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Utilizing the theoretical foundation of the stimulus-organism-response framework, the present work developed and investigated a conceptual model. The work explores the effects of perceived risk of COVID-19 on tourists' choice hesitation and choice confidence. Furthermore, it examines the impacts of choice hesitation and choice confidence on psychological distress, which, in turn, influences purchase intentions and risk-protective behavior. Additionally, the study assesses the boundary effects of vulnerability on the association between choice hesitation, choice confidence, and psychological distress.

An online survey was administered in China during COVID-19 to assess the postulated hypotheses. We collected 491 responses using purposive sampling, and covariance-based structural equation modeling (CB-SEM) was performed to investigate the relationships.

Results show that the perceived risk of COVID-19 positively influences the choice hesitation and negatively impact choice confidence. It was also found that choice hesitation and choice confidence positively developed psychological distress, which, in turn, negatively triggered purchase intentions and positively developed risk-protective behavior. Additionally, perceived vulnerability had a significant moderating impact on the proposed relationships, strengthening psychological distress.

In the current context, this study measures bipolar behavioral outcomes using the S-O-R model. Because cognitive processes influence participation in health preventative behavior during the spread of diseases, we highlighted how the perception of risk and vulnerability to a pandemic serves as a reliable indicator of certain behaviors. This study advances understanding of how the psychological mindset of tourists copes with such circumstances. Due to the pandemic, tourists face limitations in their choices and are placing greater emphasis on adopting protective measures to mitigate associated risks.

Manufacturing capability is a crucial component of every nation’s economy and pharmaceuticals are frequently a significant part of the manufacturing sector. Pharmaceutical supply chains are essential to health-care systems, contributing to living quality and shorter hospital stays. This study aims to examine the role of multiple integrations on business performance (BP) through supply chain flexibility (SCF) and supply chain agility (SCA).

Data was collected from 198 supply chain professionals in the pharmaceutical sector of the developing economy of Pakistan. The sample was collected based on a nonprobability purposive sampling approach. A five-point Likert-scale survey was used and analyzed with the PLS-SEM technique using SmartPLS 4.

This study found that process integration (PI) does not affect SCA, whereas relationship integration and measurement integration positively affect SCA. SCA positively impacts BP. In contrast, all integrations significantly influenced supply flexibility and BP except for PI. Finally, SCF significantly mediates the relationship between all integrations and BP.

This study examined the relationships of multiple integrations on BP, directly and indirectly, through SCF and agility. The theory of dynamic capabilities has been applied and extended to increase the comprehensiveness of the findings. A developing economy’s pharmaceutical industry supply chain was examined, producing empirical evidence of the results.