International Journal of Spa and Wellness, 2025 (Scopus)
This study investigates the determinants of residents’ support for health tourism development (SHTD) and the mechanisms linking them to that support. Drawing on a five-theory framework, the proposed model tests how quality of life (QL) and place identity (PI) shape a unified Perceived Tourism Impact (PTI) combining economic and sociocultural benefits and how PTI, in turn, influences support via Psychological Ownership (PO). Analysing online survey data from 381 residents of Azerbaijan’s Absheron region with partial least-squares structural equation modelling yields three main findings. (1) PTI is the strongest direct predictor of resident support. (2) The influences of PI and QL on support are transmitted chiefly through PTI and PO. (3) PO acts as a pivotal psychological bridge that transforms favourable impact perceptions into behavioural endorsement. These insights highlight that bolstering residents’ benefit perceptions and sense of communal ownership is crucial for securing sustainable community backing during the early stages of health-tourism development.