Perceived health benefits and health-driven visitation intentions in tropical forests: applying the Health Belief Model to ecotourism behavior

Introduction Tropical forests under increasing pressure from land-use change, tourism expansion, and climate stress require management strategies that simultaneously support conservation objectives and sustain human-nature interactions. While ecosystem service research has extensively documented the ecological and health functions of tropical forests, limited attention has been given to how visitors cognitively perceive these functions and how such perceptions shape ecotourists’ health-driven visitation intentions. Methods Addressing this gap, this study applies the Health Belief Model (HBM) to examine how health risk appraisal, motivational evaluations, perceived barriers, and self-efficacy influence ecotourists’ perceived health benefits and their health-driven intention to visit tropical forest environments. Survey data were collected from 650 adult visitors to tropical forest destinations in Hainan Province, China, and analyzed using structural equation modeling. Results The results show that perceived susceptibility and perceived severity significantly enhance perceived health benefits, while perceived benefits exert the strongest positive influence and perceived barriers have a significant negative effect. Perceived health benefits and self-efficacy emerge as the primary predictors of visitation intention, with cues to action providing additional activation. The model explains 42.4% of the variance in perceived health benefits and 49.0% of the variance in intention to visit forests. Discussion By conceptualizing perceived health benefits as a distinct cognitive mechanism, this study extends the application of HBM to tropical forest contexts characterized by conservation pressures. The findings highlight the importance of integrating health-oriented perceptions into forest management and ecotourism strategies, so that maintaining and promoting health-motivated visitation can indirectly strengthen conservation support while sustaining human well-being in vulnerable tropical forest systems.