In e na ional Jou nal o
En i onmen al Resea ch
and Public Heal h
A icle
Dimensions o Se ice Quali y in Heal h-Fi ness Clubs
in China
Ka en Kaijuan Xu 1,*, Kenny Kuanchou Chen 2, Euisoo Kim 3, Je ónimo Ga cía-Fe nández 4, John Nau igh 5
and James J. Zhang 3


Ci a ion: Xu, K.K.; Chen, K.K.; Kim,
E.; Ga cía-Fe nández, J.; Nau igh , J.;
Zhang, J.J. Dimensions o Se ice
Quali y in Heal h-Fi ness Clubs in
China. In . J. En i on. Res. Public
Heal h 2021,18, 10567. h ps://
doi.o g/10.3390/ije ph182010567
Academic Edi o : Paul B. Tchounwou
Recei ed: 23 Augus 2021
Accep ed: 7 Oc obe 2021
Published: 9 Oc obe 2021
Publishe ’s No e: MDPI s ays neu al
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Copy igh : © 2021 by he au ho s.
Licensee MDPI, Basel, Swi ze land.
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A ibu ion (CC BY) license (h ps://
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1School o Economics and Managemen , Shanghai Uni e si y o Spo , Shanghai 200438, China
2College o Spo Managemen , Na ional Taiwan Spo Uni e si y, Taoyuan 333, Taiwan;
[email p o ec ed]
3Depa men o Kinesiology, Uni e si y o Geo gia, A hens, GA 30602, USA; [email p o ec ed] (E.K.);
[email p o ec ed] (J.J.Z.)
4Resea ch G oup o Managemen and Inno a ion in Spo Se ices, Leisu e and Rec ea ion (GISDOR),
Uni e si y o Se ille, 41013 Se ille, Spain; [email p o ec ed]
5Richa d J. Bol e, S . School o Business, Moun S . Ma y’s Uni e si y, Emmi sbu g, MD 21727, USA;
[email p o ec ed]
*Co espondence: [email p o ec ed]; Tel.: +86-13788995780
Abs ac :
The pu pose o his s udy was o explo e he dimensions o se ice quali y in i ness
clubs in China and examine hei impac on cus ome sa is ac ion. In Phase I o he s udy, we
collec ed quali a i e da a om online commen s ela ed o se ice quali y in 30 Te a Wellness clubs
in Shanghai (k = 6252). Conduc ing con en analysis, we syn hesized he in o ma ion and iden i ied
p elimina y hemes and o mula ed measu emen s a emen s. Phase II implemen ed a se ies o
quan i a i e esea ch p ocedu es o examine he measu emen p ope ies o s a emen s de eloped in
Phase I. Conduc ing explo a o y ac o analysis, con i ma o y ac o analysis, and s uc u al equa ion
modeling analyses based on esponses o club membe s (N= 533), we iden i ied a o al o 27 i ems in
six dimensions: se ice eco e y, se ice assu ance, acili y unc ion, p og am ope a ion, ins uc o
quali y, and s a pe o mance. These ac o s signi ican ly (p< 0.05) p edic ed cus ome sa is ac ion
wi h i ness clubs in China. The indings highligh he impo ance o high-quali y se ice deli e y,
se ice eco e y, and se ice assu ance and pinpoin speci ic a eas o imp o emen .
Keywo ds: cus ome sa is ac ion; heal h- i ness clubs; Chinese ma ke ; se ice eco e y
1. In oduc ion
Du ing he ecen economic down u n, he Chinese go e nmen has chosen he spo
indus y as an impo an channel o boos business g ow h. Unde a new economic policy,
he i ness and leisu e indus y has gained ecogni ion as “sun- ising” indus y and ecei ed
unp eceden ed suppo om he Chinese go e nmen . Consequen ly, he numbe o heal h-
i ness en e p ises has inc eased, including co po a e i ness, i ness s udios, 24-h gyms,
and i ual i ness se ices. This as -paced de elopmen has led o some g owing pains;
o ins ance, club manage s egula ly need o e alua e club ope a ions in o de o main ain
o imp o e se ice quali y and adap o cons an ly changing business su oundings [1,2].
In he i ness indus y, cus ome e en ion emains a key ac o in success, and se ice
quali y con inues o ha e a s ong impac on ha e en ion. Se ice quali y in a i ness
club di ec ly ela es o p o i ma gin and o e all club de elopmen in a compe i i e ma -
ke place [
3
–
5
]. E ec i e managemen o se ice quali y inc eases cus ome sa is ac ion,
loyal y, and posi i e wo d-o -mou h [
6
,
7
]. Al hough se e al schola s ha e add essed he
impo ance o se ice quali y in managing i ness clubs (e.g., [
4
,
8
]), none has explo ed
i ness se ice quali y in he Chinese ma ke . P e ious indings sugges ha no single
model can measu e se ice quali y uni e sally because clien s om di e en cul u al back-
g ounds a e likely o ha e di e en expec a ions and needs [
9
,
10
]. As se ices expand
In . J. En i on. Res. Public Heal h 2021,18, 10567. h ps://doi.o g/10.3390/ije ph182010567 h ps://www.mdpi.com/jou nal/ije ph
In . J. En i on. Res. Public Heal h 2021,18, 10567 2 o 17
globally, unde s anding how o measu e se ice quali y in di e en coun ies becomes
inc easingly impo an . Due o he poli ical clima e and cul u al di e ences, Chinese
cus ome s migh ha e di e en pe cep ions and expec a ions o i ness club se ice quali y
han Wes e n cus ome s [11].
China’s apid ise o economic and poli ical powe has gene a ed a ious social
changes. Fo example, compe i ion in China’s i ness indus y has in ensi ied. Recen ly,
consume s ha e come o expec i ness clubs o be disciplined and hones and o expec
se ice eco e y and se ice assu ance [
12
,
13
]. Mo e gene ally, s udies abou se ice quali y
managemen in China ea u e desc ip i e s a is ics and all sho on eliabili y and alidi y
assessmen . Con ex ualized s udies ha a ge he dimensions o i ness club se ice quali y
and e eal a iables ha in luence i ness club ope a ions in China a e c ucial, especially in
ligh o ecen changes in Chinese economic condi ions [
12
,
14
]. Some o hese dimensions
and a iables a e likely o o e lap he ones ha a e ele an in Wes e n i ness se ings,
while o he s a e likely o di e in subs an ial ways.
The pu pose o his s udy was o explo e he dimensions o se ice quali y in China’s
i ness clubs and examine hei impac on cus ome sa is ac ion. The indings should
con ibu e o he li e a u e by e ealing a iables ha a ec e ec i e ope a ion o i ness
clubs in China. Some o hose a iables a e likely o e lec sociocul u al, poli ical, and
economic di e ences be ween China and he es o he wo ld. The indings should also
help i ness club manage s ele a e se ice quali y and be e sa is y he needs and wan s o
Chinese consume s.
2. Re iew o Li e a u e
In one o he ea lies se ice quali y s udies, Pa asu aman, Zei haml, and Be y [
15
,
16
]
p oposed 10 c i e ia o e alua ing se ice quali y: c edibili y, sa e y, accessibili y, commu-
nica ion, unde s anding o cus ome s, eliabili y, sensi i i y, abili y, and e ique e. They
ca ego ized hese c i e ia in o i e dimensions: angibili y, eliabili y, esponsi eness, assu -
ance, and empa hy. Then, using explo a o y ac o analyses o e ail o ganiza ions, hey
de eloped he SERVQUAL ins umen . In he con ex o he cu en s udy, se ice quali y
in i ness clubs has wo ypes, one based on he i e gene ic dimensions o SERVQUAL
and one ha accoun s o he unique cha ac e is ics, unc ions, ea u es, and ac i i ies o
heal h- i ness clubs [4,17,18].
Schola s ha e a gued ha SERVQUAL does no measu e he speci ic ope a ions
o a ious se ice sec o s. Heal h- i ness clubs, especially hose in China, ha e unique
ea u es. Fo example, i ness clubs sell expe iences, no goods. Pe sonalized se ice plays
a much mo e impo an ole in i ness clubs oday, gi en inc easing ma ke compe i ion
and shi ing consume demands [
19
]. Mo eo e , i ness clubs and consume s usually sign
long- e m con ac s in China, anywhe e om one o h ee yea s o li e long. Gi en his
signi ican commi men , consume s unde s andably conside as many ac o s as possible
when selec ing a club. These ac o s include, bu a e no limi ed o, dis ance o he club,
equipmen p o ided, a mosphe e, s a , and cos o con e ing o o he clubs [
4
,
12
]. The
eali y is ha wi hou an ex ao dina y eason (e.g., going ab oad, p egnancy, job change, o
acciden al inju y), i ness club consume s in China can a ely change o a di e en club [
12
].
Ano he impo an ac o when p omo ing consume loyal y is encou aging cus ome s
make an emo ional in es men in he club [20].
Cons uc s in a measu e e lec he heo e ical s uc u e o a concep , which would
be he case o se ice quali y in heal h- ela ed i ness clubs. Schola s ha e de eloped a
numbe o measu es o assess he se ice quali y o i ness clubs in a ious se ings. The
Scale o A ibu es o Fi ness Se ices (SAFS) includes 30 i ems in i e dimensions o
e alua ing se ice quali y in Canadian i ness clubs [
21
]. The Cen e o En i onmen al
and Rec ea ion Managemen -Cus ome Se ice Quali y (CERM-CSQ) model includes
ou ac o s: co e se ice, s a quali y, gene al acili ies, and seconda y se ice [
22
]. In
a ollow-up s udy, schola s condensed hese ou ac o s in o h ee: employees, co e
se ice, and seconda y se ices [
23
]. Kim and Kim [
24
] es ablished he Quali y Excellence
In . J. En i on. Res. Public Heal h 2021,18, 10567 3 o 17
o Spo Cen e s (QUESC) scale, which has 33 i ems o 11 ac o s o se ice quali y in
Ko ean spo cen e s: se ice en i onmen , se ice s a a i ude, se ice s a eliabili y,
in o ma ion p o ided, cou se i ems, pe sonalized se ice, discoun s, p ice, mood o
elaxa ion, incen i e, and con enience. Al hough he scale p o ides a wide spec um
o ea u es, i migh no be he mos e ec i e. Th ee ac o s (i.e., p ice, p i ilege, and
incen i e) con ain only one i em, and se e al o he ac o s had an in e nal consis ency
coe icien lowe han 0.70 [
25
]. These sho comings eme ged in a s udy by Papadimi iou
and Ka elio is [
26
], who applied he QUESC model in he con ex o G eek spo and i ness
clubs. Ins ead o an ele en- ac o model, he indings sugges ed a ou - ac o model, which
included ins uc o quali y, acili y unc ion, p og am ope a ion, and o he se ices. The
Scale o Se ice Quali y o Rec ea ion Spo (SSQRS) includes ou ac o s: p og am quali y,
in e ac ion quali y, ou come quali y, and physical en i onmen quali y [
27
]. SSQRS was
adop ed o assess pe cei ed se ice quali y o egula use s o gyms in public spo s cen e s
in he UK, and physical en i onmen pe spec i es (i.e., ambience and acili y unc ion) we e
ound o be he mos p edic i e o cus ome sa is ac ion, wi h equipmen being gene ally
mo e impo an han all o he aspec s (Polyako a & Ramchandani, 2020) [
28
]. Alexand is
e al. [
28
] used ca e ing, s a , wa e acili ies, accessibili y, d y acili ies, and cleanliness
ac o s o measu e se ice quali y in i ness clubs in England.
Lam e al. [
4
] es ablished he Se ice Quali y Assessmen Scale (SQAS) model, which
includes 40 i ems unde 6 dimensions o e alua ing se ice quali y in U.S. i ness clubs,
including s a quali y, cou se p ojec , d essing oom, physical en i onmen , i ness equip-
men , and child ca e a ea. The SQAS scale has been widely adop ed in a ious esea ch
in es iga ions in o se ice quali y issues in heal h- i ness clubs. Ga cía-Fe nández e al.
used acili ies, employees, and p og ams ac o s o explo e i ness cen e consume loyal y
and ound ha cus ome s in p i a e low-cos i ness cen e s pu a g ea e weigh in he
quali y o acili ies and employees and cus ome s in public i ness cen e s pu a g ea e
weigh in p og ams. The au ho s sugges ed ha i ness cen e s should conduc de ailed
analyses and moni o ing o he p o ided se ice and ake in o conside a ion cus ome
backg ound cha ac e is ics when aking manage ial ac ions o mee he needs and wan s o
cus ome s [
29
]. Acco ding o Polyako a and Mi za, one c i icism o Lam e al.’s scale is
ha i does no o e he measu emen o o e all pe cei ed se ice quali y and does no
include an in e -clien in e ac ion aspec no he ou come quali y p oposed by se e al o he
se ice quali y models [
30
]. Leon-Quismondo conduc ed an impo ance–pe o mance
analysis o i ness cen e se ices quali y while aking in o conside a ion gende and age
backg ound o club membe s. The indings show ha he le el o cong uence be ween
impo ance and pe o mance o i ness clubs was mo e e iden ly ele an o women han
men. Female membe s emphasized mo e on co e elemen s o club se ices, such as he
a ie y and equency o ac i i y p og am o e ings, pe sonal aining, quali y o i ness
equipmen , and pa icula ly p o ision o swimming pool and aqua-p og ams. Meanwhile,
olde club membe s pu g ea e emphasis on he impo ance, pe o mance, and hei con-
g uence in he a eas o cleanliness o ac i i y spaces and he sa e y o locke s han younge
membe s [
31
]. These indings illus a e ha no single model can cap u e se ice quali y
uni e sally because clien s wi h di e en cul u al backg ounds a e likely o ha e di e en
expec a ions and needs [9,10,29].
Schola s ha e e ec i ely e alua ed se ice quali y in i ness clubs in di e en coun-
ies and disco e ed ha e alua ion scales can di e subs an ially ac oss cul u es. Yu,
Zhang, Kim, and Chen [
8
] used s a , p og am, locke oom, physical acili y, and wo kou
acili y ac o s o assess se ice quali y in heal h- i ness clubs o senio consume s in Ko ea.
In China, i ness club ope a ions ha e been widely medioc e, uns anda dized, and diso ga-
nized in a ma ke wi h ex ensi e compe i ion [
12
,
14
]. Howe e , he si ua ion has begun o
change wi h he ecen policies implemen ed by he cen al go e nmen . Con empo a y
Chinese i ness consume s a e be e in o med and ha e highe expec a ions; inc easingly,
hey desi e be e and mo e s anda dized se ices om heal h- i ness clubs [
30
]. Build-
ing on p e ious indings, we explo ed he ollowing hemes o examine se ice quali y
In . J. En i on. Res. Public Heal h 2021,18, 10567 4 o 17
in i ness clubs in China: se ice assu ance, se ice eco e y, acili y unc ion, p og am
ope a ion, ins uc o quali y, and s a pe o mance.
2.1. Se ice Assu ance
The e m “se ice assu ance” e e s o he e hical bo om line and code o conduc
ollowed by clubs o minimize consume doub s and isks du ing business ac i i ies. In
China’s i ness indus y, consume s now expec clubs o de elop s anda dized and hones
p ac ices; hey wan psychological assu ance and p ice assu ance. Rega ding psychological
assu ance, consume s o en ha e o sign a con ac ha demands a pe sonal commi men ,
bu no any commi men on he pa o he i ness club. Mo eo e , consume in o ma-
ion con iden iali y has become an impo an indica o o se ice quali y due o social
media de elopmen . Psychological assu ance also includes commi men o he consume s
and ollow-up ea men when employees lea e and uncon ollable changes occu . The
abili y o make cus ome s us ha i ness clubs ha e he means and he compe ence
o deal wi h p oblems is a key pa o psychological assu ance. P ice anspa ency is
also c i ical o psychological balance. Unce ain y abou p ice anspa ency, p ocedu al
ees (e.g., eplenishmen , ca d suspension, and membe ship cancella ion), and easonable
a es ha e inc eased he pe cei ed isk o losing money. Today, i ness club p ices a e
la gely open and anspa en , and hones ope a ion has become a consume demand o
cu ency secu i y [30,31].
2.2. Se ice Reco e y
The e m “se ice eco e y” e e s o he p ocess by which i ness clubs ake ac ion o
make up o losses incu ed h ough se ice mis akes in o de o egain consume us .
Se ice eco e y managemen is a p ocess o inding disc epancies and is an impo an
sou ce o in o ma ion ha clubs use o imp o e se ice quali y. Wi h he su ge in con-
sume awa eness o sel -p o ec ion and igh s p o ec ion, consume s expec clubs o ake
“eme gency measu es”, which exceed he s anda ds o no mal se ice. When a club does
no ul ill i s se ice pledge o p ope ly esol e a cus ome complain , a se ice e o
occu s [
12
,
32
,
33
]. Da idow [
34
] ound ha he speed o handling o cus ome complain s
posi i ely in luenced wo d-o -mou h communica ion by cus ome s. Thus, whe he a club
can quickly implemen se ice co ec ion di ec ly a ec s pe cei ed se ice eco e y.
2.3. Facili y Func ion
The e m “ acili y unc ion” e e s o he wo king condi ion o he main acili ies and
equipmen ha consume s use du ing wo kou s. High-quali y equipmen and suppo ing
acili ies a ac new membe s, and subsequen main enance is key o inc easing membe
sa is ac ion. Fi s , quan i y and pe o mance o new and old equipmen encou age con-
sume s o join speci ic clubs. In addi ion, consume obse a ions and commen s indica e
ha pos -main enance and epai o acili ies and equipmen ha e caused widesp ead
conce n in consume s [4,17,35].
2.4. P og am Ope a ion
Fi ness club aine s o e wo ypes o p og ams: g oup and indi idual. Consume
judgmen s o p og am quali y depend on cu iculum se ing and se ice deli e y. The
a ie y o p og ams and he no el y o p og am con en a ac consume a en ion. The
quali y-o -se ice p og ams ela e o he popula i y and e ec i eness o i ness clubs.
In addi ion, i ness clubs ace inc easing compe i ion om apidly expanding bou ique
i ness s udios and he eme gence o ailo -made cou ses on he In e ne . Con enien
scheduling and con ol o e cou se ime, place, and a endance ha e become p ima y
conce ns o consume s [17,36].
In . J. En i on. Res. Public Heal h 2021,18, 10567 5 o 17
2.5. Ins uc o Quali y
Pe sonal aine s p o ide he mos di ec and equen se ice o consume s. Mo e
and mo e clubs use pe sonal educa ion p og ams as special se ices o inc ease hei
compe i i eness. These p og ams a ac membe s who seek pain elie , imp o ed pos u e,
ehabili a ion, die a y suppo , enhanced i ness, and highe men al capaci y h ough
speci ic exe cise. Membe s hi e pe sonal coaches and ha e he eedom o choose om a
wide a ie y o pe sonali ies, eaching me hods, and p o essional skills. O chie impo ance
o consume s a e p o essional skills, he abili y o build i ness con idence and main ain
in e es , pe sonali y, and deg ee o se iousness [4,21,36].
2.6. S a Pe o mance
Gene al s a include he on desk and sales s a who make up i ness club pay olls.
In oday’s ma ke , consume s pay an inc easing amoun o a en ion o he p o ec ion o
hei sel -in e es s. Fo his eason, s a should conduc sales p omo ions (e.g., elephone,
WeCha ) in ways ha nei he disgus no dis up consume s om hei no mal i ness
ou ines and daily wo k schedule. Fi ness clubs should also conside o e ing he same
se ices o new and exis ing membe s (e.g., g oup pu chase, access o p og ams). In
addi ion, mos consume s expec o es ablish a long- e m ela ionship wi h hei club o
choice, so employee hones y and eliabili y will di ec ly a ec pe cei ed c edibili y o he
en i e club [32,37].
3. Me hod
We used a mul i-me hod and mul i-s age design, which is consis en wi h a psycho-
me ic app oach [
38
]. In Phase I, we de eloped scale i ems designed o map he concep ual
p ope ies o se ice quali y and iden i ied i ems ha would indica e se ice quali y in
China’s i ness clubs and ha e accep able eliabili y. In Phase II, we s a is ically es ed
and con i med he ollowing: (a) measu emen a iables ep esen ing he se ice quali y
cons uc , (b) con e gen and disc iminan alidi y o he se ice quali y dimensions, and
(c) he concu en alidi y and eliabili y o he se ice quali y measu e.
When designing he in es iga ion p ocedu es o he cu en s udy, we ook in o
conside a ion ha due o he ising o social media ne wo ks, many consume s would
like exp ess opinions ia online o ums, ins ead o going o exp ess opinions di ec ly o
he company in ol ed [
39
]. Whe eas social ne wo ks can be used as an e ec i e channel
o ma ke ing hei p oduc s and se ices by o ganiza ions, hey can also be used as he
in o ma ion sou ce o hi d-pa y e alua ions and e en complain s as he ne wo ks help
p o ide a pla o m o people o eely ell abou hei expe iences, exp ess hei e alua-
i e opinions, and communica e wi h hei iends and e en communi y connec ions a
la ge [
40
]. Today, inc easingly mo e go e nmen agencies, local au ho i ies, and manage s
in o ganiza ions u ilize in o ma ion gene a ed om social ne wo k communica ions in
hei decision making [
41
]. I is belie ed ha ga he ing he de ails o social ne wo ks com-
men s and use hem o help make imp o emen in p oduc deli e y and se ice p o ision
can help imp o e consume s’ sa is ac ions and in u n in luence he o e all success o
en e p ises [
42
]. Fo example, by analyzing online commen s, Li assessed ou is sa is-
ac ions abou he e aco a wa io s scenic spo in Xi’an [
43
]. To s udy ho el consume
sa is ac ion, Xiong and Xu analyzed social ne wo k commen s o ho el clien s h ough
conduc ed con en analyses, which led o he o mula ion o a widely-adop ed e alua ion
index sys em o ho el se ices [44].
3.1. Phase I
Sample and Da a Collec ion. The heal h- i ness club is a p o i -making o ganiza ion
ha p o ide high-quali y p oduc s, o e sa is ac o y cus ome se ices, and mee cus ome -
cen ic goals [
45
]. The pu pose o Phase I s udy was o explo e he p elimina y dimensions
o se ice quali y in China’s i ness clubs.

In . J. En i on. Res. Public Heal h 2021,18, 10567 6 o 17
Con en analysis o e iews on Dazhong Dianping, a Chinese e sion o Yelp, helped
us de e mine how Chinese cus ome s e alua e se ice quali y in i ness clubs. Acco ding
o he Shanghai Spo s Bu eau websi e, he e a e 564 i ness clubs in Shanghai, including
225 independen ly ope a ed acili ies and 11 anchises. As anchise b ands ha e egional
sys ema ic ope a ion me hods, we selec ed anchise b ands ha (a) ope a e mo e han
h ee i ness clubs in Shanghai and (b) had a leas 50 e iews in Dazhong Dianping. We
iden i ied 152 i ness clubs ha sa is ied hose c i e ia (see Table 1). We hen collec ed
commen s pos ed on Dazhong Dianping abou hese 152 i ness clubs be ween o e a
pe iod o wo yea s. The inal sample included 6252 cus ome commen s.
Table 1. Su ey Samples in Dazhong Dianping in China.
Samples Name To al Numbe o
Fi ness Clubs
Selec ed Numbe o Fi ness
Clubs in This S udy
Selec ed Numbe
o Re iews
Sample 1 3 3 74
Sample 2 8 8 357
Sample 3 39 21 607
Sample 4 3 3 140
Sample 5 5 5 151
Sample 6 10 8 1492
Sample 7 7 6 253
Sample 8 34 29 1460
Sample 9 16 16 318
Sample 10 5 5 175
Sample 11 58 48 1225
To al 188 152 6252
Coding P ocess. Using ea lie pos ed commen s, wo code s iden i ied hemes, sha ed
coding esul s, discussed ca ego ies, esol ed con lic s, and decided on six hemes ha
we e consis en wi h exis ing heo y and e minology: se ice eco e y, se ice assu ance,
acili y unc ion, p og am ope a ion, ins uc o quali y, and s a pe o mance [
4
,
21
,
22
]. To
imp o e con en alidi y, we had an expe panel examine he ele ance, ep esen a i eness,
and cla i y o each heme. We asked i e spo managemen p o esso s who we e egula
i ness cus ome s o examine independen ly each heme. Based on a s anda d o 80%
ag eemen among he panel membe s, we e ained all o he hemes (see Table 1).
We i s conduc ed open-coding analysis using N i o 12. As each e iew ypically
con ained mo e han one heme, he code s eely assigned each e iew in o mul iple
ca ego ies when deemed necessa y. Fo example, he ollowing commen con ained h ee
di e en hemes: “ he a ic is so bad, he e is only he 946 bus line; he bus comes e e y
20 min,
he a ea is e y small, he club is on he g ound loo , and he ai is so bad”. Coding
yielded 13,369 hema ic agmen s, which we hen ca ego ized in o di e en i ems. Fo
ins ance, he example i in o h ee i ems: “ a ic”, “a ea”, and “ en ila ion”. Consequen ly,
we ca ego ized all 13,369 agmen s in o di e en i ems, and decisions abou i em e en ion
depended on equency. We conduc ed a well-planned aining session o make su e
ha he code s ully unde s ood he codebook. Each code andomly coded 600 e iews
(i.e., 10% o he o al sample). K ippendo ’s Alpha, which we used o es in e -code
eliabili y, anged om 0.88 o 1.00. The inal in e a e eliabili y ial me he c i e ia o
80% ag eemen and 0.70 kappa o mu ually exclusi e i ems. We conduc ed desc ip i e
s a is ical analyses using SPSS Ve sion 23 and epo ed equencies and pe cen ages o
all ca ego ies.
3.2. Phase II
Sample and Da a Collec ion. The pu pose o Phase II was o con i m and measu e
he dimensions o se ice quali y by using he ca ego ies and hemes de i ed om Phase
I. Th ough a su ey s udy, we conduc ed quan i a i e analyses o de e mine cons uc
eliabili y and alidi y o he scale and o assess he impac o he dimensions on cus ome
sa is ac ion. A e app o al om he Independen E hics Commi ee a he uni e si y, we
collec ed da a om 30 andomly selec ed Te a Wellness clubs in Shanghai. Te a Wellness is
In . J. En i on. Res. Public Heal h 2021,18, 10567 7 o 17
he mos well-known and bigges i ness anchise b and loca ed in he a ious dis ic s o
Shanghai, wi h cumula i e se ice o mo e han 1.0 million membe s and o e
50,000 ac i e
membe s a day. The o al numbe o Te a Wellness clubs was 58 in 2015, accoun ing o
25.7% o ha anchise i ness clubs in Shanghai. As a pa o he chain o clubs, hese
anchises a e sp ead ou h oughou he ci y o Shanghai, in esiden ial a eas wi h di e en
housing p ices and esiden s o di e se income le els.
A e communica ing wi h he CEO o Te a Wellness abou he pu pose o he s udy,
we ob ained pe mission o conduc he s udy om he CEO and om each o he b anches.
Wi h he assis ance om Te a Wellness, en ained esea ch assis an s dis ibu ed he
su ey o m o e e y en h pe son en e ing he i ness clubs be ween July and Sep embe
o 2015. Responden s i s ead in o med consen o ms, which p omised anonymi y and
he igh o e use o pa icipa e. This p ocess made su e ha pa icipa ion was olun a y.
While a o al o 600 indi iduals ag eed o pa icipa e in he s udy, only 533 comple ed he
su ey o m, ep esen ing a e u n a e o 88.8%. O he 533 esponden s, 246 (46.2%) we e
men, and 287 (53.8%) we e women. A majo i y (89.83%) had a leas a Bachelo ’s deg ee,
and he sample showed equal dis ibu ion ac oss ou age anges: 19–25, 26–35, 36–45, and
46–55. O e hal o hem ea ned mo e han 10,000 yuan/mon h (52.7%). Mos o hem
exe cised 1–3 imes a week (62.0%), and 56.5% had been a club membe o 1–3 yea s, while
31.5% had been a club membe o mo e han 3 yea s (see Table 2).
Table 2. Sociodemog aphic Cha ac e is ics o Resea ch Pa icipan s (N= 533).
Va iable Ca ego y n%
Gende Male 249 46.8
Female 284 53.2
Academic Senio high school/ oca ional school/ echnical
school and below 49 9.1
Unde g adua e Educa ion 380 71.3
G adua e Deg ee 104 19.6
Ca ee Tempo a ily unemployed (including s uden s;
s ay-a -home; e i ed) 89 16.7
F eelance (including sel -employed) 100 18.7
Employees o en e p ises and public ins i u ions 255 47.9
Managemen o en e p ises and ins i u ions 89 16.7
Age 18 yea s o younge 14 2.6
19 o 25 yea s old 115 21.6
26 o 35 yea s old 270 50.7
36 o 45 yea s old 78 14.6
46 o 55 yea s old 40 7.5
56 yea s o olde 16 3
Mon hly income
6000 yuans o less 125 23.5
6001 o 8000 yuans 115 21.6
8001 o 12,000 yuans 115 21.6
12,001 o 15,000 yuans 48 9.0
15,001 o 30,000 yuan 84 15.8
Mo e han 30,000 yuans 46 8.6
Measu emen . We con e ed he ca ego ies, hemes, and s a emen s ob ained in
Phase I in o he p elimina y Scale o Fi ness-Club Se ice (SFCS) ha con ained 40 su ey
i ems o assess he se ice quali y ac o s. To es con en alidi y, we asked i e spo
managemen p o esso s specialized in i ness ope a ion o examine he ele ance, ep e-
sen a i eness, and cla i y o each i em. Based on a s anda d o 80% ag eemen among he
panel membe s [
46
], we e ained all o he i ems, al hough we e ised nume ous i ems o
cla i y. To e i y concu en alidi y [
38
,
47
], we examined he se ice quali y scale using
an es ablished se ice- ela ed ou come a iable: sa is ac ion [
28
,
48
,
49
]. We used he well-
accep ed h ee-i em sa is ac ion scale de eloped by Mano and Oli e [
50
]. The inal su ey
con ained
40 i ems:
(a) se ice eco e y (7 i ems), (b) se ice assu ance
(8 i ems), (c) acili y
unc ion
(4 i ems),
(d) p og am ope a ion (4 i ems), (e) ins uc o quali y (4 i ems), ( ) s a
pe o mance (5 i ems), (g) sa is ac ion (6 i ems), and (h) demog aphic in o ma ion (5 i ems).
We measu ed all i ems on a 5-poin Like - ype scale (1 = s ongly disag ee; 5 = s ongly
In . J. En i on. Res. Public Heal h 2021,18, 10567 8 o 17
ag ee) and used mean alues o each a iable. The ques ionnai e was o iginally in English,
so we had wo Chinese-English bilingual schola s ansla e he 42 i ems om English o
Manda in o he esponden s li ing in Shanghai. The i s au ho hen ansla ed he
Chinese ques ionnai es in o English, yielding some mino wo d changes.
Da a Analyses. We andomly spli he sample in o wo sub-samples (266 esponden s
o explo a o y ac o analysis [EFA], 265 o con i ma o y ac o analysis [CFA]). We
de ec ed no missing da a. Fi s , EFA using 40 i ems de e mined he eliabili y and alidi y
o he se ice quali y scale. We implemen ed p incipal componen analysis wi h a imax
o a ion. CFA using 265 samples and AMOS 23 u he alida ed he la en s uc u e.
S uc u al equa ion modeling (SEM) es ablished ha he six ac o s o se ice quali y had
an impac on sa is ac ion. We used a numbe o goodness-o - i s a is ics o e alua e he
measu emen model: chi-squa ed o he deg ees o eedom a io (1 <
χ2
/d < 3), oo mean
squa e e o o app oxima ion (RMSEA < 0.08), and compa a i e i index (CFI > 0.90) [
51
].
Fu he mo e, o e i y concu en alidi y, we ollowed a wo-s ep p ocedu e using AMOS
23 o all 533 samples. CFA indica ed ha he measu emen model was su icien .
4. Resul s
We pe o med a equency analysis o cus ome e iews o igu e ou he main ca -
ego ies o se ice quali y in i ness clubs. As shown in Table 3, he wo mos popula
ca ego ies we e acili y unc ion (23.16%) and s a pe o mance (22.07%), which we e
oughly equi alen . Rega ding acili y unc ion, 10.81% o he e iews conce ned “pe o -
mance o equipmen ”, indica ing ha cus ome s ca ed abou equipmen quali y he mos ,
and 7.12% conce ned “suppo ing acili ies in good condi ion”. Rega ding s a pe o -
mance, 9.84% o he e iews conce ned “ espec membe s’ needs”, and 8.75% conce ned
“mode a e p omo ion”. Following acili y unc ion and s a pe o mance, a ound 18.03%
e iews men ioned ins uc o quali y. Se ice assu ance (15.86%) ga ne ed sligh ly mo e
esponses han se ice eco e y (12.43%), co obo a ing ou sugges ion ha hese wo new
ca ego ies a e impo an se ice quali y measu es o China’s i ness clubs. Rega ding
se ice assu ance, 3.27% epo ed “con iden ial in o ma ion”, and 2.19% epo ed “p ac-
ice e bal p omise”. Rega ding se ice eco e y, 3.37% epo ed “sol e p oblems wi hin
p omised ime”, and 1.86% epo ed “skill o handle complain ”. P og am ope a ion was
he leas men ioned ca ego y (8.46%). Table 3p esen s he dis ibu ion o ca ego ies and
he hemes in each ca ego y.
To iden i y SFCS dimensions o se ice quali y in i ness clubs in China, we i s
conduc ed EFA using 32 i ems om Phase I, u ilizing p incipal componen analysis and
VARIMAX o a ion. We ound a i e- ac o solu ion explaining 75.26% o he a iance. We
adop ed wo me ics o de e mine ac o e en ion and he espec i e i ems: (a) ac o s wi h
an eigen alue g ea e han o equal o 1.0 and (b) i ems wi h a ac o loade g ea e han o
equal o 0.40. The esul s e ealed an eigh - ac o solu ion explaining 67.45% o he a iance.
We emo ed i e i ems wi h c oss-loadings on mo e han one ac o [
47
]. A e wa d,
analysis e ealed 27 i ems in six dimensions, wi h 66.6% o he a iance explained: Se ice
Reco e y (7 i ems), Se ice Assu ance (6 i ems), Facili y Func ion (4 i ems), P og am
Ope a ion (4 i ems), Ins uc o Quali y (4 i ems), and S a Pe o mance (3 i ems). The
second EFA achie ed a mo e pa simonious scale. We named he six dimensions based on
he con en o he i ems wi hin each one (see Table 4).
In . J. En i on. Res. Public Heal h 2021,18, 10567 9 o 17
Table 3. Coding Ca ego ies and Themes De i ed om he Con en Analyses (9147 i ems).
Ca ego y Theme Classi ica ion N% % o S o es
Se ice
Reco e y
Skill o handle complain 170 1.86 64%
Simplici y o p ocedu e when handle complain
135 1.48 63%
Announce p og ess o handle complain 155 1.69 67%
E ec i eness o emedial measu es 102 1.12 73%
Responsibili y aken 137 1.50 63%
Quickly handle complain 299 3.27 66%
Sol e p oblems wi hin p omised ime 139 1.52 67%
Sum 1137 12.43
Se ice
Assu ance
Ful illmen con ac 126 1.38 69%
Con iden ial In o ma ion 290 3.17 94%
P ac ice Ve bal p omise 200 2.19 71%
S abili y p ice 138 1.51 54%
Reasonable p ice 137 1.50 60%
Facili y placemen and spacing 152 1.66 56%
P o ision and implemen a ion o eme gency
measu es 100 1.09 49%
Sui abili y o exe cise numbe s 308 3.37 95%
Sum 1451 15.86
Facili y
Func ion
Pe o mance o equipmen 989 10.81 95%
Up- o-da e equipmen 245 2.68 61%
Suppo ing acili ies in good condi ion 651 7.12 89%
To al numbe o equipmen 233 2.55 71%
Sum 2118 23.16
P og am
Ope a ion
Va ie y o p og ams 205 2.24 71%
P o essional o p og am 230 2.51 71%
P og am a angemen 189 2.07 55%
P og am ese a ion 150 1.64 57%
Sum 774 8.46
S a Pe -
o mance
Respec membe s’ needs 900 9.84 96%
Mode a e p omo ion 800 8.75 81%
Consis en se ices 188 2.06 52%
Reliable s a 131 1.43 61%
Respec membe s’ needs 900 18.02 96%
Sum 2019 22.07
Ins uc o
Quali y
P o essional skills o ins uc o 568 6.21 78%
Knowledgeable guidance 124 1.36 45%
Reliable ins uc o 456 4.99 45%
Decen beha io 500 5.47 88%
Mode a e p omo ion 400 4.37 66%
Sum 1524 18.02
We conduc ed CFA by using he 265-case sample and AMOS 23 o es he eliabili y
and alidi y o he new se ice quali y scale. In he i s CFA i e a ion, he model showed
ma ginal i (
χ
= 717.53,
χ2
/d = 2.14; RMSEA = 0.05; CFI = 0.91). The ac o loadings o all
25 i ems we e be ween 0.62 and 0.83, and he composi e eliabili y was be ween 0.77 and
0.89, showing sa is ac o y eliabili y o he scale [
51
]. Con e gen alidi y was su icien ,
based on ac o loadings ( > 0.40) and a e age a iance ex ac ed (AVE > 0.50) [
47
,
51
]
(see Table 5). Disc iminan alidi y o he scale was also su icien ; AVE exceeded he
squa ed co ela ions o all ac o s. The e o e, he se ice quali y scale was accep able o
u he examina ion. To e i y concu en alidi y, we examined he se ice quali y scale
using an es ablished ou come a iable o sa is ac ion. CFA e i ied he con e gen and
disc iminan alidi y o he se ice quali y ac o s. The solu ion indica ed accep able model
i
(χ2/d = 2.78;
RMSEA = 0.06; CFI = 0.90). The composi e eliabili y sco es we e
0.71–0.89,
wi h AVE be ween 0.60 and 0.88, g ea e han he co esponding squa ed co ela ions o
all se ice quali y dimensions and sa is ac ion, con i ming eliabili y and con e gen and
disc iminan alidi y. SEM e ealed ha , in e ms o he impac o he six ac o s o
se ice quali y on sa is ac ion, he model showed ma ginal i (
χ2
/d = 2.92; RMSEA = 0.06;
CFI = 0.89)
(see Figu e 1). All pa h weigh s among he six ac o s o se ice quali y, as well
as sa is ac ion, we e signi ican (p< 0.01) (see Table 6and Figu e 1).
In . J. En i on. Res. Public Heal h 2021,18, 10567 16 o 17
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