Abstract
To systematically understand the evolution of health tourism in China, the present study visually analyzes the theme evolution and frontiers of Chinese health tourism research on the basis of the China National Knowledge Infrastructure (CNKI) database through bibliometric analysis. The findings reflect the existence of diverse clustering themes in health tourism research, and the formation time of each theme is different. The findings also indicate that the change in the theme is led by government policy. Theoretically, the findings of the present study can, on the one hand, contribute to the health tourism literature by comprehensively exploring and summarizing the themes and topics of health tourism development in China since its appearance (i.e., 1981), and, on the other hand, provide references for future health tourism exploration directions. Findings of the present study can provide references for effective future development directions of the health tourism industry.

Introduction

Along with the outbreak of the novel coronavirus (COVID-19) pandemic, people have been paying more attention to health [1]. Consumers are more willing to pay attention to health risks, such as COVID-19-related health issues, and would like to participate more in health tourism. For example, a recent study [2] proved the moderating role of risk communication for health tourism to improve the physical and mental health of people affected by the COVID-19 pandemic. With the effective control of the pandemic in different countries and regions, the tourism industry may have more opportunities for health tourism development [3]. For instance, one recent study reflected the great needs of diversified provision of health tourism packages for different consumer groups [4]. As a result, it is expected that after the pandemic, tourists’ travel behavior may be changed [5], and the expected changes may require tourism destination organizations to be more responsible for the health concern of consumers [6]. Hence, a comprehensive overview of health tourism is conducive to explore current research gaps in order to identify future research directions and ultimately contribute to the development of the health tourism industry.

Conclusions

Theoretically, this study is expected to make meaningful contributions. First, this paper makes up for the lack of international understanding of China’s health tourism sector by reviewing health-related papers from the database in China, thereby helping to better develop Chinese and international academic and industrial cooperation. Second, on the basis of bibliometric results, this study takes policies into consideration, and analyzes the driving forces of China’s healthy tourism development in a more in-depth manner, helping to predict its future development more accurately. Third, through the analysis of the development process of China’s health tourism, the study provides a reference for the development of health tourism for other countries and regions.

Practically, this study is expected to bring some practical implications for the government and the market. First, for the government, the results found that academia has been fruitful in health tourism-related policy formulation and feedback. As such, a government can take academic research results into consideration when formulating health tourism-related policies. Second, for the destination market, the results found that the trend of health tourism is often related to government policies. Therefore, when developing resources related to health tourism, destination organizations can refer to the government’s macro policies to grasp the general direction.

Abstract

Narrative storytelling, a cornerstone of narrative persuasion theory, plays a crucial role in nurturing robust consumer-brand relationships. Understanding persuasive narratives within the social media domain is critical for destination brands. Hence, this study investigates the impact of realistic narratives on attitudinal destination brand loyalty, mediated by self-congruence and brand attachment across two experiments. Study 1 provides evidence for the superiority of adventure-themed realistic fictional narratives over fantasy one in Facebook advertisements. Study 2 supports the findings of Study 1 with a romantic-themed narrative and a diverse destination in Instagram advertisements. Moreover, Study 2 reveals that consumer fantasy proneness diminishes the influence of realistic fictional narratives on self-congruence. These findings suggest a strategic shift toward realistic narratives over fantasy ones to stimulate self-congruence and cultivate destination brand attachment, ultimately fortifying the bonds between travellers and destination brands.

Introduction

Engaging with travellers through social media has emerged as a cost-effective strategy for promoting tourism destinations ( Adamış & Pınarbaşı, 2022 ). Destination Management Organisations (DMOs) are increasingly focused on shaping and guiding brand narratives within social media channels to influence travel decisions ( Lund, Cohen, & Scarles, 2018 ; Ma, Scott, & Wu, 2023 ). However, social media advertising poses unique challenges for DMOs and destination marketers as they strive to stand out in crowded marketplaces. As a result, identifying the most persuasive methods to convey destination brand narratives has become crucial, with narrative storytelling proving to be a powerful tool in capturing travellers’ attention and encouraging them to explore destinations ( Youssef, Leicht, & Marongiu, 2019 ).

A “story-world”, which comprises a series of interconnected events centred around a specific theme, settings, and characters immerse audiences in the captivating realm of storytelling ( Ryan, 2016 ; Woodside, Sood, & Miller, 2008 ). Narrative storytelling is the art of narrating a sequence of events, whether based on true or fictional settings, by adeptly weaving together engaging story characters and immersive plots in a compelling manner ( Ma et al., 2023 ; Tu, 2015 ). This form of storytelling has a powerful ability to persuade and transport its audience by lessening negative cognitive responses and eliciting strong emotional reactions ( Escalas, 2007 ). Consequently, narrative storytelling offers significant opportunities for enhancing destination brand perception, identity, and competitiveness in saturated markets ( Bassano, Barile, Piciocchi, Spohrer, & Iandolo, 2019 ) and serves as a catalyst for destination development ( Hartman, Parra, & de Roo; 2019 ).

Conclusion

This study pioneers a shift in the exploration of perceived realism within destination brand narratives, diverging from prior research that have predominantly explored general aspects of storytelling. In contrast to earlier attempts, our research distinctly focuses on a specific and pivotal dimension—the impact of perceived realism in destination narratives on destination brand loyalty. By investigating the nuanced differences between realistic narrative and fantasy one, the current study has uncovered psychological mechanisms like self-congruity and brand attachment. Furthermore, the introduction of the concept of fantasy proneness has added a novel dimension to our understanding of how narratives operate in shaping travellers’ responses. In essence, this research has involved pioneering a more tailored and focused exploration of realistic narrative influences in the intricate realm of tourism destination branding.

Abstract

Live streaming has been increasingly integrated into e-commerce platforms to sell tourism offerings, yet its value-adding mechanism for enhancing customer shopping experiences remains underexplored. From a value co-creation perspective, this study investigates how customers can co-create value by leveraging the interactive potential in tourism live shopping, and how such customer co-creation behavior can be fostered through the attributes and actions of tourism live streamers, drawing on source credibility and social presence theories. The empirical findings indicate that the credibility traits of tourism live streamers, characterized by trustworthiness, expertise, and attractiveness, are instrumental in fostering customer co-creation behaviors, which can in turn elevate customer perceived value of their tourism live shopping experiences. Additionally, the study reveals that the level of social presence during tourism live shopping sessions may positively moderate the influence of streamer credibility traits on customer co-creation behaviors.

Introduction

Live-streamed shopping, or live shopping, merges live broadcasting with e-commerce, offering a more dynamic and interactive alternative to traditional TV and web-based online shopping (Wongkitrungrueng & Assarut, 2020). This approach features live streamers who actively demonstrate products and communicate with potential customers in a real-time manner to facilitate sales (Chen & Zhang, 2023). By integrating socialization, entertainment, and instant purchasing, live-streamed shopping provides a superior shopping experience, making it a significant experiential marketing channel across diverse product categories (Bai et al., 2024).

The same trend has also been witnessed in the hospitality and tourism industry. Numerous tourism sectors, including hotels, restaurants, attractions, and destination marketing organizations, now adopt live streaming for communication, promotion, and direct sales (Lin et al., 2022). In such tourism live shopping events, tourism organizations collaborate with live streamers, including travel influencers, celebrities, and professional sellers, to promote and sell tourism offerings (Xu et al., 2021). Streaming viewers, namely those potential travelers, can engage directly with the streamers, participating in real-time interactions and making on-the-spot purchases as needed (Xu et al., 2021). Extant research has underscored the potential economic, emotional, social, and knowledge-based benefits of tourism live e-commerce, highlighting its role as a promising digital tourism marketing channel (Wang and Guo, 2024, Xie et al., 2022).

Results

4.1. Sample profile
Table 2 outlines the demographic profile of the survey respondents. The predominant group consisted of female young adults, aged between 18 and 35 years. A large portion of these respondents were single and held a college degree. Over half of the participants reported an annual income below 10,000 RMB (around 1,500 EUR). In terms of preferred platforms for tourism live shopping, Douyin emerged as the most popular, followed by Taobao and Flyzoo, both Alibaba affiliates, and then Ctrip. As for the types of tourism offerings purchased through live shopping, hotels were the most common choice, succeeded by restaurants and tourist attractions. Purchases of event tickets, tour packages, and transportation services via live shopping were less frequent.

4.2. Measurement validity
Before hypotheses testing, we conducted preliminary analyses to assess measurement validity. First, in our analysis, we employed the Maximum Likelihood with Robust Standard Errors (MLR) method, a parameter estimation that does not require strict multivariate normality (Mueller & Hancock, 2008). Second, to address common method bias, we implemented both procedural and statistical controls. Procedurally, we made the online survey anonymous, clearly stated the study’s purpose in the introduction, kept the survey questions brief and included attention-check questions. Statistically, Harmon’s single-factor test showed that the largest factor accounted for 36.3 % of the total variance, below the 50 % threshold suggested by Podsakoff (2003). Also, the Common Latent Factor (CLF) test indicated that the differences in standardized regression weights for all items in models with and without a CLF were smaller than 0.2, in line with the guidelines by MacKenzie and Podsakoff (2012). Hence, common method bias was not deemed a serious concern.

Abstract

The upper echelons theory postulates that the cognitive frameworks of top executives shape organizational decisions and behaviors. Based on this theory, this study contributes to the literature by analyzing the effects of the chief executive officer’s (CEO) political ideology and political climate on variations in the market value of tourism firms resulting from their innovation activities. An empirical application was conducted on major U.S. hotel companies that have traded on the stock market for the last 25 years (1998–2022) and made innovation-related announcements. This application shows that, although the implementation of innovative activities positively affects a firm’s market value, both the CEO’s political ideology and the political climate influence the degree of change in the said market value. This study has fundamental theoretical implications for upper echelons theory by improving the understanding of how cognitive diversity derived from political ideology influences decision-making and its outcomes.

Introduction

Do the values of chief executive officers (CEOs) of publicly traded tourism companies influence their behavior? To what extent can these personal beliefs influence the effect of innovation on the market value of the companies they lead? Does the national political climate affect stock profitability when tourism organizations undertake innovative actions?

Innovation has been widely recognized as a critical element for tourism and hospitality companies and emerges as an indispensable strategic factor for their long-term success and growth (Gao & Zhang, 2023; Martínez-Ros & Orfila-Sintes, 2009; Pikkemaat et al., 2019; Sundbo et al., 2007; Vu & Hartley, 2022). Tourism literature has highlighted multiple benefits associated with innovation: it enables the tourism sector to be more resilient, productive, and adaptable (Zenker & Kock, 2020); it helps cope with an increasingly competitive and uncertain environment (Gao & Zhang, 2023; Martínez-Ros & Orfila-Sintes, 2009; Vu & Hartley, 2022); it facilitates the creation of new products and tourist experiences (or improves the quality and efficiency of existing processes and services) that contribute to stimulating demand and increasing business performance (Hall & Williams, 2019; Hjalager, 2010; Nicolau & Santa-María, 2013a, 2013b; Raad et al., 2023; Sharma et al., 2021; Zach et al., 2020); and it helps tourism companies grow (Love et al., 2011) and remain competitive (Aldebert et al., 2011; Martín-Rios & Ciobanu, 2019; Pikkemaat et al., 2019). In the context of hotel management, Chen (2011) states that “innovation appears to be the only means for an organization to convert change into opportunities and thus succeed [in the market]” (p. 64).

Conclusions

This study has assessed the potential effects of a CEO’s political ideology on the abnormal returns resulting from hotels’ innovations investments. In particular, the empirical application looks into the major U.S. hotel companies that have traded on the stock market for the last 25 years (1998–2022) and made innovation-related announcements. The results show that, although the implementation of innovation activities positively affects the market value of hotels, a CEO’s political ideology affects the level of reaction on the part of shareholders. Specifically, the implementation of innovation activities by hotel companies led by liberal CEOs (compared with those led by conservative CEOs) results in low abnormal returns. Moreover, when a liberal party has greater control over the governing bodies than a conservative party, the implementation of innovation activities leads to high positive effects on a hotel’s market value.

These results have relevant theoretical implications. First, this study represents a significant advancement in the literature related to tourism innovation, as it strengthens the connection between the hospitality industry and political ideology. While existing literature has highlighted that political decisions profoundly impact the development of tourism activities (including innovation), this study goes a step further by revealing that hotels must consider the ideology of their CEOs as a critical factor when evaluating and implementing tourism innovations. The political beliefs of these top executives significantly influence the ability of hotels to generate positive abnormal returns through the announcement of any innovative initiative. This approach not only optimizes the positive impact associated with innovations in the stock market but also provides a pathway for companies in the sector to increase their market value in an increasingly dynamic and complex competitive environment.

Abstract

     The extant paper aims to explore the effects of the COVID-19 pandemic on marketing activities. In this respect, the study adopted Structural Equation Modeling (SEM) using SPSS26 and Smart PLS-3 to analyze the descriptive survey that was distributed among 200 hotel managers. The findings revealed that although the pandemic affected the technology application in the hospitality sector positively, it also has negative impacts on marketing performance. The results also illustrated the considerable effect of technology on marketing performance. Thus, by providing a comprehensive research model, the study calls on hotel managers and executives to reconsider their marketing activities.

Introduction

     Just after the outbreak of the Covid-19 across the world, many countries set strict travel bans (tourism restrictions, border closures, etc.) to prevent further spread (Nuseira and Aljumahb, 2020). Most of the countries in the world enforced partial or complete border closures, and the travel ban impacted the majority of the world’s population. The hotel industry is among the four main pillars of tourism and traveling which has been severely influenced by this pandemic crisis (Zanker & Kock, 2020; Hemmington & Neill, 2021). Hence, The industry faced the crisis of reduced demand and high costs that threated the profitability (Polemis, 2020). Around 113 countries placed global travel bans since the outbreak of the pandemic until the first half of 2020. The World Tourism Organization has estimated a 60–80% decline in 2020 compared to the previous year, which is 15–20 times more than the case of the 2008 global financial crisis. The World Travel and Tourism Council has estimated that over 100 million jobs in hotel and tourism industries were in danger that over half of them were in Asia (International Trade Center, 4: 1). Then, after the decline of COVID-19 in 2021 and 2022, tourism tripled from January to July 2022 (+172%) compared to the same period of 2021 (UNWTO, 2022).

     On the other hand, the profitability crisis in the hotel industry made a decline in the number of workforces (Zou et al., 2020). Hotels also laid off thousands of people to reduce their costs in response to their economic crisis (Khan et al., 2021). Under such circumstances, technology and its capabilities can be a solution for hotels to implement their marketing strategies with minimal costs (Gursoy & Chi, 2020).

Conclusion

     The increasing technological developments in the contemporary world highlight the need to study the consequences of the COVID-19 pandemic on marketing. In other words, the need for developing marketing activities and the role of technology has become more tangible than ever before due to the recent global pandemic.

     The present paper sought to investigate the influence of using technologies on marketing performance considering the role of the COVID-19 pandemic. Marketing strategies based on digital technologies can have an overall positive impact on the marketing performance of hotels since they help users visit social media pages more often and review the comments of others. It has been revealed that new technological approaches like digital marketing could impact sales and profits and customers in a positive and profitable way (Baharuddin et al., 2022). Overall, digital marketing strategies can influence the marketing performance of hotels and increase their reservation rates given the widespread use of social media since they offer customized services to the users of digital media (De Pelsmacker et al., 2018).In this respect, the result of the present study confirmed the first hypothesis and it showed that the use of technology has a positive influence on hotels’ marketing performance.

Abstract

     Globally, tourism is currently one of the fastest-growing industries, with strong impacts on territories, from an environmental, economic and social point of view. The increase in the number of tourists who flock to destinations requires greater attention to sustainability through tools (indicators) such as strategic destination management support. This paper, through the review of 104 scientific papers, aims to analyze the structure and evolution of the evaluation and monitoring of sustainable tourism through the use of sets of indicators. In particular, the study favors the understanding of the most significant aspects of sustainable tourism that the literature suggests to analyze, evaluating how these vary in relation to the type of destination and the time period of the study. The results contribute to the understanding of the theoretical and operational aspects which, today, are considered representative of the concept of sustainable tourism, improving the sustainable management of territories.

Introduction

     Globally, tourism is currently one of the fastest-growing industries in the world. According to the recent UNWTO study for the year 2019 (UNWTO 2021), international tourism recorded the tenth consecutive year of growth. In 2019, the growth compared to 2018 was þ 6% and, compared to 2017, it was þ 7%. Europe represents almost 40% of international tourism receipts, followed by Asia and the Pacific with almost one third. It is recognized for its ability to generate an important part of gross domestic product for many economies around the world (in particular, tourism accounts for 48% of GDP in Macao—China). It employs numerous companies, about 80% of which are micro, small and medium sized enterprises (MSMEs). It generates millions of direct and indirect jobs, employing a high proportion of women and young people.

     In addition to the economic aspect, tourism has also proved to have strong impacts on the sociocultural and environmental aspects of territories (Lee and Jan 2019; Zhuang, Yao, and Li 2019; Su and Swanson 2017; Su, Hsu, and Swanson 2017; Buckley 2012; Miller et al. 2010; Boksberger and Laesser 2007; Hunter and Shaw 2007). Unfortunately, the continuous and constant growth of this sector, as studied by the UNWTO (2019), places destinations and the entire tourism sector in a situation where it excessively influences the use of local resources, causing a progressive deterioration of the destinations and compromising their competitiveness and appeal on the market (Torres-Delgado and Saarinen 2014; Torres-Delgado and Palomeque 2014).

Conclusions

     The study reports a critical analysis of the main results concerning sustainable tourism analyzed through the use of indicators. The extensive bibliography available on this topic has been analyzed in relation to specific aspects: (a) descriptive aspects of each 22 S. Marinello et al. paper, collection methods and type of work; (b) type of destination; (c) dimensions of sustainability; (d) indicators considered; (e) sustainability issues and their temporal evolution and with respect to the type of environment analyzed.

Abstract

Previous studies on health tourism were limited to a small range of topics related to medical tourism. At present, the concept of health tourism has become profound because medical care has been altered from “disease-centered” to “health-centered”. The main purpose of this study is to identify the key factors influencing the development of health tourism in China. To this end, in the first stage, an intra-industry trade theory was introduced and quantitative methods were applied to discover the important factors. In the second stage, multiple sources, including empirical studies, official data, research reports, and notably field investigations and case studies were incorporated to take in-depth discussions. The results indicated the foremost factors affecting the health tourism trade were total health expenditure per capita and the number of domestic health consumers. Notably, health tourism was substantially determined by the “willingness to spend on health” of domestic health consumers. In addition, Chinese health tourists were more likely to positively accept health tourism services in China. An important conclusion is that China should diversify health tourism offerings for different consumer groups. Once diversified products for health tourism are provided, the number of health tourism consumers will soar accordingly, which thus contributes to forming economies of scale, lowering the average costs of health treatment, increasing health tourism profit, and stimulating economic development.

Introduction

“Sustainable health tourism” can be broadly defined as tourism that involves medical and wellness activities that enhance both physical and mental health (Hei and Xiang, 2020). However, health tourism is a dynamic phenomenon, that is to say, there is no uniform standard for the concept. Before exploring health tourism in more depth, it is important to note that early studies in tourism were not attentive to the role of health—this is not surprising given that for many years most tourism-related businesses (e.g., hotels) and destinations have primarily provided regular tourism resources. During this period, medical services and facilities did not play a meaningful role in attracting tourists (Goodrich and Goodrich, 1987). However, of late, the role of healthcare is becoming increasingly important, with travelers “specifically seeking treatment for diseases and travel health services from other countries” (Goodrich, 1993). This trend has clarified the concept of the “health traveler”, which represents the collection of all phenomena associated with temporarily leaving one’s place of residence to seek health services for the purpose of maintaining and promoting health (Mueller and Kaufmann, 2001). This gradual expansion of the cognitive boundary of health tourism has given rise to “a commercial phenomenon of improving health tourism services” (Hall, 2003).

Conclusions

From the perspective of health globalization, health tourism balances high-quality medical resources, broadens people’s access to health, gives patients a fairer choice, and speeds up competition in the health tourism trade between countries. In this sense, this study is novel and of great practical importance. Using the intra-industry trade theory and the empirical model, our study uncovered the most critical factors affecting health tourism trade in China, which, under the conditions of open trade, are total health expenditure per capita and the number of domestic health consumers. Generally, we found that health tourists would seek a diversity of products on a global scale to maximize their health benefits. Domestic demand would enable domestic enterprises to gain comparative advantages in the production of health tourism products, and domestic trade could drive international trade and attract more foreign tourists to earn foreign exchange income.

ABSTRACT
Taking a firm perspective, this study investigates cooperation in a destination network in a mountain village in Norway. 51 organizations participated in a survey, indicating their main cooperation partners and assessing the value of each cooperation in terms of ten intermediary benefits (increased sales, reduced costs, etc.) and two ultimate outcomes (business results, destination development). Firms perceived a cooperation to contribute to business results if the cooperation had led to increased sales or made the firm more resilient to market fluctuations. Firms perceived a cooperation to contribute to destination development if the cooperation had led to new knowledge, improved customer satisfaction, and hat not simply helped improve operations. The findings demonstrate the interconnectedness of intermediate and ultimate relationship outcomes on firm and destination level. The study contributes to a more comprehensive understanding of network relations, relevant to the literature on relational benefits and destination development.
Introduction
Firms expand their boundaries and engage in external relationships to achieve benefits that will increase firm performance (Giuliani, 2013; Parmigiani & Rivera-Santos, 2011). Each firm participates in several cooperative dyads, and for any given dyad, several relationship outcomes can be distinguished. Some of these contribute to increased revenues, for example by enabling the focal firm to develop new products, enter new markets or increase sales to existing customers. Others may help a firm reduce costs, for example by enabling it to negotiate shorter delivery times with suppliers and thereby reduce inventory.

Abstract

Introduction

Theoretical background and literature

Environmental concerns in travel, tourism and hospitality

Methodology

Variables

Model specification

Key findings

Discussion and conclusion

Conclusion and limitations

Acknowledgements

References

Abstract

     By deploying big data analytical techniques to retrieve and analyze a large volume of more than 2.7 million reviews, this work sheds light on how environmental concerns expressed by tourists on digital platforms, in the guise of online reviews, influence their satisfaction with tourism and hospitality services. More specifically, we conduct a multi-platform study of Tripadvisor.com and Booking.com online reviews (ORs) pertaining to hotel services across eight leading tourism destination cities in America and Europe over the period 2017–2018. By adopting multivariate regression analyses, we show that OR ratings are positively influenced by both the presence and depth of environmental discourse on these platforms. Theoretical and managerial contributions, and implications for digital platforms, big data analytics (BDA), electronic word-of-mouth (eWOM) and environmental research within the tourism and hospitality domain are examined, with a view to capturing, empirically, the effect of environmental discourse presence and depth on customer satisfaction proxied through online ratings.

Introduction

     Human consumption activities have been found to generate natural resources depletion and jeopardize the very existence of the planet (United Nations, 2013). Tourism is no exception. As a subset of human activities, tourism-related activities have been found to consume considerable natural resources. In 2010, it was estimated that tourism-related activities consumed (on average) 3,575MJ of energy per trip, 6,575 liters of water per tourist, 42 m2 of land per bed, 1,800 g of food per tourist/day, and generate 250 kg CO2 of emission per trip (Gössling & Peeters, 2015). The overall situation is getting worst over time, with growth factors over the period 2010–2050 estimated to be 2.64 for energy and CO2 emissions, 1.92 for fresh water, 2.89 for land use and 2.08 for food use. Tourism activities – the tourism and hospitality infrastructure, and transit activities – have a detrimental impact on the environment (for example, in the form of CO2 emission). An excess of tourism flow, known as over-tourism, is identified as one of the major issues associated with tourism activities and has been increasingly researched (Oklevik et al., 2019).

Discussion and conclusion

     Building on more than 2.7 million ORs collected from Booking.com and Tripadvisor.com (Li et al., 2018; Mariani et al., 2018), and examined with sophisticated big data analytical techniques, this work has described consumers’ behaviors and how consumers perceive and deal with sustainability issues, and if consumers’ environmental discourse affects their OR ratings. By adopting multivariate regression analyses, we have shown that OR ratings are positively influenced by both environmental discourse presence and depth on both the platforms analyzed. Overall, our findings shed light on the presence and impact on customer satisfaction of consumers’ environmental concerns embedded in tourists’ UGC, across several leading tourism destinations based in two different continents.