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Article

Building Health and Wellness Service Experience Extension: A Case Study of Bangkok, Thailand

by
Supawat Meeprom
1,*,† and
Surachai Chancharat
2,*,†
1
The Department of Hospitality and Event Management, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen 40002, Thailand
2
The Department of Finance, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen 40002, Thailand
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Sustainability 2022, 14(18), 11691; https://doi.org/10.3390/su141811691
Submission received: 8 August 2022 / Revised: 12 September 2022 / Accepted: 13 September 2022 / Published: 17 September 2022
(This article belongs to the Section Economic and Business Aspects of Sustainability)
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Abstract

:
This study examines the relationship between customer engagement, customer evaluation of service offerings, trust in health and wellness services, quality of life, and experience extension based on usable data obtained from 360 international customers via a self-administration approach to health and wellness service providers in Thailand. A two-step approach was employed to evaluate the relationship between the proposed relationship. AMOS software was used. The results found that customer engagement affected service evaluation of health and wellness providers and customers’ quality of life, but customer engagement had no significance in predicting trust and experience extension. Furthermore, the results revealed that service evaluation increased trust in the health and wellness services, quality of life, and experience extension. In addition, customers’ quality of life affected experience extension, but trust had no significant impact on experience extension. The mediating role of trust and quality of life mediates the relationship between customer engagement and experience extension. These findings can provide a deeper understanding of customer engagement and service evaluation of health and wellness for increasing customer experience extension.

1. Introduction

The health and wellness industry has grown significantly worldwide, which has contributed to the service sectors. The industry is also becoming increasingly competitive [1,2], and customers are becoming more demanding and discerning when selecting wellness services and assessing their experience [3]. Health and wellness can be defined as s physical activities that customers undertake to increase their physical ability and psychological health [4], for example, physical fitness and beauty treatments, healthy nutrition, relaxation, spas and massages, and mental activities [5]. According to Wang [6], health and wellness services are distinguished by their perishability and intangibility; they are also dominated by the service experience aspect of the business for both domestic and international customers. Regarding the characteristics of providers of health and wellness services, the customer’s perception of the service is what can differentiate one provider from its competitors [6,7]. Many countries have recently become more and more competitive in this area, particularly in the Asia-Pacific region; it has the third largest wellness market valued at USD 6.4 billion in 2014, integrating both international and domestic expenditures [8]. Specifically, Thailand, Malaysia, Singapore, and India are becoming global leaders in attracting customers from around the world in the growing area of wellness tourism [9,10].
Faced with intensifying competition in this health and wellness trend, the present study demonstrates that the theoretical underpinnings of the customer consumption experience in building an experience extension to other people remain indisputable. Many firms allow customers to interact and participate with the firms in order to improve product and service offerings, such as providing feedback or suggestions to firms about their service encounters [11]. This benefit can affect firm performance indirectly. Such beyond-purchase interactions are the behavioural manifestation of customer engagement [12,13]. The service and hospitality literature also supports the advantages of customer engagement. For instance, customers can deeply evaluate a product or service offering, such as service quality and satisfaction [14]. Customer engagement can create a perception of trust in the service [15], build customer well-being [16], and establish customer loyalty [17]. Specifically, customer engagement behaviour also helps firms attract more customers and facilitates customers to become advocates and ambassadors for service firms by talking to other customers and asking for their opinions [18].
Although there is rising interest in building customer engagement, examinations of its role in service and hospitality contexts is still limited [15,19]; very little is known about the role customer engagement plays in experience extension and how it interacts with created experience extension determinants [20,21]. To address this, the purpose of this study was to empirically investigate the relationships between customer engagement, customer evaluation of the service experience, trust in health and wellness service, and quality of life to explain customers experience extension decisions among international customers who have experienced health and wellness services in Thailand. Furthermore, the social exchange theory was adopted to unpack customer engagement with health and wellness services and the evaluation of their experience in health and wellness services to encourage customer’s experience extension decisions.

2. Literature Review and Hypotheses

2.1. Health and Wellness Service Evaluation

The term “service evaluation” is widely employed in service marketing to describe a service encounter during a customer’s service consumption [22] in areas such as hospitality and tourism branding. The main elements of service are related to hedonic consumption [23]. The notion of service evaluation is rarely employed in association with traditional products or functional services in fields such as banking. As the health and wellness industry becomes more service-oriented, providing professional services and more interactive experiences [24,25], understanding the customer evaluation of service becomes more important in this context. Previous studies have endeavoured to indicate what should be included in service evaluation [15], but the results are still far from unequivocal. According to Bloemer et al. [26], the consumer evaluation of service provision factors can impact service evaluation processes that are measured by a perceived level of service quality. Brady et al. [27]. investigated how customers evaluate service delivery and presented an indicator that contained different aspects of a customer’s evaluation of their service encounter; the indicator included sacrifice, service quality, service value, customer satisfaction, and the influence of behavioural intentions. More recently, So, King, Sparks, and Wang [15] demonstrated how a firm explored customers’ assessments of actually experienced service branding (e.g., airline and hotel brands) in order to capture more consumers’ post-use perspectives. Keshavarz and Jamshidi [28] have argued that service firms such as hotels are increasingly considering maximising superior service provision, such as service quality, value, and satisfaction, to create service differentiation and strategies to enhance customer loyalty.
However, in a thought-provoking paper on service evaluation, So, King, Sparks, and Wang [15] suggest a model that encompasses the key dimensions embedded in the service evaluation phases, including customer satisfaction, perceived value, and service quality. They revealed that customers will evaluate service evaluation factors primarily via assessing the service delivered. Despite prior empirical studies that have investigated the role of the customer–service/product relationship, such as satisfaction, perceived value, and service quality as distinct factors, a review of the service marketing literature suggests that these factors can be integrated to perform at a higher level of abstraction, given that they all represent higher-order factors summarizing the customers’ knowledge of and experiences with a focal business [15]. Importantly, Crosby and Stephens [29] and Rust et al. [30] suggest that such customer evaluation factors have strong statistical relationships, recognised as halo effects or multicollinearity. The cognitive and memory aspects were generated to demonstrate where service evaluations synthesize many experiences and perceptions [31]. Moreover, marketing researchers have merged diverse types of cumulative evaluations (e.g., trust and satisfaction) to capture a single factor and model the relationship quality [32,33].
In the current study, the combination of perceived service quality and satisfaction forms a higher-order construct of customer evaluation of service that appears to be conceptually appropriate. A review of the health and wellness literature indicates that service quality and satisfaction can build customer loyalty intention. However, the perceived value of wellness service presents a lower priority that could influence the customer decision-making process and post-purchase behaviour. This can be explained by the wide variety of options for customers, from budget to high-end luxury [34,35]. Based on this logic, this study proposes integrating both service quality and satisfaction into a higher-order model of service evaluation in the health and wellness services context.

2.2. Customer Engagement

Customer engagement plays an important role in increasing the level of behavioural focus. For example, Kumar and Bhagwat [36] posit that when customers interact with a service and product, they may use their knowledge or feedback by providing suggestions to the firms, and those firms will then understand their customers’ preferences. Firms can apply the knowledge or feedback from customers to develop products and services and/or create new products that impact the firm’s performance more indirectly. Moreover, the Marketing Science Institute [37] identifies customer engagement (CE) as a priority topic and describes the concept as “customers’ behavioural manifestation toward a brand or firm beyond purchase, which results from motivational drivers including word-of-mouth activity, recommendations, customer-to-customer interactions, blogging, writing reviews, and other similar activities” (p. 4). Marketing researchers such as Van Doorn, Lemon, Mittal, Nass, Pick, Pirner and Verhoef [12], and Lemon and Verhoef [38] demonstrate a behavioural orientation. Therefore, customer behaviours such as providing feedback and suggestions to improve the consumption experience, helping and coaching service providers, and helping other customers to consume better are all aspects of co-creation and, hence, customer engagement.
In the emerging view of customer engagement in the service marketing and hospitality literature, scholars present a positive relationship between increasing engagement and service brand evaluation, such as satisfaction, trust, perceived value, and firm performance perceptions amongst customers [11,15,19]. For example, Hollebeek [39] has developed a conceptual framework to understand the customer engagement process, which could have a direct effect on satisfaction and an indirect effect on customer value. Vivek, Beatty, and Morgan [14] argue that the potential effect of customer engagement can leverage favourable attitudes toward service, product, and firm. So, King, Sparks, and Wang [15] further support the relationship between customer engagement and service evaluation (e.g., satisfaction, value, and quality), trust, and loyalty in the context of hospitality brands (e.g., airline and hotel). The findings of So, King, Sparks, and Wang [15] suggest that when customers are strongly engaged in a service brand, it makes a stronger contribution to building customer post-consumption evaluation, such as experience extension. Therefore, this study suggests that in the context health and wellness services, when customers are strongly engaged with wellness spa and massage service offering, they may perceive high standards of spa and massage facilities, modern equipment, and comfortable ambient atmospherics. Thus, the following was proposed in this study:
Hypothesis 1 (H1).
Customer engagement positively influences service evaluation.
Hypothesis 2 (H2).
Customer engagement positively influences experience extension.
Hypothesis 3 (H3).
Service evaluation positively influences experience extension.

2.3. Trust in the Health and Wellness Service

Many scholars have defined trust in different ways depending on their specific setting, which can lead to confusing and apparently contradictory understanding of the concept [40,41]. While specific definitions of trust have differed, many scholars have generally agreed with a common definition that trust is “the willingness to rely on an exchange partner in whom one has confidence” [42]. Within the hospitality and tourism literature, the broader aim of trust is to contribute to positive customer impressions, ensure peace of mind in a service provider’s reliability, and instil a sense of security during the consumption of services [43]. Importantly, trust in a service or product can assist researchers and managers in understanding the customer decision process. For example, a customer will purchase or not purchase products or services depending on whether they trust or do not trust a service provider [44,45].
Recently, customers have been more likely to change consumption patterns to consume a focal service and product. Some customers do not want to be only passive observers but want to actively assist in contributing to their own favourable service experience. Sharing a similar view, social exchange theory provides a useful idea for better understanding the relationship between a customer-service experience and the continuation of favourable reciprocal exchange [46,47]. The theory suggests that individuals who are more engaged are likely to be in more immersive and high-quality relationships with a service firm. In this way, social exchange theory might explain how customers are willing to engage in exchange depending on the perceived benefits and costs [48]. The evaluation of service providers by a customer is performed when they are facing the service encounter process, and when these extra exchange relationship interactions are positive, they enhance trust levels. According to social exchange theory, customers feel enjoyment and affection to the extent that they are immersed in an evaluation of service offerings. If so, a desire for engagement would certainly be expected to assist in generating a customer’s evaluation of service trust.
Previous research on trust in the hospitality and tourism literature has examined a number of different contexts. Han and Hyun [49] assessed the perception of service trust of restaurant customers within the context of luxury restaurants. Abubakar and Ilkan [50] examined the perceived destination trust of a tourism service among customers in Cyprus. Moreover, Han [51] focused on customer trust when they assessed the perceived quality of service providers and the behavioural intentions of customers in the context of medical services. As shown empirically in these studies of various contexts, in the hospitality and tourism literature, trust is more likely to be a consequence of customer evaluation of a service encounter [15,35].
According to agency theory, trust increases a customer’s perception of integrity and the ability of service provisions, resulting in the establishment of a relationship between the service provision and its customers [52]. For example, So, King, Sparks, and Wang [15] examined the influence of service evaluation within the context of a tourism service branding context. Their empirical findings indicated that a positive interaction between service providers and their customers increased the levels of feelings of trust in the service. Increased by a positive evaluation of the service providers, trust in service could engender post-consumption behavioural intentions as a result of building highly valued exchange relationships with the service. In examining the impact of trust on health and wellness post-consumption behavioural intention, Han and Hyun [35] verified that strong levels of trust in a medical and health service significantly influenced customer active intention to revisit. Their findings also indicated that customers perceived high levels of service quality and customer satisfaction with experiences of consuming health services, enhancing trust with those services. Taking this into account, customers’ perceptions of high standards of spa and massage offerings and their satisfaction with excellent wellness spa and massage service performance (e.g., a wellness spa product) foster their level of confidence in a wellness spa and massage service offering’s reliability and integrity. Therefore, trust based on such customer evaluations of wellness spa and massage services (e.g., service quality and satisfaction) can act as a significant determinant of post-consumption evaluation of wellness spa and massage service experience. Therefore, the following was proposed:
Hypothesis 4 (H4).
Customer engagement positively influence trust.
Hypothesis 5 (H5).
Service evaluation positively influence trust.

2.4. Quality of Life

The concept of quality of life has been investigated in a variety of disciplines such as psychology, sociology, and gerontology [53,54]. The review of the literature considers quality of life in slightly different terms, such as happiness, psychological well-being, subjective well-being, life satisfaction, and quality of life, and all these constructs are sometimes used interchangeably [55]. Quality of life refers to people’s emotional responses, happiness, or satisfaction with life and the environment, including needs and desires, aspirations, and lifestyle preferences that determine their overall well-being [56]. According to the hospitality and tourism literature, pleasure trip experiences and leisure activities play a crucial role in contributing to the overall quality of life [53,57]. For example, Kim, Woo, and Uysal [53] state that leisure and vacation experiences can assist a customer’s physical and mental fitness and lead to increases in the levels of life satisfaction.
The use of quality of life in the context of health and wellness services can be seen when a customer perceives improvement in their enjoyment and desirability from health and wellness services (e.g., wellness spa and massage services) with which they are satisfied. The present study highlights the central role of the customer evaluation of wellness spa and massage services (e.g., satisfaction and perceived service quality) in boosting the customer’s quality of life after the conclusion of a consumption experience. Therefore, the following was proposed:
Hypothesis 6 (H6).
Service evaluation positively influences the quality of life.
While the existing hospitality and tourism literature has examined the role of quality of life as a consequence of satisfaction, service quality, and perceived value [53,57], the evidence on the influence of the benefits of customer engagement on the quality of life remains limited. However, few studies in a hospitality and tourism context demonstrate that engagement in a leisure activity or a vacation experience can contribute to people’s perceptions of their quality of life. Based on this logic, customers’ perceived quality of life may result from the gratification of psychological needs that motivate customers to enjoy and engage in certain activities [53,58]. Thus, among customers, those with high levels of engagement in wellness spa and massage service offerings are more likely to have increased perceptions of quality of life than those with lower levels of engagement. Therefore, the following was proposed:
Hypothesis 7 (H7).
Customer engagement positively influences the quality of life.

2.5. Experience Extension

Many service firms, of course, hope that a favourable service experience will extend into real life. They hope that a favourable service experience will not only foster long-term behavioural outcomes, such as perceived value, satisfaction, behavioural intentions, and a willingness to pay, but that it may also stimulate an immediate need to share the consumption experience via social media. The potential evidence of social media presents a great opportunity to engage with and motivate customers and leverage the value of integrating social media technologies into service and hospitality marketing [59].
Experience extension considers post-experience behavioural intentions, which are explained as customers’ efforts to widely spread the perceived affective and/or cognitive benefits from their experience, often by sharing with their peers [60]. The result of service encounters can be positive word-of-mouth information through online interaction. If customers perceive good service performance and feel that the service provides something that is exclusive, unique, and pleasing, they will maintain that favourable experience for an extended period. In preserving it, they can feel extended happiness. In addition, experience extension has a cognitive aspect as a customer expands their vision and increases their knowledge. On social media, social influence has an impact on message forwarding behaviour, as individuals exposed to their friends’ sharing behaviour are significantly more likely to spread information [61]. Potential customers who are seeking information about good wellness spa and massage services may rely heavily on others’ opinions as a reliable information channel in decision making [62]. Therefore, the following was proposed:
Hypothesis 8 (H8).
Trustpositively influences experience extension.
Hypothesis 9 (H9).
Quality of lifepositively influences experience extension.
Therefore, Figure 1 depicts the research model of this study.

3. Methodology

3.1. Research Setting

Data were collected using convenience sampling and a self-administered approach from international customers who had experienced health and wellness services in Bangkok, Thailand. Specifically, Thailand is popular for its abundant natural resources, such as its wide and long beaches, and is well known for its international festivals and events. Most travellers come for new experiences, relaxation, and natural resources. As a leader in health and wellness service in the Asian-Pacific region, Thailand is one of the preferred destinations on account of its excellent and unique wellness service providers and facilities (e.g., hotel and resort spas for healthy holidays; fitness, club spas, and massages; and destination spas), as well as its efficient medical staff [10,63]. In 2018, Thailand generated nearly USD 3.5 billion in revenue in this area. Wellness service accounts for 3% of the Thai GDP, with 90% of the receipts coming from beauty/anti-ageing and preventive medicine/health consciousness businesses; the other 10% was from spa treatment businesses [64]. Furthermore, Thailand’s government has promoted and implemented health and wellness policies and programs to motivate international customers. The country has also promoted its world-class health and wellness centres [65,66]. Moreover, Thailand also has a very large metropolitan city in Bangkok. Many Thai health and wellness services are available there and in resort areas such as Phuket and Chiang Mai. Health and wellness services can be commonly found throughout Bangkok. Therefore, Bangkok was selected as the survey site for the present study. The data collection took place at health and wellness service providers after customers had received massages or wellness spa in the services. This data collection strategy helped to minimize bias among the respondents in that the samples represented a mixture of all sectors of the health and wellness businesses in the city. The customers were 20 years of age or older. The interviewers randomly approached customers at the health and wellness services and explained the purpose of the research project. Only customers who had received massages or wellness spa programs were qualified to participate in the survey, with a screening question at the beginning of the questionnaire used to determine eligibility. A total of 400 questionnaires were collected. After eliminating 40 respondents who did not fully complete the surveys, we received usable data from 360 respondents that could be analysed for this study. There were no missing data for these respondents, as completed surveys were needed for inclusion in the study, as noted.

3.2. Measures

The measures used in this study were drawn from the literature and were adapted as appropriate for the context of the study. The use of existing measurement items helped to ensure the reliability and validity of the survey instrument. The respondents of this study were asked to respond regarding their engagement with the service offering, satisfaction, perception of service quality, trust, quality of life, and experience extension on a 7-point Likert-type scale (1 = strongly disagree, 7 = strongly agree). To measure customer engagement, three items were adapted from Chan et al. [67]. Six items were adapted from Cronin and Taylor [68] and Yim et al. [69] to measure the two underlying dimensions of service evaluation (i.e., perceived service quality and satisfaction). This study used six items from Abubakar and Ilkan [50] to measure trust and adapted items from Sirgy et al. [70] to capture the customers’ perceived quality of life. Finally, from Dong and Siu [60], the study adapted three items for measuring experience extension.
The questionnaire instrument was examined for logic, relevance, and validity by service and hospitality academics. A few wording issues called for minor revisions, and the relevant material was slightly altered and improved. No major issues were reported [35]. After receiving feedback from the academics, the measurement items were assessed in terms of their readability, comprehension, logic, and relevance. A pilot test was conducted with a sample of 30 in order to ascertain item comprehension and readability. As a result, no major concerns were reported.

4. Data Analysis and Results

4.1. Profile of Respondents

Among the health and wellness customers participating in the survey, the sample contained nearly equal ratios of males (48%) and females (52%). The highest proportion of respondents was 20–30 years old (42.3%), followed by respondents 31–40 years old (24.8%), and customers aged 51–60 years were the smallest group (6.7%). With regard to nationality, 31.3% of the respondents self-identified as Europeans, followed by 30.5% as Asians (such as Chinese, Korean, and Japanese); 13.2% were American, and 10.5% were Australian. Most of the respondents were well educated, as 43.9% had an undergraduate degree and 26.4% had postgraduate degrees. A small number of respondents reported having received only a primary school education (1.6%). In terms of occupation, 50.4% of the respondents reported full-time employment, while 1.6% were unemployed. With regard to the service encounter, 37.4% had spent around two hours at the location, 26.3% had been there more than three hours, and 15.0% were there less than one hour.

4.2. Common Method Bias

Furthermore, one common latent factor was created to ensure that the measurement items were not impacted by common method bias, and its associations with other observed variables were examined. The results showed that none of the measures were significantly influenced by a common method bias. The AMOS statistical modelling software was employed for this purpose. As suggested by Anderson and Gerbing [71], a two-step approach was employed to evaluate the relationship between the proposed relationship. First, the measurement model was calculated, and the structural model was then formulated. In the first stage, to assess the measurement of the constructs of interest, mean scores were formulated, and confirmatory factor analysis (CFA) was implemented to ensure the validity of the measures. Convergent validity was examined by calculating the average variance extracted (AVE) for each latent construct, and discriminant validity was assessed by examining the correlations between the latent constructs. Furthermore, reliability was examined by assessing the coefficient alpha and composite reliability of each construct.

4.3. Measurement Assessment

Following the prior research in the service literature, service evaluation was considered a second-order construct, implying that the two multi-dimensional service evaluation concepts used in this study include more concrete (or first-order) dimensions. The CFA was used to formulate the measurement model with higher-order components. Hence, all the constructs were measured by multiple items used in this study, followed by a second-order CFA to assess the proposed second-order components of the service evaluation. To assess the measurement model, a CFA using AMOS was employed to test all the first-order components modelled simultaneously as correlated factors with a maximum likelihood estimation method. As indicated in Table 1, the results of the analysis demonstrated a good fit for the sample data (n = 371), x 2 = 688.224, df = 194, p < 0.001, x 2 /df = 3.54, goodness of fit index (GFI) = 0.80, Tucker–Lewis index (TLI) = 0.90, incremental fit index (IFI) = 0.90, comparative fit index (CFI) = 0.91, normed fit index (NFI) = 0.90, and root mean square error of approximation (RMSEA) = 0.08.
Construct validity was formulated through convergent validity and discriminant validity. Convergent validity was supported with statistically significant (p < 0.01) item-factor loadings [72]. All measurement items had greater than the acceptable minimum criterion of 0.50, as suggested by Hair et al. [73], providing strong support for convergent validity, as shown in Table 1. As presented in Table 2, the discriminant validity was calculated and exhibited that the square root of AVE for each measurement variable exceeded the corresponding correlation [74]. According to the Fornell–Larcker criterion, all the constructs demonstrated adequate discriminant validity.
To assess the construct reliability, the average variance extracted (AVE), composite reliability, and Cronbach’s alpha were calculated for each construct [75]. The AVEs of each measurement construct were greater than the acceptable minimum criterion of 0.50, as suggested by Hair, Matthews, Matthews, and Sarstedt [73]. All composite reliability estimates exceeded the recommended level of 0.60 [73], providing support for the construct reliability of the measurement scales.
In the second-order measurement model, a hierarchical CFA with service evaluation, trust, customer engagement, quality of life, and experience extension was calculated and modelled as correlated constructs. The measurement model achieved a good fit for the sample data, x 2 = 264.365, df = 176, p < 0.001, x 2 /df = 1.50, goodness of fit index (GFI) = 0.94, Tucker–Lewis index (TLI) = 0.90, incremental fit index (IFI) = 0.97, comparative fit index (CFI) = 0.98, normed fit index (NFI) = 0.95, and root mean square error of approximation (RMSEA) = 0.04. As the construct validity and reliability of trust, customer engagement, quality of life and experience extension were formulated in the first-order CFA, this analysis focused primarily on the assessment of the service evaluation as a second-order model. Based on these fit indices, the measurement model exhibited adequate performance of the sample [73].
As Table 3 shows, the factor loadings of the two components of service evaluation were significant at the α = 0.01 level. In addition, the AVEs of service evaluation was greater than the acceptable minimum criterion of 0.50 [73], supporting its convergent validity. The discriminant validity of the second-order factors and the other four first-order factors (i.e., trust, customer engagement, quality of life, and experience extension) was supported, as the square root of the AVE for each factor was greater than its correlations with other factors [74]. Furthermore, the composite reliability values for service evaluation were acceptable according to the minimum criterion of 0.60 [73], and their AVEs were also well above the 0.50 threshold [74].

4.4. Structural Model and Hypotheses Tests

The test of the proposed structural model was conducted using a maximum likelihood estimate in AMOS, as presented in Table 4; it demonstrated a good model fit, x 2 = 264.365, df = 176, p < 0.001, x 2 /df = 1.50, goodness of fit index (GFI) = 0.94, Tucker–Lewis index (TLI) = 0.90, incremental fit index (IFI) = 0.97, comparative fit index (CFI) = 0.98, normed fit index (NFI) = 0.95, and root mean square error of approximation (RMSEA) = 0.04. The critical ratios of the structural paths were examined for hypothesis testing. The findings of the structural equation modelling demonstrated that customer engagement was a significant predictor of service evaluation (H1: β = 0.42, t = 6.31, p < 0.01), explaining 99.7% of its variance. Service evaluation (H5: β = 0.63, t = 16.47, p < 0.01) significantly predicted trust, collectively explaining 53.9% of its variance. Customer engagement (H4: β = 0.04, t = 1.10, p = 0.272) was not statistically significant in predicting trust. In addition, service evaluation (H6: β = 0.42, t = 9.28, p < 0.01) and customer engagement (H7: β = 0.15, t = 3.16, p < 0.01) significantly predicted quality of life, accounting for 74.3% of its variance. Furthermore, service evaluation (H3: β = 0.32, t = 4.95, p < 0.01) and quality of life (H8: β = 0.19, t = 3.48, p < 0.01) significantly predicted experience extension. However, customer engagement (H2: β = 0.10, t = 1.80, p = 0.073) and trust (H9: β = −0.04, t = −0.70, p = 0.483) were nonsignificant in predicting experience extension. Collectively, the model accounted for 78.2% of the variance in experience extension, demonstrating the predictive quality of the model. Regarding the R2 values, all endogenous constructs were over the benchmark of 0.1 proposed by Falk and Miller [76] and ranged from 0.539 to 0.997, demonstrating good predictiveness. Table 4 exhibits the results. In addition, Figure 2 presents a graphical depiction of the hypothesised theoretical model.

4.5. Additional Analysis

The study also conducted tests of the indirect effects of customer engagement and service evaluation on experience extension through trust and quality of life; a structural path was created using the recommended bootstrapping approach (MacKinnon et al., 2007 [77]) in AMOS (Byrne, 1998 [78]). This study used the normal maximum likelihood procedure to examine the indirect effects. The results shown in Table 4 demonstrate that customer engagement had a significant indirect effect on trust (β = 0.21, p < 0.01, 95% C.I. for the indirect effect (0.13, 0.28)) and quality of life (β = 0.14, p < 0.01, 95% C.I. for the indirect effect (0.09, 0.20)). The indirect effect of customer engagement (β = 0.15, p < 0.01, 95% C.I. for the indirect effect (0.09, 0.22)) had a significant indirect effect on experience extension. Therefore, the results provide strong evidence in support of the need for incorporating the indirect effect in developing experience extension, except for the indirect effect of service evaluation on experience extension through trust and quality of life was not significant (β = 0.05, p = 0.282, 95% C.I. for the indirect effect (−0.05, 0.15)).

5. Conclusions and Discussion

With the increasing growth and competitiveness in health and wellness service markets, many businesses have faced challenges in fostering long-term customer connections for their services. Thus, the search for marketing strategies and goals for enhancing customer engagement and delivering a superior service experience is paramount. The aim of this study was to examine the effect of customer engagement, customer evaluation of the service experience, trust, and quality of life on customer experience extension. Furthermore, this study investigated the role of trust and quality of life as mediation in the relationship between customer engagement, customer evaluation of the service experience, and experience extension. To examine these proposed hypotheses, a total of 360 valid samples were collected from international customers who received spa services and massages from a health and wellness businesses in Bangkok, Thailand, and analysed using the structural equation modelling (SEM) approach.
Drawing on the social exchange theory, the findings of this study show that customer engagement with health and wellness services significantly contributes to developing customer perceptions of service experience evaluation in health and wellness service providers operating in Thailand. Interestingly, prior research has acknowledged the benefits of customer engagement in fostering customer experiences consumption evaluation, such as satisfaction, trust, and behavioural intention, across a wide range of areas, e.g., [15,17,79]. In advancing the literature, the current findings show that customer engagement contributes to fostering customer favourable attitudes toward a health and wellness offering, and the customer needs to actively engage in a service encounter to attain higher levels of service experience. This supports prior studies that conceptualise the customers’ evaluations of a product or service as a consequence of customer engagement for both new and existing customers [15].
As mentioned earlier, prior research has recognised customer engagement as a crucial building block for fostering behavioural intention or customer loyalty, such as advocacy and referral service experience to other people or new customers [11,17,80]. However, the results of the study are not consistent with previous research that indicated customer engagement did not directly affect building a customer experience extension to advocate their experience to other people. This unexpected finding suggests that the nature of a service business may be lack of transparency and intangibility [81]. The characteristics of service industries, especially hospitality and tourism, may include a high-risk perception toward service products (e.g., health and wellness services). In addition, we consider customer engagement as a customer actively participating in the service offering. In the context of a health and wellness service, customers prefer to improve their health, physical relaxation, and mental well-being, which develops emotional bonds. Engaged customers must be considered from an emotional and cognitive perspective of engagement [80]. Therefore, to increase a customer experience extension to health and wellness services, considering customer engagement solely from the view of a behavioural perspective (interaction and participation) is not sufficient. It is important to establish a deeper understanding of customer engagement in terms of strengthening the customers’ emotional and cognitive bonds with health and wellness services. In other words, active customer engagement from merely an interaction perspective cannot be neglected when elaborating on the customer engagement links to a customer experience extension. Therefore, this study offers an essential explanation of how customer engagement influences experience extension in the health and wellness domain and supplements this nomological framework of customer engagement offered by prior studies [15,79,82].
Furthermore, the review of the literature indicated that customer engagement and service evaluation are critical in improving customer attachment and loyalty [17,19,82,83]. However, limited research to date has investigated the role of quality of life as an outcome of customer engagement and service evaluation, specifically in the context of health and wellness services. The findings presented in this study further show that customers who actively engage in receiving health and wellness services and hold favourable attitudes toward them are more likely to be satisfied with their quality of life. These insights contribute to a better understanding of the important role of subjective well-being aspects associated with customer perceptions of health and wellness services.
The effect of customer trust in health and wellness services is unsurprising. The results of this study were not consistent with prior empirical studies that customer engagement increases the level of trust in a product or service [79,83]. These findings may imply that customers need to generate a service evaluation of experience in health and wellness services instead of customer engagement. Customer engagement is an important aspect of active participation in health and wellness services. Its insignificant effect in this study was probably due to consumer behaviour and its intrapersonal nature, as customer engagement is stimulated and formed within a person and remains on a behavioural level. Customer engagement in terms of only the behavioural level (e.g., participation in the service process) may not be enough to influence trust in health and wellness services.
Although customer engagement with health and wellness providers and a customer’s increased quality of life play a vital and crucial role in fostering experience extension, in a highly competitive health and wellness service environment, a customer actively engaged with service providers and good quality of life are the expected standards rather than triggering factors for health and wellness success. In contrast, the service evaluation of health and wellness providers demonstrates a strong customer–service relationship beyond purchase [32,60], representing it as a stronger contributor to producing a favourable service experience.

6. Implications

6.1. Theoretical Implications

This study contributes to adopting the benefit value evaluation of the social exchange theory perspective in order to understand the relationship links of customer engagement, service evaluation of health and wellness providers, trust in health and wellness services, quality of life, and customer experience extensions. The motivation for focusing on this theoretical view is to respond to an issue raised by Dong and Siu [60]; Su, Swanson, and Chen [32]; and So, King, Sparks, and Wang [15] in terms of a lack of research connecting engagement and post-consumption evaluation such as referral and experience extension. Contrary to existing empirical studies that portray customer engagement as an effective factor in enhancing customer satisfaction and loyalty, e.g., [19,84,85], the present research reasons that this belief raises challenges for theory in this emerging domain. This research theoretically argues that the service evaluation of health and wellness providers creates a major enhancement experience extension, which results from its effectiveness in affecting the service quality of encounters and inducing satisfactory experiences of providing health and wellness services. In addition, customers with a high service evaluation of a health and wellness offering are more critical and concerned with service trust due to complex risk components, such as professional health and wellness staff, quality of the treatment, and staff knowledge, when deciding to consume health and wellness services, which in turn highly influence their behaviour such as advocacy and telling other people about their experiences. Therefore, this finding extends our understanding of social exchange theory and better explains the peripheral and situational factors affecting consumption experiences.
Furthermore, prior research notes that customer engagement plays an important role in driving service evaluation, such as satisfaction and quality [15,86]. However, at present, social identity theory has not addressed how engaged customers perceive the quality of life from engaging with a service offering in the context of a hospitality and marketing service. This study theoretically argued that customers express themselves cognitively, emotionally, and physically while interacting during a service encounter. Customers not only fulfil their desires to feel positive emotional support and cohesion with the delivery of other health and wellness services, but they also perceive increased meaningful leisure experiences that could affect their assessment of their quality of life. Therefore, the theory advanced in this study suggests that to support quality of life, customers who engage in health and wellness service offerings increase emotional bonds, pursue their ideals, and feel satisfied that they may facilitate their subjective well-being.
As the service evaluation of health and wellness providers has been demonstrated as an essential construct affecting experience extension, the present study not only found a direct relationship between the service evaluation of health and wellness providers and customer engagement but also examined the mediating role of quality of life and trust in service offerings. An interesting finding in this study was the mediating effect of quality of life on the relationship between the service evaluation of health and wellness providers and experience extension. Customer engagement with a health and wellness service offering was found to indirectly affect experience extension through the quality of life and trust, although customer engagement did not directly affect the experience extension. Thus, it is important to ensure that customers perceive a high level of engagement in the service offering to build the customer experience extension.

6.2. Practical Implications

The strong influence of service evaluation of health and wellness providers on experience extension offers a sound reason for health and wellness businesses to also focus on marketing strategies and actions that are likely to engage customers in service encounters, influencing not only their evaluation of the service but also their advocacy to other people related to the health and wellness experience. Therefore, the findings of this research expand upon the managerial understanding of customers’ evaluation of the offerings by substantiating the service quality and satisfaction in the service encounter while developing a strong experience with their services. Managers should establish or maintain the presence of their service in various aspects, such as providing comfortable atmospherics, improving the layout, enhancing the décor, developing diverse wellness programs, and improving the staff’s proficiency and services in health and wellness.
The positive, significant effect of customer engagement on the service evaluation of health and wellness providers confirms that engaged customers increase the perception of service quality and satisfying health and wellness offerings. For example, a customer who is actively engaged in the service encounters (e.g., services in spa and massage, health and wellness programs, and staff) is more likely to be satisfied with the service than customers who have an unfavourable outcome. Moreover, a customer who actively interacts and engages in a service encounter is happy with their decision to consume a particular health and wellness service and give it meaning for the rest of their lives could enhance positive experiences. This results in increasing their quality of life after the service process concludes. Given this, managers should build upon customers’ attention, relaxation, and pleasurable experiences towards health and wellness services when consuming the service in order to reinforce their quality of life, which in turn extends their experience, leading to them saying positive things about Thailand’s health and wellness services to other people.

7. Limitations and Recommendations

This research focused on experience extension related to health and wellness as a consequence of the study. Longitudinal research would be better for understanding the perspectives of customer engagement and service evaluation of health and wellness providers in relation to pre- and post-health and wellness consumption experiences and would reflect the impact of multiple moments of customer engagement with the service over a longer period [87]. For this reason, an examination of the change in customer judgment of the overall experience, the quality of the health and wellness services after the service is concluded, and customer loyalty over time would be valuable. Therefore, it is recommended that further research employs a longitudinal approach to capturing enduring health- and wellness-related outcomes that are maintained and sustained in the long term. Second, as the research was limited to the health and wellness aspects of the service industry, further testing of the theoretical framework in other hospitality and tourism contexts (e.g., hotel branding and the cruise setting) may afford greater generalizability of the results. Given the globalization of the hospitality and tourism sectors, further investigation of the conceptual model with samples from other Asian counties (e.g., Malaysia, India, and Singapore), America, or Europe would contribute to the generalizability or limitations of the research framework in demonstrating the post-consumption evaluation of the service experience process.

Author Contributions

Conceptualisation, S.M.; data curation, S.M.; formal analysis, S.M.; investigation, S.C.; methodology, S.M. and S.C.; writing—original draft, S.M. and S.C.; writing—review and editing, S.M. and S.C. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Exempted by the Center for Ethics in Human Research, Khon Kaen University.

Data Availability Statement

The data presented in this study are available on request from the first author. The data are not publicly available due to confidentiality reasons.

Conflicts of Interest

The authors declare no conflict of interest.

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Figure 1. The Conceptual Framework.
Figure 1. The Conceptual Framework.
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Figure 2. Results for the final structural model.
Figure 2. Results for the final structural model.
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Table
Table 1. The Results of the Measurement Model.
Table 1. The Results of the Measurement Model.
Constructs and ItemsMSDFLAVECRCronbach’s
Alpha
Service Quality5.851.20 0.810.930.93
Overall, the quality of this health and wellness service is excellent. 0.86
Overall, the quality of this health and wellness service is superior. 0.96
Overall, the quality of this health and wellness service is high standard. 0.88
Satisfaction4.851.08 0.750.890.89
I am satisfied with the services provided. 0.86
The wellness and health of this service meet my expectations. 0.89
Overall, I am satisfied with the wellness and health provided by this service. 0.84
Trust4.890.91 0.700.960.87
These wellness and health services meet my expectations. 0.80
I feel confident with this wellness and health service. 0.87
I will not be disappointed with this wellness and health service. 0.81
This wellness and health service would be honest and sincere in addressing my concerns. 0.69
I could rely on this wellness and health service to solve my wellness and health problems. 0.61
These wellness and health services would make any effort to satisfy me. 0.55
Customer Engagement4.561.03 0.620.878.12
I put a lot of effort into expressing my personal needs to the staff during the service process. 0.82
I have a high level of participation in the service process. 0.75
I am very much involved in deciding how the services should be provided. 0.74
Quality of Life4.941.03 0.710.910.86
Feeling mentally recharged after the service. 0.87
Feeling that own health improved because the service required physical activity. 0.90
Judging that the service was well worth the money spent. 0.75
Spending money specifically saved for service. 0.55
Experience Extension4.521.42 0.760.930.87
I used social media to interact with friends about this service. 0.82
I used social media to tell others about this service. 0.93
I posted/shared photos/videos for friends/family, and acquaintances on social media (e.g., Facebook). 0.74
Notes the results of the goodness of fit of the model were x 2 = 688.224, df = 194, p = 0.000, x 2 /df = 3.54, goodness of fit index (GFI) = 0.80, Tucker–Lewis index (TLI) = 0.90, incremental fit index (IFI = 0.90, comparative fit index (CFI) = 0.91, normed fit index (NFI) = 0.90, and root mean square error of approximation (RMSEA) = 0.08, M = factor mean, SD = standard deviation, FL = factor loadings, AVE = average variance extracted, CR = composite reliability.
Table
Table 2. Discriminant Validity Analysis from First-Order Confirmatory Factor Analysis.
Table 2. Discriminant Validity Analysis from First-Order Confirmatory Factor Analysis.
AVESQSATTRCEQOLEE
Service Quality (SQ)0.810.90
Satisfaction (SAT)0.750.390.87
Trust (TR)0.700.460.810.84
Customer Engagement (CE)0.620.300.290.300.79
Quality of Life (QOL)0.710.380.480.530.320.84
Experience Extension (EE)0.760.460.290.310.280.370.87
Note: Diagonal bold italics entries are square root of AVE; all others are correlations coefficients. AVE = Average Variance Extracted.
Table
Table 3. Second-Order Measurement Model for Service Evaluation.
Table 3. Second-Order Measurement Model for Service Evaluation.
Components and Manifest
Variables		FLAVECRCronbach’s
Alpha
Service Evaluation 0.500.600.55
Service quality0.70
Customer satisfaction0.55
Table
Table 4. Results of the Structural Model Analysis and Hypothesis Testing.
Table 4. Results of the Structural Model Analysis and Hypothesis Testing.
HypothesisIndependent VariablesRegression Weights (β)Result
DirectIndirectTotal
Experience Extension (R2 = 0.782)
H9Trust−0.04 −0.04Not supported
H8Quality of life0.19 ** 0.19 **Supported
H3Service evaluation0.32 **0.050.37 **Supported
H2Customer engagement0.100.15 **0.25 **Not supported
Quality of life (R2 = 0.743)
H7Customer engagement0.15 **0.14 **0.29 **Supported
H6Service evaluation0.42 ** 0.42 **Supported
Trust (R2 = 0.539)
H5Service evaluation0.63 ** 0.63 **Supported
H4Customer engagement0.040.21 **0.25 **Not supported
Service evaluation (R2 = 0.997)
H1Customer engagement0.33 ** 0.33 **Supported
Note: ** p < 0.01.
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Meeprom, S.; Chancharat, S. Building Health and Wellness Service Experience Extension: A Case Study of Bangkok, Thailand. Sustainability 2022, 14, 11691. https://doi.org/10.3390/su141811691

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Meeprom S, Chancharat S. Building Health and Wellness Service Experience Extension: A Case Study of Bangkok, Thailand. Sustainability. 2022; 14(18):11691. https://doi.org/10.3390/su141811691

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Meeprom, Supawat, and Surachai Chancharat. 2022. "Building Health and Wellness Service Experience Extension: A Case Study of Bangkok, Thailand" Sustainability 14, no. 18: 11691. https://doi.org/10.3390/su141811691

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