness

to travel for health care, it refers to the degree of

support, opposition or recommendation from family

members, relatives, friends and other people in their

life circle for their willingness to travel for health care

(Huang, 2011). Personal stress is self-imposed

pressure or influence that leads to a false

understanding of one's own behavior. In terms of the

willingness of health tourism, most of the groups that

conduct health tourism are intellectuals, public

institutions and successful people. These tourists tend

to form the psychological comparison between

advanced and decent when they choose Chinese

medicine health tourism, forming personal pressure.

H2A: Social pressure has a significant impact on

the willingness of to travel for health and

recuperation.

H2B: Personal pressure has a significant impact

on the willingness to travel for Chinese medicine

3.2.3 Control and Behavioral

Perceptual control refers to the difficulty of

performing a particular behavior perceived by the

subject through the experience and opportunities he

has mastered and the obstacles in the implementation

of the expected behavior before performing it (Li,

2018). The more resources and opportunities you

think you have and the fewer obstacles you expect,

such resources include knowledge, information, etc.

The main influencing factor of behavioral intention is

whether an individual can control sufficient

resources, and the convenience degree of perceived

behavioral control can well reflect the will of tourists.

The degree of convenience refers to the behavior

subject's perception of the convenience of external

factors. In the aspect of Chinese medicine health

tourism, the degree of convenience mainly refers to

the information of transportation costs, routes and

trips.

H3: The degree of convenience has a significant

impact on the intention of health tourism

3.2.4 Attractions and Behavior

Under the scenic area attribute, natural resources are

the first aspect. Natural resources are also called

natural resources. In this study, they mainly refer to

the natural resources that are beneficial to tourists in

their original state, such as forests, lakes, hot springs,

land, climate and biology. Tourists have different

cognition of the importance of natural resources, so

they will perform different behaviors and have

different intentions for certain behaviors and

activities. Based on common sense, the more types of

natural resources, the more unique scenery and the

stronger selectivity, that is, the importance of

resources is positively correlated with the

willingness. For example, the more abundant natural

resources, the stronger the willingness. In other

words, the more important the resources are, the more

willing the tourists are, and the more opportunities

they have to take action (Zhu, 2020). However, health

tourism involves a wide range of areas and belongs to

a new tourism model. The more tourists pay attention

to natural resources, the more willing they are to

choose.

H4: Natural resources have a significant impact

on the intention of health tourism

Under the attribute of scenic spot, cultural

resources are its second aspect. Human resources are

the sum total of material and spirit created by human

society. This paper mainly refers to the existence of

cultural landscapes, such as modern hotels, shopping

malls, transportation and historical sites. Tourists'

cognition of the importance of cultural resources is

different, and they will perform different behaviors

for certain behaviors and activities, and their

willingness will be different. Based on common

sense, scenic spots are rich in architecture, profound

in culture and perfect in service, and the more

selective they are. That is, resource importance has a

positive relationship with willingness. For example,

it is pointed out in the analysis and research of

Ukrainian tourism resources that the richer historical

and cultural resources are, the more willing tourists

are. In other words, the more important cultural

resources are, the more willing tourists are and the

more chances they have to take action. However,

there is an influence relationship between natural

resources and human resources on tourists'

willingness. The author believes that cultural

resources will have an impact on tourists' behavior,

but the impact is weaker than that of natural

resources.

H5: Human resources have a significant impact

on the intention of health tourism

Research on Inﬂuencing Factors of Chinese Medicine Health Tourism Choice Intention of Tourists Based on ETPB Theory

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Under the property of scenic spot, basic cost is its

fourth aspect. Tourists have different cognition of the

importance of accommodation, food and ticket fees,

and will carry out different behaviors and will also be

different for certain behaviors and activities. In

reality, the lower the ticket cost, the stronger the

tourists' willingness to pay. For example, it is pointed

out that the tourist's willingness to pay is stronger in

the ticket promotion activities of scenic spots (Kong,

2010). That is, the more important the cost of

accommodation, food and entrance fee is, the more

willing the tourists are to go. The author believes that

accommodation, food, ticket costs reasonable, honest

management, tourists will be stronger.

H6: The basic cost has a significant impact on the

intention of health tourism

Under the attribute of scenic spot, infrastructure is

its fifth aspect. Tourists have different cognition of

the importance of infrastructure, and will perform

different behaviors for certain behaviors and

activities, as well as different degrees of willingness.

In reality, the better the infrastructure, the more

willing tourists are to spend. The more important the

infrastructure, the more willing the tourists are. But

in reality, infrastructure has little impact on tourists'

willingness. Chinese medicine health tourism is

different from simple tourism, involving many

aspects, staying longer than mass tourism, more

demanding basic requirements. Therefore, the author

believes that the more important the infrastructure,

the more willing the tourists are.

H7: Infrastructure has a significant impact on the

intention of health tourism

Based on the above assumptions, this paper

constructed the ETPB theory model of tourists'

intention to travel for Chinese Medicine. See Fig1 for

details.

Figure 1: Theoretical model of extended planning behavior.

4 RESEARCH DESIGN

4.1 Research Methods

Based on the theoretical analysis of literature, this

study uses empirical analysis method to explore the

influence of individual attributes, scenic attributes,

attitudes, subjective norms, perceptual control and

other factors on tourists' intentions. At the same time,

questionnaires and random sampling were used to

select some groups as research samples. According to

the determination method of sample size in sampling

survey, 500 valid sample data were planned for this

study, and 551 valid sample data were actually

obtained. For the collected data, the invalid samples

were firstly eliminated through sample screening, and

then the score distribution, variable correlation,

demographic distribution and other information of

the data results were preliminarily obtained through

descriptive statistics and other analysis methods of

valid data. At the same time, reliability test and

confirmatory factor analysis were combined to verify

the quality of data and model. In addition, the

structural equation analysis model of the

comprehensive influence relationship between

variables was established, and the significance test of

regression coefficient in the structural model P <0.05

was taken as the critical criterion of significant

influence.

4.2 Measurement Variables

In order to make the results more objective and

accurate, and before the questionnaire need index

definition for the variables in the model, the model of

information such as gender, age group and other

objective factors is commonly used in the

questionnaire survey data collection methods, the

continuous variables such as age, family income in a

reasonable manner after the grouping variable into a

grade, Educational background is divided into

primary school to graduate school, and professional

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background is divided into Chinese medicine,

tourism and other majors, so as to explore the

influence of professional correlation on group

willingness. Due to the theoretical model

constructing, involves subjective factors such as

attitude, direct measurement when there is a big

subjectivity and randomness, easy to generate

random errors, so each measure using multiple

subject, subjective variables analysis by foreign show

subject to extract the latent variable factor, realize the

data acquisition of subjective variables, All questions

are coded using the Five-point scoring method of

Likert Scale

where 1-5 means "completely disagree"

to "completely agree" (Kai, 2006).

5 DESCRIPTIVE STATISTICS

AND CORRELATIOS

ANALYSIS

5.1 Statistics Survey

After screening, a total of 551 valid sample data were

obtained in this questionnaire survey, among which

the group between 18 and 27 years old accounted for

more than 50%, followed by the group between 28

and 45 years old accounted for 31.8%. The female

group is slightly higher than the male group; College

education and above accounted for 72.8%;

Household income is more evenly distributed; majors

accounted for 22.9%, tourism for 39.2%, and other

majors accounted for 37.9%.

5.2 Reliability Analysis

Reliability, also called reliability, refers to the degree

of stability of questionnaire survey results. In theory,

a good questionnaire should be reliable only when

repeated measurements are made to the same group.

However, it is impossible to use such multiple

measurements in actual tests, so it needs to be

evaluated internally from the questionnaire survey

results. In general, kronbach α coefficient value is

used as an internal index to evaluate the reliability of

questionnaire results. When α>0.9, the reliability of

questionnaire results is very good; when α< α<0.9,

the reliability of questionnaire results is good; when

it is lower than 0.7, the reliability parameters need to

be revised and re-tested (Ma, 2000).

According to the above principles, spSS24.0

statistical analysis software was used to calculate the

overall reliability of the scale and the reliability of

each dimension. Among them, the overall reliability

of likert scale reached 0.942. In the total statistical

results of items, the correlation between the revised

items and the total score was higher than 0.4, and the

cronbach α value after deletion was not higher than

the overall reliability. All topics can be reserved for

further analysis.

The reliability test results show that the reliability

values of all dimensions in the questionnaire are

above 0.8, and the questionnaire survey results are

relatively stable with high reliability.

Table1: Reliability of each dimension.

Dimension Number Reliability

Selfish attitude(1) 3 0.844

Social pressure(2) 3 0.885

Personal pressure(3) 3 0.887

Convenience(4) 3 0.883

Natural resources(5) 3 0.881

Human resources(6) 3 0.876

Basic fee(7) 3 0.882

Infrastructure(8) 3 0.895

Intention(9) 3 0.880

5.3 Validity Analysis

Based on the reliability and descriptive statistical

analysis results, confirmatory factor analysis was

conducted for likert scale variables in the

questionnaire. The test results showed that

RMSEA=0.014<0.08; CFI=0.997> 0.9; TLI =

0.996 > 0.9, SRMR=0.020<0.08;

2/DF=318.341/288=1.105<3, all fitting parameters

meet the requirements of the analysis standard, and

the model has good structural validity. Table 2 shows

the calculation results of load values, combined

reliability CR, mean variance extraction AVE and

other parameters in likert scale. Among them, the

standardized load value of each topic is above 0.7,

and CR value is higher than 0.8, AVE higher than 0.6.

All latent variables in the model have good

aggregation validity. See Table2 for details.

Research on Inﬂuencing Factors of Chinese Medicine Health Tourism Choice Intention of Tourists Based on ETPB Theory

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Table 2: Test of subject load values and variable aggregation validity.

Dim Load value Standardized loa

SE t

CR AVE

1.000 0.830

0.846 0.647 0.798 0.781 0.041 19.356 <0.001

0.875 0.801 0.045 19.320 <0.001

1.000 0.829

0.885 0.720 1.003 0.861 0.044 22.886 <0.001

0.961 0.856 0.042 23.105 <0.001

1.000 0.824

0.889 0.727 1.110 0.859 0.047 23.412 <0.001

1.240 0.875 0.053 23.450 <0.001

1.000 0.826

0.884 0.718 0.988 0.865 0.043 22.993 <0.001

1.025 0.851 0.045 22.590 <0.001

1.000 0.848

0.882 0.714 0.987 0.869 0.040 24.551 <0.001

0.940 0.817 0.042 22.463 <0.001

1.000 0.783

0.877 0.704 1.152 0.874 0.054 21.288 <0.001

1.171 0.858 0.056 20.769 <0.001

1.000 0.825

0.882 0.714 1.073 0.872 0.046 23.307 <0.001

1.019 0.837 0.046 22.176 <0.001

1.000 0.833

0.896 0.742

0.988 0.876 0.041 24.016 <0.001

1.061 0.874 0.044 23.895 <0.001

1.000 0.844

0.880 0.710 0.897 0.827 0.039 23.015 <0.001

1.001 0.857 0.042 23.603 <0.001

In addition, the correlation coefficient matrix of

each dimension is sorted out according to the

calculation results of latent variable correlation, and

the square root of AVE is taken as the value of the

diagonal dimension to compare the relationship

between latent variable correlation and AVE square

value. It can be seen from the data in the table that the

correlation coefficients of all dimensions are lower

than the corresponding value of diagonal positions,

indicating that the correlation between dimensions is

weaker than the aggregation of variable dimensions

themselves, so all latent variables in the model have

good discriminative validity. See Table 3 for details.

Table 3: Validity test of variable differentiation.

1 2 3 4 5 6 7 8 9

1 0.804

2 0.494 0.849

3 0.543 0.479 0.853

4 0.415 0.448 0.595 0.847

5 0.598 0.634 0.599 0.531 0.845

6 0.350 0.327 0.341 0.381 0.482 0.839

7 0.505 0.513 0.533 0.535 0.638 0.478 0.845

8 0.401 0.342 0.425 0.353 0.436 0.292 0.415 0.861

9 0.570 0.558 0.611 0.602 0.687 0.486 0.633 0.492 0.843

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6 STRUCTURAL MODEL

ANALYSIS AND HYPOTHESIS

TESTING

First of all, to groups of individual properties,

attitude, subjective norm, perceived control, the

scenic spot attribute factors as prediction variables,

groups' willingness to travel as outcome variables,

structural equation regression model is established,

on the inspection results to choose the international

comparison recognized five indicators to

discriminant model adaptation degree, selection and

adaptation standard (DAWN, 2010).

Secondly, the path test analysis, regression

coefficient and results show. The four indicators of

attitude, subjective norms, perceived behavioral

control medium egoistic attitude, social pressure,

personal pressure and convenience degree have a

significant positive regression effect on tourism

intention. The group with higher variable score has a

stronger intention to participate in health tourism. In

addition, the attributes of natural resources, human

resources, basic cost and infrastructure also have a

positive impact on the tourist intention. The higher

the evaluation of natural resources, human resources,

basic cost and infrastructure, the higher the tourist

intention. See Table2 for details.

Figure 2: Path coefficient test.

7 RESEARCH CONCLUSIONS

AND RECOMMENDATIONS

7.1 Conclusion

The empirical results show that natural resources are

unique and diverse, reasonable basic fees and high

family income have the second most influence on

tourists' behavior choice. Personal pressure,

educational background and social pressure also have

a positive impact on tourists' behavior choice.

7.2 Suggestion

According to the above research conclusions, in order

to effectively improve tourists' willingness to travel

for Chinese medicine and health care, suggestions are

as follows:

7.2.1 Strengthen Propaganda

Health tourism experience tour is launched for this

group, and will be translated into practical actions, so

as to improve the group's awareness of health

tourism, take the health benefits of health tourism into

heart, and guide them to relatives and friends.

7.2.2 Analyze Requirement

Different groups have different needs for health

tourism projects. Personalized and scientific health

care contents are customized for individual needs,

and health care knowledge is taught with the help of

Internet and other technologies.

7.2.3 Protect Resource

Natural resources is a Chinese medicine, to raise the

premise condition of tourism development, tourism

will be in Chinese medicine, to raise the kinds of

natural resources, unique in the first place, in the

development of Chinese medicine, a travel should be

practical and protect the scenic spots of natural

resources, human resources at the same time also will

have a positive impact to tourists, therefore, the

protection and development complement each other,

improve the infrastructure, To improve the

willingness of tourists and realize the healthy and

orderly development of health tourism.

7.2.4 Perfect Law

Chinese medicine health tourism is different from

mass tourism in that tourists' consumption will

Research on Inﬂuencing Factors of Chinese Medicine Health Tourism Choice Intention of Tourists Based on ETPB Theory

705

increase when they stay for a long time. Moreover, a

large part of the fees for tickets, accommodation, food

and other aspects of scenic spots must be spent.

Therefore, in order to improve the willingness of

tourists to make behavioral choices, a unified price

system must be implemented to protect the basic

rights and interests of tourists.

In addition, the influence of social pressure and

personal pressure should be considered. Around a

friend's recommendation and inner comparing to

tourists behavior has also had a certain effect, but the

factors as part of the subjective initiative, the author

thinks that only through education and inner

adjustment to solve, it also became the deficiency of

the study, in the following study, the author will

continue to explore better able to solve the problem

of countermeasures.

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