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Antecedents and outcomes of health risk perceptions in tourism, following the COVID-19 pandemic


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The purpose of this paper is to clarify the concept of perceived risks, identify the main antecedents and outcomes of health risk perceptions and propose a conceptual model of health risk perceptions in tourism. Design/methodology/approach This paper provides a review of the literature on customer risk perceptions, along with their antecedents and outcomes, and proposes a conceptual model of health risk perceptions in tourism. Findings Key findings reveal that the main factors of health risk perceptions can be broadly classified into cognitive, affective, individual and contextual components. The proposed conceptual model of health risk perceptions provides a theoretically integrated overview of relationships between all groups of factors, tourists’ risk perceptions and travel intentions. Originality/value The paper contributes to theory by offering a new approach to health risk perceptions in tourism, which remain underexplored in previous studies. The literature review adds to the body of knowledge by introducing four main groups of factors affecting tourists’ health risk perceptions, while the conceptual model proposes relationships between these factors, tourists’ risk perceptions and travel intentions.
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Antecedents and outcomes of health risk perceptions in tourism,
following the COVID-19 pandemic
Maksim Godovykh, Abraham Pizam, and Frida Bahja
University of Central Florida
The purpose of this paper is to clarify the concept of perceived risks, identify the main antecedents and
outcomes of health risk perceptions, and propose a conceptual model of health risk perceptions in
This paper provides a review of the literature on customer risk perceptions, along with their antecedents
and outcomes, and proposes a conceptual model of health risk perceptions in tourism.
Key findings reveal that the main factors of health risk perceptions can be broadly classified into
cognitive, affective, individual, and contextual components. The proposed conceptual model of health risk
perceptions provides a theoretically integrated overview of relationships between all groups of factors,
tourists’ risk perceptions, and travel intentions.
The paper contributes to theory by offering a new approach to health risk perceptions in tourism, which
remain underexplored in previous studies. The literature review adds to the body of knowledge by
introducing four main groups of factors affecting tourists’ health risk perceptions, while the conceptual
model proposes relationships between these factors, tourists’ risk perceptions, and travel intentions.
Keywords: risks; risk perceptions; tourism; health; COVID-19; travel intentions.
To cite this article:
Godovykh, M., Pizam, A., & Bahja, F. (2021). Antecedents and outcomes of health risk
perceptions in tourism, following the COVID-19 pandemic. Tourism Review.
Tourists’ risk perceptions have been described as one of the major factors of decision making
and behavioral intentions (Artuger, 2015; Hasan et al., 2017; Wolff et al., 2019). Although the
COVID-19 pandemic significantly changed the tourism and hospitality industry through travel
restrictions in different countries and regions worldwide, tourists’ behavior after reopening
depends on their perceptions of safety and risks associated with various travel activities
(Dryhurst et al., 2020; Wen et al., 2020). Risk perceptions, however, are different from real
risks. Whereas real risks are traditionally characterized by uncertainty about the effects of the
activity and probability of outcomes in question (Kahneman and Tversky, 2013; Schmidli,
2017), perceived risks are related to an individual’s subjective perceptions, which are influenced
by multiple social, cultural, and contextual factors based on personal judgments, attitudes,
experiences, and feelings (Brown et al., 2018; Pidgeon, 1998; Ropeik, 2011). As a result,
perceived risks might influence people’s attitudes, decisions, and behavior even if the real risks
are minimal (Cakar, 2020; Quintal et al., 2010; Reichel et al., 2007). Conversely, unperceived
risks will not have any effect on people’s behavior even if the risks are real, significant, and
People’s perceptions about risks also depend on their individual differences, including
personality traits, gender, culture, and prior experience (Dryhurst et al., 2020; Menon et al.,
2006). While some people strictly follow government guidelines and generally accept rules of
isolation, social distancing, and sanitation, others ignore these norms due to differences in
perception of health-related risks, which vary by groups and individuals (Cori et al., 2020).
Furthermore, various cognitive, affective, individual, and contextual risk factors might interact
with each other and exert different effects on tourists’ behavioral intentions. The purpose of this
paper is to discuss the concepts of health risk perceptions in tourism, identify the main
antecedents and outcomes of health risk perceptions, propose a conceptual model of health risk
perceptions in tourism, and call for a further investigation of the impacts of different factors of
health risk perceptions on tourists’ behavior during the COVID-19 pandemic and other disease
The concept of risk perceptions
The majority of risk perceptions studies originated from the fields of risk management and
behavioral finance (e.g., Hoffmann et al., 2013; Hopkin, 2018; Kahneman and Tversky, 2013),
which describe risks in terms of uncertainty, severity, and the probability of negative outcomes
(Loewenstein et al., 2001; Slovic, 2016). Risk perceptions were also presented as important
determinants of customer attitudes and behavior in consumer behavior studies (Hasan et al.,
2017). In a broader context, risk perceptions can be defined as people’s subjective judgments
about risk characteristics and severity (Cui et al., 2016).
Categories of risk perceptions traditionally included financial, political, social, psychological,
and physical (Hasan et al., 2017), while several studies further introduced property risks, health
risks, security risks, facilities risks, value risks, moral hazards, weather risks, and other types of
risks (Cui et al., 2016; Li, 2010; Liu and Gao, 2008). It is often difficult to clearly differentiate
between such categories, as physical risks might influence psychological and social risk
perceptions. For this reason, measuring risk perceptions as a multi-dimensional construct became
popular in marketing, consumer behavior, and tourism literature (Hasan et al., 2017).
Risk perceptions in tourism
In contrast with economic and psychological research, tourism studies apply distinct
explanations of risk perceptions, mostly associated with tourists’ fear, anxiety, worry, and
nervousness (Fuchs et al., 2013; Reichel et al., 2007; Wolff et al., 2019). Tourists’ concerns
about financial and security risks are abundant in the tourism and hospitality literature (Fuchs
and Pizam, 2011; Pizam et al., 1997; Quintal et al., 2010), while a minority of studies described
other categories of tourists’ risk perceptions such as security (Liu and Gao, 2008), property loss
(Dolnicar, 2005), crime (Maser and Weiermair, 1998), terrorist attacks (Law, 2006), and natural
disasters (Fuchs and Reichel, 2011). Among the other previously discussed factors influencing
tourists’ risk perceptions and travel avoidance were negative media coverage (Brown, 2015),
susceptibility (Cahyanto et al., 2016), destination image (Carter, 1998), novelty preference (Lepp
and Gibson, 2003), and cultural characteristics (Kozak et al., 2007).
A number of studies explored tourists’ risk perceptions as an important determinant of travel
intentions and avoidance of potentially dangerous destinations (e.g., Casidy and Wymer, 2016;
Cooper, 2006; Khan et al., 2019). Common findings from the previous research yielded a
negative correlation between risk perceptions and tourists’ behavioral intentions. It was reported
that higher levels of perceived risk evaluations led to lower levels of satisfaction, loyalty, attitude
toward a destination, and visit intentions (e.g., Casidy and Wymer, 2016; Hasan et al., 2017;
Roehl and Fesenmaier, 1992). Health risk perceptions, however, have not received much
attention in previous tourism research.
Health-related risk perceptions
Tourism has been previously described as one of the major factors in contagious disease
transmission (Hall, 2006). The mobility of international tourism can introduce new infectious
diseases to world populations, and tourists might bring unfamiliar pathogens from remote areas
to their home countries (Richter, 2003). Among the previously described health-related risks in
tourism are HIV, schistosomiasis, Legionnaires disease, sexually transmitted infections, SARS,
and COVID-19 (e.g., Bauer, 2007; Jonas et al., 2011; Joseph et al., 1996; McKercher and Chon
2004; Schwartz et al., 2005). While several empirical papers examined the effects of global
health issues on travel intentions (e.g., Nazneen et al., 2020; Wen et al., 2020), their results
describe the impact of the pandemic on attitudes toward different types of travel without
specifying the nature and relative importance of various factors affecting tourists’ perceptions.
Most health studies in tourism describe tourists’ visit intentions in medical tourism settings (e.g.,
Collins et al., 2019; Dryglas and Lubowiecki-Vikuk, 2019; Medhekar et al., 2020; Rahman,
Notwithstanding, several previous studies reported the influence of tourists’ health-related risk
perceptions on travel behavior during the previous SARS outbreak, as well as the significant
effects of cultural dimensions, previous experience, and perceived control (e.g., Jonas et al.,
2011; Kozak et al., 2007; Rittichainuwat and Chakraborty, 2009). These findings, together with
theoretical insights from psychology, medicine, and risk research, can be used as a benchmark
for developing a conceptual model of health risk perceptions in tourism. Previous explanations of
health risk perceptions include factors such as people’s knowledge and understanding of the
disease, personal experience, trust, and cultural values, as well as demographic, cultural, and
personality characteristics (Prati and Pietrantoni, 2016; van der Linden, 2015; Zambrano-Cruz et
al., 2018). These factors can exert a great influence on tourists behavior than the disease itself
(Cooper, 2006; McKercher and Chon, 2004). Therefore, it is important to identify the
antecedents of health risk perceptions in tourism and ascertain their effects on tourists’ behavior.
Antecedents of risk perceptions
Numerous factors of risk perceptions were identified and described in previous studies (Table 1).
The first group of factors is related to tourists’ trust in tourism providers, governmental officials,
healthcare institutions, and knowledge about the risk. For instance, trust significantly affected
tourist behavior during the COVID-19 pandemic period, and it is anticipated that regaining trust
in these institutions will be a long time in coming after the COVID-19 pandemic (Cori et al.,
2020; Slovic, 2000). Tourists’ knowledge about risks also affects risk perceptions (Ropeik,
2011). Unknown risks are usually perceived as more frightening than known ones. In the case of
SARS and the COVID-19 pandemic, the fear of new and unknown viruses, coupled with
contradictory information about origin and outcomes, had significant negative effects on tourists’
perceptions, attitudes, and behavioral intentions. Knowledge about risks is mostly formed
indirectly via the media or word of mouth. In turn, media affects risk perceptions through the
valence, amount, and tone of the coverage, the trustworthiness of the information sources, and
the applied frames for presenting risks (McCarthy et al., 2008). As an illustration, Oh et al.,
(2015) explored perceptions of H1N1 influenza risks in South Korea and found that news
coverage and entertainment media had significant effects on various dimensions of risk
Table 1
Antecedents of risk perceptions.
Block and Keller (1995)
Positive and negative affect.
Carter (1998)
Destination image.
Slovic (2000)
Perceived lack of control, dread, catastrophic potential, fatal
consequences, unknown hazards.
Lepp and Gibson (2003)
Health, political instability, strange food, novelty preference.
Kozak et al. (2007)
Power distance, individualism, uncertainty avoidance.
McCarthy et al. (2008)
Amount of media coverage, frames used for presenting
risks, valence and tone of media coverage, trustworthiness
of risk information sources.
Ropeik (2011)
Trust, origin, control, nature, scope, awareness, imagination,
dread, uncertainty, familiarity, specificity, personal impact,
fun factor.
Sharot (2011)
Optimism bias.
Zhang et al. (2013)
Age, education, profession, risk experiences, knowledge.
Brown (2015)
Negative media coverage.
van der Linden (2015)
Cognitive, experiential, socio-cultural, demographic.
Henrich et al. (2015)
Framing of risks.
Cahyanto et al. (2016)
Perceived susceptibility, severity, self-efficacy, subjective
knowledge, socio-demographics.
van Hoorn et al. (2016)
Social desirability.
Becken et al. (2017)
Destination image.
Paek and Hove (2017)
Voluntariness, controllability, familiarity, equity, benefits,
understanding, uncertainty, dread, trust in institutions,
Murdock and Rajagopal
Framing of risks.
Xie et al. (2019)
Affect, descriptive norms, mitigation response inefficacy.
Dryhurst et al. (2020)
Knowledge, experience, prosociality, trust, efficacy.
Bogacheva et al. (2020)
Travel experience.
Cori et al. (2020)
Voluntariness, knowledge, visibility, trust.
Source: Authors.
The next group of factors affecting risk perceptions is related to personality traits, including risk
aversion, adventurousness, neuroticism, conscientiousness, agreeableness, and emotional
stability (Chauvin et al., 2007; Hampson, 2012; Zambrano-Cruz et al., 2018), as well as peoples’
cognitive biases such as optimism bias, anchoring, adjustment, social influence, status quo bias,
and perceived control (Cui et al., 2016). According to previous research, people with optimism
bias believe that they are less likely to contract a disease than others (Sharot, 2011; Brewer et al.,
2007). Several studies demonstrate that risk is perceived as low if it is taken voluntarily (Cori et
al., 2020) and that people are ready to follow the majority (van Hoorn et al., 2016). Previous
studies also identified that risk perceptions are influenced by travel characteristics (Adam, 2015),
destination image (Becken et al., 2017), previous travel experience (Bogacheva et al., 2020;
Sternberg et al., 2000), and other factors.
All factors affecting tourists’ health risk perceptions can be broadly classified into cognitive,
affective, individual, and contextual types. The first group of cognitive factors is related to
destination characteristics, gravity of the health risk event, media coverage, information
accessibility, and risk-mitigating measures (Brown, 2015; Paek and Hove, 2017). Among the
current measures undertaken by tourism practitioners to mitigate the risks of COVID-19 are
social distancing, sanitizing, temperature checks, and contactless services. The second group of
affective factors plays an important role in people’s ability to deal with negative information
(Block and Keller, 1995). Previous studies show that, just as customers in positive emotional
states are readier to deal with negative information and outcomes, negative affective states
prevent the processing of negative information about possible risks while enhancing self-
positivity biases.
Among the previously described contextual factors of risk perceptions are the framing of risk
information and the availability of alternative information sources. People tend to take
preventive actions when the outcomes are framed in negative terms (Robberson and Rogers,
1988; Murdock and Rajagopal, 2017). For instance, a study by Henrich et al. (2015) reported
significant effects of the framing of earthquake risk scenarios on participants’ risk perception.
The final group of individual differences includes gender, age, cultural characteristics, prior
travel experience, and personality traits, all of which significantly influence risk perceptions.
While tourism providers, destination marketing and management organizations, and
governmental authorities can affect some cognitive and contextual factors of risk perceptions,
they have no real influence on individual characteristics that determine tourists’ subjective
evaluations of risk. The effects of the previously described factors of risk perceptions were not
explored in the context of global life-threatening health risks and, therefore, a series of studies
should be conducted to investigate the influence of each factor on tourists’ health risk
perceptions to determine their effects on behavioral intentions.
Outcomes of risk perceptions
Previous studies described the effects of risk perceptions on tourist attitudes and behavioral
intentions (Table 2). Baker (2014) pointed out that tourist risk perceptions have strong negative
effects on attitude toward a destination. In a similar vein, Sohn et al. (2016) found that perceived
risk led to negative perceptions of a local festival. Jin et al. (2016) described the negative effects
of risk perceptions on trust, customer satisfaction, and loyalty. Another group of risk perceptions
outcomes is related to tourists’ behavioral intentions. Le and Arcodia (2018) described purchase
intentions as the main outcomes of customer risk perceptions in different settings. Chew and
Jahari (2014) found that the relationship between different components of tourists’ risk
perceptions and revisit intentions were mediated by affective and cognitive destination image.
Among the other described consequences of perceived risks are destination image (Lepp and
Gibson, 2003), avoidance behavior (Nomura et al., 2004), loyalty (Hossain et al., 2015),
willingness to pay more (Casidy and Wymer, 2016), need for variety (Sohn et al., 2016), and
self-protected behavior (Wang et al., 2019).
Table 2
Outcomes of risk perceptions.
Risk-taking behavior.
Risk-taking attitude, avoidance behavior.
Travel intentions.
Behavioral intentions.
Emotions, satisfaction, behavioral
Visit motivation.
Destination image.
Revisit intentions, destination image.
Attitude toward a destination.
Destination loyalty.
Negative perceptions, need for variety.
Trust, customer satisfaction, loyalty.
Willingness to pay more.
Revisit intentions.
Purchase intentions.
Self-protective behavior.
Source: Authors.
The relationships between risk perceptions and tourist outcomes, however, are not always
straightforward and might be mediated and moderated by other constructs, such as tourists’
individual characteristics, attitudes, and previous experience. For instance, the study by
Reisinger and Mavondo (2006) reported the effects of risk perceptions on international travel
intentions as moderated by tourists’ cultural differences. Yuksel and Yuksel (2007) found that
the relationship between tourists’ risk perceptions, satisfaction, and behavioral intentions is
mediated by tourists’ emotions. A study by Liu et al. (2013), however, did not reveal significant
effects of risk perceptions on customer purchase intentions in an online context. Moreover, risk
perceptions can even stimulate risk-taking behavior among certain groups of customers (Weber
et al., 2002). Therefore, it is important to develop a conceptual model of health risk perceptions
in tourism and empirically test it among different groups of tourists and destinations.
Conceptual model and future research directions
The main predictors of tourists’ risk perceptions include cognitive, affective, contextual, and
individual factors (Figure 1). The cognitive factors are associated with the perceived gravity of
health-related risks, media coverage, availability of information about risks, and mitigating
measures including social distancing, sanitizing, required wearing of masks, temperature checks,
and contactless services. The affective factors include tourists positive and negative affective
states that can influence people’s ability to deal with negative information and self-positivity
biases. The effects of the above factors are moderated or complemented by a group of contextual
factors related to the framing of risk information and availability of alternative information
sources and individual factors, such as cultural characteristics, gender, age, personality traits, and
previous experience.
Figure 1. Conceptual model of health risk perceptions in tourism.
Travel intentions are introduced as the main outcome in the proposed model. On the one hand,
most research demonstrates that low levels of risk perceptions predict greater behavioral
intentions (e.g., Cahyanto et al., 2016; Kozak et al., 2007; Law, 2006; Reisinger and Mavondo,
2005). At the same time, a few studies suggest that perceived barriers to action related to costs
and competing activities might disrupt the link between risk perceptions and behavioral
intentions (e.g., Akompab et al., 2013; Bubeck et al., 2012). Therefore, the pathway between
tourists’ health-related risk perceptions and their travel intentions demands additional
investigation in relation to the current COVID-19 situation.
The main components of risk perceptions include cognitive and affective dimensions (Dryhurst
et al., 2020; Xie et al., 2019). The previously applied measurement scales of risk perceptions in
tourism, however, mostly measured the cognitive components and were validated in contexts that
are completely different from global health-related risks such as the COVID-19 pandemic. For
instance, Fuchs and Reichel (2006) explored risk perceptions of a tourist destination by asking
respondents to evaluate their judgments regarding terrorism, crowds, and other dimensions of
risk. Chew and Jahari (2014) evaluated financial risk, physical risk, and socio-psychological risk
to investigate the effects of perceived risks on revisit intentions in post-disaster Japan. None of
the previously applied scales focuses on health issues and fully satisfies the need to measure
physical health-related risk perceptions. Therefore, new scales should be developed and
validated specifically to assess tourists’ health-related risk perceptions by using a mixed-methods
approach (Churchill, 1979, Creswell and Clark, 2019; DeVellis, 2016).
This paper intends to clarify the concept of health risk perceptions in tourism, identify the main
factors of health risk perceptions, and propose a conceptual framework of health risk perceptions
in tourism. The conceptual model advances a systematic and theoretically integrated overview of
the main factors affecting tourists’ risk perceptions and behavioral intentions and suggests that
future research ought to understand these factors and their effects on travel behavior. New
measurement scales of health-related risk perceptions should be developed and validated in
tourism settings by using a mixed-methods approach. The relative importance of each of the
cognitive, affective, contextual, and individual factors that affect health risk perceptions for
different groups of tourists, as well as their relationship with tourists’ behavioral intentions,
should be empirically explored in future studies by conducting surveys, interviews, online
content analysis, experiments, and longitudinal studies.
This paper contributes to theory by offering a new approach to health risk perceptions in tourism,
which remain underexplored in extant studies. The literature review adds to the body of
knowledge by introducing four main groups of factors affecting tourists’ health risk perceptions,
while the conceptual model advances relationships between these factors, tourists’ risk
perceptions, and travel intentions. The paper provides important practical implications as well.
While tourism providers, destination marketing and management organizations, and
governmental authorities currently make every effort to eliminate the negative consequences of
COVID-19, they cannot influence tourists’ individual characteristics such as personality traits,
socio-demographic characteristics, and prior experience. Therefore, it is necessary for tourism
practitioners to be aware of individual factors of perceived risks, constantly measure the factors
and outcomes of tourists’ risk perceptions, and segment proposals to potential customers based
on their sociodemographic, experiential, and personality characteristics. The proposed
conceptual model can be used as a framework for exploring the effects of different factors of risk
perceptions on tourists’ behavioral intentions in the context of the COVID-19 pandemic and
other disease outbreaks.
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... Perceived risks may influence people's attitudes, decisions, and behavior, even if the real risks are minimal [13]. However, there is a lack of research on perceived health risks in association with tourism [14]. ...
... In tourism, risk perceptions are mostly associated with fear, anxiety, worry, and nervousness [14,27]. Several studies explored tourists' risk perceptions as an important determinant of travel intentions and avoidance of potentially dangerous destinations [28]. ...
... Fear processed through the problem frame impacts viewers and their perceptions of risk in their everyday lives and for travel. Media coverage has been found to contribute to perceived travel risk affecting attitudes towards travel and destination image [14,20]. When online news media relay the problem frame of fear and highlight travel restrictions through antitrust and anxiety, citizens are apt to restrict and avoid travel, thus impacting travel demand. ...
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This paper analyzes the role of Canadian online news media in framing travel during the pandemic. The article applies Altheide’s concept of the problem frame to reflect how news media contribute to the emergence of a highly rationalized problem that, in turn, generates a discourse of fear. While the impacts of COVID-19 on tourism have been extensively examined within tourism scholarship, less attention has been devoted to the impact of news media. Because travel and the pandemic are heavily intertwined, discourse analysis can help process media narratives, furthering our understanding of their role in influencing perceived risk of travel. A critical discourse analysis of over 100 online news articles was conducted using thematic analysis to uncover themes in Canadian media sources and to explore how the media have framed travel during the pandemic. The role of online news media in promoting fear was communicated through the themes of anxiety, antitrust, avoidance, and animosity. The role of the media in producing the problem frame in the context of travel was examined as well as its implications for perceived travel risk and tourism demand. The power dynamics between media, government, and the citizens it serves are also discussed.
... The word "risk" refers to uncertainty that originates from different events [1]. Risk perception is a subjective judgment that individuals have about the characteristics and severity of a risk [2,3]. Individual's reaction is based on their perception of risk and not based on an objective risk level or a scientific evaluation of risk [4]. ...
... Individual's reaction is based on their perception of risk and not based on an objective risk level or a scientific evaluation of risk [4]. Risk perception and individual reactions are different from real risks, because it is influenced by a wide range of emotional factors, individual factors, and the unknown nature of the risk and its catastrophic nature [3,5]. Following the outbreak of COVID-19 in December 2019, the World Health Organization (WHO) declared this disease a pandemic in March 2020 [6]. ...
Background: The COVID-19 disease has worse outcomes in individuals with underlying diseases and elderly individuals. Therefore, identifying COVID-19 risk perception and its related factors and outcomes in vulnerable groups is essential for the health system. Objectives: This study aimed to determine COVID-19 risk perception, its related factors, and outcomes in vulnerable groups (individuals with underlying diseases, smokers, opioid addicts, the elderly, and pregnant women). Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out using the keywords “Risk perception” and “COVID-19” in PubMed, Scopus, Science Direct, SID, Proquest, and Magiran databases in the period from 2019 to July 3, 2021. The quality of selected studies was checked by two authors independently according to Newcastle-Ottawa Scale adapted for cross-sectional. Results: In the initial search, 640 articles were found, of which 56 remained in the screening phase. Then, the full text of 56 articles was studied. Eventually, based on the inclusion and exclusion criteria of the articles, 8 articles were reviewed. This systematic review showed that suffering from an underlying disease, more anxiety, younger age, and female gender are associated with higher COVID-19 risk perception. The outcomes of COVID-19 risk perception were higher COVID-19 risk perception, delayed treatment sessions, increased anxiety and fear, increased ineffective safety behaviors, and greater compliance with health protocols. Conclusion: Creating sensitivity and proper COVID-19 risk perception is necessary to follow health protocols, but high COVID-19 risk perception can endanger vulnerable groups’ mental and physical health. Besides, reducing the sensitivity of vulnerable groups toward COVID-19 can expose them to the disease
... Likewise, in the case of this study, perceived risk and perceived risk knowledge are the newly integrated variables of the MGB model that fit well into the post-COVID era context and rationalize better the antecedents of behavioral intentions (i.e., attitude towards the behavior, subjective norm, perceived behavioral control, anticipated emotion and desire). Under the circumstances of large-scale and widespread epidemics such as SARS and COVID-19, which pose an array of unknown risks, risk perception tends to be drastically higher and more influential than those existing in times of normalcy [83]. Besides, the impact of perceived knowledge living in the so-called unknown era is inevitable in this case. ...
... Adventure tourism's rise has been ascribed to its advantages for enhancing subjective well-being and promoting good mental health [5]. Adventure seekers look forward to interactions and experiences that are stimulating, physically demanding, or otherwise affect their subjective well-being and satisfaction [6]. Likewise, the popularity of tourism and aquatic sports is rising everywhere in the world, with large bodies of water being used for a wide variety of outdoor recreational activities [7]. ...
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Adventure tourism is among the sectors that has experienced the greatest growth in participation in recent years. In addition, it provides a unique opportunity to generate different benefits for rural populations as well as for the preservation of their environment. The objective of this study was to analyze gender differences in the profile, estimated expenditure, perception of economic impact and satisfaction of adventure tourists visiting the Valle del Jerte (Extremadura, Spain) for kayaking activities. The sample was composed of 511 tourists who kayaked in the Valle del Jerte. Gender differences were analyzed by the Mann-Whitney U test in continuous variables and Pearson’s chi-square test in categorical variables. The predominant profile of the kayaking tourist is Spanish, married, employed, with university education, lives with their partner with children at home, chooses a rural home for accommodation, travels with companions, uses their own car for transportation, spends 550 euros on average, has good perceptions of the economic impact of the activity on the destination and is satisfied with the kayak service received. This information is relevant for public and private organizations as well as for the local community to be able to offer services more oriented to the tourist who engages in these activities, as well as to attract more tourists.
... History records that tourism is one factor that spreads infectious diseases, such as in the case of HIV to Covid-19. Therefore it is vital to understand the perception of health risks in the tourism industry (Godovykh et al., 2021). The study found that the determinant of tourist satisfaction in making a trip is assessing health factors in the destination area based on personal opinion (Medeiros et al., 2020). ...
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This research is based on the phenomenon of a shift in tourist behaviour during the Covid-19 pandemic. Cleanliness, Health, Safety, and Environment (CHSE) are the primary considerations for tourists when deciding to choose a tourist destination while on vacation, beating other aspects such as low prices. This study provides an initial picture of how tourists perceive the application of CHSE in a tourist destination. The method used in this research is descriptive quantitative through a survey using a questionnaire, then the results are tabulated into a frequency distribution table. The results of this study indicate that according to the perception of tourists who are dominated by the Millennials market segment, assessing that the application of CHSE in destinations around Bandung Raya is in the category of fair. Keywords: tourist perception, CHSE, Cleanliness, Health, Safety
... Perceived risk refers to people's subjective judgments about risk characteristics and severity. 22 COVID-19 perceived risk refers to an individual's anxieties, concerns and fears regarding the potential threat of infection, his or her estimation of the likelihood of contracting the disease and its outcome based on the available information. 23 Risk perception is an important determinant of individuals adopting health-protective behaviors to reduce potential risks. ...
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Purpose: This study examined the influencing mechanism and boundary conditions underlying the relation between COVID-19 perceived risk and flight attendants' turnover intention by investigating the mediating role of job insecurity and the moderating effect of job crafting. Methods: A two-wave survey was conducted with 240 Chinese flight attendants. We used structural equation modeling to test the moderated mediation model. Results: The results indicated that perceived risk of COVID-19 positively affected flight attendants' job insecurity and turnover intention. Moreover, job insecurity plays a fully mediating role in the relationship between perceived risk and turnover intention. Furthermore, the mediating role of job insecurity was moderated by job crafting; for higher levels of job crafting (opposed to low), the effect of job insecurity on turnover intention was significantly weaker. Conclusion: Our findings indicate that dissipating job insecurity and increasing job crafting behavior are critical to employees' work-related attitudes and behavior during the COVID-19 pandemic.
... RP is an important predictor of TI during COVID-19 [92]. H1, H2, and H3 are accepted, indicating that RP has an effect on AT, DE, and TI, which is consistent with the obtained results [93,94]. The greater the perceived risk is of an activity, the more likely people are to avoid it. ...
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The outbreak of COVID-19 has brought increasing attention to proximity travel. This mode of travel is a convenient travel setup for both tourists and neighboring destinations. With the help of the model of goal-directed behavior (MGB), this study investigates the influence of tourists’ perception of epidemic risk on their intentions for proximity travel during the normalization of epidemic prevention and control. This study takes Shenzhen, China as the research area, and carried out the investigation in the context of normalization of the epidemic in China. A total of 489 pieces of valid sample data were collected through questionnaire surveys. Statistical analysis software, such as SPSS26.0 and AMOS23.0, were used to analyze the collected data information quantitatively, including descriptive statistical analysis, reliability and validity test, CFA and SEM. The results showed that attitude, subjective norms, positive anticipated emotions, and perceptual behavior control have significant positive effects on travel desire. Travel desire has a significant positive impact on travel intention, whereas negative anticipated emotions have no significant effect on travel desire. Meanwhile, the epidemic risk perception has a significant positive effect on attitudinal travel desire and travel intention. Under the background of the COVID-19, the stronger that the epidemic risk is perceived by tourists, the more the desire and intention to proximity travel are enhanced.
The spread of the COVID-19 pandemic has had a significant negative impact on many tourist destinations around the world, including Thailand. A shift in typical vacation behavior has emerged as a major issue in the global tourism industry as a result of travel restriction and social distancing issues. In the new normal scenario of COVID-19 pandemic, creative tourism, which focuses on participating in onsite activities and interacting with people, is facing challenges. It is important to pay attention to what tourists consider when making decisions about future travel plans, especially in creative tourism. This chapter focuses on tourist motivation, travel decisions, and travel practices for service providers, all of which are discussed in terms of how Thailand's creative tourism potential can be revitalized. Furthermore, an integrated model of creative tourism is proposed in predicting future travel behavior related to health risk concerns. Several potential implications and concerns for managerial decision-making in service and marketing contexts are discussed.
COVID-19 has posed a massive challenge for destination marketers to restore safety perceptions among tourists after the onslaught of the pandemic. The objective of the current study is to develop an integrated model linking social and technical elements via socio-technical theory helping in theory development and tourism recovery. Destination marketing researchers agree on the importance of STTs to restore faith among tourists However, there is a lack of theory in the studies related to tourism recovery. Socio-technical theory, which attributes the interdependence of technical systems and social systems for maximizing organizational productivity is used by the current study to help understand the tourism recovery process. This study uses the elements of socio-technical theory in a structural equation model (SEM) to help destination marketers better understand the effect of technology in attaining tourism recovery. Based on self-selection sampling, we collected the data via a web survey from, the modeling in this study was done via variance-based structural equation modeling. The study results demonstrate a strong effect of Smart Tourism Technologies (STTs) in reducing the impact of pandemics on tourists’ perceptions.
Conference Paper
The tourism industry is very sensitive to the influence of various crisis situations which can have smaller or greater negative impact on its development. Many tourist destinations closed their borders due to the development of a global pandemic of COVID-19, which resulted in a dramatic reduction of tourist turnover as well as the temporary stop of normal functioning of the tourism industry. Moreover, the current health crisis influenced significantly the changes in decision-making process of tourists when choosing a holiday destination and the way of organizing their journey. The purpose of this paper is to examine the relations among travel risk perception, tourist behavior during travel and the frequency of travel among Serbian residents when the individual characteristics of the respondents are controlled. Results of the empirical research indicate that tourist’s behavior during travel is positively connected with the travel risk perception. Furthermore, age and education affect the travel risk perception.
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Purpose - The aim of the present paper is to examine how crises impact overall tourist behaviour and travel preferences in times of crisis events, both man-made and natural disasters. In doing so, the present paper has been designed to provide a new conceptualisation of travellers’ shifting preferences in terms of the selection of holiday destinations through the new concept of tourophobia, and to classify this as a new type of tourist behaviour. Design/methodology/approach - The present study employs a literature review as a qualitative deductive content analysis of 58 field studies published by major hospitality and tourism journals. By utilizing a deductive content analysis approach, the current paper is designed to delineate tourist behaviour through a generic review of relevant literature detailing travellers’ preferences in times of crisis. Findings - The developed concept of tourophobia and the suggested model, which proposes two possible scenarios, shows that traveller behaviour is heterogeneous in terms of the destination selection process; this finding is based on a content analysis of the articles chosen. Further, by using the developed model, the decline in travel and tourism can also be explained by an increase in what is termed in this paper ‘tourophobia’, which results from the various devastating effects of crises. Research limitations/implications - The proposed model is expected to help destination managers and marketers to segment and forecast the future market demand of tourist travel preferences, thereby enabling them to form effective marketing strategies and increase their responsiveness during difficult times. Only articles from hospitality and tourism journals were subjected to the content analysis; this is a major limitation of the study. Originality/value - The present research contributes to current knowledge by describing the concept of tourophobia as a tourist behaviour in times of crisis. As an emerging phenomenon, it is also introduced as being one criterion for the selection of destinations and, therefore, is regarded as a driver for tourist behaviour, thus generating the originality of the paper. This study strives to provide a new direction for future studies on tourist behaviour, rather than offering new empirical data.
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Purpose - The 2019 novel coronavirus (COVID-19) outbreak is projected to have adverse consequences on the global tourism and hospitality industry. This paper aims to examine how the outbreak may alter Chinese tourists’ lifestyle choices, travel behaviour and tourism preferences in the short and long term. Design/methodology/approach - This paper is based on the synthesis of news broadcasted by several media outlets to be supported by an overview of the related literature on tourism marketing, tourism management and tourist behaviour. The authors’ experiences investigating trends in tourism and hospitality at the local and international level have also contributed to the study. Findings - This paper predicts that COVID-19 will likely affect Chinese travellers’ consumption patterns, such as the growing popularity of free and independent travel, luxury trips and health and wellness tourism. New forms of tourism including slow tourism and smart tourism may also drive future tourism activities. Such changes are likely to force businesses to reconsider their service designs and distribution channels. Research limitations/implications - While Chinese and other potential visitors rethink how they travel, professionals, too, should reflect upon how to bring positive or negative changes to the tourism industry following this pandemic. Subsequent research should also consider how to mitigate the effects of similar public health crises in the future. Practical implications - Recommendations for industry practitioners and policymakers focus on tailoring travel arrangements to tourists’ backgrounds. The suggestions may help to alleviate outbreak-related stress, offer travellers newly enriching experiences and partially mitigate the effects of COVID-19 on the tourism and hospitality industry. These recommendations can also apply more broadly to global tourist markets. Social implications - The COVID-19 outbreak has already brought significant impacts to nearly every society and industry. Tourism scholars and practitioners should carefully consider this tragedy and how it may inform industry and social practices. This and other public health crises represent sterling opportunities to view the industry holistically in terms of its effects on the environment, climate and travellers themselves. Originality/value - This paper presumably represents a frontier study, critically examining the possible impacts of COVID-19 on Chinese travellers’ consumption patterns and how the tourism and hospitality industry may respond to such changes in the future.
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The World Health Organization has declared the rapid spread of COVID-19 around the world a global public health emergency. It is well-known that the spread of the disease is influenced by people's willingness to adopt preventative public health behaviors, which are often associated with public risk perception. In this study, we present the first assessment of public risk perception of COVID-19 around the world using national samples (total N = 6,991) in ten countries across Europe, America, and Asia. We find that although levels of concern are relatively high, they are highest in the UK compared to all other sampled countries. Pooled across countries, personal experience with the virus, indi-vidualistic and prosocial values, hearing about the virus from friends and family, trust in government, science, and medical professionals, personal knowledge of government strategy, and personal and collective efficacy were all significant predictors of risk perception. Although there was substantial variability across cultures, individualistic worldviews, personal experience, prosocial values, and social amplification through friends and family in particular were found to be significant determinants in more than half of the countries examined. Risk perception correlated significantly with reported adoption of preventative health behaviors in all ten countries. Implications for effective risk communication are discussed.
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The ongoing COVID-19 pandemic is shaking the foundations of public health governance all over the world. Researchers are challenged by informing and supporting authorities on acquired knowledge and practical implications. This Editorial applies established theories of risk perception research to COVID-19 pandemic, and reflects on the role of risk perceptions in these unprecedented times, and specifically in the framework of the International Journal of Environmental Research and Public Health Special Issue “Research about risk perception in the Environmental Health domain”.
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Medical decision-making is often related to risk and uncertainty, but existing research does not offer a comprehensive approach to this matter. We discuss the necessity to study cognitive representations of risks (CRRs), which we define as the subject’s images of risky situations, possible outcomes, and alternative decisions. The psychometric approach towards risk assessment often involves the evaluation of different risks, but we aim to create such a list from medical professionals’ expert knowledge. Via qualitative analysis, CRRs were obtained from interviews with practicing doctors from Russia (N = 24). The list includes 21 risks from real-life medical practice, with seven aspects for numerical evaluation each. Then, practicing doctors (N = 64) evaluated CRRs along with filling risk-related personality traits questionnaires: Personal Decision-Making Factors Questionnaire, Melbourne Decision Making Questionnaire, Ten Item Personality Measure, and Budner’s Intolerance of Ambiguity Scale. A correlational analysis showed interconnections between most CRRs aspects, with predictability and negative outcome probability seemingly being the central aspects of the risk assessment. CRRs aspects were also found to be gender- and experience-specific, with female doctors and younger specialists being more sensitive to professional risks. Personality traits in relation to CRRs aspects, medical experience and gender are also discussed.
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Research on risk perceptions within the tourism domain suffers from two closely related problems: diverging conceptual and measurement definitions. The lack of precision and standardization is hindering comparisons of findings across studies as well as systematic accumulation of knowledge. The present paper gives some examples of how diverging definitions of risk may constitute a serious problem. It also shows how measures of perceived risk are influenced by various heuristics and biases via item wording. Lacking awareness of the effects of these biases may lead to erroneous conclusions regarding the relative risk of various hazards. The paper concludes with specific suggestions for how some of these problems can be tackled, and should be of practical use for tourism scholars researching risk perceptions.
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Purpose The purpose of this paper is to identify Poland’s image as a medical tourism destination (MTD). Design/methodology/approach Survey data were collected from 282 German and British medical tourists, using a self-administered questionnaire. The Computer-Assisted Web Interviewing method was used to conduct the survey. Subsequently, the responses were analysed using advanced statistical tools (McNemar’s exact test, Cochran’s Q test and Chi-square test). Findings Before visiting Poland, the respondents perceived the country through the prism of medical attributes, whereas after the visit, they perceived it through the prism of non-medical attributes. Research limitations/implications Identification of a set of MTD image characteristics has important implications for scholars, allowing them to understand attributes which shape projected and perceived MTD image. Such construct can also be a useful tool for marketing planners, destination managers and marketers to create an effective marketing policy and projected image of MTDs based on these features. Originality/value The study fills an important gap regarding the lack of conceptual and empirical content allowing for exploration of MTD image.
### READERS: CLICK DOI LINK ABOVE FOR THE TEXT ### Risk perception refers to people’s subjective judgments about the likelihood of negative occurrences such as injury, illness, disease, and death. Risk perception is important in health and risk communication because it determines which hazards people care about and how they deal with them. Risk perception has two main dimensions: the cognitive dimension, which relates to how much people know about and understand risks, and the emotional dimension, which relates to how they feel about them.
Purpose The purpose of this paper is to explore the supply-side factors that determines the quality of global healthcare services from medical tourism healthcare providers’ (MTHP) perspective, which provide value-in-medical-travel to foreign patients/medical tourists, who travel to India for medical treatment/surgery. Design/methodology/approach The thematic content analysis of in-depth interviews with 15 senior MTHP, from 15 private hospitals in India was undertaken, to generate the themes, and identify the supply-side factors necessary for sustainable medical tourism management. Findings The findings conclude that MTHP ranked in ascending order, less waiting-time for surgery, healthcare quality and accreditation, staff/surgeon’s expertise, healthcare information, hospital facilities and services, patient-safety, travel-risk, surgical costs and holiday opportunity as essential factors for providing sustainable quality and value-in-medical-travel to patients. Research limitations/implications Many private hospital spokespersons declined to be interviewed due to confidentiality and privacy policy Practical implications The findings are generalised in case of global private hospitals treating foreign patients. Policy implications suggest that private hospitals in developing countries need to focus on providing value-in-medical-travel, such as accreditation quality of healthcare, no waiting-time, patient-safety, qualified and experienced medical and non-medical staff, hospital facilities and post-surgery care with positive healthcare outcomes. Social implications Medical-tour facilitators, hotels and tourism sites need to collaborate with agencies to provide inclusive built environment, first-aid and wheelchair access, to medical tourists, having financial and legal implications for business. Originality/value There is little qualitative empirical research on the views of MTHP, regarding management of essential supply-side factors that provide value-in-medical-travel to attract medical tourists to India.