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PUSH-PULL FACTORS AFFECTING WILLINGNESS TO PAY FOR COMMUNITY-BASED HEALTH TOURISM IN SOUTHERN THAILAND: A STRUCTURAL EQUATION MODELING APPROACH

Geojournal of Tourism and Geosites | 2026

Paper Details

Authors: Kongpim T.; Thaveeseng H.; Visuthismajarn P.

DOI: 10.30892/gtg.65242-1747

Journal: Geojournal of Tourism and Geosites

Year: 2026

Publisher: Editura Universitatii din Oradea

Document Type: Article

Open Access: All Open Access; Gold Open Access

Cited by: 0

Abstract

Community-based health tourism has emerged as a significant segment within the global wellness tourism industry, yet the economic valuation of such experiences remains insufficiently understood. This investigation seeks to explore push-pull factors impacting tourists' willingness to pay (WTP) for community-based health tourism in the Mae Tom Subdistrict of Songkhla Province in Thailand. The study addresses critical gaps including the limited application of push-pull theory in community-based health tourism contexts, the underrepresentation of community-based approaches in health tourism research, and the absence of integrated structural equation models examining hierarchical push-pull relationships with WTP. The data from 413 tourists were analyzed using structural equation modeling (SEM) with a hierarchical factor structure, incorporating push-pull theory with an understanding of WTP using confirmatory factor analysis (CFA) and structural modeling. Push factors were operationalized as a second-order construct encompassing internal needs, attitude toward health tourism, information perception, health tourism values, and tourism experience, while pull factors comprised destination image, value for money, health activities, and tourism information. The analysis revealed that both push factors (β = 0.21, p < 0.01) and pull factors (β = 0.23, p < 0.01) had a significant impact on WTP, with pull factors exerting a more substantial influence. The internal needs had the highest loading (λ = 0.83) among push factors, while destination image had the highest loading (λ = 0.80) among pull factors. The model demonstrated an acceptable fit and consequently explained 42% of the variance in WTP. Conclusions suggest that pull factors supersede the normative view of push factors having greater dominance in the context of community-based health tourism. The findings advance theoretical knowledge and provide evidence-based guidance for sustainable tourism development strategies that emphasize destination credibility, authentic community participation, and the preservation of local health wisdom in southern Thailand. © 2026 by the authors.

Keywords

community-based health tourism; push-pull theory; structural equation modeling; Thailand; willingness to pay