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Customer positivity and participation in services: an empirical test in a health care context

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Abstract

Many service interactions require customers to actively participate, yet customers often do not participate at levels that optimize their outcomes, particularly in health care. To gain insight into how customers shape a service experience with highly uncertain outcomes, we construct a model on the broaden-and-build theory of positive emotions. The model is used to empirically assess how situation-specific emotions and customer participation during a health care service experience affect perceptions of the service provider. The model is tested using data from 190 medical clinic customers. Consistent with theory, results reveal that as customers’ relative affect levels become more positive, levels of participation increase as well. In turn, higher levels of positivity and participation improve customer perceptions of the quality of the service provider and satisfaction with the co-produced service experience. Implications of this research focus managers on designing services to help clients manage their emotions in ways that facilitate positivity and participation and thus improve service perceptions.

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Notes

  1. We use the term affect as a global construct for feeling that may contain various emotions that are situation-specific, often intense, and may be related to specific actions. For a more complete discussion, see Bagozzi et al. (1999).

  2. A tertiary-care facility refers to a major medical facility with subspecialties that provide a full complement of services that go beyond the capabilities of community-based specialists.

References

  • Agency for Healthcare Research and Quality. (2011). The ten questions you should know. Retrieved December 12, 2011, from http://www.ahrq.gov/questions/.

  • Alexandrov, A. (2010). Characteristics of single-item measures in likert scale format. Paper presented at the American Marketing Association Summer Marketing Educators' Conference 2010, Boston, MA.

  • Amyx, D., & Bristow, D. N. (2001). An empirical investigation of customer satisfaction with health care services. Marketing Intelligence & Planning, 19(6/7), 515–525.

    Article  Google Scholar 

  • Anderson, E. W., Fornell, C., & Mazvancheryl, S. K. (2004). Customer satisfaction and shareholder value. Journal of Marketing, 68(October), 172–185.

    Article  Google Scholar 

  • Auh, S., Bell, S. J., McLeod, C. S., & Shih, E. (2007). Co-production and customer loyalty in financial services. Journal of Retailing, 83(3), 359–370.

    Article  Google Scholar 

  • Bagozzi, R. P. (1992). The self regulation of attitudes, intentions, and behavior. Social Psychology Quarterly, 55(2), 178–204.

    Article  Google Scholar 

  • Bagozzi, R. P., Gopinath, M., & Nyer, P. (1999). The role of emotions in marketing. Journal of the Academy of Marketing Science, 27(2), 184–206.

    Article  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.

    Article  Google Scholar 

  • Baumeister, R. F., Bratslavsky, E., Finkenauer, C., & Vohs, K. D. (2001). Bad is stronger than good. Review of General Psychology, 5(4), 323–370.

    Article  Google Scholar 

  • Bell, S. J., Auh, S., & Smalley, K. (2005). Customer relationship dynamics: service quality and customer loyalty in the context of varying levels of customer expertise and switching costs. Journal of the Academy of Marketing Science, 33(2), 169–183.

    Article  Google Scholar 

  • Berry, L. L., & Bendapudi, N. (2007). Healthcare: a fertile field for service research. Journal of Service Research, 10(2), 111–122.

    Article  Google Scholar 

  • Bitner, M. J., Faranda, W. T., Hubbert, A. R., & Zeithaml, V. A. (1997). Customer contributions and roles in service delivery. International Journal of Service Industry Management, 8(3), 193.

    Article  Google Scholar 

  • Bitner, M. J., Ostrom, A., & Morgan, F. N. (2008). Service blueprinting: a practical technique for service innovation. California Management Review, 50(3), 66–94.

    Article  Google Scholar 

  • Bolton, R. N. (1993). Pretesting questionnaires: content analyses of respondents' concurrent verbal protocols. Marketing Science, 12(3), 280–303.

    Article  Google Scholar 

  • Brown, T. J., & Kirmani, A. (1999). The influence of preencounter affect on satisfaction with an anxiety-provoking service encounter. Journal of Service Research, 1(4), 333–346.

    Article  Google Scholar 

  • Brown, S. W., & Swartz, T. A. (1989). A gap analysis of professional service quality. Journal of Marketing, 53(2), 92–98.

    Article  Google Scholar 

  • Cegala, D. J., Street, R. L. J., & Clinch, C. R. (2007). The impact of patient participation on physicians' information provision during a primary care medical interview. Health Communication, 21(2), 177–185.

    Article  Google Scholar 

  • Chan, K. W., Yim, C. K. B., & Lam, S. S. K. (2010). Is customer participation in value creation a double-edged sword? evidence from professional financial services across cultures. Journal of Marketing, 74(2), 48–64.

    Article  Google Scholar 

  • Chen, P. W. (2011). When optimism is unrealistic. The New York Times.

  • Claycomb, C., Lengnick-Hall, C. A., & Inks, L. W. (2001). The customer as a productive resource: a pilot study and strategic implications. Journal of Business Strategies, 18(1), 47–68.

    Google Scholar 

  • Clore, G. L., & Huntsinger, J. R. (2007). How emotions inform judgment and regulate thought. Trends in Cognitive Sciences, 11(9), 393–399.

    Article  Google Scholar 

  • Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah: Lawrence Erlbaum Associates.

    Google Scholar 

  • Collins, S., Britten, N., Ruusuvuori, J., & Thompson, A. (2007). Understanding the process of patient participation. In S. Collins, N. Britten, J. Ruusuvuori, & A. Thompson (Eds.), Patient participation in health care consultations: Qualitative perspectives (pp. 3–21). New York: Open University Press.

    Google Scholar 

  • Cronin, J. J., & Taylor, S. A. (1992a). Measuring service quality: a reexamination and extension. Journal of Marketing, 56(3), 55–68.

    Article  Google Scholar 

  • Cronin, J. J., Jr., & Taylor, S. A. (1992b). Measuring service quality: a reexamination and extension. Journal of Marketing, 56(3), 55–68.

    Article  Google Scholar 

  • Cronin, J. J., Brady, M. K., & Hult, G. T. M. (2000). Assessing the effects of quality, value and customer satisfaction on consumer behavioral intentions in service environments. Journal of Retailing, 76(2), 193–218.

    Article  Google Scholar 

  • Dabholkar, P. A. (1990). How to improve perceived service quality by increasing customer participation. In B. J. Dunlap (Ed.), Developments in marketing science (Vol. 13, pp. 483–487). Cullowhee, N.C.

  • Dagger, T. S., & Sweeney, J. C. (2006). The effect of service evaluations on behavioral intentions and quality of life. Journal of Service Research, 9(1), 3–18.

    Article  Google Scholar 

  • Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., & Sheridan, J. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.

    Article  Google Scholar 

  • Dellande, S., Gilly, M. C., & Graham, J. L. (2004). Gaining compliance and losing weight: the role of the service provider in health care services. Journal of Marketing, 68(3), 78–91.

    Article  Google Scholar 

  • Diener, E., & Diener, C. (1996). Most people are happy. Psychological Science, 7(3), 181–185.

    Article  Google Scholar 

  • Doucet, L. (2004). Service provider hostility and service quality. Academy of Management Journal, 47(5), 761.

    Article  Google Scholar 

  • Dubé, L., Bélanger, M.-C., & Trudeau, E. (1996). The role of emotions in health care satisfaction. Journal of Health Care Marketing, 16(2), 45–51.

    Google Scholar 

  • Edvardsson, B. (2005). Service quality: beyond cognitive assessment. Managing Service Quality, 15(2), 127–131.

    Article  Google Scholar 

  • Eldh, A. C., Ekman, I., & Ehnfors, M. (2006). Conditions for patient participation and non-participation in health care. Nursing Ethics, 13(5), 503–514.

    Article  Google Scholar 

  • Fallowfield, L., & Jenkins, V. (2004). Communicating sad, bad, and difficult news in medicine. Lancet, 363(9405), 312–319.

    Article  Google Scholar 

  • Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50.

    Article  Google Scholar 

  • Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology, 2(3), 300–319.

    Article  Google Scholar 

  • Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: the broaden-and-build theory of positive emotions. American Psychologist, 56(3), 218–226.

    Article  Google Scholar 

  • Fredrickson, B. L. (2003). The value of positive emotions. American Scientist, 91, 330–335.

    Google Scholar 

  • Fredrickson, B. L., & Branigan, C. (2005). Positive emotions broaden the scope of attention and thought-action repertoires. Cognition and Emotion, 19(3), 313–332.

    Article  Google Scholar 

  • Fredrickson, B. L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychological Science, 13(2), 172–175.

    Article  Google Scholar 

  • Fredrickson, B. L., & Losada, M. F. (2005). Positive affect and the complex dynamics of human flourishing. American Psychologist, 60(7), 678–686.

    Article  Google Scholar 

  • Gaur, S. S., Xu, Y., Quazi, A., & Nandi, S. (2011). Relational impact of service providers' interaction behavior in healthcare. Managing Service Quality, 21(1), 67–87.

    Article  Google Scholar 

  • Gotlieb, J. B., Grewal, D., & Brown, S. W. (1994). Consumer satisfaction and perceived quality: complementary or divergent constructs? Journal of Applied Psychology, 79(6), 875–885.

    Article  Google Scholar 

  • Gottman, J. M. (1994). What predicts divorce? The relationship between marital processes and marital outcomes. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Grönroos, C. (1983). Strategic management and marketing in the service sector. Cambridge, MA: Marketing Science Institute.

    Google Scholar 

  • Grönroos, C. (1984). A service quality model and its marketing implications. European Journal of Marketing, 18(4), 36–44.

    Article  Google Scholar 

  • Grönroos, C. (2006). Adopting a service logic for marketing. Marketing Theory, 6(3), 1–16.

    Article  Google Scholar 

  • Groth, M., Hennig-Thurau, T., & Walsh, G. (2009). Customer reactions to emotional labor: the roles of employee acting strategies and customer detection accuracy. Academy of Management Journal, 52(5), 958–974.

    Article  Google Scholar 

  • Gruca, T. S., & Rego, L. L. (2005). Customer satisfaction, cash flow and shareholder value. Journal of Marketing, 69(3), 115–130.

    Article  Google Scholar 

  • Gupta, S., & Zeithaml, V. (2006). Customer metrics and their impact on financial performance. Marketing Science, 25(6), 718–739.

    Article  Google Scholar 

  • Hausman, A. (2004). Modeling the patient-physician service encounter: improving patient outcomes. Journal of the Academy of Marketing Science, 32(4), 403–417.

    Article  Google Scholar 

  • Hibbard, J. (2009). Using systematic measurement to target consumer activation strategies. Medical Care Research and Review, 66(1), 9S–27S.

    Article  Google Scholar 

  • Homburg, C., Koschate, N., & Hoyer, W. D. (2006). The role of cognition and affect in the formation of customer satisfaction: a dynamic perspective. Journal of Marketing, 70(3), 21–31.

    Article  Google Scholar 

  • Howard, J. (2010). GROW: An Herb Garden System. Retrieved March 1, 2011, from http://designforservice.wordpress.com/health-services-innovation-interview/

  • Ilies, R., Scott, B. A., & Judge, T. A. (2006). The interactive effects of personal traits and experienced states on intraindividual patterns of citizenship behavior. Academy of Management Journal, 49(3), 561–575.

    Article  Google Scholar 

  • Isen, A. M., Daubman, K. A., & Nowicki, G. P. (1987). Positive affect facilitates creative problem solving. Journal of Personality and Social Psychology, 52(6), 1122–1131.

    Article  Google Scholar 

  • Jaworski, B. J., & Kohli, A. K. (2006). Co-creating the voice of the customer. In R. F. Lusch & S. L. Vargo (Eds.), The service-dominant logic of marketing: Dialog, debate, and directions (pp. 109–117). Armonk, NY: M.E. Sharpe.

    Google Scholar 

  • Jayanti, R. (1996). Affective responses towards service providers: implications for service encounter satisfaction. Health Marketing Quarterly, 14(1), 49–65.

    Article  Google Scholar 

  • Kelley, S. W., & Hoffman, K. D. (1997). An investigation of positive affect, prosocial behaviors and service quality. Journal of Retailing, 73(3), 407–427.

    Article  Google Scholar 

  • Kellogg, D. L., Youngdahl, W. E., & Bowen, D. E. (1997). On the relationship between customer participation and satisfaction: two frameworks. International Journal of Service Industry Management, 8(3), 206–215.

    Article  Google Scholar 

  • Knowles, P. A., Grove, S. J., & Pickett, G. M. (1999). Mood versus service quality effects on customers' responses to service organizations and service encounters. Journal of Service Research, 2(2), 187–199.

    Article  Google Scholar 

  • Lengnick-Hall, C. A. (1996). Customer contributions to quality: a different view of the customer-oriented firm. Academy of Management Review, 21(3), 791–824.

    Google Scholar 

  • Leventhal, H., Singer, R., & Jones, S. (1965). Effects of fear and specificity of recommendation upon attitudes and behavior. Journal of Personality and Social Psychology, 2(1), 20–29.

    Article  Google Scholar 

  • Levinson, W., Gorawara-Bhat, R., & Lamb, J. (2000). A study of patient clues and physician responses in primary care and surgical settings. Journal of the American Medical Association, 284(8), 1021–1027.

    Article  Google Scholar 

  • Lindell, M. K., & Brandt, C. J. (2000). Climate quality and climate consensus as mediators of the relationship between organizational antecedents and outcomes. Journal of Applied Psychology, 85(3), 331–348.

    Article  Google Scholar 

  • Lindell, M. K., & Whitney, D. J. (2001). Accounting for common method variance in cross-sectional research designs. Journal of Applied Psychology, 86(1), 114–121.

    Article  Google Scholar 

  • Locke, K. (1996). A funny thing happened! the management of consumer emotions in service encounters. Organization Science, 7(1), 40–59.

    Article  Google Scholar 

  • Longtin, Y., Sax, H., Leape, L., Sheridan, S. E., Donaldson, L., & Pittet, D. (2010). Patient participation: current knowledge and applicability to patient safety. Mayo Clinic Proceedings, 85(1), 53–62.

    Article  Google Scholar 

  • Losada, M., & Heaphy, E. (2004). The role of positivity and connectivity in the performance of business teams: a nonlinear dynamics model. American Behavioral Scientist, 47(6), 740–765.

    Article  Google Scholar 

  • Lytle, R. S., & Mokwa, M. P. (1992). Evaluating health care quality: the moderating role of outcomes. Journal of Health Care Marketing, 12(1), 4–14.

    Google Scholar 

  • Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: does happiness lead to success? Psychological Bulletin, 131(6), 803–855.

    Article  Google Scholar 

  • Mathieu, J. E., & Taylor, S. R. (2006). Clarifying conditions and decision points for mediational type inferences in organizational behavior. Journal of Organizational Behavior, 27(8), 1031–1056.

    Article  Google Scholar 

  • Mathieu, J. E., DeShon, R. P., & Bergh, D. D. (2008). Mediational inferences in organizational research: then, now and beyond. Organizational Research Methods, 11(2), 203–223.

    Article  Google Scholar 

  • Mattila, A. S., & Enz, C. A. (2002). The role of emotions in service encounters. Journal of Service Research, 4(4), 268–277.

    Article  Google Scholar 

  • Meuter, M. L., Bitner, M. J., Ostrom, A. L., & Brown, S. W. (2005). Choosing among alternative service delivery modes: an investigation of customer trial of self-service technologies. Journal of Marketing, 69(2), 61–83.

    Article  Google Scholar 

  • Mills, P. K., & Morris, J. H. (1986). Clients as 'partial' employees of service organizations: role development in client participation. Academy of Management Review, 11(4), 726–735.

    Google Scholar 

  • Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York: McGraw-Hill.

    Google Scholar 

  • Odhuba, E. (2010). How to Attract Clients without Hard Selling. Retrieved February 23, 2011, from http://eriaodhuba.com/

  • Oliver, R. L. (1993). Cognitive, affective, and attribute bases of the satisfaction response. Journal of Consumer Research, 20(3), 418–430.

    Article  Google Scholar 

  • Oliver, R. L. (1994). Conceptual issues in the structural analysis of consumption emotion, satisfaction, and quality: Evidence in a service setting. Provo, UT: Paper presented at the Advances in Consumer Research.

    Google Scholar 

  • Parker-Pope, T. (2008). Doctor and patient. The New York Times: Now at Odds.

    Google Scholar 

  • Podsakoff, P. M., MacKenzie, S. B., Lee, J.-Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903.

    Article  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891.

    Article  Google Scholar 

  • Price, L. L., Arnould, E. J., & Tierney, P. (1995). Going to extremes: managing service encounters and assessing provider performance. Journal of Marketing, 59(2), 83–97.

    Article  Google Scholar 

  • Roter, D. L. (1984). Patient question asking in physician-patient interaction. Health Psychology, 3(5), 395–409.

    Article  Google Scholar 

  • Roter, D. (2000). The enduring and evolving nature of the patient-physician relationship. Patient Education and Counseling, 39(1), 5–15.

    Article  Google Scholar 

  • Salter, C. (2006). A Prescription for Innovation. Fast Company, 104, 83.

    Google Scholar 

  • Sharma, N., & Patterson, P. G. (1999). The impact of communication effectiveness and service quality on relationship commitment in consumer, professional services. Journal of Services Marketing, 13(2), 151–162.

    Article  Google Scholar 

  • Shaw, C. (2007). The DNA of customer experience: how emotions drive value. Basingstoke, UK: Palgrave Macmillan.

    Book  Google Scholar 

  • Skaggs, B. C., & Huffman, T. R. (2003). A customer interaction approach to strategy and production complexity alignment in service firms. Academy of Management Journal, 46(6), 775–786.

    Article  Google Scholar 

  • Sparta, K. (2008). Help Emotional Clients Keep Their Cool, from http://www.realtor.org/rmosales_and_marketing/salescoach/columns/0811_salescoach_emotions

  • Stone-Romero, E. F., & Rosopa, P. J. (2008). The relative validity of inferences about mediation as a function of research design characteristics. Organizational Research Methods, 11(2), 326–352.

    Article  Google Scholar 

  • Street, R. L. J., Gordon, H. S., Ward, M. M., Krupat, E., & Kravitz, R. L. (2005). Patient participation in medical consultations: why some patients are more involved than others. Medical Care, 43(10), 960–969.

    Article  Google Scholar 

  • Swartz, T. A., & Brown, S. W. (1989). Consumer and provider expectations and experiences in evaluating professional service quality. Journal of the Academy of Marketing Science, 17(2), 189–195.

    Article  Google Scholar 

  • Taylor, S. A., & Cronin, J. J. (1994). Modeling patient satisfaction and service quality. Journal of Health Care Marketing, 14(1), 34–44.

    Google Scholar 

  • Taylor, A. B., MacKinnon, D. P., & Tein, J.-Y. (2008). Tests of the three-path mediated effect. Organizational Research Methods, 11(2), 241–269.

    Article  Google Scholar 

  • Vargo, S. L., & Lusch, R. F. (2004). Evolving to a new dominant logic for marketing. Journal of Marketing, 68(1), 1–17.

    Article  Google Scholar 

  • Vinagre, M. H., & Neves, J. (2008). The influence of service quality and patients' emotions on satisfaction. International Journal of Health Care Quality Assurance, 21(1), 87–103.

    Article  Google Scholar 

  • von Nordenflycht, A. (2010). What is a professional service firm? toward a theory and taxonomy of knowledge-intensive firms. Academy of Management Review, 35(1), 155–174.

    Article  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.

    Article  Google Scholar 

  • Youngdahl, W. E., Kellogg, D. L., Nie, W., & Bowen, D. E. (2003). Revisiting customer participation in service encounters: does culture matter? Journal of Operations Management, 21(1), 109–120.

    Article  Google Scholar 

  • Zeithaml, V. A., Berry, L. L., & Parasuraman, A. (1996). The behavioral consequences of service quality. Journal of Marketing, 60(2), 31–46.

    Article  Google Scholar 

  • Zhao, X., Lynch, J. G., & Chen, Q. (2010). Reconsidering Baron and Kenny: myths and truths about mediation analysis. Journal of Consumer Research, 37(3), 197–206.

    Article  Google Scholar 

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Acknowledgment

The authors gratefully acknowledge the cooperation and financial support of a major national healthcare organization and Center for Services Leadership in the W.P. Carey School of Business at Arizona State University. We appreciate the helpful comments of Jagdip Singh and Ruth Bolton on previous versions of this article.

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Authors and Affiliations

  1. Driehaus College of Business, DePaul University, 1 East Jackson Boulevard, Chicago, IL, 60604, USA

    Andrew S. Gallan

  2. College of Business, Southern Illinois University, 1025 Lincoln Drive, Rehn 223, Carbondale, IL, 62901, USA

    Cheryl Burke Jarvis

  3. W.P. Carey School of Business, Arizona State University, P.O. Box 874106, Tempe, AZ, 85287-4106, USA

    Stephen W. Brown & Mary Jo Bitner

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  1. Andrew S. Gallan
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Correspondence to Andrew S. Gallan.

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Table 3 Measurement scales
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Gallan, A.S., Jarvis, C.B., Brown, S.W. et al. Customer positivity and participation in services: an empirical test in a health care context. J. of the Acad. Mark. Sci. 41, 338–356 (2013). https://doi.org/10.1007/s11747-012-0307-4

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