The effect of cave visitors' attitudes and behaviors to use complementary and alternative medicine in health tourism on revisit intention: The case of Ballıca Cave

Health tourism, among the travel motivations, is an important alternative tourism type with many supply sources and demand for individuals both to protect their health and to regain their health. Individuals can benefit from health-themed tourism activities as well as benefiting from health institutions for their health, which is their most basic right. Considering thermal tourism, some caves are valuable in terms of speleotherapy (cave treatment), which is considered as one of the complementary and alternative medicine types due the oxygen content, humidity and clean air they feature. Individuals who aim to protect or regain their health by taking advantage of the microclimate effect of the caves can experience complementary and alternative medicine in the cave atmosphere in health tourism. Examining health, tourism, cave, complementary and alternative medicine under one roof has been the subject of curiosity of this thesis. In this context, the aim of the research is to examine the effect of the attitudes and behaviors of the cave visitors towards the use of complementary and alternative medicine in health tourism on the intention to re-visit, in Ballıca Cave. For this purpose, this study is prepared as the PhD Thesis of Aydın Adnan Menderes University, Institute of Social Sciences, Department of Tourism Management. In the present study, the survey technique, one of the quantitative research methods, is used. The data of the research were obtained from people who visited the Ballıca Cave for health purposes at any time between August 19, 2022 and March 30, 2023. 408 of the available questionnaires were analyzed. Data were evaluated using reliability analysis, exploratory factor analysis, means of the items, and standard deviation analyses. Also correlation, regression and difference analyzes were made. The reliability measurement of the research was evaluated using Cronbach's Alpha and the value of the whole scale was determined as 0,898. The dimensions that emerged according to the results of the explanatory factor analysis applied to the Complementary and Alternative Medicine Attitude Scale are the dissatisfaction with modern medicine, a holistic view of health, and an intellectual view of complementary medicine. As a result of the correlation relationship between attitude towards complementary and alternative medicine and revisit, a moderate correlation of 0.382 (p≤0.01) was found between the holistic view of health and the intention to revisit. A moderate and significant correlation was found at the level of 0.454 (p≤0.01) between the intellectual view towards complementary medicine and the intention to revisit. No significant relationship was found between dissatisfaction with modern medicine and revisit intention (0.003). As a result of the regression analysis, it was determined that the dimensions of a holistic view of health and an intellectual view of complementary medicine explained 0.20 of the total variance in revisit intention (p≤0.005). As a result of the mean analyzes done for demographic characteristics, a significant difference was found in all dimensions in age and income levels. While a significant difference was found in some dimensions in terms of gender, education, occupation, disease status, learning style, number of visits, reason for orientation and duration of stay, no significant difference was found in other dimensions. On the other hand, during the data collection process, random interviews were conducted with 57 participants who visited the Ballıca Cave for health reasons. As a result of these interviews, it was found that 36 participants experienced temporary relief between 6 months and 2 years, 19 participants fully recovered and 2 participants did not see any benefit after their cave visits. In order to ensure the sustainability of tourism in all seasons, developments in alternative tourism activities will create positive effects on the level of welfare and development, both on a sectoral and national basis. Besides, the fact that the health factor, which is a mandatory requirement for individuals, does not have seasonal, temporal and spatial significance, is considered very important in terms of demand for caves that have taken their place in health tourism and alternative tourism. It is considered that the results of this study will be guiding tourism sector and local governments, especially in Ballıca Cave and the region where it is located. It is thought that it will be beneficial in creating a new strategy and policy for the development of the region.