Development and Initial Validation of Healing and Therapeutic Design Indices and Scale for Measuring Health of Sub-Healthy Tourist Populations in Hot Spring Tourism

The built environment, technology, human health and well-being, and sustainable development are closely related, and human-centered therapeutic design in environmental, architectural, spatial, and landscape domains demonstrates human health promotion potential. This study examines health promotion design measurement indices and develops a scale for sub-healthy tourists in a hot spring tourism destination. Recent research mainly emphasized the development and utilization of hot spring resources and their economic benefits. It rarely provided a systematic discussion on the health-promoting impact of environmental design and evaluation criteria. Thus, this study employs the literature review method and the Delphi expert method to construct an index system and measurement scale that comprises 20 evaluation indices of physical, mental, and social health. Moreover, this study conducts a questionnaire survey to measure the physical, mental, and social health of sub-healthy tourists and non-sub-healthy tourists (observation and control groups) and the sub-healthy tourists before and after their visit to the hot spring tourism destination (pre-test group and post-test group). The scale demonstrates satisfactory reliability and validity, and the health–healing design measurement indices for the sub-healthy tourists consist of three subscales: physical, mental, and social health. The evaluation index system and measurement scale can comprehensively and effectively measure the effects of healing and therapeutic design (HTD) and can be used as reliable tools for sub-healthy tourists in hot spring tourism.