Document Type : Article extracted From phd dissertation
Authors
1
Department of Business Administration, Ki.C, Islamic Azad University, Kish, Iran
2
Department of Business Administration, North Tehran Branch, Islamic Azad University, Tehran, Iran
Abstract
A B S T R A C T
This study aims to investigate the effect of destination security and local community behavior on health tourism destination branding with the mediating role of destination marketing. The study is applied in terms of purpose and descriptive-analytical in terms of methodology. The statistical population consists of tourists who came to Tehran for treatment of illness and use of medical facilities. Given the lack of accurate statistics on the number of incoming tourists, Cochran’s sample size calculation formula for an unlimited population was employed, establishing an empirically acceptable sample size of 384 participants. The validity of the research tool was calculated utilizing the confirmatory factor analysis model and its reliability calculated using Cronbach's alpha. Data analysis was performed using SPSS and SMART PLS software with descriptive statistics and structural equation modeling. The findings indicate that destination security, local community behavior, and destination marketing have a positive and significant effect on health tourism destination branding. Among the variables, the most significant effect was related to destination marketing with a path coefficient of 0.485 and the least significant effect was related to destination security with a path coefficient of 0.255. Based on the findings, it can be concluded that policymakers and planners in the field of health tourism in Tehran should prioritize the strategic brand positioning of the medical tourism sector. Establishing a distinct institutional brand identity is a fundamental prerequisite for accelerating international patient acquisition and capturing the socio-economic benefits of regional tourism development.
Extended Abstract
Introduction
Tehran, as the capital of Iran, possesses many capabilities in the field of health tourism. These capabilities are focused on hospitals and medical centers, beauty and cosmetic centers, recreational and welfare centers, traditional and complementary medicine, and education and research. Tehran has several well-equipped hospitals and medical centers. These hospitals provide high quality medical services using advanced equipment and experienced staff. In addition, Tehran, with its numerous beauty and cosmetic centers, offers services for body and face care and makeup. The city also hosts recreational and welfare centers that provide opportunities for rest, recreation, and relaxation (Khodai et al., 2023: 99). On the other hand, Tehran, with its prominent universities and research centers in the field of medical sciences, provides very important educational and research facilities. These centers contribute to the development of health awareness and knowledge in society by striving for advanced research, new technologies, and higher education.
Given these capabilities, Tehran is able to become a prominent destination in the health tourism industry by using appropriate marketing strategies, including branding and cooperation with related industries. These efforts will be effective in attracting health tourists, improving the local economy, improving Tehran's image, and increasing its reputation at national and international levels. In fact, branding, as one of the important strategies in developing health tourism and improving the experiences of health tourists in Tehran, has a significant impact. Accordingly, since Tehran, as the capital and one of the most populous cities in Iran, inherents desirable characteristics in health tourism development, place branding in this city can ensure the improvement of the experience of health tourists and have a positive impact on this industry development. Accordingly, this study addresses the following central research question: What is the impact of destination security and local community behavior on the branding of health tourism destinations with the role of destination marketing mediator?
Methodology
The study is applied in terms of purpose and descriptive-analytical in terms of methodology. Library and field methods were adopted to collect data. The statistical population consisted of tourists who entered Tehran for treatment of illness and use of medical facilities. Given the lack of accurate statistics on the number of incoming health tourists, Cochran’s sample size calculation formula for an unlimited population was employed, establishing an empirically acceptable sample size of 384 participants. Utilizing a stratified random sampling methodology, the city of Tehran was partitioned into five operational geographic areas: northern, southern, eastern, western, and central, and an equal proportion of samples were selected from each class. Participants within each designated stratum were selected via simple random sampling. A questionnaire was utilized to collect field data. The reliability of the questionnaire was measured by calculating Cronbach's alpha and the composite reliability (cr). The value of Cronbach's alpha and the composite reliability coefficient for each variable were between zero and one, and if the value obtained is higher than 0.7, the questionnaire has appropriate reliability. The results of Cronbach's alpha and composite reliability of the questionnaire confirm the appropriate reliability of the questionnaire. In this study, SmartPLS software was employed to analyze the data. In addition, the Sobel test was used to examine the mediating variable.
Findings and Discussion
This study aims to investigate the effect of destination security and local community behavior on health tourism destination branding with the mediating role of destination marketing. The results indicated that in relation to the effect of destination security on health tourism destination branding, destination security is able to explain 10.6% of the variance of the dependent variable, namely health tourism destination branding. In interpreting these findings, it can be argued that security constitutes a fundamental prerequisite for sustainable urban habitability. Consequently, an elevated safety threshold within tourism destinations directly correlates with a higher volume of socio-cultural and economic interactions, thereby fostering urban vitality. Conversely, the lower the safety coefficient of health tourism destinations, the more people are in an atmosphere of fear and terror, and the level of interactions and exchanges decreases and they suffer in terms of quality. Consequently, while objective security is vital, the subjective feeling of security - or perceived safety - constitutes a vital need of every individual in social life to achieve peace, confidence, and an appropriate quality of life. Security, as one of the main pillars of the destination image, plays a vital role in health tourism branding. In fact, security has become more than a competitive advantage, it has become a necessary condition for choosing a destination by health tourists.
Within health tourism, patients are looking for the highest quality of treatment, but this search is accompanied by deep concerns about safety and reliability. According to the Medical Tourism Association, nearly $20 billion in revenue is lost annually due to trust factors. Half of potential international patients are discouraged from traveling due to lack of confidence in the outcome of treatment or financial security. Research shows that the image of a health tourism destination directly affects the willingness to revisit. Furthermore, scientific models for measuring this image introduce dimensions such as ease of travel and safety as key elements, along with the quality of doctors and hospitals. In other words, the brand of a medical destination will be incomplete and unreliable without ensuring security. Security constitutes the core of branding in health tourism. Security does not simply mean the absence of crime and danger, but also includes trust in the quality of treatment, ensuring financial safety, maintaining privacy, as well as creating a sense of peace and security throughout the entire travel process.
Analytical findings validated the proposed hypothesis, confirming that destination marketing has a statistically significant, positive influence on destination branding architecture. With a standardized path coefficient of 0.485, the independent variable exerts a strong direct effect, explaining 23 percent of the variance within the target dependent variable. The empirical findings confirm the mediating role of destination marketing, demonstrating that the influence of local community behavior on destination branding is transmitted through strategic marketing channels. In explaining the results of this section, it can be stated that among the factors that can develop and improve health tourism branding is the use of effective marketing tools and parameters. In this regard, tourism marketing is of particular importance because if we consider marketing as a management process, all planning activities for preparing tourism products and attracting tourists require marketing operations and activities. Tourism marketing is a variable for identifying and predicting the needs of tourists and providing facilities to meet their needs and motivating them to visit, which will ensure tourist satisfaction and achieve organizational goals.
Destination marketing plays a fundamental role in branding health tourism destinations and, beyond an advertising tool, acts as a comprehensive strategy for creating identity, trust, and sustainable competitive advantage. Health tourism is associated with high financial and physical risks. In these circumstances, strong branding acts as a powerful tool of quality and reliability and reduces patient uncertainty. Destination marketing is the core of branding in health tourism, which plays a vital role in the success of a destination by building trust, creating brand equity, and influencing patient decision-making. Accomplishment in this area requires a comprehensive, integrated, and long-term view that encompasses all stakeholders, from policymakers and healthcare providers to tourism industry activists.
Conclusion
Studies reveal that not only Iran failed to use its tourism capacities efficiently, but the nation is being outpaced by emerging destinations in terms of the role of this industry in improving development indicators. Despite these geographical features of Iran, along with historical monuments, customs and rich culture, unprecedented security in the region, etc., have increased Iran's power in the tourism competition. Iran's health tourism destinations are considered one of the most important tourist attractions, which are sometimes neglected. effective urban planning and governance in Tehran can ensure not only localized sustainable development but also a positive, large-scale impact on broader regional development indicators. In this regard, experiences from branding market products exhibit that if a tourist destination can make a name for itself and prove its good reputation to tourists, its development will be inevitable. Branding in health tourism is a comprehensive strategy that combines the quality of treatment, tourism experience and supportive policies to convey security to patients. Success in this area, instead of competing solely on price, depends on building an integrated and trust-based ecosystem.
Given the importance of recognizing the factors that affect branding, the results indicated that the branding of health tourism destinations is influenced by various factors, including the factors that were examined in this study, which can be attributed to the positive effect of tourism destination security on tourism destination branding. Considering the path coefficient obtained for this variable, which is equal to 0.255, the effect can be assessed as moderate. Another result of this study can be attributed to the positive effect of local community attitudes on health tourism destination branding. Considering the path coefficient obtained, the effect of the local community attitude variable on health tourism destination branding is assessed as moderate. Furthermore, the mediating role of destination marketing and its direct effect on health tourism destination branding. This study, like many other studies, has limitations that should be considered in interpreting and generalizing the results. First, the data were collected through self-report instruments, which may be affected by factors such as respondents' honesty, accuracy, and impartiality. Therefore, it is suggested that future research studies should also employ complementary methods such as interviews and observations to increase the validity of the findings. On the other hand, the design of this research was based on structural equation modeling, so it is not possible to definitively comment on the causal relationships among the variables. Accordingly, it is recommended to use longitudinal research designs in future studies.
Funding
There is no funding support.
Authors’ Contribution
Authors contributed equally to the conceptualization and writing of the article. All of the authors approved thecontent of the manuscript and agreed on all aspects of the work declaration of competing interest none.
Conflict of Interest
Authors declared no conflict of interest.
Acknowledgments
We are grateful to all the scientific consultants of this paper.
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