WelDest Primary Research Report

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Health and Well-being in Tourism Destination primary reseach report

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WelDest Primary Research Report

  1. 1. ERASMUS Lifelong Learning Program Health & Well-being in Tourism Destination 2012 - 2014 Work Package 4: Research Report Date: Author: Distribution: File name 2014_01_21 Team FHJ; Lead: Prof. Dr. Kai Illing WelDest team and public 2014_01_17_WelDestResearchReport_ FHJ_final 12.0 Research Report Version: Description: Version 1.0 2.0 3.0 4.0 Date 11.11.2013 26.11.2013 15.1.2014 17.1.2014 Status Draft Progress Edited Finalized Author Team FHJ Team FHJ Team FHJ Team FHJ Changes Development Commenting Round 1 Editing and revision Layout, Spelling
  2. 2. Content 1 RESEARCH REPORT – INTRODUCTION ............................................................................. 6 1.1 Terms and abbreviations ................................................................................................................. 7 1.1.1 Terms ........................................................................................................................................... 7 1.1.2 Abbreviations ............................................................................................................................... 8 2 STAKEHOLDER INTERVIEWS PART A – A QUANTITATIVE APPROACH ........................ 9 2.1 Methodology .................................................................................................................................. 9 2.2 Research results ............................................................................................................................ 10 2.2.1 Which of the following options best describe the role of health and well-being in your destination now and by 2020? ................................................................................................................. 10 2.2.2 What do you think are the most important reasons customers come to your destination? .... 11 2.2.3 Which elements prevent your guests from recognizing your destination as health and wellbeing destination? ............................................................................................................................. 13 2.2.4 How important are the following competencies for you regarding the management of your destination? .............................................................................................................................................. 14 2.2.5 What is your personal need for further training regarding the following competencies? ........ 16 2.2.6 points Please evaluate the present performance of your destination regarding the following specific ................................................................................................................................................... 19 2.2.7 How important are the following specific points regarding the development of a HW&Bdestination? .............................................................................................................................................. 21 2.2.8 Please define the level of your current job ................................................................................ 24 2.2.9 What is the highest level of education you have completed so far? ......................................... 24 2.2.10 How many years of experience do you have in the following categories? ........................... 25 2 WP 4: Research | WelDest 2012 - 2014
  3. 3. 3 STAKEHOLDER INTERVIEWS PART B – A QUALITATIVE APPROACH .........................26 3.1 Methodology ................................................................................................................................ 26 3.2 Research results ............................................................................................................................ 28 3.2.1 Definition of a H&WB destination .............................................................................................. 28 3.2.2 Key service supply, resources, staff competencies and elements of H&WB destinations......... 30 3.2.3 SWOT Analysis of H&WB destinations ....................................................................................... 33 3.2.4 Importance of nature/sustainability in H&WB destinations now and in the future .................. 35 3.2.5 Role of national/regional health policy in H&WB destinations now and in the future ............. 37 3.2.6 Destination development now and in the future ...................................................................... 38 3.2.7 Resources in destination development...................................................................................... 40 3.2.8 Processes in destination development now and in the future .................................................. 42 3.2.9 Balance between needs of tourists and needs of locals ............................................................ 43 3.2.10 Competencies needed in the destination ............................................................................. 44 3.2.11 Core business of the destination in the future ...................................................................... 45 3.3 Discussion ..................................................................................................................................... 46 4 CONSUMER RESEARCH .....................................................................................................48 4.1 Methodology ................................................................................................................................ 48 4.2 Research results ............................................................................................................................ 49 4.2.1 In which country are you right now while filling in this questionnaire? .................................... 49 4.2.2 Please write down some key words, which come into your mind if you think of a H&WB destination................................................................................................................................................ 49 4.2.3 What kind of services, staff competences and elements attract / did attract you to come to a destination like this? ................................................................................................................................ 51 4.2.4 How did you come to the idea to visit this destination you are currently staying at / you have stayed at? ................................................................................................................................................. 54 4.2.5 What was the overall reason for you to come to this destination? ........................................... 55 4.2.6 Which services, activities, and elements do you value the most in this destination? ............... 57 3 WP 4: Research | WelDest 2012 - 2014
  4. 4. 4.2.7 Which of the following options best describe your needs when choosing a health and wellbeing holiday? .......................................................................................................................................... 58 4.2.8 To which extent does/did the destination as a whole meet your expectations regarding the health and well-being related offering during your stay? ........................................................................ 59 4.2.9 How would you score the destination’s services in general? .................................................... 62 4.2.10 To which extent were/are you able to use the variety of services offered in the H&WB destination? .............................................................................................................................................. 64 4.2.11 How do/ did you check the influence of your current holiday on your health at the end or after the stay? .......................................................................................................................................... 65 4.2.12 Which of the following alternatives best describe your expectation of the price level of an H&WB holiday compared to a standard holiday of the same length? ..................................................... 66 4.2.13 Which are the elements which prevent you from recognizing a destination as a health and well-being destination? ............................................................................................................................ 67 4.2.14 What is the highest level of education you have completed so far? .................................... 68 4.2.15 Sex ......................................................................................................................................... 68 4.2.16 Your age................................................................................................................................. 69 4.2.17 Origin ..................................................................................................................................... 70 5 DISCUSSION OF THE RESULTS: STAKEHOLDER AND CONSUMER RESEARCH 71 5.1 The term „health“ and related meanings ...................................................................................... 71 5.2 Elements which prevent guests from recognizing a destination as a H&WB destination ............... 72 5.3 The quality of services ................................................................................................................... 74 5.4 Country-specific analysis 1: What people do for their health ........................................................ 74 5.5 Country-specific analysis 2: Price level .......................................................................................... 76 5.6 Specific analysis: Health activities and education .......................................................................... 77 5.7 H&WB destination: Characteristics and definition ........................................................................ 79 6 SUMMARY AND MANAGERIAL IMPLICATIONS ............................................................80 7 LIMITATIONS ......................................................................................................................83 4 WP 4: Research | WelDest 2012 - 2014
  5. 5. 7.1 Qualitative stakeholder analysis ................................................................................................... 83 7.2 Consumer Research....................................................................................................................... 83 7.3 Limitations in general .................................................................................................................... 83 8 APPENDIX ............................................................................................................................84 8.1 Stakeholder questionnaire – part A ............................................................................................... 84 8.2 Stakeholder questionnaire – part B ............................................................................................... 91 8.3 Consumer questionnaire ............................................................................................................... 94 8.4 Literature ...................................................................................................................................... 99 8.5 List of charts ................................................................................................................................ 100 5 WP 4: Research | WelDest 2012 - 2014
  6. 6. 1 Research report – Introduction This WelDest research report focuses on health tourism, wellness tourism, and destination management. The aim of WelDest is to create a development framework to be used by public bodies, destination management organizations and private companies when developing holistic health and well-being destinations (H&WB). The project “Health and Well-being in Tourism Destination” (WelDest) combines the expertise of 5 Higher Education Institutes, 10 industry and 15 associate partners from Austria, the Czech Republic, Finland, Germany, and the UK. The purpose of the research is to conduct research that is relevant to the health and well-being tourism industry and destinations. The goal is to create a development framework to be used by public bodies, DMOs and private companies at tourism destinations willing to strengthen the elements influencing the well-being level of tourists and locals alike. One of the objectives of the research is to identify the current knowledge and competence needs in managing and developing health and well-being destinations (needs analyses to be conducted among core partner target groups: industry partners, associated partners and HEI-partners, and outside the partnership: representative sample of managers, developers, experts and policy makers responsible for destination development). The WelDest research consists of both primary and secondary research. The report at hand is the primary research paper which comprises two different approaches. The first is based on stakeholder interviews and the second on consumer research. The stakeholders were interviewed on the basis of two different approaches, quantitative (questionnaire part A) and qualitative (questionnaire part B): 6 WP 4: Research | WelDest 2012 - 2014
  7. 7. WelDest research Primary research Stakeholder interviews Part A Secondary research Consumer interviews Part B Chart 1: Structure of the WelDest-research 1.1 Terms and abbreviations 1.1.1 Terms Facilities: Something which is built for a special purpose. The term infrastructure is rarely used in this report as it means basic equipment such as roads and bridges. This report uses the word destination instead of region as it deals with tourism. If the word region is used, the report refers to regions in general without referring to tourism specifically. Consumers or guests are visitors to a destination. Positioning: To endow a destination with a clear brand identity in order to distinguish it from its competitors. Healthy activities: This report uses phrases such as “healthy activities” or “to do something for one’s health” to comprise all things done to improve the guests’ health. Thus, certain terms as for example “health promotion” can be avoided as they are confined to strict definitions. 7 WP 4: Research | WelDest 2012 - 2014
  8. 8. 1.1.2 Abbreviations H&WB Health & well-being USP Unique Selling Proposition DMO Destination Management Organization 8 WP 4: Research | WelDest 2012 - 2014
  9. 9. 2 Stakeholder interviews part A – A quantitative approach 2.1 Methodology Methodology for the stakeholder needs analysis concerning health and well-being destinations (part A) was developed, beginning in October 2012, by the university partners and the industry partner CHC. There were three feedback loops, involving all project partners, regarding further improvement of the questionnaire. The final version was created in April 2013.The questionnaire comprises two parts: The first part uses a quantitative approach (see chapter 8.1), the second part has open questions (qualitative approach, interviews, see Chapter 8.2). The latter part was done on the basis of an interview guideline either face to face or via telephone. Ten to eleven standardized interviews were conducted by each of the WelDest partners in their own countries and then uploaded to Webropol 1. The data were transferred into MS Excel and analysed descriptively by FHJ. Frequency analyses were chosen, with the results shown in graphs. The choice of the interviewees was conducted according to the following suggestions ensuring a broad sample of different professions and management levels: • Regional developers (e.g. LEADER managers, staff of regional management authorities). • Hospitality managers from wellness-hotels, spas/medical spas, and fitness clubs. • Health managers such as health promoters, medical doctors, nutrition experts, or sport scientists. • Local tourism managers, such as authorities from destination tourism boards. • A policy-maker holding a relevant job with national importance (e.g. federal tourism board). 1 Webropol is an online solution for conducting surveys, gathering data, managing feedback, and reporting data (http://www.webropol.com/) 9 WP 4: Research | WelDest 2012 - 2014
  10. 10. All project partners were asked to choose at least one of their interviewees from each the above mentioned groups. 2.2 Research results The following chapters present the results of the survey with the sequence of questions corresponding with the questionnaire (chapter 8.1). 2.2.1 Which of the following options best describe the role of health and well-being in your destination now and by 2020? for the future now 21 H&WB will be/is an essential part of the tourism offering alongside other services 15 1. H&WB will be a part of the destination strategy but not yet implemented at the destination level 2. H&WB is already a part of the destination strategy H&WB will be/is a minor offering H&WB will be/is the core tourism offering of our destination 4 10 3 9 10 5 38/39 responses Chart 2: What describes the role of H&WB now and in future? How to read the chart: 21 responses stress that H&WB will play "an essential part of the tourism offering alongside other services" in the future. 10 WP 4: Research | WelDest 2012 - 2014
  11. 11. The chart clearly shows that the idea of health and well-being serves as a promising approach for further destination development. Conversely, health and well-being as a "minor offering" plays a less important role in future. 2.2.2 What do you think are the most important reasons customers come to your destination? Natural scenery 24 Doing something for health 24 Reputation / image of destination 19 Culture 11 Others, such as major events, regional cuisine and wine 9 Price level 8 Visiting friends and relatives 5 Suitable accommodation 5 40 responses Multiple answers Chart 3: Reasons for coming to the destination 9 respondents selected "other reasons, please specify" listing ideas such as "major events”, “regional cuisine”, and “wine." According to this chart, "suitable accommodation" and "visiting friends and relatives" play a minor role. Interestingly, the stakeholders attach more importance to “health” than the guests do themselves (see chart 20). Those, who ticked "doing something for health", could fill in a subsequent question, the analysis of which is presented in the next chart: 11 WP 4: Research | WelDest 2012 - 2014
  12. 12. Relaxation 25 Pampering spa services 21 Enjoying natural scenery and its nature 19 Outdoor and indoor sport 11 Natural healing resources 10 Clinical/medical services Other reasons, such as fun, sport, outdoor events… 9 2 36 responses Multiple answers Chart 4: Specifications from those who ticked „to do something for his or her health“ Interestingly, the two most important items deal with approaches which are aimed at reducing stress. Obviously, health in a more medical sense plays a less important role. The responses may give deep insight into the clients’ needs and the situation of the societies they live in. 12 WP 4: Research | WelDest 2012 - 2014
  13. 13. 2.2.3 Which elements prevent your guests from recognizing your destination as health and wellbeing destination? Lack of medical services/infrastructure 15 Lack of wellness and spa services / infrastructure 14 Others, such as lack of overall concept, lack of willingness on the part of service… 11 Sprawling cities, villages and industrial areas 8 No medical staff available 8 Outdated health-promoting facilities, such as old-fashioned baths, gyms, etc. 6 Bad quality of services, such as signage of walking trails,… 6 Lack of natural environment 4 Too many disturbing industries 3 Too many tourists 2 Too expensive 2 Too much traffic 2 40 responses Multiple answers Chart 5: Reasons which prevent guests from recognizing a destination as H&WB destination Interestingly, it is not the industry and traffic which disturb according to the stakeholders. They believe it is the "lack of medical services" and the "lack of wellness and spa facilities" which prevent guests from recognizing a destination as a H&WB destination. These results show a contradiction of what was stated in the previous question (chart 4), with medical services playing a less important role (9 responses). It seems that stakeholders are confused as to what is meant by a H&WB destination. 13 WP 4: Research | WelDest 2012 - 2014
  14. 14. 2.2.4 How important are the following competencies for you regarding the management of your destination? 14 WP 4: Research | WelDest 2012 - 2014
  15. 15. not important at all not very important Recognition of customer expectations quite important 1 very important 6 33 Recognition of service gaps 11 29 Rhetoric /Presentation / Communication 11 29 Sales & Marketing know-how Networking skills to contribute to destination d. 13 1 1 27 13 3 HRM 15 34 Complaint management 25 12 21 2 Problem solving within the organisation 22 17 20 Quality management 3 17 20 Process- & project management 3 17 19 2 Team leading Self-management Understanding of H&WB related concepts/… Responsible management (sustainable issues) 19 18 1 5 15 17 1 7 12 6 15 18 5 Knowledge management 9 1 5 1 4 2 Business law 3 Intercultural communication & foreign language Others 7 1 Chart 6: Importance of certain competencies 15 WP 4: Research | WelDest 2012 - 2014 16 15 13 5 Employment law 19 15 Recruiting process Understanding the benefits of applied research 21 16 Innovation management IT skills and e-Business 16 16 21 13 12 11 13 10 10 13 21 17 17 40 responses Multiple answers
  16. 16. The chart reveals the importance of the “recognition of customer expectations” as one of the core competencies with respect to the management of a H&WB destination. The next three items include communication in the form of rhetoric and presentation, marketing, and networking. In this chart, "quality management" plays quite an important role in comparison to other questions in which it is assigned less importance.. "Others" was ticked up just one time and mentions "appraisals, HR-procedures, health and safety". 2.2.5 What is your personal need for further training regarding the following competencies? Charts no. 6 and no. 7(previous and next) belong together as they are part of an importance-performance-analysis. This approach compares the importance of defined services and their present performance by the interviewee, assuming that a high need for training reveals an insufficient performance at present or an increasing demand for this capability in future. Chart no. 7 and its blue bars combines the previous chart with the result of the performance analysis (red bars),, taking only “very important and quite important” (blue) and ”high and some need for further training” (red) into account. If there are differences between importance and performance, a gap arises indicating a need for action. The need for action arises if both bars (blue and red) are particularly long, as is the case with respect to “recognition of customer expectations”. Another example: “Quality management” is rather important too (blue bar, 37 votes), but the necessity for training seems to be comparatively low (red bar, only 17 votes). 16 WP 4: Research | WelDest 2012 - 2014
  17. 17. performance ("high and some need for further training") importance ("very important and quite important") 27 Recognition of customer expectations 39 24 Recognition of service gaps Rhetoric /Presentation / Communication 23 Sales & Marketing know-how 23 Networking skills to contribute to destination d. 40 23 40 38 24 HRM 37 19 Complaint management 33 20 Problem solving within the organisation Quality management 40 37 17 37 Process- & project management 23 Team leading 23 37 20 Self-management 32 24 Understanding of H&WB related concepts/… 32 22 Responsible management (sustainable issues) 37 24 Innovation management 33 22 Knowledge management 34 19 Recruiting process 31 22 IT skills and e-Business 34 20 Understanding the benefits of applied research Employment law 16 Business law 34 16 Intercultural communication & foreign language 36 24 27 23 24 35 responses Multiple answers Chart 7: Need for further training compared to the importance of the competence in question It appears that those competencies which get the most points with regard to “very important” (chart 6, upper part) seem to have the highest need for further training. Example: The “recognition of customer expectations” gets a high ranking with respect to a need for the training (chart no. 7, first red bar). 17 WP 4: Research | WelDest 2012 - 2014
  18. 18. The first two items in chart no. 7 deal with the customers and their expectations and related service gaps. The second group of training needs comprise communicative issues such as “rhetoric/presentation”, “sales/marketing”, and “networking skills”. Legal subjects such as "employment law" and “business law" play a minor role, as is the case with "intercultural communication & foreign languages”. 18 WP 4: Research | WelDest 2012 - 2014
  19. 19. 2.2.6 Please evaluate the present performance of your destination regarding the following specific points I strongly disagree I disagree I agree 2 There is an understanding of the importance of strategic destination development 13 3 We follow a destination brand identity 11 2 15 15 11 We provide an innovation friendly environment 10 19 9 3 We collect and utilize destination level data systematically (knowledge management) 13 14 9 3 Aspects of sustainability will be considered in decision making processes 19 8 3 We are involved in destination-wide decision making processes 12 17 8 2 We have an effective destination management organization 13 18 7 8 There is a commitment and co-operation of all actors (private and public) 7 12 13 3 We follow joint sales & marketing strategies 14 15 7 2 There is an adequate development process- & project management in place 11 24 3 2 There is transparency in communication processes 16 20 2 7 There is a feeling of togetherness and common goals amongst the actors We use a quality management system (e.g. ISO, EFQM,…) I strongly agree 15 15 2 8 1 Chart 8: Evaluation of the present performance of the destination 19 WP 4: Research | WelDest 2012 - 2014 12 18 65 responses Multiple answers
  20. 20. Interestingly, the statement concerning the "commitment and co-operation of all actors" gets quite a critical evaluation as eight interviewees "strongly disagree". This corresponds to other questions in this research the responses to which high importance was attached to inter-regional communication and networking in general. 20 WP 4: Research | WelDest 2012 - 2014
  21. 21. 2.2.7 How important are the following specific points regarding the development of a HW&B-destination? not important Quite important important Destination brand identity 1 Feeling of togetherness and common goals amongst the actors 2 1 Commitment and co-operation of all actors (private and public) 1 Common understanding of the importance of strategic destination development 4 2 3 27 11 4 26 13 1 23 17 2 22 17 6 14 3 14 11 15 14 Chart 9: Importance of certain points for the destination development 21 WP 4: Research | WelDest 2012 - 2014 19 17 17 3 Use of a quality management system (e.g. ISO, EFQM,…) 21 18 18 5 Providing an innovation friendly environment Process- & project management with regard to destination development 28 9 Consideration of sustainability in decision making processes Transparency in communication processes 30 11 Involvement in destination-wide decision making processes Joint sales & marketing strategies 33 8 A destination management organization Systematic collection and utilization of destination level data very important 23 40 responses Multiple answers
  22. 22. Many of the above mentioned items deal with communication and cooperation. If "very important" and "important" are taken together many items have more or less the same number of responses. So, we propose to differentiate between "important" and "very important". The "use of quality management system" and certifiable quality seals such as ISO 9001 and EFQM seem to be of less importance, at least in this question. The next chart deals with the same data while trying to present the outcome in another way. There are points given to each category: • „not important“ • „quite important“ 1 point • „important“ 2 points • „very important“ 3 points. 0 points If calculated together, one gets a result in the middle of the next chart which delivers deeper insight into the outcomes: 22 WP 4: Research | WelDest 2012 - 2014
  23. 23. points not important 0 points very important 3 points important 2 points 108 2 1 4 8 30 109 1 11 28 101 2 9 27 103 3 11 13 23 101 1 17 22 99 2 17 21 91 6 14 19 93 18 18 90 5 Feeling of togetherness and common goals amongst the actors Commitment and co-operation of all actors (private and public) Common understanding of the importance of strategic destination development A destination management organization 26 99 4 3 Destination brand identity 33 107 1 Quite important 1 point Linear (points) 17 17 91 3 14 23 72 15 14 11 Involvement in destination-wide decision making processes Systematic collection and utilization of destination level data Joint sales & marketing strategies Consideration of sustainability in decision making processes Transparency in communication processes Providing an innovation friendly environment Process- & project management with regard to destination development Use of a quality management system (e.g. ISO, EFQM,…) Chart 10: Interpretation of the previous questions 23 WP 4: Research | WelDest 2012 - 2014
  24. 24. 2.2.8 Please define the level of your current job Mid-management (e.g. department head) 14 Executive Manager (e.g. CEO) 11 Others, such as director of customer operations, mayor, academic university professor, senior manager, resort… 8 Owner/entrepreneur 7 40 responses Chart 11: Level of the current job 2.2.9 What is the highest level of education you have completed so far? Master's degree or similar 17 Bachelor's degree or similar 8 Secondary school 7 Doctoral degree Basic education 6 1 39 responses Chart 12: Highest level of education The comparatively high number of doctoral degrees results from the fact that quite a lot of medical doctors were among the interviewees, as experts from the health industry were part of this survey. 24 WP 4: Research | WelDest 2012 - 2014
  25. 25. 2.2.10 How many years of experience do you have in the following categories? Working in hotels / restaurants Destination management or regional authority Health related services such as (thermal) spa, public / private health care, etc. 14 more than 6 years 11 2 4 to 6 years 1to 3 years Less than 1 year 4 5 4 8 1 1 17 2 5 39 responses Chart 13: Years of experience The chart delivers insight into the job experience of the interviewees. The majority of them have more than 6 six years of job experience in tourism, health, or destination management. 25 WP 4: Research | WelDest 2012 - 2014
  26. 26. 3 Stakeholder interviews part B – A qualitative approach 3.1 Methodology The development of the stakeholder needs analysis (qualitative questionnaire, part B) was developed, beginning in October2012, by the university partners. There were three feedback loops, involving all university partners and the industry partner CHC, for ensuring the quality of the questionnaire. The final version was created in April 2013. Part B was developed as a semi-structured interview guideline consisting of 12 questions. The topics of the semi-structured questions were: • Terms and Definitions • SWOT • Role of nature • Role of national / regional health policy • Current situation in destination development • Internal versus external resources in destination development • Instruments to be applied for destination development • Locals versus tourists • Training and education on a destination level • Future Markets Through the development of a guideline which described the implementation and analysis of the interviews in detail, standardization was ensured. In that way it was ensured the method for conducting the interviews was the same in all partner countries. This document “Notes for qualitative stakeholder needs analysis” was divided into three sections: 26 WP 4: Research | WelDest 2012 - 2014
  27. 27. • 1. Conducting the interviews • Preparation for the interview • The interview itself • How to get the data in analyzable form • Data selection and analysis • 2. Interview Guideline • 3. Template for interview protocols (a form into which the transcription of an interview was to be filled in). Ten to eleven interviews were conducted by each WelDest partner. The interviews were either done face to face or via telephone. The selection of interviewees was conducted by every project partner (see chapter 2.1). The interviewees, chosen as experts in their field, were first contacted via telephone or e-mail to make an appointment for the interview. Therefore, the experts selected comprised regional developers, hospitality managers, health managers, local tourism managers, and policy makers on a national level. The confidentiality and the anonymity of the data were assured to the interviewees. Before the interview started the interviewees were asked to get permission to audiotape the interview. An interview guideline was used during each interview in which it was recommended to use open questions and to avoid closed questions in order to keep the interviewee talking. The face to face interviews were recorded, transcribed and then translated into English when needed. One protocol for each interview was compiled in English or German. It was recommended to use an audiotape for writing the protocol to avoid a loss of information. Furthermore, some basic information had to be gathered before the interview started, such as the interview number, the interviewee (first name, last name), his/her function, interviewee initial number (partner country, interview number; e.g. AT1), date of interview, length of interview, and name of the interviewer. All teams fed their interview protocols into Webropol to make them available to FHJ for analyzing. The interviews were transcribed according to Froschauer & Lueger, 2003. Afterwards, the categorizing of the data was done with aid of MaxQDA 2007 to ensure a professional categorizing system. The Austrian transcripts were used to validate the 27 WP 4: Research | WelDest 2012 - 2014
  28. 28. categories of the interview. This was to ensure a comprehensive system of categories (word-clusters). In other words: The Austrian transcripts were used as kind of a pretest. Additionally, the categorization was discussed in a team meeting with all partner countries, with almost all suggestions for improvement being taken into account. Then, the interviews from all partners were categorized according to the same categorizing system. Most of the interviews took about one hour. The shortest interview time was 30 minutes, and the longest interview took 2 hours. 3.2 Research results Overall, 52 interviews were conducted (10 in Finland, Germany, and the United Kingdom, and 11 in Austria and the Czech Republic) comprising 15 regional developers, 15 hospitality managers, 12 health managers, 8 local tourism managers, and 2 policy makers. 3.2.1 Definition of a H&WB destination The first question deals with the definition of a H&WB destination. About half of the interviewees think that health and wellness are two different things. The term health is attached more with sick people as medical issues, whereas wellness has a more holistic view of the person, and comprises the body, mind, and soul. This holistic view is, according to the interviewees, very important for H&WB destinations. Nevertheless, most interviewees stated that expertise in medicine and health are core factors: “If you talk about health tourism or well-being tourism then there should be evidence, something that “tastes” right, not only pampering as such. Wellbeing can be many things but in this, especially when discussing rehabilitation it has to be real and true.” (FIN10, 7) Core factors for the definition of a H&WB destination are wellness offers, possibilities to relax, spa facilities, and well-being. These are as important as expertise in medicine and health. There can be a negative association with the term wellness because it is not defined properly and almost all hotels use the term to market themselves. 28 WP 4: Research | WelDest 2012 - 2014
  29. 29. When it comes to nature and environment, interviewees stressed the importance of a sound, beautiful, clean nature and the use of local natural resources such as thermal water for thermal baths, because they distinguish destinations from one another. “Why should a guest even go to a thermal spa, because almost each higher categorized hotel has all offerings that thermal spas have, too? And you get to the point what a thermal spa is all about: It is the thermal water, which is simply not available everywhere.” (AUT04, 9) Another distinctive feature can be a unique offering of services, providing different types of services and also a wide range of services. In order to be able to offer these services, sufficient facilities are necessary. This also involves indoor and outdoor activities like hiking, biking, going for walks or going to the gym, etc. Another important aspect is to provide healthy food and also organic/regional healthy products. Not only physical goods, but also the service attitude and the friendliness of the staff contribute to an enhanced experience during a holiday in a H&WB destination. Qualified staff plays an important role in the perception of the delivery of services for guests. “Personally I can forgive small shortcomings in accommodation, but the way people treat you, the cleanliness and the friendliness, the presence of flowers etc. not really. Inner feelings and emotions are definitely decisive for clients, they are absolutely essential.” (CZK08, 7) Destinations should also take into consideration their historical values and culture which they can identify with authenticity. Some interviewees stated that homogenous offers in the destination help the guests to become oriented, and they function as a positioning statement. The whole destination should offer a chain of services for the guests so that they can experience their holiday as a complete package. Interdisciplinary co-ordination is necessary to achieve this goal. Differences between the countries of the interviewees could be especially seen in the following points: It seems that the Finns have a very holistic approach to wellness. According to them, it should involve the body, mind, and soul of individuals, whereas they associate health with medical services and recovering from an illness. For the other countries this holistic approach is important as well, but Finns put a very high importance on it. So there should be a distinction between the two terms „wellness“ 29 WP 4: Research | WelDest 2012 - 2014
  30. 30. and „medical,“ which the Austrian interviewees also put a focus on. As for the Austrians and the Finns, the term wellness is quite imprecise and overused and should therefore not be part of a definition of a H&WB-destination. The British stressed that the term H&WB is not understood in the UK as there is the term spa tourism, which is not directly linked to health. Travelers normally have no associations with the term H&WB, but understand the term spa tourism well. If we look at the answers from the point of view of the various professions of our interviewees, health managers put a strong focus on natural resources, nature, and environment of H&WB destinations as well as medical expertise and wellness offers. Hospitality managers are more service-oriented and focus on well-being offers. Regional developers, on the other hand, emphasized the importance of a homogenous offer and health-promoting expertise. The chain of services is crucial to them. Local tourism managers put a focus on well-being and a holistic approach. Summary It seems that health and wellness are seen as two different things. Health is associated with medical issues and wellness has a more holistic approach, at least for the interviewees. This holistic approach is important for H&WB destinations, and competencies in health and medicine are core factors for H&WB destinations. Other core factors mentioned include wellness services, possibilities to relax, spa facilities, and well-being. The interviewees stressed the importance of a sound, beautiful, and clean nature as well as capitalizing on local (authentic) resources. It seems to be necessary to offer different types of services, and appropriate facilities are necessary, too. Service quality and friendliness were also emphasized, as was the need for qualification. 3.2.2 Key service supply, resources, staff competencies and elements of H&WB destinations The second question is about the key service supply, resources, staff competencies, and elements of a H&WB destination. As far as the service supply is concerned, interviewees agreed that the offered services have to be of high quality in order to satisfy the customer. There should be a broad range of offers. According to the interviewees, a H&WB destination must 30 WP 4: Research | WelDest 2012 - 2014
  31. 31. provide well-being offers such as services for relaxation, beauty treatments, and spa procedures. However, the same importance is attached to medical offers like rehabilitation, prevention, and education in achieving a healthier lifestyle. Additionally, outdoor and indoor sport activities were mentioned as key services of a H&WB destination. Another issue is tailor-made services for special interest groups. Extremely important for H&WB destinations is the way the services are offered. There should be a network that provides supporting products and services, so customers feel that the offer in the region is homogenous and comprising. The chain of services is crucially important for the experiences of the guests. As one Czech interviewee summarized: “At the end of the day, health and well-being are all about the services (…).” (CZK09, 13) The key resources of H&WB destinations evolve around the big topics of nature, environment and landscape. These factors are seen as being very important to the overall impression of the destination. Furthermore, natural resources available in destinations should be used in tourism, for example thermal water for spa treatments or regional and healthy products in restaurants. The other big topic for the interviewees in this category is the facilities. Interviewees agreed that a minimum level of facilities in H&WB destinations is necessary in order to deliver appropriate services. Most important in this field are the facilities for well-being, and spa facilities like pools, saunas, gyms, relaxation, and treatment rooms. “Definitely for me it’s the nature and natural conditions, for example forest, river, clean mountain water and healing climate, and of course the landscape and of course the facilities for doing activities, like hiking trails and trails for biking, in the winter for cross-country and other winter sports. In the same time the place should be able to offer spa services starting from the bath and massages to spa centers.” (CZK09, 10) Crucial to H&WB destinations are the staff competencies. The offered services must be delivered in a professional manner. Also very important is the qualification, training, education and knowledge which they have obtained. All these things enable the staff to be capable of delivering services of high quality. Almost all interviewees 31 WP 4: Research | WelDest 2012 - 2014
  32. 32. agreed on the fact that social skills and the direct interaction with the guests are the key factors that enhance the guests’ well-being as well. “I think that the human factor is crucial, I mean service standards, staff standards and their ability to be affable. The education of people working in the field of tourism is essential as well.” (CZK08, 7) Another important aspect is the public transport system, which should be sufficient so that guests can easily reach the destination and places of interest within the region. The culture and heritage of the destination should not be left out, but rather included in the packages, as guests are interested in the history and traditions of the locals. When it comes to the positioning of the H&WB destination, it is very important to communicate a clear USP. Guests want to know what they can expect from the destination and choose the appropriate offering for themselves. This is explained in the statement below: “If we talk about a USP, for example we are the health destination for weight reduction; appropriate services like exercise should be coordinated. In other words: specific joint-friendly sports or also the facilities for example a lake or a therapeutic bath where these things can be offered. The whole offer should be a smooth concept, adjusted to the hotels with their programs, all factors that influence the medical indications of diseases. (…) Target-group-specific offers with target-group-specific staff in all areas.” (AUT08, 13) Viewed from the point of view of the country and profession, there are some differences. For the Austrian interviewees qualified staff is the most important key competency of a H&WB destination. On the other hand, for the English, complementary services (which do not belong to the core competencies) seem to be very important. Hospitality managers put a clear focus on the quality of staff and customer service. Summary According to the interviewees the key service supply of a H&WB destination should be of high quality and combine medical services with well-being, relaxation, and spa offers. 32 WP 4: Research | WelDest 2012 - 2014
  33. 33. There should be a network that provides supporting services and products to the guests. Interviewees think that the key resource for H&WB destinations is nature and environment. Natural resources like thermal water also play an important role. Sufficient facilities have to be available to deliver the desired services to the consumers. Professionally trained staff has to get adequate training and education in the core areas. Most important to the interviewees are social skills. 3.2.3 SWOT Analysis of H&WB-destinations The third question dealt with a SWOT-analysis of the interviewees’ own H&WB destinations. Interviewees were asked to name the strengths (S), weaknesses (W), opportunities (O) and threats (T) of their HW&B-destinations. Many factors were identified by the interviewees with the answers matching partly with the key competencies of H&WB destinations. The most important strength for H&WB destinations mentioned is a beautiful and sound nature and environment, which have to be maintained as they can become a weakness if they are not taken care of. The history, culture, and traditions of H&WB destinations should be included in the tourism offers as it underlines authenticity. Good facilities combined with accessibility and public transport are very important factors. Other factors mentioned are the reputation of a H&WB destination, professional staff and the preparation of relaxation offers. “Strengths are the tradition, the location, the natural curative resources, the human resources, their language skills somewhat, and the demand for the type of service that we supply. Also the natural environment, which is relatively clean (…)“ (CZK10, 13) The weaknesses largely correspond with the strengths, which mean that if the strengths of H&WB destinations are not taken care of, they can quickly turn into weaknesses. A further point mentioned in the weaknesses is the positioning and marketing of a USP. There was general agreement that too many destinations market themselves in the same way, thus not being distinguishable from others. In part, this can be traced back to a low level of co-operation in the destination as well as to low financial resources. 33 WP 4: Research | WelDest 2012 - 2014
  34. 34. “The weakness is the co-operation between public, state, and local authorities. Even among business units we are speaking different languages and we are not setting the same goals. And every four years the authorities are changing their priorities according to the political situation. It is kind of difficult. And I would say that this is the obstacle to growth.” (CZK09, 13) Regarding the opportunities of H&WB destinations, the biggest potential according to the interviewees can be seen in attracting new target groups. Often, H&WB destinations focus on strictly defined target groups which do not have enough potential. Also the improvement of networking and co-operation in the destination is seen as an opportunity. “(…) attract more people in a broader age range, but that is not easy because of the competitors in the market and so on the other hand because of the expanding number of people, because of the expanding part that is older in the long run, a spa has this association with people who are older because this is becoming such a growing part of the market.” (AUT05, 9) The biggest threat for H&WB destinations according to the interviewees is the high level of competition. Many destinations and companies link themselves with H&WB, which could potentially also lead to an oversupply in the near future. For the interviewees uncertainty is also associated with potential political friction or economic recessions. The withdrawal of public financing for H&WB destinations, especially for health tourism 2, is seen as big hazard because it is not clear whether consumers will be willing to pay for health activities themselves. “(…) potentially in a certain segment of H&WB tourism there is already a little bit of an oversupply (…)” (AUT01, 13) Austrian interviewees advance the view that prevention and medical services belong to the biggest opportunities for the future development of H&WB destinations. Czech 2 The treatments of which can be paid by the health insurance as it can be part of the health care legislation. 34 WP 4: Research | WelDest 2012 - 2014
  35. 35. interviewees think that the biggest weaknesses of their H&WB destinations are the low service quality which results from a lack of qualified staff. For the British heritage, history, and reputation are key strengths of H&WB destinations. Hospitality managers think that qualified staff is the biggest strength of H&WB destinations. Summary This chart presents the SWOT Analysis of H&WB-destinations from the interviewees. Strengths sound nature / landscape / environment history / culture / tradition good facilities reputation / image / brand professional / qualified staff accessibility / public transport location relaxation / health / retreat offers Opportunities enlargement of target groups / segments networking / co-operation in the destination nature / natural attractions differentiation / positioning facilities and infrastructure (renewal, expansion of both roads and public transport as well as spa resorts) 3.2.4 Weaknesses unqualified staff no positioning / marketing of a USP weak facilities weak public transport / accessibility no networking in the destination Unclean environment low financial resources Threats high competition political friction economic / financial crisis or recession withdrawal of state / public financing Importance of nature/sustainability in H&WB destinations now and in the future The fourth question is about the importance of nature at present and in the future (2020). Generally, interviewees stressed that nature and sustainability are very important aspects for H&WB destinations. The protection of the environment is a crucial topic which should be pursued in the future. In general, interviewees think that H&WB destinations are to make use of their local natural resources such as thermal water and marshland for swimming pools and spa treatments (wrappings). According to the interviewees, nature is one of the core reasons to travel to H&WB destinations and their unique selling proposition (USP). Nature can also be used for outdoor activities like hiking, biking and so on. 35 WP 4: Research | WelDest 2012 - 2014
  36. 36. “(…) It’s extremely important to take care of ecology and nature now and it will be even more important within ten years. Because if we’re not going to take care of the nature (…) even within seven to ten years we will have nothing to offer. So the more we take care of it now, the more we will be able to offer in 2020.” (CZK09, 16) On the subject of sustainability there was agreement that it is very important for H&WB destinations in order to maintain the scenery and natural resources, although there is mostly no sustainability codex applied in the destinations so far. Some interviewees put a focus on local networks and the marketing of regional products. “Sustainability is interpreted locally (…) as developing local partnerships and supporting the rural economy. It is about developing links between wellness and other products. It is about retaining a distinct local mix of shops and other businesses. It is about integrating local products, especially local food to the wider tourism offering.” (UK01, 16) When asked about the future importance of nature and sustainability in H&WB destinations, most interviewees said that the importance of these topics will increase. Others stated that they will have the same importance in the future because these are already now very important topics. Summary Nature and sustainability are both very important elements for H&WB destinations. They can act as USP for destinations and core reasons for guests to travel to certain destinations. Interviewees think that the protection of the environment is crucial in order to be able to offer outdoor activities. This should be underlined even more in the future. Natural resources such as marshland can be used for spa treatments in tourism offers. The importance of these two elements is already very high in H&WB destinations and interviewees think that this will probably increase even more in the future. 36 WP 4: Research | WelDest 2012 - 2014
  37. 37. 3.2.5 Role of national/regional health policy in H&WB destinations now and in the future The fifth question is about the role of national / regional health policy in H&WB destinations at the moment and in the future (2020). Interviewees think that the political influence on H&WB destinations largely depends on the services available. Destinations concerned with offering cures 3and medical treatments for example have bigger connections with health policy than destinations operating with well-being services. About half of the interviewees stated that politics play no significant role in their destination, but almost the same number said that health policy has a big influence on the development of their destination. Some also agreed that politics does have some impact on them, if not largely. “Health policy, of course there is a connection, that is without question (…)“. (AUT11, 42) On the contrary, a Finn and an English interviewee said: “I cannot say more to regional health politics – we are not that medical, that it would reflect on us. (…).” (FIN09, 19) “There has been no contact between tourism and the health authority, no mention of tourism in the (…) health strategy.” (UK05, 19) Most destinations are familiar with some sort of subsidies, financial aid or copayments by the government or health insurance companies, which have just as large an influence on the type of guests as on the treatments and the qualifications of the staff. For the future, interviewees think that health policy will have a big influence on cuts in subsidies. More prevention offers in the future are desired, but it is unclear 3 The Central European concept of „Kur“ (nowadays called ambulant prevention) is part of the preventive health care at least in the German speaking countries which aims at subsidizing treatments in health spa centers to maintain the ability of employees to work. Thus, “Kur” does not mean curing from a surgical and clinical point of view but is based on treatments using natural remedies such as healing water or healing climate. 37 WP 4: Research | WelDest 2012 - 2014
  38. 38. whether politics will support these services or not. Generally, interviewees wish to have more co-operations with health policy in the future. “(…) so the key here, it seems to me, is that national and regional health policies become more orientated to prevention that’s to be driven by economics. It won’t be possible anymore to focus on treatment. There is much too little emphasis upon Austria’s health policy now, and the same for regional policy in the location, and they are directly connected with one another (…).” (AUT05, 17) Again, there are some differences between the countries concerning the importance of health policy. The Finns and Austrians largely agreed that health policy influences their H&WB destinations while Czech and British interviewees think that it doesn’t influence their destinations a lot. Summary The influence of health policy on H&WB destinations depends largely upon the offered services. Destinations focusing on medical procedures or cures have more connections with health politics than destinations with well-being offers. Nevertheless, almost all H&WB destinations are familiar with some sort of financing through the state or health insurance companies. For the future, interviewees think that politics will have a bigger influence on H&WB destinations and hope that more preventive services are offered. Interviewees also seek more cooperation between the public and private sectors. 3.2.6 Destination development now and in the future This question deals with the topic of destination development in general. It has a focus on the current situation and future development of H&WB destinations. Most interviewees think that co-operation, partnerships, and networks support destination development in a positive way. Common destination planning and development are seen as improving the performance of destination for tourists and politicians, if the latter ones officiate in a fluently communicating and conflict-free 38 WP 4: Research | WelDest 2012 - 2014
  39. 39. destination. According to the interviewees, many of their H&WB destinations have developed their tourism product recently. Infrastructure and facilities are another issue for H&WB destinations as they should satisfy customer needs. Interviewees also stated that a focus was put on the marketing and positioning of the destinations. Regular meetings are held to ensure co-operation and planning. “(…) health and wellness is clearly being seen as an important development opportunity for destinations. (…).” (UK04, 22) The interviewees also had some negative associations with the current destination development. The biggest limiting factors for H&WB-destinations at the moment seem to be financial factors. Many wish for more financial support from government and feel a big influence from the current recession. Some regions also miss cooperation from all stakeholders and feel that there is a lack of networking. Other negative factors mentioned are political frictions and a lack of time for appropriate destination development. “(…) in this recession the development of the destination is pretty small, so basically we just try to survive the competition and the recession.”(FIN05, 22) In the future, interviewees stated that their H&WB destinations plan to invest in their facilities both on maintenance and construction. Many of the interviewees also hope that co-operation and networking become bigger topics in all regions in order to enhance destination development. A focus will be put on H&WB offers and, generally, services will be diversified in order to attract more market segments. For some the protection of the local environment is the most important aspect in the future development. “As an example every company is trying to understand how to attract more foreign visitors, instead they should do it together and they could offer bigger entities that would attract more than a single company offering.” (FIN03, 22) Looking at the question from the point of view of different countries, a difference can be seen concerning the Czech interviewees. For the Czech interviewees the presence of a destination management organization (DMO) is a very important aspect in 39 WP 4: Research | WelDest 2012 - 2014
  40. 40. destination development, and should be further enhanced in the future. Other countries did not put a special focus on this subject. Summary Common regional planning and acting is seen as improving the performance of destinations for both tourists and politics. Many destinations have recently developed their facilities and the range of services offered to attract more consumers. According to the interviewees, marketing and positioning are both attached with the utmost importance. Interviewees think that the biggest limiting factors for current destination development are financial issues, mostly due to recession. Future development is aimed at improving facilities and the co-operation and networking in the destinations. The range of services will be diversified. 3.2.7 Resources in destination development This question discusses whether internal (endogenous) or external (exogenous) resources should be exploited for destination development. The general agreement of interviewees is that a mix of external and internal resources is vital to destination development. It is very important to make use of external resources, too, such as consultants or market research data. This also includes the monitoring of tourism trends and an examination of science and current research. Interviewees think that the government and public sector have a large influence on destination development because they predetermine many aspects of H&WB destinations, for example certain regulation about hotel categories or health offers. “(…) there needs to be a mixture of both, active participation of the locals but at the same time external experts, that means a combination of both (…).” (AUT08, 38) From the internal point of view, interviewees think that it is very important to gain ideas for development internally and also make decisions internally, but with the help of external consultants. Local co-operation and partnerships can also foster 40 WP 4: Research | WelDest 2012 - 2014
  41. 41. development and help to work towards a common goal. In this context, stakeholder management plays a central role. Some H&WB-destinations are guided by a DMO and feel that this guidance is very helpful for the development. “We work with a destination management organization very closely; we have representation on the board. We take advantage of what the DMO is doing. We communicate, offer proposals to their strategies, we meet. They do it well, and they‘re interested in opinions from the field.” (CZK06, 25) Concerning external resources, most interviewees stated that they have used external consultants in their destination development process so far to get an outside view. The examination of best practice examples and benchmarking is very common and provides them with new ideas. The interviewees stress that memberships in different associations and organizations also contribute to the conflux of external knowledge which has to be exchanged systematically within the destination. Most interviewees said that their H&WB destinations are familiar with external investments. “(…) we try to get the influence from elsewhere because otherwise we have the cave effect; we only see the shadows but do not see what is happening out there.” (FIN05, 22) Summary According to the interviewees, a mix of external and internal resources is vital for the development of H&WB-destinations. Current tourism trends, research, and science should be monitored to be able to react to changes in customer behavior etc. Interviewees think that government and the public sector have a big influence on their H&WB destinations as they predetermine certain regulations. Interviewees feel that internal ideas should be supported by external guidance and local co-operations and partnerships. The presence of a DMO facilitates the development of a H&WB destination. The H&WB destinations are familiar with the use of external consultants and external investments for the development of their region. Examination of best practice examples and benchmarking is a common feature as well as membership in organizations. 41 WP 4: Research | WelDest 2012 - 2014
  42. 42. 3.2.8 Processes in destination development now and in the future Question number eight is about the processes used for destination development now and in the future. Currently, most interviewees said that they use regular and personal communication in meetings to develop their destination. Also the co-operation of stakeholders is a common tool used for the development of H&WB-destinations, and co-operation between the public and private sectors is vital as well. Interviewees develop their destinations with the aid of various platforms such as forums, membership organizations, and associations. Other points mentioned are on-going research and the monitoring of tourism trends, as well as promotion and marketing of their H&WB-destinations. “Attend exhibitions, conferences, networking events, trade publications. Discuss new product development with other companies. Owners travel abroad for ideas regarding key and emerging trends.” (UK09, 32) For the future, interviewees think that local guidelines for co-operation will be the most important instruments for destination development. This includes the continuous involvement of locals in the decision-making processes. Important points that will remain in the future, according to interviewees, are market-research, trend analyses, and also the marketing of H&WB destinations. “Developing local partnerships is the key to any future success. There is a close working relationship with local businesses (…).” (UK01, 28) Summary Most interviewees said they use regular, personal communication to develop their destination. Another common tool for destination development mentioned by the interviewees is the co-operation of stakeholders and the public and private sectors. According to the interviewees, various platforms as well as market-research and marketing are used for destination development. Interviewees think that in the future co-operation on a destination level will be the most important process for destination development. This also involves the participation of local inhabitants. Research and marketing will remain important in the future. 42 WP 4: Research | WelDest 2012 - 2014
  43. 43. 3.2.9 Balance between needs of tourists and needs of locals This question deals with the balance between the needs of tourists and the needs of locals. The interviewees’ opinions vary largely on this topic. About half of the interviewees think that the relationship between tourists and locals is problematic, but the other half thinks that there are no conflicts between tourists and locals. “Finding the balance is very challenging! I feel however, that the local inhabitants are positive about this; what is good for tourism is good for the locals, too. But we would need to give them more information about what we do and use them in the development and raise their status, increase their role in the development.” (FIN01, 34) There is general agreement that the facilities and the range of services should be for both groups and that facilities are improved regularly. Locals should participate in tourism development, being able to advance their opinions. Furthermore, interviewees think that tourism creates a lot of jobs for locals and supports local businesses. Some interviewees also stated that there are discounts or benefits for locals using tourism facilities. “It is important to develop agreement for tourism development with local residents. Advice on wise sustainable growth needs a bottom-up approach and local mechanisms to ensure the views of locals are considered.” (UK04, 34) Summary In the interviewee’s opinion, finding a balance between needs of locals and needs of tourists is very challenging. One half of the interviewees think that the relationship between tourists and locals is problematic; the other half thinks that there are no conflicts between these groups. There is general agreement that both the facilities and services should be used by tourists and locals as well. Locals should also participate in tourism development. Interviewees think that tourism creates jobs for locals and supports local businesses. 43 WP 4: Research | WelDest 2012 - 2014
  44. 44. 3.2.10 Competencies needed in the destination The next question is about the competencies which are needed in H&WB destinations. The interviewees’ answers show that many competencies are needed. As far as staff development is concerned, competencies such as management skills, marketing and selling skills, as well as social skills seem to be of special importance. However, the most important competency in the future is the knowledge of foreign languages. Interviewees feel that their H&WB-destinations lack these skills at the moment. Connected with this topic is customer service, which should also be improved in the future. Interviewees also hope that staff has a comprehensive knowledge about the destination and its range of services. “Very often we're able to deliver quality itself but we’re not able to smile, that’s very simple. This is what I see very often. I used to say that we’re not in the post office, we’re serving guests. We’re not sitting at the counter and waiting for the guests to come. We should approach them and make advances to the guests.” (CZK09, 37) Interviewees feel that the physical goods and services which they offer should be further developed in the future to attract more guests. Another important topic is the development of supporting services (explanation: a bike rental company needs a bike-route, a medical spa needs a pharmacy) and the improvement of single steps within one process (process management of successive steps such as information, booking, payment, which are altogether realized as one service), also called a service chain. “(…) We would need development in the direction of cluster management, where it is clearly defined, what are the core competencies, core strengths. And along these core competencies a high degree of liability of the service chain is needed, and we are lacking liability for long periods for now.” (AUT07, 75) 44 WP 4: Research | WelDest 2012 - 2014
  45. 45. Summary The training and education of staff is the most important aspect in the needed competencies for H&WB-destinations according to the interviewees. Language skills make up the largest part in this area. Also important are customer service and the regional knowledge of staff. Management skills, marketing, and sales as well social skills could also be further developed according to the interviewees. Interviewees feel that the goods and services have to be improved as part of a chain of services. Another important topic for interviewees is an adequate information policy. 3.2.11 Core business of the destination in the future The last question which was addressed to the interviewees is about the core business of their destinations in the future. Almost all interviewees think that H&WB will be the focus of their destinations in the future. Interviewees also think that there will be a trend towards more active holidays with a focus on sports and outdoor activities. This will need further investment in the expansion and maintenance of related facilities. “I think health and well-being is a good theme as you can connect it with experiences and nature values in overall well-being.” (FIN03, 40) Concerning the target groups, interviewees think that domestic tourism and tourism from nearby countries will grow in importance. For some interviewees, international visitors will also play a big role in H&WB destinations. Another trend seems to be that older people remain more active and more interested in H&WB destinations and will therefore become a big target group in the future. “Close-by markets will be growing according to all studies.” (FIN02, 40) Considering differences between the countries, it can be seen that Austrians put a very clear focus on health and medical offers while the interviewees of the other countries did not stress that point. 45 WP 4: Research | WelDest 2012 - 2014
  46. 46. Summary As for the future, almost all interviewees want their destinations to focus on H&WB. They also think that there will be a trend towards more active holidays and that is why bigger investment in outdoor and sport facilities is needed. Interviewees think that domestic tourism and tourism from nearby countries will grow in importance. Some also see international visitors as playing an even bigger role in future. Older people become more active and interested in H&WB, which makes them a future target group. 3.3 Discussion As stated in the analysis of the qualitative interviews with the stakeholders, the dichotomy between health and wellness can be seen also in the quantitative part of the stakeholder interviews (part A). The results of question 2 (part A, chart no. 4) reveal a strong emphasis on wellness issues (the first two bars from the top) and a quite weak emphasis on health related issues (lower part of the chart). Question two of the qualitative stakeholder interview (chapter 3.2.2) reveals the necessity of the quality of all services offered. This might be understood as a contradiction to the results of the interview part A (chart no. 8) which attached little importance to quality issues. But part A somehow stresses the aspect of certifiable quality management systems, whereas the statements in part B emphasized a broader approach to quality in the sense of delivering services satisfying the expectations of the clients. The way services are offered plays as important a role in part A as in part B. The results of the stakeholder interview part B stress the importance of the staff competencies in general. Part A specified which competencies are among the most important ones. We learned that the importance of "recognition of customer expectations” is one of the core competencies with respect to the management of a H&WB destination. Other important items comprise various communicative issues such as rhetoric, presentation, marketing, and networking. Regarding the SWOT-analysis as part of question 3 in the stakeholder survey (chapter 3.2.3), many responses stress the importance of nature, landscape, and a healthy environment. This corresponds with the results in part A (chart no. 3) which rank this 46 WP 4: Research | WelDest 2012 - 2014
  47. 47. environmental and nature-based issue at the top together with “doing something for health”. Question no. 8 (chapter 3.2.8) of the stakeholder interview part B stresses the importance of proper communication among the players of the destination and the use of regular and personal contacts. We refer to the results of the chart of question no. 9(chapter 2.2.7) that also attaches very much importance to better communication within a H&WB destination. Question 9 of the stakeholder interview (part B) points out that at least the half of all interviewees thinks that the relationship between tourists and locals is somehow problematic. It is foremost a matter of communication to harmonize the different expectations and needs of all players in a destination for the sake of smoothly running the destination development. This problem was not mentioned by the consumers at all, who obviously do not feel the tensions between locals and tourists as keenly. Question no. 10 of the stakeholder interview (part B, chapter 3.2.10) deals with the competencies necessary for the destination management and its personnel. Very much importance is attached to language skills. The managers themselves rank “intercultural communication & foreign languages” very low, with the question they answered focusing on their individual need. Pondering the core business of the future in H&WB-destinations (chapter 3.2.11), the stakeholders think there will be a trend towards more active holidays. However, other parts of the research did not correspond with that: In part A (chart no. 4) the stakeholders did not attach that much importance to “outdoor and indoor sport”, although active holiday might not necessarily be the same as “outdoor and indoor sport”. As the consumers attach as much importance to “indoor and outdoor sport” as to “enjoying natural scenery and nature” (chart no. 20), an active holiday in the outdoors is among the highly demanded activities. Nonetheless, pampering and indulging spa procedures belong to the most important ones. An intensely debated issue in the theory of regional development is the relationship of the influence on development processes of locals or non-locals, also described with the terms endogenous and exogenous approaches in regional development. It is clear that the stakeholders want to have a balance between these two approaches (chapter 3.2.7). 47 WP 4: Research | WelDest 2012 - 2014
  48. 48. 4 Consumer research 4.1 Methodology The methodology used in the consumer research comprised the following steps: • The consumer questionnaire was developed beginning in October 2012 by the university partners. There were three feedback loops for improvement, involving all the project partners. The final version was created in May 2013. • The English questionnaire was then translated to Finnish, German, Russian, and Czech as not all interviewees were able to fill in an English questionnaire. • The questionnaire was distributed either electronically or as hardcopy with the recipients being guests or recent guests in H&WB-destinations. Email-databanks were used from DMOs or relevant companies such as hotels, thermal spring spas or medical spas. • The quantitative research: • • • Those, who filled in the questionnaire electronically, did so via link to Webropol so that the questionnaires were immediately archived in Webropol. The questionnaires of those who filled in the questionnaire in hardcopy form, were collected, re-translated into English and then fed into Webropol. Webropol itself disposes of a reporting function which creates charts transferring them to Excel which offers further tools for data processing. The qualitative research: • • • Some questions had an option to fill in comments (“others, please specify”) and those statements were collected. The next step was to analyze them according to methods in qualitative research, already described in chapter 3.1. The results presented in chapter 4.2 are based on quantitative and qualitative data. The data are ready to be analyzed further with aid of more refined methods (e.g. crossclassified tables). Some interesting results will probably be achieved if country-specific approaches, gender-specific approaches or age-specific approaches are chosen (see also chapter 5.4ff.). 48 WP 4: Research | WelDest 2012 - 2014
  49. 49. 4.2 Research results The sequence of the following sub-chapters corresponds with the sequence of the questions in the questionnaire. 4.2.1 In which country are you right now while filling in this questionnaire? Germany 204 Finland 187 United Kingdom 173 Czech Republic Austria 122 98 784 responses Chart 14: In which country the questionnaire has been filled in 4.2.2 Please write down some key words, which come into your mind if you think of a H&WB-destination There were 1638 exploitable answers from the consumers, categorized in different clusters as follows: Word-clusters (bold) and related issues Number of responses Nature Calm, clean, silence, fresh air, sun, forest, water 383 Relaxation recover, detox, recreation 374 Facilities Thermal bath, spa, sauna, gym, hotel, comfort, luxury 235 49 WP 4: Research | WelDest 2012 - 2014
  50. 50. Treatments Massage, therapies 227 Active life Exercising, hiking, doing sport, biking 196 Food Regional, organic, healthy food 118 Other friendly staff, wellbeing, services, health, wellness, certain destinations 169 altogether 1638 The associations guests have when they think of a H&WB destination seem to focus on nature, relaxation, spa facilities, its treatments, and various activities. Nature 383 Relaxation 374 Facilities 235 Treatments 227 Active life Healthy Food Other meanings 196 118 105 1638 responses Multiple answers Chart 15: What guests think of a H&WB destination The results of this chart present a quite clear image of what a H&WB destination should consist of: lovely nature with spa facilities which are altogether inviting for relaxation, treatments, and sport activities. Comparing these results with what the stakeholders think guests feel attracted by in their destination (chapter 2.2.2), some differences and similarities can be detected: 50 WP 4: Research | WelDest 2012 - 2014
  51. 51. • Stakeholders put “relaxation” into the category of “doing something for health (second bar from the top), ranking relaxation very high in the context of this question (see chart no. 4). • Both stakeholders and guests attach the utmost importance to “nature” and “natural scenery.” • “Culture” plays a bigger role for the stakeholders than for the guests. • The “reputation/image of the region” did not get any scores amongst the guests. • “Health” plays a bigger role for the stakeholders than for the guests. 4.2.3 What kind of services, staff competences and elements attract / did attract you to come to a destination like this? There were 1333 exploitable answers from the consumers categorized in different clusters as follows: Word-clusters (bold) and related issues Staff social skills, friendly, services, professional Treatments massages, variety, diversity, versatile Cleanliness hygiene, clean USP new, stunning, unique Water springs, pools, healing water Culture historic, tradition, regional originality Facilities spa, exotic, steam bath, pools, modern, hotel, swimming, renovated, facilities, wellness-area, sauna, hotel, furnishing Atmosphere decoration, calm, relaxation, peaceful, luxurious, pampering, safety, homey, rituals, hospitality, silence, recreation Sport outdoor, gym, exercise, fitness, hiking, biking, motion Communication Sales, marketing, prices, cost-performance-ratio, packages, image, services, reputation, information, web-site Food healthy, eating, variety 51 WP 4: Research | WelDest 2012 - 2014 Number of responses 208 140 32 8 80 18 169 111 87 99 76
  52. 52. 117 Nature landscape, environment, natural attractions, scenery, garden, air Accessibility not far from home, short distances within spa, transport Medical post-operative care, rehabilitation, health, doctor, healing, recuperation, healing climate Quality high quality Location peaceful, pleasant, surroundings Entertainment activities, shopping 24 59 34 44 27 1333 total Presented as chart it turns out to be as follows: Staff 208 Facilities 169 Treatments 140 Nature 117 Atmosphere 111 Communication 99 Sport 87 Water 80 Food 76 Medical 59 Location 44 Quality 34 Cleanliness 32 Entertainment 27 Accessibility 24 Culture USP 18 8 Chart 16: What attracts you to come to this destination? 52 WP 4: Research | WelDest 2012 - 2014
  53. 53. It turns out that factors such as “staff”, “facilities”, and “treatments” are up for debate. The middle-ranking issues are “nature”, “atmosphere”, “sales”, “sport”, “water”, “food”, and “medical”. Comparing these results, one gets a quite holistic approach to what a H&WB destination actually consists of. The thicker the bar the more responses it got: Chart 17: The H&WB triangle 53 WP 4: Research | WelDest 2012 - 2014
  54. 54. 4.2.4 How did you come to the idea to visit this destination you are currently staying at / you have stayed at? The destination was recommended by friends 287 I read about the dest. in the internet (or other… 241 An earlier positive experience in this destination 217 The positive image of the destination 184 I wanted to try a new destination 144 I read about the destination in print media 131 I actively looked for a H&WB-dest. to spend… 93 Other, please specify 86 My health insurance sent me here 46 An advertisement of the dest.led me to book… My doctor recommended it to me 44 31 1504 responses Multiple answers Chart 18: To come to the idea to visit a destination Obviously, the word of mouth recommendation plays a very important role in making the decision to visit a H&WB destination. Digital media play important role, too. Thirdly, “an earlier positive experience in this destination” makes people come again. Traditional marketing tools such as advertisements play a far less important role. The health insurance and a recommending doctor do not play an important role, either. 54 WP 4: Research | WelDest 2012 - 2014
  55. 55. 4.2.5 What was the overall reason for you to come to this destination? To do something for his or her health 398 Natural scenery 369 Reputation / image of the destination 304 Suitable accommodation 245 Price level 123 Other reasons, please specify Culture Visiting friends and relatives 94 75 66 1674 responses Multiple answers Chart 19: The overall reason to come to this destination “Doing something for health”, “the natural scenery”, and the “image of the destination” seem to be of utmost importance with regard to the overall reasons for the guest to visit a H&WB destination. Health in general was ticked many times. Those, who “want to do something for his/her health” specified their wishes in an additional question as follows: 55 WP 4: Research | WelDest 2012 - 2014
  56. 56. Relaxation 258 Pampering spa services 174 Enjoying natural scenery and its nature 152 Outdoor and indoor sport 126 Natural healing resources 121 Clinical/medical services Other reasons 58 15 904 responses Multiple answers Chart 20: What clients want to do for their health Interestingly, “relaxation and pampering spa services” belong to those services which seem to be most important. Chapter 4.2.2 put a similar emphasis on relaxation as one of the most important things guests want to do. In a more health-oriented context as it is shown here, relaxation plays an equally important role. All these items mentioned by the respondents are aspects of health leading to a quite broad definition of what health actually is. It comprises different approaches such as relaxation, pampering spa experiences, natural healing resources, sport, and the natural scenery. Thus, health in a health & wellbeing destination is much more than only clinical services in a nice region. 56 WP 4: Research | WelDest 2012 - 2014
  57. 57. 4.2.6 Which services, activities, and elements do you value the most in this destination? Diverse beauty and pampering treatments 364 Attractive environment 305 Diverse sauna, pool and steam bathing… 214 Hiking, nordic walking and similar outdoor… 204 Comfortable accommodation 170 Curative treatments 164 Healthy food 133 Professionally skilled staff 113 Fitness activities 110 Preventative services 78 Services for mind and soul (e.g. retreat) 77 Diverse entertainment and cultural services Other 50 38 2020 responses Multiple answers Chart 21: The most valued services and activities According to some other charts, spa services (“diverse sauna, pools and steam bathing facilities”) and an “attractive environment” seem to be the most important role with regard to the destination’s services. The guests like to do “diverse beauty and pampering”, “outdoor sports” in an “attractive environment” accompanied by various spa services. 57 WP 4: Research | WelDest 2012 - 2014
  58. 58. 4.2.7 Which of the following options best describe your needs when choosing a health and well-being holiday? To escape the pressures of everyday life 495 To get mentally refreshed 462 To spend time with family/friends 265 To improve my physical condition 241 To experience something new 154 To learn new things about my health and… 130 To recover/recuperate from an illness 80 To improve my appearance/beauty 74 Other 38 To find new social relations 33 1972 responses Multiple answers Chart 22: Needs when choosing a well-being holiday This chart deals with needs of guests who choose a H&WB destination. It reveals that the majority wants to escape from the burdens of daily life in order to reduce mental stress and relax. This is another confirmation of points made earlier. The third most important bar (“to spend time with family/friends”) is consistent with this, as a good time with friends and family members may contribute to an inner harmony and peace. 58 WP 4: Research | WelDest 2012 - 2014
  59. 59. 4.2.8 To which extent does/did the destination as a whole meet your expectations regarding the health and well-being related offering during your stay? Meets/Met my needs well 467 Meets/ Met my needs extremely well 204 Meets/ Met my needs to some extent Doesn’t meet my needs/ Did not meet my needs 92 11 774 responses Multiple answers Chart 23: Meeting the expectation of the clients This chart reveals a quite high satisfaction with the destination, whereas “extremely well” received much fewer responses. Therefore, potential for further development can be taken from this chart. If the respondents ticked “did not meet/met my needs” they could proceed to an open question, the results of which are as follows: There were 1638 exploitable answers from the consumers categorized in different clusters as follows: No. Word-clusters …and related aspects 1 Treatments need more, lack of certain treatments, lack of privacy, more flexibility, more medical 2 Staff more active, guidance of exercise, more educated, more personal touch 3 Destination only spa in the region, landscape not nice, routes not marked out, no shopping, not calm enough, too many unpleasant tourists, rush time 4 Prices too high 59 WP 4: Research | WelDest 2012 - 2014
  60. 60. 5 Facilities in general too big, too old, bad playground, not warm enough 6 Activities more, certain kinds of sport, more for kids 7 Spa not enough relaxation area, too small, not calm, more facilities 8 Food buffet, bad quality 9 Hygiene bad 10 Service in general could not change room, should be better, more complementary services 11 Entertainment more 12 Location bad, more life in downtown 13 Duration of stay wants to stay longer 14 Communication false information in brochure, guest misunderstood hotel target group 15 Travel conditions e.g. lacking travel companion 16 Accommodation bad quality This table reveals some aspects which count for the destination as a whole. Especially row 3, but also rows 6, 12, and 14 can be taken as information on how to develop a destination. 60 WP 4: Research | WelDest 2012 - 2014
  61. 61. The chart below calculates the number of responses together: Treatments (need more, lack of certain t., lack of privacy, more flexibility, more medical) 11 Staff (more active, guidance of exercise, more ecucated, more personal touch) 8 Destination (only spa in the region, landscape not nice, routes not marked out, no shopping,… 7 Prices (too high) 6 Facilities in general (too big, too old, bad playground, not warm enough) 4 Activities (more, certain kinds of sport, more for kids) 4 Spa (not enough relaxation area, too small, not calm, more facilities) 4 Food (buffet, bad quality) 3 Hygiene (bad) 3 Service in general (could not change room, should be better, more complementary… 3 Entertainment (more) 3 Location (bad, more life in downtown) 2 Duration of stay (wants to stay longer) 2 Communication (false information in brochure, guest misunderstood hotel target group) 2 Travel conditions (lacking travel companion) 1 Accommodation (bad quality) 1 Chart 24: Causes of disappointment with the chosen destination Depending on the way the categorization has been done, “treatments” and “staff” seem to be the most important issues, with the destination in general coming directly behind. What can be learned from this chart is that the guests’ perception of their journey very much depends on what happens in their place to stay (hotel or similar). There are not so many issues concerning the destination in general. 61 WP 4: Research | WelDest 2012 - 2014
  62. 62. 4.2.9 How would you score the destination’s services in general? 5068 responses 1 tick in each row Meets / Met my needs extremely well Meets / Met my needs well Meets / Met my needs to some extent Doesn’t meet my needs / Did not meet my needs Linear (Meets / Met my needs extremely well) Services with respect to my accommodation Services with respect to food & beverage Services with regard to wellbeing, relaxation, and pampering Services concerning booking and reservation Services concerning information services during my holiday (e.g. guest relations in hotel) Services concerning information services before I started my holiday (e.g. internet) Services with respect to health promotion and medical issues 286 10 89 270 17 101 269 13 78 259 14 79 208 13 108 156 13 19 110 149 128 338 370 380 378 395 423 395 Chart 25: Scoring the destination’s services This question calls attention to indoor services of the destination’s facilities. With respect to the violet bars (“met my needs extremely well”), it turns out that the classic hotel services such as accommodation and F&B come first, followed by spa-services, and at the end medical services. The chart below adds the scores from “meets my needs well” and „meets my needs extremely well“ from the previous, leading to a modified analysis: 62 WP 4: Research | WelDest 2012 - 2014
  63. 63. well and extremely well Services with regard to wellbeing, relaxation, and pampering 649 Services with respect to food & beverage 640 Services concerning booking and reservation 637 Services with respect to my accommodation 624 Services concerning information services during my holiday (e.g. guest relations in hotel) 603 Services concerning information services before I started my holiday (e.g. internet) Services with respect to health promotion and medical issues 579 544 4276 responses 1 tick in each row Chart 26: Which services are scored both „well“ and „extremely well“ with regard to the destination’s services in general As opposed to the previous chart, spa-services turn out to be appreciated most. Medical services get much less appreciation than other services. 63 WP 4: Research | WelDest 2012 - 2014
  64. 64. 4.2.10 To which extent were/are you able to use the variety of services offered in the H&WB-destination? I did nearly all my activities in my hotel/spa, so I didn’t use any of the destination’s offerings 249 I make useusethethe regions services regularly I make of of region’s services regularly 235 I did not have enough time to make use of the possibilities in the destination 234 I made use especially of the destination’s services to help to improve my health status 212 I didn’t have enough information about all the possibilities in the destination I would not come to this hotel/spa/clinic again if the destination would not have all these interesting possibilities 73 49 I did not find interesting services/places outside my hotel/clinic/spa 40 I did not know how to get to all the interesting services/places in the destination 39 I was unable to use interesting services/places outside my hotel/clinic/spa because of age/handicap/ lack of transportation 35 1166 responses Multiple answers Chart 27: How guests made use of services in the health and well-being destination This question wants to find out if a H&WB destination disposes of various services which were not used for different reasons. It comes out that four bars take the lead with respect to the number of respondents, with the first two ones listing some reasons which prevent people from making use of the destination’s services and the lower ones saying that clients indeed use them. Another bar (73 responses) states that due to communicative problems guests do not make use of all the services as they simply do not know about them. 64 WP 4: Research | WelDest 2012 - 2014
  65. 65. 4.2.11 How do/ did you check the influence of your current holiday on your health at the end or after the stay? I don’t check/ I didn’t check 441 I am not interested / I wasn’t interested 143 I am / was interested in checking this, but there are limiting factors (no time, too expensive etc.) 118 I will have a check done by a specialist at the end of the stay 78 I don’t know / didn’t know where to do this 74 I will have a check done by a specialist upon return home 57 911 respondents Chart 28: Check of the health status How to read the chart: 57 respondents state that they will check the influence of the current holiday upon return home Obviously, the majority is not really interested in checking the influence of the current holiday on the health, although the number of those who show an interest is not that low. 65 WP 4: Research | WelDest 2012 - 2014

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