Review Reports

Comments 1: Lines 31-32: “There has been 31 a 75.6 percent decline in international passenger demand since the pandemic in 2020.” A reference is needed here.

Response 1: Thank you for pointing this out. We agree with this comment. Therefore, we have updated the reference. This change can be found – page number 1, 1^st paragraph, line 33.

Comments 2: Since the hypothesis related to Perceived severity (PS) is given before the hypothesis of Perceived barriers (PB), it would be better to replace the second and third paragraphs of section 2.2.

Response 2: Agree. We have, accordingly, revised and modified to emphasize this point.

This change can be found – page number 3, Section 2.2 ; 2^nd and 3^rd paragraph (124-139).

Comments 3: Hypothesis 4 must be rewritten to make it clear.

Response: We have revised the hypothesis.

“Hypothesis 4:  Perceptions of COVID-19 vaccine effectiveness (PVE) are positively associated with individuals' intention to travel (ITT)”

This change can be found on page 4, lines 159 and 160.

Comments 4: A figure of the research model showing the hypotheses must be drawn after the development of the hypotheses.

Response: We have added the research model.

This change can be found on page number 5, line 186.

Comments 5: In the methodology section, the authors mentioned that “the questionnaire was adopted in its original form and modified to meet the research objectives”. The questionnaire must be provided in the appendix, and the references for each question must be given.

Response: We have added the questionnaire measured items with references in Appendix I. 

This change can be found on page 11.

Comments 6: What is the predictive power of the structured model? High, moderate, or weak? More discussion is needed here.

Response 6: We have revised the discussion.

“The predictive capability of the structured model was from weak to moderate, considering the values of R², Q², and f² from Table 3. As Hair et al. (2022) indicated, an R² value of 0.25 is considered weak, 0.50 is moderate, and 0.75 is substantial. In this case, the threshold values are higher than those of this research but do not reach the substantial measure, thus depicting that the model showcases weak to moderate predictive power.

The fact that the Q² values are greater than zero confirms its predictive relevance, which means this model is not only considered explanatory but can also efficiently predict the dependent variables. Analogous to this are the f² effect sizes for predicting constructs, wherein some exert a small effect. In contrast, others exert a far greater effect, therefore providing further assurance that the model must be seen overall as moderately effective.

Nevertheless, it ensures some fair explanatory and predictive accuracy. These results imply that the psychological variables considered in this study still play a definite role in post-pandemic intention to travel, rendering the conceptual model a moderate ability to predict, with reasonable practical implications for academic and industrial relevance”

This change can be found on page number 8, line 269-282.

Comments 7: Model validation metrics are not enough. Only providing the value of chi-square represents nothing. For a perfect fit model or an acceptable model, chi-square/degree of freedom value must be less than or equal to 3 or 5, respectively. The NFI value of 0.816 is below the acceptable level. The authors must provide a reference to accept this NFI score. Furthermore, more metrics such as RMSEA, RMR, CFI, GFI, NNFI, or AGFI should be given (at least some) to prove that the structural equation model is valid.

Response: No, it is not necessary, and generally not recommended, to report fit indices like SRMR and NFI for PLS-SEM because its primary focus is on prediction and maximizing explained variance, not on exact model fit. The information is valid for Classical SEM (CB-SEM) and is inappropriate for PLS-SEM, which has different evaluation criteria centered on model performance and predictive accuracy rather than goodness-of-fit. Therefore, we’ve removed the discussion.

Comments 8: In the discussion section, the authors stated that their results are parallel to the literature (lines 235-236). Have you ever compared the “beta scores” of your study against the articles cited? Is there a difference between medical students and other surveyed people? To make it clear, assume that there exist two studies that examine effects of PR on ITT: Study 1 (b=-0.3) and study 2 (b=-0.2). You can say that PR is more important for surveyed people in study one compared to that of study 2.

Response 8: We did not compare the beta (path) coefficients with those from other studies for similarity as these values are not universal and specific to a dataset, sample, and model. However, we compare the findings with previous research to see if our results align with or diverge from existing knowledge, which can strengthen our study's contribution and interpretation. 

3. Point-by-point response to Comments and Suggestions for Authors

Comments 1: The introduction presents a concise, yet not detailed, overview of the existing state of knowledge of the field of research. It states that a lot of literature between 2020-2022 exists on the impact of the pandemic, such as changes in preventive behavior, health threat perception, and telecommuting transitions. It goes on to state that travel intention literature has explored behavioral intentions.

Response 1: We agree with this comment. Therefore, we have sought to identify the factors influencing the behavior and intention to travel among Malaysian medical students who are highly aware of health risks. “These studies (Rastegar et al., 2021; Tung & My, 2023) have improved our understanding of travel intentions by examining trust, solidarity, and electronic word of mouth. They mainly focused on media exposure and destination image influencing travel intentions. However, they have not investigated the internal psychological processes that affect individual confidence and travel intentions during times of uncertainty. However, how the cognitive appraisals and self-regulatory beliefs influence intentions in post-crisis contexts is yet to be explored.”

Explained in Section 1, Page 2, line 51-54.

Comments 2: The use of convenience sampling, while convenient, could potentially introduce the risk of selection bias. The students who volunteered to participate in the survey would perhaps have some traits or opinions that differ from non-participants. For example, students who travel more frequently or students who are more concerned about the health risks would perhaps respond more easily. This would skew the results and make them less generalizable to the medical student population at large.

Response 2: Agree. We expanded the Limitations to address this issue.

“ In addition, this study is based on convenience sampling, which may have potential for selection bias. This implies that the findings may not be fully generalizable to the broader population of Malaysian medical students. Future studies can use stratified sampling to include samples from different medical colleges in Malaysia, thereby increasing representativeness and decreasing sampling bias. “

The change can be found on page number 10, paragraph 3, and lines 371-375.

Comments 3: The study relies on self-reported data collected through a web-based survey. The method is susceptible to common method bias and social desirability bias. Participants provide answers that they believe are socially acceptable rather than their true feelings or intentions, especially when the topic is sensitive like health behavior and travel risk. This can affect the validity of the results and the accuracy of the relationships between the variables.

Response 3: To avoid response bias, we have maintained the respondents' anonymity and assured them at the beginning of the survey.

“Participants were assured of complete anonymity during data collection to reduce response bias and lessen the influence of social desirability.”

“Respondents, on average, took 12 minutes to complete this questionnaire, indicating an average level of engagement with the items. Respondents had to use their email ID, which restricted them from submitting duplicate entries. None of the participants were monetarily rewarded, a step that therefore decreased potential bias in responses that would be instigated by any offered incentive. This ensures the data quality and reliability.”

Updated in the text: Page 5, , line 190-197.

Comments 4: The medical students who chose to complete the survey may not be representative of the entire population of Malaysian medical students. For example, students who are more interested in academic research have stronger opinions about post-pandemic travel, or possess higher levels of self-efficacy may have been more inclined to respond. This creates a non-random, potentially skewed sample. The findings therefore, might not accurately reflect the travel intentions and psychological constructs of all medical students, let alone the broader general population.

Response 4: Agree. We expanded the Limitations to address this issue.

“ Despite these contributions, this study has several limitations. Several limitations of this study warrant being noted. First, the study sample contained only Malaysian medical students. While this is a target group, considering their health literacy, they may view the effectiveness of vaccination, self-efficacy, and risk perception in ways that differ systematically from most people. This limitation constrains how generally applicable the findings are, thus making it necessary for other studies to replicate this kind of study with a more diverse sample, including groups in both non-medical studies and the general traveling population.”

The change can be found on page number 9, paragraph 7, and lines 354-360.

5. Response to Comments on the Quality of English Language

Point 1: English could be improved to express the research more clearly.

Response 1: The whole manuscript is reviewed and proofread to enhance the quality of English.

Comments 1: The current title "Restoring Confidence and Assessing Travel Intentions of Medical Students during Post-Pandemic" does not seem compelling. The manuscript would be more compelling if the title truly reflects the objectives, results, and key constructs used in the Framework.

Response 1: Thank you for pointing this out, we have revised the title as:

Psychological Determinants of Travel Intention in the Post-Pandemic Era: Evidence from Malaysian Medical Students.

Comments 2: The authors assert that “the relationship of psychological construct that affects individuals' mindsets and confidence with travel intention is missing.” This statement is misleading. While the literature may be limited, it is not absent. For instance, studies such as:

1.         How COVID-19 Case Fatality Rates Have Shaped Perceptions and Travel Intention

2.         Electronic Word of Mouth, Attitude, Motivation, and Travel Intention in the Post-COVID-19 Pandemic

…offer conceptually similar insights. The authors should revise this claim and provide a more nuanced justification for the research gap.

Response 2: Agree. We have, accordingly, revised the research gap to emphasize this point.

These studies (Rastegar et al., 2021; Tung & My, 2023) have improved our understanding of travel intentions by examining trust, solidarity, and electronic word of mouth. They mainly focused on media exposure and destination image influencing travel intentions. However, they have not investigated the internal psychological processes that affect individual confidence and travel intentions during times of uncertainty. However, how the cognitive appraisals and self-regulatory beliefs influence intentions in post-crisis contexts is yet to be explored. [Updated in the manuscript]

The change is on page 2, lines 51-56.

Comment 3: The stated objective “to identify the factors that influence the behaviour and intention to fly again among the medical students of Malaysian travellers”—lacks precision. It should be reformulated to specify the constructs examined, the theoretical lens applied, and the intended contribution to the literature.

Response 3: Revised accordingly.

“Therefore, the present study framework addresses this gap by integrating core psycho-logical constructs, i.e., perceived risk, perceived severity, perceived barriers, perceived vaccination effectiveness, and self-efficacy to intention to travel. The present study approach draws attention from health behavior theories, i.e., Health Belief Model and Protection Motivation theory, to highlight how cognitive appraisals and self-regulatory beliefs influence travel intentions among the medical students of Malaysia”

The change can be found on page number 2, paragraphs 2, and lines 57-62.

Comment 4: The literature review suffers from excessive use of acronyms, many of which are unfamiliar and unnecessary. This practice impedes readability and comprehension. I strongly recommend removing or minimizing acronyms unless they are widely recognized or essential to the theoretical framework.

Response 4: Revised accordingly.

Comment 5: The discussion section lacks depth and theoretical integration. The authors should interpret the findings in light of the conceptual framework and existing literature, highlighting both consistencies and divergences.

Response 5: Reviewed and accordingly updated.

“The study’s findings affirm the hypothesized relationships between psychological constructs and intention to travel and align with the health belief model. According to this theory, health-related behaviors are influenced by individuals' perceptions of susceptibility, severity, benefits, and self-efficacy. The negative association of perceived risk and perceived severity validates the model since increased perceptions of health threats and travel uncertainties dominate the travel intentions, which is consistent with prior research (e.g., Huang et al., 2023; Das & Tiwari, 2021; Golets et al., 2021).”

The change can be found on page number 9, paragraphs 2, and lines 311-317

Comment 5: The use of cross-sectional data from medical students requires clearer justification. Why this demographic group was selected, and how their travel intentions may differ from other populations, should be explicitly addressed.

Response: Addressed in the Introduction section. “Medical professionals have a heightened awareness of health risks. They have seen the pandemic's dangerous situation very closely and faced unique stressors during the pandemic. Therefore, mental health, burnout, and emotional well-being may influence their travel intentions.  A study of this group could offer new insights into evidence-based decision-making coping mechanisms. It provides valuable insight into consumer behavior for the decision-making of a particular group in the aviation and tourism industries during the post-pandemic period.”

Can be found on Page number 2, Paragraph 2, Line 63-68

Comment 6: The authors acknowledge the omission of age and gender as variables yet fail to justify this exclusion. Given the well-documented influence of these factors on travel intentions, their integration as covariates is not only feasible but necessary. I recommend expanding the analysis to include these variables to assess potential confounding effects and improve the robustness of the findings.

Response: The issue of age and gender is acknowledged as a limitation, and future studies have been proposed.

Can be found on Pg number 10, line 361-369.

Comments 1: By 2025, most of the fervor of fear of travel is passed. Now, there are always things to learn from crises, but the paper could make more clear what this study does for research, policy, and practice in the present and near future.

Response 1: By 2025, fears about COVID-19 travel will have diminished, but studies such as these will remain highly relevant for research, policy, and practice. Results demonstrated that psychological constructs, such as perceived travel risk, severity, barriers, vaccination effectiveness, and self-efficacy, significantly influence travelers’ intentions. These constructs are not unique; they can define traveler behavior during future public health crises or disruptions.

From a research standpoint, this study extends the HB Model into the context of post-pandemic travel and validates intention formation through risk perceptions and coping conceptualizations. From a policy standpoint, it stresses the importance of creating health communication practices that build self-efficacy and confidence while addressing perceived risks. From a practical perspective, a psychological understanding of travelers can inform marketing, communication, and service strategies within the tourism and aviation sectors to facilitate recovery and build resilience against future crises.

Can be found in the manuscript page number 2, line 71-83

Comments 2:

It would be helpful to describe some high-level results from the survey. The paper could include some summary statistics and/or tabulations of responses to the survey—both in the inputs (“constructs”) and outcomes (“intent to travel”).  What is the typical frequency of response?

Response 2:

In support of the suggested structural model, descriptive statistics on the survey responses give further insights. The respective averages for the constructs were as follows (measured on a Likert scale from 1 to 5).

The low risk and severity perception scores intuitively correspond to a high confidence mean for vaccination effectiveness and self-efficacy, which conforms to their encouraging effect on travel intention.

Exploratory correlation checks showed some interesting patterns suggestive of respondent profiles. Some participants consistently indicated high perceptions of risk and severity, accompanied by low confidence in vaccine ("worriers"), while others gave mixed responses, with moderate risk perception and high vaccine confidence and self-efficacy. This heterogeneity implies the psychological responses toward post-pandemic travel are not homogeneous but clustered as latent orientations.

Can be found in the manuscript @ page number 6, line 229-240.

Comment 3: The survey was administered online. Some basic reporting on reliability could be in order. How long did the average respondent spend? (Did they seem to actually read and consider, or just “click through”?) Was compensation offered? Could some respondents take it more than once?

Response 3: Respondents on average took 12 minutes to undertake this questionnaire, indicating an average level of engagement with the items. Respondents had to use their email ID, restricting them from submitting duplicate entries. None of the participants were monetarily rewarded, a step that therefore decreased potential bias in responses that would be instigated by any offered incentive. This ensures the data quality and reliability.

 Revised accordingly, can be found at page number 5, Line 192-197.

Comment 4: The paper is upfront about the survey being administered to medical students. That is a narrow, targeted population, but it can be useful to know in a larger body of work.  It would be helpful to make some comparison against other populations in other studies, especially in regards to how the target population compares to other populations on the “constructs.” For example, I would imagine that medical students have higher than average confidence in interventions and vaccines.

 Again on the survey—it is possible there was further selection on the type of people who took the survey compared with the rest of the medical student population.  Some descriptives and balance tests could be in order (age, race/ethnicity, family status, urban/rural residence or origin, income, etc. etc.).

Response 4:

We appreciate the reviewer’s valuable comments regarding the sample. We agree that surveying medical students represents a narrow, targeted population, and this is both a strength and a limitation. Medical students are a relevant group for studying psychological constructs such as vaccine confidence and perceived health risk, as they are more likely to be informed about health interventions compared to the general population. At the same time, this could lead to higher-than-average levels of confidence in vaccines and self-efficacy relative to other groups. We emphasized this point in the discussion by noting that findings should be interpreted with caution when generalizing to broader populations.

The updated manuscript can be found on Page 9, 3^rd and 4^th paragraphs, line 318 to 335.

Comment 4: Specifically, what type of air travel was asked about? Domestic or foreign? Business or pleasure? Solo or with family and friends? Do any of these other margins make a difference in the risk/return trade off the respondents are (implicitly) making? For example, one may be willing to travel solo for business but not for pleasure with family.

-Responses and attitudes can vary over time.  Are there any seasonal or cyclical factors in play? For the former, I simply mean whether there were different perceptions summer vs/ winter, rainy vs. dry season, etc. For the latter, I mean to ask whether recent events such as outbreaks or surges (on the negative side) or vaccine rollouts or reporting of results (on the positive side) could affect respondents’ perceptions.

Response: The questionnaire was designed to capture respondents’ general intention to travel by air rather than distinguishing between specific types of travel (e.g., domestic vs. international, business vs. leisure, solo vs. family). Our aim was to measure overall behavioral intention as a function of psychological constructs within the Health Belief Model framework. We acknowledge, however, that willingness to travel may vary significantly across these dimensions. For example, individuals may be more willing to travel domestically or for essential purposes (e.g., business or education) than internationally or for leisure with family. We note this limitation in the manuscript and recommend that future research disaggregate travel intentions by purpose and context to better capture heterogeneity in risk/return trade-offs.

It is also possible that respondents’ perceptions were influenced by recent events, news cycles, or evolving global narratives about pandemic recovery. We have clarified this in the manuscript and emphasized that while our cross-sectional design captures perceptions at a particular point in time, longitudinal or repeated-measure studies would be valuable to assess how travel intentions evolve with changing conditions.

 The study assessed the general intention of traveling by air without further distinguishing between domestic and international trips, business and leisure purposes, or traveling solo versus with family. Being as such, it is safe to assume that respondents weigh risks and benefits differently across these contexts; for instance, they may be more likely to travel domestically for an essential purpose than internationally for leisure with family members.

 Can be found at : Page 10, section: Limitations, paragraph 4, Line 376-380.

Comment 5: Before Table 1, I recommend a table of summary statistics from the survey itself. 

Response: Addressed in the result section.

It can be found on page number 12, Annex II.