Tourism Management 33 (2012) 89e99

Contents lists available at ScienceDirect

Tourism Management
journal homepage: www.elsevier.com/locate/tourman

The impact of non-pharmaceutical interventions for 2009 H1N1 influenza

on travel intentions: A model of goal-directed behavior
Choong-Ki Lee a, *, Hak-Jun Song b, Lawrence J. Bendle a,1, Myung-Ja Kim a, 2, Heesup Han c, 3
a
College of Hotel & Tourism, Kyung Hee University, 1 Hoegi-dong, Dongdaemoon-gu, Seoul 130-701, Republic of Korea
b
Department of Hotel & Convention Management, College of Tourism & Fashion, Pai Chai University, 14 Yeon-Ja 1 Gil, Seo-gu, Daejeon 302-735, Republic of Korea
c
Department of Tourism Management, College of Business Administration, Dong-A University, Bumin-dong 2-ga, Seo-gu, Busan 602-760, Republic of Korea

a r t i c l e i n f o a b s t r a c t

Article history: Theoretically, in the tourism context this study introduced a new concept of non-pharmaceutical
Received 22 August 2010 intervention (NPI) for influenza, and tested the impact of NPI on the behavioral intention of potential
Accepted 8 February 2011 international tourists. This study also extended the model of goal-directed behavior (MGB) by
incorporating the new concepts of NPI, and the perception of 2009 H1N1. The model found that
Keywords: desire, perceived behavioral control, frequency of past behavior, and non-pharmaceutical interven-
2009 H1N1
tions predicted tourists’ intention but perceptions of 2009 H1N1 had nil effect on desire and
Non-pharmaceutical intervention
intention. Personal non-pharmaceutical interventions were theorized as adaptive behavior of tour-
Model of goal-directed behavior
Travel intention
ists intending to travel during a pandemic which should be supported by tourism operators on
a system-wide basis. Practically, this study dealt with the issue of influenza 2009 H1N1 with the
study findings and implications providing government agencies, tourism marketers, policy-makers,
transport systems, and hospitality services with important suggestions for NPI and international
tourism during pandemics.
Ó 2011 Elsevier Ltd. All rights reserved.

1. Introduction 2010, p. 7). Looking back at international tourism arrivals in

In June 2009 the United Nations World Tourism Organization
identified the outbreak of a novel influenza A (H1N1) virus, later
known as 2009 H1N1, as intensifying the harsh effect of the global
economic crisis on international tourism, however, this was
varying by region (UNWTO, 2009a, p. 1). All regions, excepting
Africa (þ3%) and South America (þ0.2%) seeing declines in tourism
demand. By October, the UNWTO’s panel of experts was predicting
that after fuel costs, the 2009 H1N1 pandemic, and uncertain
currency exchanges rates would have secondary negative impacts
on long-haul travel in 2010 (UNWTO, 2009b, p. 6). Then, in
January 2010, 2009 H1N1 was classified as a downside risk with
less overall impact than expected but which could emerge as
a threat to international tourism recovery and growth (UNWTO,
* Corresponding author. Tel.: þ82 2 961 9430; fax: þ82 2 964 2537.
E-mail addresses: cklee@khu.ac.kr (C.-K. Lee), bloodia00@hotmail.com (H.-J.
Song), bendle@khu.ac.kr (L.J. Bendle), silver@khu.ac.kr (M.-J. Kim), heesup@
donga.ac.kr (H. Han).
1 personal non-pharmaceutical interventions (NPI) which could
Tel.: þ82 2 961 9274; fax: þ82 2 964 253.
2
Tel.: þ82 2 961 0549; fax: þ82 2 964 2537.
3
Tel.: þ82 51 200 7427; fax: þ82 51 201 4335.
2009, which were estimated as declining by 4%, the economic
crisis, currency variations, and the 2009 H1N1 pandemic were all
factors depressing outbound travel. With the pandemic impacting
markets in Northeast Asia and the Americas particularly (UNWTO,
2010, p. 14), the 2009 H1N1 pandemic was a significant negative
factor in an “exceptionally challenging” year for international
tourism.
Yet, little is known about how potential outbound tourists
behave when they are considering overseas travel during an
Influenza pandemic. Understanding their behavior would help
government agencies, tourism marketers, transport systems, and
hospitality services cope with a crisis more effectively. This study
classified the perceived risk for 2009 H1N1, a novel influenza virus
that emerged in Mexico, as an obstacle which could discourage
tourists from visiting other countries. For instance, if tourists who
are planning international travel perceive risks from 2009 H1N1,
such as suffering illness while abroad, they could postpone or
cancel their plans (Reisinger & Mavondo, 2005). We theorized that
in a pandemic, potential tourists would consider voluntary
decrease their risk of 2009 H1N1 infection while traveling. Tourists
may choose NPI because of the delay in the production of effective

0261-5177/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.tourman.2011.02.006
90 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99
antiviral drugs and vaccines, or because of limited vaccine avail-
ability in their country (Chaturvedi, 2009). Personal NPI include
getting better knowledge of the disease and pandemic; improving
personal hygiene practices while traveling; using social distancing
to avoid suspect people or places; and monitoring personal health
before and after the trip (Nicholl, 2006).
Comprehending and predicting travelers’ behavior is a main
issue for tourism marketers, particularly when a certain obstacle for
traveling like an Influenza pandemic exists. The Theory of Reasoned
Action (TRA) and the Theory of Planned Behavior (TPB) are
frequently used in previous studies for understanding travelers’
intentions or behavior. However, these theories have limitations.
They do not contain the influence of past behavior which may affect
intention and behavior (Leone, Perugini, & Ercolani, 1999) and they
focus on the cognitive variables without considering affective
variables associated with behavior (Conner & Armitage, 1998). So,
the present study employed the model of goal-directed behavior
(MGB), which considers motivational process, affective process,
and past behavior, to better predict potential travelers’ decision-
making processes. According to Perugini and Bagozzi (2001) theory
broadening and deepening of this theory is necessary for improving
predictions of human behavior in differing contexts. Hence, this
research extended the MGB by including perceptions and NPI for
2009 H1N1 that were meaningful in explaining human behavior
better.
Using a sample of Korean potential international tourists we
explain tourists’ decision-making procedures by applying the
MGB theory and a model that includes perceptions of the
disease 2009 H1N1 and the NPI which respond to that disease.
The study had four aims. First, examining potential travelers’
decision-making processes when the risk of 2009 H1N1 infection
discourages traveling abroad, by developing an extended model
of goal-directed behavior (EMGB) explaining international travel
intent that includes perceptions of 2009 H1N1 and NPI in the
MGB framework. Second, verifying the superior predictive ability
of the EMGB compared with the TRA and TPB. Three, examining
the perceptions of the 2009 H1N1 virus and the NPI for the virus
among a sample of Korean potential overseas travelers and the
role of these perceptions in a proposed theoretical framework.
Four, providing government agencies, tourism marketers, trans-
port systems, and hospitality services with practical suggestions
for NPI which could mitigate pandemics and benefit the public
and tourism businesses.
2. Background to the study
2.1. Pandemics and tourism: historical context
and global consequences
The worldwide caution surrounding the 2009 H1N1 outbreak
stems from international apprehension of another global catas-
trophe like the 1918 ‘Spanish Flu’ influenza pandemic or of an
economic shock like the 2003 Severe Acute Respiratory Syndrome
corona virus (SARS) epidemic. During March 2009, an unfamiliar
influenza-like illness appeared in the Mexico (World Health
Organization [WHO], 2009a). In April under international health
protocols the Mexican government reported this to the Pan-
American Health Organization as an outbreak of a novel influenza
type virus (Neumann, Noda, & Kawaoka, 2009; WHO, 2009a). Then,
the United States Centers for Disease Control identified the virus as
a new strain of Influenza A H1N1 (Jeeninga, de Jong, & Berkhout,
2009) now known as 2009 H1N1. Within six months, as the
number of people infected by 2009 H1N1 rapidly increased glob-
ally, the WHO quickly increased the pandemic alert for 2009 H1N1
to the high phase six level (WHO, 2009b).
Symptoms of 2009 H1N1, including cough, runny or stuffy
nose, sore throat, and high fever are similar to seasonal influ-
enzas as are the inter-person infection paths. Scientists worry
about it being a critical virus which could mutate into a virulent
deadly form (WHO, 2009a; Jeeninga et al., 2009) like the Influ-
enza A H1N1 that ravaged the globe on the heels of the First
World War. That lethal strain of influenza, known as the ‘Spanish
Flu’, killed up to 100 million people between 1918 and 1920,
according to later estimates (Kolata, 2001, p. 7). Appearing in
a mild form causing flu-like symptoms of coughs and high fever
for three days with mild mortality, then, reappearing within six
months as a deadly mutation with a high mortality level it
spread around the world killing millions rapidly. In the steam
transport era the killer disease circled the globe in a year
(Kolata, 2001).
In the air transport era, which yearly moves more than two
billion passengers around a network of 35,000 commercial airline
connections among commercial airports in close to 3500 cities,
a lethal disease can spread around the planet rapidly (St. Michael’s
Hospital, 2009, p. 17). For example, SARS, called the first emerging
disease of the age of globalization (Omi, 2006, p. ix), moved about
the planet on airline jets, appearing in China’s Guangdong Province
during November 2002 and arriving in Toronto, Canada, on 23
November 2003. A Canadian tourist, who unknowingly contracted
the illness while staying in a Hong Kong hotel, flew home while
authorities were trying to identify the novel virus (Varia et al.,
2003). The Toronto SARS outbreak caused 44 deaths, hundreds of
infections, quarantine for thousands of citizens, billions of dollars in
lost production, and a billion dollars in outbreak control measures
(St. Michael’s Hospital, 2009).
Criticisms of overreaction, directed in retrospect, at the WHO,
various national governments, and the media about the handling
of the 2003 SARS outbreak shows the sensitivity surrounding
international cooperation for pandemic disease control (Mason,
Grabowski, & Du, 2005; McKercher & Chon, 2004). Reactions to
SARS included WHO travel warnings for particular geographical
regions, extensive media coverage of the outbreak, travel advi-
sories against Asian countries, and the curtailing tourist’s civil
rights at some borders and destinations. In the following panic
three million people lost their tourism industry jobs, a $20 billion
gross domestic product (GDP) decline occurred in China, Hong
Kong, Singapore, and Vietnam, and tourism flows across Asia
lessened by 70% (McKercher & Chon, 2004). The global
management of emerging infectious diseases occurs in this
complex environment of fear of an unstoppable killer virus, rapid
mass international travel, and the reluctance to cause national or
international economic damage through inappropriate alerts and
warnings.
2.2. 2009 H1N1: pharmaceutical and non-pharmaceutical
interventions
National management choices for constraining an emerging
influenza virus include pharmaceutical and non-pharmaceutical
interventions (Oshitani, 2006; Rizzo & degli Atti, 2008). Pharma-
ceutical choices include using antiviral drugs and fabricating new
vaccines. Several groups of antiviral drugs are useful during an
influenza pandemic’s early stage. However, drug resistance limits
the efficacy of the cheaper and more obtainable group of M2
inhibitors, whereas difficulties of distribution, dosage, and supply
limit the usefulness of the more expensive group of neuraminidase
inhibitors. Also, three parameters govern the benefits of pandemic
influenza vaccines: the four to six months to fabricate a new
vaccine, the possibility of several doses being needed, and limited
production capacity (Finkelstein, Prakash, Nigmatulina, Klaiman, &
 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99
Larson, 2009, p. 6; Oshitani, 2006, p. 168). With these constraints
on the efficacy and availability of pharmaceutical interventions
during an influenza pandemic’s early stage, NPI are essential
for slowing the outbreak (Aledort, Lurie, Wasserman, & Bozzette,
2007).
These NPI comprise administrative control measures and non-
mandatory personal protective measures (Raude & Setbon, 2009,
p. 339). Administrative NPI measures include isolating infected
patients, quarantining individuals in contact with the infection,
hospital infection control, and border control whereas personal
NPI measures include social distancing, and personal hygiene
protection (Oshitani, 2006, p. 169). Social distancing by closing
schools, calling off public events, reducing access to public
transport, and working from home during an outbreak diminishes
the chance for person-to-person infection. Hygiene action by
washing hands, wearing masks, and techniques for containing
coughing and sneezing restrict disease transmission (Finkelstein
et al., 2009). During the SARS outbreak, the administrative NPI
of contact tracing, quarantine, and isolation were important in
restricting the spread of the virus (Omi, 2006). A supplementary
NPI was the Internet’s role in keeping the global public up-to-
date, and linking the medical experts seeking to identify the novel
virus (Omi, 2006).
At the end of 2009, the impact of 2009 H1N1 pandemic on
tourism and hospitality remains unclear as declines in travel
sales occurred simultaneously with the worldwide economic
recession (Department of Health and Human Services, 2009). As
May 2009 ended, a high correlation appeared between H1N1
importations and 16 out of the 20 countries with the uppermost
quantity of air passenger arrivals from Mexico. More generally, if
a country received more than 1400 air passenger arrivals from
Mexico the risk of H1N1 importation increased markedly (Khan
et al., 2009). During the 2009 Southern Hemisphere winter,
however, fear of the disease probably caused short-term and or
localized social and economic effects and a temporary decline in
tourism in Australia, Argentina, Chile, New Zealand, and Uruguay
(Department of Health and Human Services, 2009, p. 9). The five
countries each used community mitigation measures in
response to the disease including using antiviral drugs and NPI
measures.
The NPI measures were administrative controls like closing
schools, banning public gatherings, and quarantining ill patients.
Before the disease appeared in their territories Australia and Chile
used thermal screening to detect inbound tourists with raised
surface temperatures and then switched from this containment
phase to a mitigation phase when the disease appeared in their
populations. Some flights were canceled between Argentina and
Mexico; questionnaires and information pamphlets were used at
the U.S. and Mexico border; and New Zealand screened passen-
gers from countries of concern (Department of Health and Human
Services, 2009, p. 7). The 2009 H1N1 outbreak illustrates the
complexity of implementing NPI administrative controls on
a global basis. For example, 2.35 million air tourists from Mexico
arrived in 1018 cities in 164 countries during March and April
2008, with a similar pattern estimated during the same months
in 2009 when the novel 2009 H1N1 virus emerged (Khan
et al., 2009).
There are several complications in detecting and discouraging
travel by infected passengers who may be the vector by which
a virulent influenza virus moves across the global airline network
(St. Michael’s Hospital, 2009, p. 111). First, the disease incubation
period is longer than the typical journey period. Second,
passengers who experience symptoms may not admit their
condition for fear of disrupting their travel arrangements. Third,
fast reliable screening and diagnostic techniques for infectious
91
diseases among airline passengers while they are in the airline
network are not commonly available. Therefore, passive controls
at national borders have limited effectiveness at halting the
arrival or departure of an influenza-like infectious disease and the
near symmetry between international airport-pairs means shared
risk of export and import of ill passengers. Besides, to impede
an outbreak by several weeks or more would need a 99% effec-
tiveness of border controls and internal travel checks (Ferguson
et al., 2006).
The 2009 H1N1 outbreak from Mexico shows how rapidly
and broadly a disease spreads while the authorities scrambled
to identify the new virus. Therefore, improving disease recog-
nition, scrutiny, management, and education which limit
person-to-person disease transfers in aircraft and at airports,
requires cooperation beyond national borders (St. Michael’s
Hospital, 2009, p. 111). The complexity of rapid international
air transport; the efficacy and availability of antiviral drugs and
vaccines; and the difficulty of NPI like border controls, mean
that stopping a pandemic is an evolving global challenge. A
pandemic affects tourism-related industries negatively because
potential tourists experience increases in perceived risk and
anxiety due to inadequate information about the origins,
prevention, and treatments for the disease (Wu, Law, & Jiang,
2010). So, when a pandemic alert is active the intentions of
tourists to travel internationally, their perception of the disease,
and personal protective NPI measures for the disease need
further investigation.
2.3. Theories of behavior and hypothetical relationships
The TRA and TPB are considered as a representative social
psychological theory in the understanding of specific human
behavior (Zint, 2002). To improve the usefulness of the TRA and
TPB, Perugini and Bagozzi (2001) proposed the model of MGB
which includes all original variables in the TPB but redefines their
role as indirectly affecting behavioral intention through desire.
They also claimed that motivational, affective, and habitual
processes should be included in the social psychological model in
order to better comprehend human behavior. In terms of moti-
vational process, desire was suggested as a critical factor in
explaining decision formation (Perugini & Bagozzi, 2001). With
regard to affective process, anticipated affective reactions to
a specific behavior were recommended as an imperative variable
in decision-making processes (Conner & Armitage, 1998). In terms
of habitual process, past behavior was suggested as a significant
determinant of human decisions (Aarts, Verplanken, & van
Knippenberg, 1998; Bentler & Speckart, 1981; Ouellette & Wood,
1998). So, to better understand specific human behavior the
MGB incorporates desire, positive and negative anticipated
emotions, and past behaviors as well as the original variables of
the TPB. Therefore, the MGB incorporates desire, positive and
negative anticipated emotions, and past behaviors besides the
original variables of the TPB.
A revision of existing social psychological theories is necessary
to improve predictions of human behavior in unique contexts
(Ajzen, 1991). Perugini and Bagozzi (2001) describe this process of
including new constructs as theory broadening and deepening.
Taylor (2007) showed that the MGB can explain variance of
intention and behavior in a particular context by including extra
variables as an extended MGB.
In order to understand international tourists’ decision-making
process during the emerging 2009 H1N1 pandemic, this study
added two more constructs (the perception of 2009 H1N1
pandemic and the NPI for 2009 H1N1 pandemic) as an EMGB
besides the original framework of MGB.
92 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99
2.4. Attitude, subjective norm, perceived behavioral
control, and desire
Researchers agree that attitude toward a behavior exerts
a positive influence on a person’s intention to perform the
behavior (Baker, Al-Gahtani, & Hubona, 2007; Cheng, Lam, & Hsu,
2006). The TPB asserts that attitude toward a behavior
strengthens a person’s intention to perform it, however, the MGB
redefines attitude as affecting intention indirectly through desire.
So, attitude toward a behavior in the MGB affects intention
indirectly through desire (Leone, Perugini, & Ercolani, 2004;
Perugini & Bagozzi, 2001; Prestwich, Perugini, & Hurling, 2008).
As salient referents influence personal decision-making and
behavior (Bearden & Etzel, 1982; Cheng et al., 2006) a person
considers complying with other people’s opinions when deter-
mining if they should undertake a behavior. This subjective norm
is the perceived social pressure to perform or not to perform the
behavior (Ajzen, 1991). In the MGB this would not directly fortify
a person’s behavioral intention but effects behavioral intention
indirectly through desire (Leone et al., 2004; Perugini & Bagozzi,
2001; Prestwich et al., 2008).
The PBC, which refers to individual confidence to carry out
a behavior, is an important factor in forming intention (Ajzen,
1991; Ajzen & Madden, 1986) and affecting decision-making
formation in the TPB (Ajzen, 1991; Ajzen & Madden, 1986;
Conner & Abraham, 2001; Taylor & Todd, 1995). In the MGB it
reinforces desire, behavioral intention, and actual behavior
(Carrus, Passafaro, & Bonnes, 2008; Perugini & Bagozzi, 2001;
Prestwich et al., 2008). Using the literature, three antecedent
variables for attitude, subjective norm, and PBC were hypothe-
sized to have a positive effect on the desire for overseas travel.
These were: H1 e Attitude has a positive influence on desire;
H2 e Subjective norm has a positive influence on desire; and
H3 e PBC has a positive influence on desire. Also, it was
hypothesized that PBC would positively affect the intention for
overseas travel: H4 e PBC has a positive influence on behavioral
intention.
2.5. Relationships between anticipated emotions and desire
With regard to affective influence on a decision-making process,
anticipated affective reaction to performing a behavior would be an
important determinant of intention (van der Pligt & De Vries, 1998;
Triandis, 1977). In uncertain situations people may have forward-
looking emotions toward future behaviors. Gleicher et al. (1995)
identified these anticipated counterfactuals as prefactuals which
can affect intention and behavior implying that expected emotions
of goal success or failure can be included in the MGB. Perugini and
Bagozzi (2001) showed that both positive and negative anticipated
emotions have a critical role in forming desire. It was hypothesized
that positive and negative emotions significantly affect desire as
follows: H5 e positive anticipated emotion has a positive effect on
desire; and, H6 e negative anticipated emotion has a negative effect
on desire.
2.6. Relationship between past behavior, desire, and intention
The influence of past behavior was found to have an effect on
individual intention in several attitude and behavior studies
(Bagozzi & Warshaw, 1992). Specifically, past behavior is often
integrated into a theoretical framework that explains an indi-
vidual’s decision-making process (Conner & Armitage, 1998).
Past behavior is regarded as a proxy of habit, implying that
it influences desire and intention (Bagozzi & Warshaw,
1992; Bentler & Speckart, 1981; Fredricks & Dossett, 1983). In
the MGB, it was theorized that past behavior influenced desire,
intention, and actual behavior (Conner & Armitage, 1998;
Ouellette & Wood, 1998). The final dependent variable in
this study was behavioral intention, not actual behavior. So,
this study hypothesized that past behavior affects desire
and intention as follows: H7 e past behavior has a positive effect
on desire; and H8 e past behavior has a positive effect on
intention.
2.7. Relationships between desire, intention, 2009 H1N1,
and non-pharmaceutical interventions
Bagozzi (1992) claims that the TPB omits desire as a key factor,
a motivation-based construct leading to intention where desire
relates closely to intention, so in the MGB desire is a proximal
cause of intention. Whereas the MGB considers other antecedents
as distant causes which desire mediates before they affect
intention (Bagozzi, 1992). Leone et al. (1999) claimed that the TPB
did not entail motivational commitment but that the intention to
undertake a specific behavior requires desire (Bagozzi, 1992;
Leone et al., 1999). In the MGB desire is regarded as the most
proximal determinant of intention (Perugini & Bagozzi, 2001). So,
it was hypothesized that desire has a positive effect on intention
to travel overseas, whereas other antecedents (e.g., attitude,
subjective norm, positive anticipated emotion, negative antici-
pated emotion, and frequency of past behavior) in the MGB affect
intention through desire: H9 e desire has a positive effect on
intention.
Perception refers to an individual’s knowledge, information,
and experiences which are responsive to their cognition of
objects, behaviors, and events (Anderson, 2004). People form
their attitudes, interests, and opinions through the perceptions
which they acquire in their day-to-day lives (Oliver, 1997). Some
studies of perceived risks support the possible relationships
between perception of influenza, desire, and intention (Aro,
Vartti, Schreck, Turtiainen, & Uutela, 2009; Brug et al., 2004;
Reisinger & Mavondo, 2005; Sonmez & Graefe, 1998; Wu et al.,
2010). Sonmez and Graefe (1998) stated that perceived risks
play a critical role in altering a tourist’s decision-making process.
Reisinger and Mavondo (2005) claimed that risks perceived by
tourists negatively affect their travel intention so they are likely
to choose between keeping their travel plans, changing their
destination choice, altering their travel behavior, or getting
pertinent information. Thus, an individual’s perception of 2009
H1N1 may affect their decision-making process as an interna-
tional tourist.
Therefore, in spite of the influenza, some tourists who desire
and intend to travel overseas will prepare health procedures in
conjunction with their trip (Reisinger & Mavondo, 2005). Without
the pharmaceutical protection of a vaccine they may voluntarily
implement personal NPI prior to, during, and following their trip to
mitigate their perceptions of risk (Aledort et al., 2007; Aro et al.,
2009; Brug et al., 2004). These include gaining better knowledge
about the disease and the pandemic, actions for improving their
personal hygiene while traveling, and decreasing infection possi-
bilities by social distancing from suspect people and places. The
study posited that perceptions of 2009 H1N1 have a direct or
indirect effect on tourists’ desire and intention to travel through NPI
to avoid H1N1 infection as follows. H10 e perception of 2009 H1N1
has a negative influence on desire; H11 e perception of 2009 H1N1
has a positive effect on non-pharmaceutical interventions; H12 e
perception of 2009 H1N1 has a negative effect on intention; and
H13 e non-pharmaceutical interventions have a positive effect on
intention.
 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99
3. Methods
3.1. Measures and operational definition of variables
A preliminary list of measurement items was generated after an
extensive review of literature concerning the behavior of interna-
tional tourists, theories of human behavior including TRA, TPB, and
MGB, information on Influenza A H1N1, and prevention measures
for influenza diseases (Ajzen, 1985, 1991; Ajzen & Madden, 1986;
Bagozzi, Baumgartner, & Pieters, 1998; Bentler & Speckart, 1981;
Brug et al., 2004; Carrus et al., 2008; Lam & Hsu, 2004, 2006;
Ministry for Health, Welfare and Family Affairs, Korea, 2009a,
2009b; Oh & Hsu, 2001; Perugini & Bagozzi, 2001; Reisinger &
Mavondo, 2005; Sonmez & Graefe, 1998; UNWTO, 2009c; WHO,
2009c). Then to ensure the questionaire’s understandability
tourism scholars and travel industry managers were asked to assess
the items of measurements and a pretest was also conducted with
20 people who experienced an overseas trip during the past three
years. Through these processes items that seemed ambiguous were
reworded for clarity.
The subjects’ attitude toward overseas travel was operational-
ized with six items (see Appendix) as suggested by previous
research (Ajzen & Madden, 1986; Bagozzi et al., 1998; Lam & Hsu,
2004, 2006; Oh & Hsu, 2001). The subjective norm to travel
internationally was operationalized with four items (see
Appendix) as suggested by previous research (Ajzen, 1991;
Perugini & Bagozzi, 2001; Oh & Hsu, 2001). The perceived behav-
ioral control was operationalized with four items (Appendix) as
suggested by previous research (Ajzen, 1991; Lam & Hsu, 2006).
The perception of Influenza A (H1N1) was operationalized with
four items (Appendix) as suggested by previous research
(Reisinger & Mavondo, 2005; Sonmez & Graefe, 1998). The non-
pharmaceutical interventions for Influenza A (H1N1) were oper-
ationalized with seven items. These items were derived from the
codes and precautions of UNWTO, WHO, and MIHWFA to prevent
from catching Influenza A (H1N1) (MIHWFA, 2009a, 2009b;
UNWTO, 2009c; WHO, 2009c). Three of these items included
actions to improve knowledge of the disease (Appendix). Three
items included actions about personal hygiene and health. And
one item included action on social distancing. Desire was oper-
ationalized with four items (Appendix) as suggested by previous
research (Carrus et al., 2008; Perugini & Bagozzi, 2001). Positive (4
items) and negative (4 items) anticipated emotions (Appendix)
were operationalized with eight items as suggested by previous
research (Carrus et al., 2008; Perugini & Bagozzi, 2001; Prestwich
et al., 2008). The variables of attitude, subjective norm, perceived
behavioral control, perception of Influenza, and NPI were rated on
a 7-point Likert scale ranging from strongly disagree (1) to strongly
agree (7). However, positive and negative emotions were rated on
a 7-point Likert scale ranging from not at all (1) to very much (7).
The frequency of past behavior was assessed with a single item as
suggested by previous research (Bentler & Speckart, 1981; Oh &
Hsu, 2001), “How many times have you traveled internationally
in the past 12 months?”
3.2. Data collection and analysis
With the development of Internet some researchers in
hospitality and tourism fields use online surveys to reach
broader populations of interest efficiently (Han, Hsu, & Lee,
2009; Kim & Ok, 2009). This study used data collected by the
top ranking Korean Internet survey firm that utilizes a nation-
wide panel of 490,000 online respondents from which repre-
sentative samples are selected. Their standard procedures use
Korean resident registration numbers matched against personal
93
passwords for verifying the identity of panelists included in each
sample. They are selected as best-fit participants by response to
a sampling questionnaire and rejected during the survey if they
complete their questionnaire too rapidly (Embrain, 2009). The
study data were collected during July 2009, when the 2009
H1N1 outbreak was being covered by international and national
media in Korea.
The Internet survey firm distributed questionaires to 990
potential tourists chosen randomly. From these, by using
a screening question, we selected those with at least one overseas
trip during the past three years. By this procedure 400 ques-
tionnaires were collected (40.4%) and after excluding three
questionnaires as outliers 397 were coded for analysis. Collected
data were analyzed with the Statistical Package for the Social
Sciences (2001) and EQS eStructural Equation Modeling Soft-
ware (Bentler & Wu, 1995). As a first step in the evaluation of the
measurement model, exploratory factor analysis identified the
structure of factors and systematically measured variables in
underlying constructs. This lessened multicollinearity or error
variance correlations among indicators (Bollen, 1989; Yoon &
Uysal, 2005). The structural equation modeling used a two-step
hybrid method by specifying a measurement model in the
confirmatory factor analysis and testing a latent structural model
developed from the measurement model (Anderson & Gerbing,
1988; Hatcher, 1994; Kline, 2005).
4. Results
4.1. Profile of respondents and measurement model
The proportion of male and female respondents was 57.4% and
42.6% respectively, most respondents (73.8%) were aged 20e49
years, and university graduates predominated (64.4%). Respon-
dents with an international travel plan (78.1%) preferred package
tours (55.9%), liked traveling internationally with family (47.6%) or
friends (24.4%), and most (79.3%) indicated that vacationing was
their main reason for overseas travel. The preferred destinations
included East Asia (26.2%), Europe (23.9%), Japan (17.4%), China/
Hong Kong/Macao (11.8%), and Australia or New Zealand (9.8%). The
model was analyzed using EQS 6.1 to establish the degree of reli-
ability and validity of the confirmatory factor analysis which was
composed of 42 observed variables and 9 latent variables. Since
Mardia’s standardized coefficient (76.5) is greater than the criterion
of 0.5 (Byrne, 2006) it is considered the data are multivariate non-
normally distributed, so maximum likelihood robust estimation
associated with the SatorraeBentler was used (Byrne, 1994a,
1994b).
This approach for non-normality in multivariate data makes
corrections to the standard errors, Chi-square, and other fit
indexes (Bentler & Wu, 1995; Byrne, 1994a). Table 1 shows the
good fit to the data (RMSEA ¼ 0.029, CFI ¼ 0.973, NFI ¼ 0.899) and
enough internal consistency with Cronbach’s alpha ranging from
0.853 to 0.961 (Nunnally, 1978). Convergent and discriminant
validity were examined to judge construct validity. All factor
loadings were greater than the minimum criterion of 0.5, with
significant associated t-values and all average variance extracted
and composite reliability values for the multi-item scales
exceeding the minimum criterion of 0.7 and 0.5 respectively (Hair,
Black, Babin, Anderson, & Tatham, 2006). Thus, convergent validity
was fully supported. Also, the average variance value extracted for
each construct was greater than the squared correlation coefficient
for corresponding inter-constructs. These results confirmed the
sufficient level of discriminant validity of the measurement model
(Fornell & Larcker, 1981).
94 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99

Table 1
Results of measurement model.

Constructs Correlations among latent constructs (squared)a and reliabilities of constructs

AT SN PBC PAE NAE PI DE NPI BI CRc AVEd

Attitude (AT) 1.000 0.944 0.739
Subjective norm (SN) 0.491 (0.241) 1.000 0.961 0.861
Perceived behavioral 0.255 (0.065) 0.396 (0.157) 1.000 0.841 0.571
control (PBC)
Positive anticipated 0.751 (0.564) 0.510 (0.260) 0.201 (0.040) 1.000 0.916 0.732
emotion (PAE)
Negative anticipated 0.278 (0.077) 0.309 (0.095) 0.188 (0.035) 0.504 (0.254) 1.000 0.867 0.620
emotion (NAE)
Perception of 0.042 (0.002) 0.113 (0.013) 0.019 (0.000) 0.090 (0.008) 0.036 (0.001) 1.000 0.877 0.641
Influenza (PI)
Desire (DE) 0.700 (0.490) 0.579 (0.335) 0.251 (0.063) 0.792 (0.627) 0.496 (0.246) 0.034 (0.001) 1.000 0.917 0.734
Non-pharmaceutical 0.208 (0.043) 0.194 (0.038) 0.133 (0.018) 0.235 (0.055) 0.089 (0.008) 0.584 (0.341) 0.209 (0.044) 1.000 0.885 0.527
interventions (NPI)
Behavioral intention (BI) 0.605 (0.366) 0.656 (0.430) 0.461 (0.213) 0.692 (0.479) 0.428 (0.183) 0.083 (0.007) 0.842 (0.709)b 0.283 (0.080) 1.000 0.938 0.790
Cronbach’s alpha 0.942 0.961 0.853 0.914 0.876 0.882 0.914 0.904 0.933
SB c2 ¼ 981.532, df ¼ 736, p < 0.001, RMSEA ¼ 0.029, CFI ¼ 0.973, NFI ¼ 0.899
a
Correlation coefficients are estimates using a EQS software program.
b
Highest correlations between pairs of constructs.
c
CR ¼ composite reliability; AVE ¼ average variance extracted.
d
Frequency of past behavior was not included in the measurement model because it was a single indicator.

4.2. TRA, TPB, and EMGB tests Chang, 1998) and imply that including perceived behavioral
control did play a significant role in predicting behavioral
In Table 2, the TRA model had a good fit to the data (c2 ¼ 84.549, intention. Second, the TPB model was slightly better in fit
df ¼ 74, p < 0.001, c2/df ¼ 1.143, RMSEA ¼ 0.019; CFI ¼ 0.996; statistics, but the model still lacks the explanatory power of
NFI ¼ 0.972). Attitude toward a behavior and subjective norm behavioral intention as compared to the EMGB. That is, the EMGB
explained 53.4% of the total variance of intention. The TPB model improved R2 largely from 0.573 to 0.793.
had a sufficient fit to the data (c2 ¼ 160.127, df ¼ 128, p < 0.001, c2/ Chi-square tests indicate there was significant difference
df ¼ 1.251, RMSEA ¼ 0.025; CFI ¼ 0.992; NFI ¼ 0.960). Three between these two models (Dc2 (657) ¼ 931.10, p < 0.001). The
antecedent variables (i.e., attitude, subjective norm, and PBC) MGB better accounted for the variance in explaining behavioral
accounted for approximately 57.3% of the variance of intention to intention. This model was superior to the TRA model for explana-
travel internationally. The value of R2 for intention improved tory power (EMGB ¼ 0.793 vs. TRA ¼ 0.534, Dc2 (711) ¼ 1008.41,
slightly from 0.534 to 0.573. Finally, the EMGB showed an excellent p < 0.001). Consistent with other research (Bagozzi & Dholakia,
fit to the data (c2 ¼ 1087.184, df ¼ 785, p < 0.001, c2/df ¼ 1.385, 2006; Carrus et al., 2008; Prestwich et al., 2008; 2008; Taylor,
RMSEA ¼ 0.031; CFI ¼ 0.967; NFI ¼ 0.891). The value of R2 for Bagozzi, & Gaither, 2005) the results showed the EMGB with
intention was 0.793. desire, positive anticipated emotion, negative anticipated emotion,
and frequency of past behavior performs better than the TRA and
TPB models. Enhancing our understanding of the decision process
4.3. Comparing the three models of behavioral intention these results prompt several suggestions.
The TPB is inadequate for explaining behavioral intention to travel
The three competing models, the TRA, the TPB, and the EMGB, internationally, and the processes behind the effect of the predic-
were compared for their relative explanatory power. First, the tors are more intricate than assumed in the TPB (Perugini &
TPB model had a better explanatory power than the TRA model. Bagozzi, 2001).
Specifically, three predictor variables (attitude, subjective norm,
and perceived behavioral control) in the TPB model explained
4.4. Test of hypotheses
approximately 57.3% of the total variance in the behavioral
intention to travel internationally while both attitude and
As shown in Fig. 1, four predictor variables (attitude, subjective
subjective norm jointly explained about 53.4% of the total vari-
norm, positive anticipated emotion, and negative anticipated
ance in the TRA model (Table 2). These findings were consistent
emotion) in the EMGB were positively associated with desire to
with previous research in other settings (Ajzen & Madden, 1986;
travel internationally (bAT/DE ¼ 0.206, t ¼ 2.568, p < 0.01;
bSN/DE ¼ 0.236, t ¼ 3.920, p < 0.01; bPAE/DE ¼ 0.461, t ¼ 4.867,
p < 0.01; bNAE/DE ¼ 0.136, t ¼ 3.244, p < 0.01). This implies an
Table 2
Modeling comparisons.
individual’s desire is a significant function of attitude, subjective
norm, positive anticipated emotion, and negative anticipated
SeB c2 df c2/df RMSEA CFI NFI R2 for BI emotion. However, the findings indicate that PBC, frequency of past
TRA 84.549 74 1.143 0.019 0.996 0.972 0.534 behavior, and perception of 2009 H1N1 did not have a significant
TPB 160.127 128 1.251 0.025 0.992 0.960 0.573
influence on desire (bPBC/DE ¼ 0.017, t ¼ 0.380, not significant;
EMGB 1087.184 785 1.385 0.031 0.967 0.891 0.793
Suggested 3  0.08  0.90  0.90 bFPB/DE ¼ 0.004, t ¼ 0.102, not significant; bPI/DE ¼ 0.046,
value* t ¼ 1.340, not significant). Thus, hypotheses H1, H2, H5, and H6
Note: Suggested values were based on Hair et al. (2006), and Bearden and Etzel
were accepted, but H3, H7, and H10 were rejected.
(1982). RMSEA ¼ root mean square error of approximation; CFI ¼ comparative fit The relationships between the perception of 2009 H1N1 and NPI
index; NFI ¼ nonnormed fit index. were found positive and significant (bPI/NPI ¼ 0.585, t ¼ 7.568,
 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99 95

Attitude Perception of
(AT) 0.585** Non-
Influenza A (7.568)
H1N1 Pharmaceutical
0.206* (PI) Interventions
(2.568) (NPI)
Subjective 0.016 R2: 0.342
Norm 0.236** -0.046 (0.367) 0.100*
(SN) (3.920) (-1.340) (2.308)

Positive 0.461** 0.781**

Desire Behavioral
Anticipated (4.867) (11.684)
(DE) Intention
Emotion
(BI)
(PAE)
0.136** R2: 0.713
(3.244) R2: 0.793

Negative 0.062*
Anticipated -0.004
-0.017 (-0.102) (2.248)
Emotion (-0.380)
(NAE)
0.251** Frequency of
(5.611) Past
Behavior
Perceived (FPB)
Behavioral
Control
(PBC)

Fig. 1. Results of the extended model of goal-directed behavior. Note: Shaded area shows the basic components of the MGB and the two bold ovals with italics are the additional
constructs of PI and NPI that contribute to developing the EMGB.

Table 3
Decomposition of effects with standardized values.

Direct effect Indirect effect Total effect

DE NPI BI DE NPI BI DE NPI BI

AT 0.206** e e e e 0.161** 0.206** e 0.161**
SN 0.236** e e e e 0.184** 0.236** e 0.184**
PBC 0.017 e 0.251** e e 0.013 0.017 e 0.238**
PAE 0.461** e e e e 0.360** 0.461** e 0.360**
NAE 0.136** e e e e 0.106** 0.136** e 0.106**
PI 0.046 0.585** 0.016 e e 0.022 0.046 0.585** 0.039
NPI e e 0.100** e e e e e 0.100**
FPB 0.004 e 0.062** e e 0.003 0.004 e 0.059
DE e e 0.781** e e e e e 0.781**

*p < 0.05, **p < 0.01, n/s: not significant Note: AT ¼ attitude; SN ¼ subjective norm; PBC ¼ perceived behavioral control; PAE ¼ positive anticipated emotion; NAE ¼ negative
anticipated emotion; FPB ¼ frequency of past behavior; PI ¼ perception of Influenza A (H1N1); NPI ¼ non-pharmaceutical interventions; DE ¼ desire; BI ¼ behavioral
intention.

p < 0.01). Therefore H11 was supported. Four predictor variables
(desire, PBC, frequency of past behavior, and NPI) were positively
associated with intention to travel internationally (bDE/BI ¼ 0.781,
t ¼ 11.684, p < 0.01; bPBC/BI ¼ 0.251, t ¼ 5.611, p < 0.01;
bFPB/BI ¼ 0.062, t ¼ 2.248, p < 0.01; bNPI/BI ¼ 0.100, t ¼ 2.308,
p < 0.01). Thus, hypotheses H9, H4, H8, and H13 were accepted. This
implies that desire, PBC, frequency of past behavior, and NPI are
important in an individual’s intention to travel internationally.
However, the path from 2009 H1N1 to intention was not significant
(bPI/BI ¼ 0.016, t ¼ 0.367, p > 0.05), not supporting the proposition
that 2009 H1N1 has a negative effect on intention. So, H12 was
rejected.
anticipated emotion (0.106), and NPI (0.100). When predicing
desire the powerful factor was positive anticipated emotion with
a total impact of 0.461, followed by subjective norm (0.236), atti-
tude (0.206), and negative anticipated emotion (0.136). The
perception of 2009 H1N1 indirectly effected travel intention when
it is mediated by personal NPI (see Fig. 1). Although the perception
of 2009 H1N1 had no effect on desire and behavioral intention, the
NPI for 2009 H1N1 was a significant predictor of behavioral
intention to travel internationally. The four constructs of desire,
perceived behavioral control, frequency of past behavior, and NPI,
all performed an important role in predicting potential tourists’
behavioral intention to travel internationally.

4.5. Indirect and total effects 5. Conclusions

As Table 3 shows, when predicting behavioral intention desire 5.1. Travel desire and adaptive behavior
was the important factor with an impact of 0.781, followed
by positive anticipated emotion (0.360), perceived behavioral Knowledge is limited about how the 2009 H1N1 pandemic
control (0.238), subjective norm (0.184), attitude (0.161), negative impacted potential international tourists’ decision-making although
96 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99
it is assumed that tourists’ apprehension of contracting 2009 H1N1
while traveling affected the tourism industry negatively. To the
authors’ awareness, this is the first trial which focused on improving
predictions of international tourists’ travel intention and decision-
making using an extended model of the MGB. In specific, this
approach included the perception of 2009 H1N1 and the personal
NPI for 2009 H1N1. The EMGB incorporated the construct of desire as
a mediator which considered volitional factors (attitude and
subjective norm), non-volitional factors (perceived behavioral
control, the perception of 2009 H1N1, and the NPI for 2009 H1N1),
emotional factors (positive anticipated emotion and negative antic-
ipated emotion), and the frequency of past behavior. Also, including
both the perception of 2009 H1N1 and personal NPI in the EMGB
were supported by the model’s increased power in predicting
potential tourists’ intention to travel internationally.
Showing its superior predictive validity the EMGB accounted for
significantly more variance in travel intention than either the TRA
or the TPB, which is an improvement in explaining potential
international tourists’ intentions. Demonstrating, in this context,
that theory broadening and deepening as described by Perugini and
Bagozzi (2001) is reasonable by integrating new constructs or by
altering the paths to be more appropriate in the model. So, the
revised model explains a substantial proportion of the total vari-
ance of the dependent variable of intention in this study. Also,
consistent with previous studies of MGB (e.g., Bagozzi & Dholakia,
2006; Carrus et al., 2008; Taylor, 2007) desire as a sufficient
impetus for intention formation was the most important latent
variable. In the model, the more important determinants to desire
were the emotional factors, specifically positive anticipated
emotion while the other determinants such as the subjective norm,
attitude, and negative anticipated emotions are less important to
the prediction of desire. It is not problematic that all antecedent
variables in the EMGB do not make a considerable contribution to
behavioral intention because the relative importance of individual
antecedent variables in a model may differ based on given contexts
(Sparks & Pan, 2009).
It is noteworthy the perception of 2009 H1N1 was not a signif-
icant (direct) predictor of either desire or behavioral intention
although some previous research proposed possible relationships
among the perceptions of a disease, the response to that disease,
attitude, and intention (Reisinger & Mavondo, 2005; Sonmez &
Graefe, 1998). However, it did influence international travel inten-
tions indirectly through personal NPI. This Korean data suggests
that the perception of 2009 H1N1 did not constrain the desire for
international travel among potential tourists as they had some
adaptive behavior in mind which lowered the infection threat to
a level acceptable to them. In effect, personal NPI are an adaptive
behavior which reinforce the desire that supports their behavioral
intention. This coincides with the findings of Raude and Setbon
(2009, p. 342) that the French public has moderately adaptive
beliefs and attitudes about new infectious respiratory illnesses
which lead them to personal NPI as a means for lowering contagion
risks.
5.2. Implications for global tourism and future research
Recognizing personal NPI for 2009 H1N1 as an adaptive
behavior among tourists infers four significant implications for
government agencies, tourism marketers, transport systems,
and hospitality services which raise opportunities for practical
suggestions. First, the intention to travel internationally is
resilient during a global pandemic because potential interna-
tional tourists perceive personal NPI like hand washing, mask
wearing, and information gathering as plausible protective
behaviors while taking a trip. This approach may not be shared
by all tourists because socioeconomic characteristics are linked
to variations in health outcomes (Raude & Setbon, 2009), so
educational initiatives are needed. For example, guidelines for
NPI hygiene should be continually available alongside other
safety information in airline onboard publications. Also, tourism
operators can improve their online communications concerning
pandemic diseases to reassure tourists of their relative safety
and reduce their apprehension about traveling. Second, in
addition to public restrooms, transport and hospitality services
should provide convenient NPI hygiene and information kiosks
within their facilities which support self-protective health
behavior by staff, passengers, or guests. Because personal NPI
are the adaptive behavior of many potential tourists who wish
to proceed with their journey during a pandemic when uncer-
tainty surrounds administrative disease control measures and
the efficacy and availability of pharmaceutical interventions. For
example, if designed for high usage these kiosks can provide
multiple hand cleaning devices and multi-lingual displays of
current health risks at regular locations in airport boarding
lounges.
Third, similar to green tourism certification, tourism operators
and governments should establish a validation system for NPI
friendly businesses which continuously support the personal NPI
actions of their staff, passengers or guests. Because the global reach
of novel influenza-like viruses and the limits of mandatory
administrative NPI, such as border control and passenger screening
techniques, provide tourism businesses with opportunities for
good corporate citizenship and for health related competitive
advantages. For example, transport systems and hospitality
services should implement staff training in personal NPI for their
own benefit and for them to better assist their passengers and their
guests. This could be promoted as a “Green & Clean” certification
process developed by cooperation between tourism businesses and
health agencies. Businesses that are accredited with better hygiene
support for their passengers or guests should have a positive brand
identity in the minds of potential tourists who are planning their
next trip.
Four, government agencies, tourism marketers, transport
systems, and hospitality services should adopt the system-wide
tourism industry approach of a permanent, as opposed to an
episodic, disease mitigation strategy which supports personal
responsibility for staff, passenger or guest health. At a planetary
scale influenza pandemics are a continuous risk due to a combi-
nation of issues. These are the complexity and rapidity of the
global air transport; the practical and technological constraints
on border controls and passenger screening; the influenza virus’s
antigenic changeability; and the limited efficacy of antiviral
drugs and vaccines. For example, to combat the complexity of
these issues international and national governmental tourism
organizations should give health, hygiene, and disease preven-
tion equal status with sustainability or security as a policy
priority.
Future research suggestions that reinforce these approaches
include longitudinal studies of the effect of global pandemics on
tourists’ intentions and their approach to personal NPI as pandemic
alert levels vary over time. Also, as we focused on Korean tourists,
new research should address variations of nationality and socio-
economic status among tourists to discover the communication
and education issues surrounding pandemic disease awareness,
and the use of personal NPI and travel behavior. Finally, identifying
the NPI hygiene techniques which are practical in diverse tourism
setting and the actions required to modify tourist behavior
accordingly, require research attention.
 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99 97

Appendix.

Operational definitions of the measures

Construct Operational definition

Attitude (AT) Strongly disagree (1)/Strongly agree (7)
I think that traveling internationally is positive.
I think that traveling internationally is useful.
I think that traveling internationally is valuable.
I think that traveling internationally is dynamic.
I think that traveling internationally is attractive.
I think that traveling internationally is enjoyable.*
I think that traveling internationally is delightful.

Subjective norm (SN) Strongly disagree (1)/Strongly agree (7)

Most people who are important to me
Most people who are important to me
Most people who are important to me
Most people who are important to me
Most people who are important to me
think it is okay for me to travel internationally.
support that I travel internationally.
understand that I travel internationally.
agree with me about traveling internationally
recommend traveling internationally.*

Perceived behavioral control (PBC) Strongly disagree (1)/Strongly agree (7)

Whether or not I travel internationally is completely up to me.*
I am capable of traveling internationally.
I am confident that if I want, I can travel internationally.
I have enough resources (money) to travel internationally.
I have enough time to travel internationally.
I have enough opportunities to travel internationally.*

Perception of Influenza A (H1N1) (PI) Strongly disagree (1)/Strongly agree (7)

It is dangerous to travel internationally because of Influenza A (H1N1).
Influenza A (H1N1) is a very frightening disease.
Compared to SARS and avian flu, Influenza A (H1N1) is more dangerous.
I have much information about Influenza A (H1N1).*
I am afraid of Influenza A (H1N1).
People around me seem to refrain from traveling internationally due to Influenza A (H1N1).*

Desire (DE) Strongly disagree (1)/Strongly agree (7)

I want to travel internationally in the near future.
I wish to travel internationally in the near future.
I am eager to travel internationally in the near future.
My wish to travel internationally in the near future can be described desirably.

Frequency of past behavior (FOP) How many times have you traveled internationally in the past 12 months?

Non-pharmaceutical interventions Strongly disagree (1)/Strongly agree (7)

for Influenza A(H1N1) (NPI) I will check the information of on Influenza A (H1N1) by visiting the website of the Korean
Ministry of Foreign Affairs or WTO before traveling internationally.
I will read and check precautions about Influenza A (H1N1) through doctors or health centers
before traveling internationally.
I will prepare a first aid kit for Influenza A (H1N1) before traveling internationally.*
I will get the information about local medical facilities and Korean Embassy for preparing for an
emergency because of Influenza A (H1N1) before traveling internationally.
I will frequently wash my hands while traveling internationally.
I will restrain from touching my eyes, nose, and mouth while traveling.
I will cover my mouth and nose with a tissue when sneezing while traveling internationally.*
I will keep away from those who have the symptoms of Influenza A (H1N1) while traveling internationally.
I will restrain from meeting people for a while after traveling internationally.*
I will carefully keep an eye on my health condition after traveling internationally.

Anticipated emotion (AE) Not At All (1) to Very Much (7)

If I succeed in achieving my goal of traveling internationally, I will be excited.
If I succeed in achieving my goal of traveling internationally, I will be glad.
If I succeed in achieving my goal of traveling internationally, I will be satisfied.
If I succeed in achieving my goal of traveling internationally, I will be happy.
If I succeed in achieving my goal of traveling internationally, I will be proud.*
If I fail in achieving my goal of traveling internationally, I will be unsatisfied.*
If I fail in achieving my goal of traveling internationally, I will be angry.
If I fail in achieving my goal of traveling internationally, I will be disappointed.
If I fail in achieving my goal of traveling internationally, I will be worried.
If I fail in achieving my goal of traveling internationally, I will be sad.

Behavioral intention (BI) Strongly disagree (1)/Strongly agree (7)

I intend to travel internationally in the near future.
I am planning to travel internationally in the near future.
I will make an effort to travel internationally in the near future.
I will certainly invest time and money to travel internationally in the near future.
I am willing to travel internationally in the near future.*

Note: Based on the results of EFA and CFA. * items were excluded from further analyses.
98 C.-K. Lee et al. / Tourism Management 33 (2012) 89e99

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