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Journal of Services Marketing

ISSN : 0887-6045

Article publication date: 24 May 2011

The aim of this paper is to provide a literature review of the state‐of‐the‐art and up to date concepts and measures undertaken in the research on perceived value. The purpose especially is to provide a comprehensive and systematic overview of the research on perceived value.

Design/methodology/approach

The common perceived value definitions, conceptual and measurement approaches and its close relationship with important and highly researched service industry components such as service quality and customer satisfaction are discussed.

This paper demonstrates underlying and foundational theories, systematises the research streams and addresses the unsolved concerns of perceived value. The paper concludes with recommendations for the future research and application of perceived value as being relevant to the service industry.

Originality/value

The contribution of the paper lies in achieving a more profound understanding of the nature of perceived value for, equally, academics and industry.

• Consumption
• Value‐in‐use pricing

Boksberger, P.E. and Melsen, L. (2011), "Perceived value: a critical examination of definitions, concepts and measures for the service industry", Journal of Services Marketing , Vol. 25 No. 3, pp. 229-240. https://doi.org/10.1108/08876041111129209

Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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ORIGINAL RESEARCH article

Accessing the influence of perceived value on social attachment: developing country perspective.

• School of Economics and Management, Beijing Jiaotong University, Beijing, China

Perceived value has a positive impact on users’ social attachment in social media usage contexts and is a topic at the forefront of current research in consumer behavior. Although studies have begun to investigate the factors influencing social attachment, there is a lack of research on how perceived value affects social attachment. Therefore, this study uses privacy concern theory, to build a theoretical model with moderated and mediation roles, using Chinese Tik Tok users as data and survey sample, and applying Mplus7.0 to analyze the mediation mechanism and boundary conditions of the relationship between perceived value and social attachment through the structural equation model. In Study 1, data were collected from 600 Tik Tok users to verify the mediating role of the sense of belonging in perceived value and social attachment relationship. The users participating in the questionnaire survey were mainly from mainland China. In Study 2, two waves of data were collected from 500 Tik Tok users to verify the mediating role of the sense of belonging, and support part of the moderating role of privacy concern. However, except that the relationship between information value and social attachment is inhibited by privacy concern, the relationship between entertainment and social value and social attachment is not regulated by privacy concern. This research examines the practical effects of perceived value in the context of social media use, reveals the internal mechanism of the impact of perceived value on social attachment, and provides a reference for the innovative management and commercial practice of social media.

Introduction

The new wave of information technology revolution has given rise to the flourishing of social media, making social media a sustainable activity in which everyone can participate ( Skoric et al., 2016 ; Hogan and Strasburger, 2018 ). On one hand, with the improvement of people’s material living standards and the maturity of communication technologies such as the Internet, the number of social media options available to users continues to grow and their voice in the market gradually increases ( Christmas, 2021 ). On the other hand, the rapid increase in market demand and the stimulation of the technological revolution dividend have resulted in more intense competition for social media ( Irwin et al., 2021 ), leading to the emergence of similar social media APPs in the market, which have sprung up in the lives of the public. This means that competition is driving social media platforms to consider how to meet the needs of their users and to increase their value as the starting point of their business in order to obtain sustainable development. Further research shows that spatial distance and physical separation are weakened in the context of social media use, and that users gain a variety of perceived values such as emotional, informational and entertainment value ( Wang and Huang, 2017 ; Gomez-Galan and Martinez-Lopez, 2020 ). At this point, perceived value serves as a stimulating element that allows users’ needs to be continuously satisfied, thus forming a sustainable usage behavior pattern dominated by social attachment. Clearly, in the face of increasing competition, enhancing the perceived value of users is a key issue in attracting and retaining users to promote the sustainable development of social media. The present study focuses on the following aspects of the relationship between perceived value and social attachment.

Firstly, in the context of social media usage, perceived value refers to the user’s overall preference and comprehensive evaluation of the goods or services involved in a video based on existing subjective impressions when viewing the video on a mobile short video social application ( Wang and Huang, 2017 ). A higher degree of perceived value indicates that users get more pleasure and satisfaction in their interactions with others through self-expression and presentation in the process of using social media, thus establishing a good emotional connection with social media ( Hsu and Lin, 2016 ). It has been argued that perceived value essentially reflects users’ subjective perceptions of the specific value that using social media brings to them ( Wang and Huang, 2017 ; Casalo and Romero, 2019 ) and plays an important role in the formation of affective attachments ( Li and Gao, 2019 ). Thus, social attachment may be influenced by perceived value, which produces specific satisfaction of various needs of the user, which in turn influences the user’s perception of social media; and treats the self as part of social media, and with the continuous satisfaction of individual perception, the user develops emotional attachment to social media and continuously invests time, energy and even money in social media. This investment ultimately strengthens the bond between the user and the social media, creating a sense of closeness and dependency, which in turn leads to a strong long-term connection ( Yang et al., 2021a ).

Secondly, previous research suggests that a sense of belonging is a necessary condition and a prerequisite for continued use of social media ( Duffett, 2020 ; Chen et al., 2021 ; Yang et al., 2021b ). So, does the perceived value inspired by users’ use of social media affect their social attachment through the mediating effect of belongingness? Belonging theory suggests that the users’ emotional value gaining self-expression and care from others through social media application platforms will strengthen the emotional connection between users and social media, the essence of which is that users want to be recognized and accepted by social media, making users feel the value of their existence in the virtual society ( Hsu and Lin, 2016 ). This increases users’ reliance on and satisfaction with social media, which in turn enhances their sense of identity and belonging to social media, laying a positive impact on their emotional use of social media. Related studies have also found that users’ perceived value does affect social attachment between users and social media through the mediating effect of belongingness brought about by using social media ( Yang et al., 2021b ). Thus, the perceived value inspired by social media use may lead to an indirect positive effect on users’ social attachments through the mediating effect of belonging.

In addition, in the context of social media usage, individuals are concerned about who has access to their private information and how this information will be used. The exact attitudes and behaviors of users when confronted with privacy concern also depend on their awareness of privacy protection ( Tsai et al., 2017 ). For example, users will abandon the use of social media once they believe that the scope and extent of their access and the use of personal information exceed their permitted risk tolerance threshold ( Tang et al., 2019 ). As can be seen, users’ privacy concern in social contexts are extremely important, as they help to reduce the likelihood of personal privacy information leakage, reduce the possible negative impact of personal information leakage, and enhance privacy protection, which has become an indispensable moderating variable in big data era. Therefore, based on privacy concern theory, this study proposes that privacy plays a moderating role in the “perceived value-social attachment” relationship ( Ayaburi and Treku, 2020 ).

Despite these valuable results, there are few studies in current literature that have explored and examined the mechanisms and boundary conditions underlying the effects of perceived value on social attachment: First, what effect does perceived value have on social attachment? What are the mediating mechanisms through which this influence is transmitted? Second, does this mediating mechanism show different patterns of action in different management contexts? Third, most previous studies have taken social media in developed western countries as a sample, and there is a lack of research on the factors influencing the perceived value of social media in China. Although these inferences can be drawn from both practical and theoretical perspectives, the deeper theoretical logic remains to be explored, and the pathways through which perceived value works remain to be explored.

To this end, this study constructs a theoretical model of the impact of perceived value on social attachment in the context of the use of social media. The social media Tik Tok is used as the research object, and its mass users are targeted as effective samples. Structural Equation Modeling (SEM) is applied to explore how the different modes of perceived value lay down a driving effect of social attachment, under the mediation of the sense of belonging and the moderation of privacy concern. Through in-depth exploration of its internal theoretical logic and influence mechanism, it will provide practical guidance mechanism formed by social attachment in the social context, and provide theoretical support to the role factors contributing in the formation of users’ social attachment.

Theoretical Foundation and Hypothesis Development

Theoretical foundation on privacy concern.

With the increasing use of the Internet, social networks and other forms of information sharing, the concern for privacy has gradually become the focus of many studies and discussions. In the existing literature, privacy is defined as “an anxiety about personal privacy” ( Yun et al., 2019 ). Another definition describes it as “concern about controlling the acquisition and subsequent use of personal information” ( Tan et al., 2012 ). Throughout the development of social media, researchers paid special attention to privacy issues in social media ( Fogel and Nehmad, 2020 ). Some researchers tried to evaluate the impact of information disclosure and privacy options of social media on user privacy control. Acquisti et al. (2006) conducted a survey of more than 4,000 Facebook users to study the patterns of information disclosure in online social networks and their impact on privacy. The survey results show that although students’ privacy may be attacked in many ways, only a small percentage of students have changed their privacy preferences. As to the reason of the shortage of social media privacy control, Choon (2018) believe that the privacy options provided by social media do not provide users with the required flexibility to deal with conflicts with friends with different privacy concepts. The study proves that there is often a disconnection between users’ desire to protect privacy and their privacy control behavior. This phenomenon is called privacy paradox ( Chung et al., 2021 ).

Despite the growing interest in research on privacy concern in social media, there is little information and empirical evidence on how privacy concern affects the acceptance of social media ( Dienlin and Trepte, 2015 ). In fact, when users have stronger privacy concern about social media, they are more likely to inhibit the frequency of usage, which undermines the likelihood of continued usage. Therefore, this study aims to explore the impact of social media users’ persistence intention from the perspective of privacy concern, in order to understand the boundary conditions of privacy concern on users’ persistence in using social media, and to provide valuable references for social media developers to design their products and develop marketing strategies, so as to provide more effective services to social media users.

Hypothesis Development

Perceived value and social attachment.

Perceived value, a concept based on consumers’ subjective impressions, reflects their evaluation of the perceived benefits and losses of a kind of good or service ( Petrulaitiene and Jylha, 2015 ). However, unlike the graphic information in traditional virtual social environment, the video information in the social media context makes the value perceived by users more intuitive, rich and real, so that users can express their emotional connection with the social media platform in various forms, such as likes, comments and retweets, etc. Therefore, based on the social media usage context, social value, entertainment value and information value are generally used to represent perceived value ( Yang et al., 2021b ). The perceived value accumulated in this relationship is seen as an extension of the self and has a significant impact on social attachment. As perceived value increases, so does the emotional connection users have to social media ( Li and Gao, 2019 ). This is because the emotional connection created by the interaction between the user and the social media in the context of social media use satisfies the user’s need for perceived value, creating perceptions, memories and a sense of belonging, which leads to a social attachment to the social media ( Yang et al., 2021b ). Thus, in the context of social media use, perceived value makes users attach to the social media. Specifically, the three perceived values of social value, entertainment value and information value in the context of social media use have an impact on users’ social attachment.

Firstly, social values are mainly the subjective feelings that individuals have about satisfying their self-esteem and enhancing their social identity, reflecting the importance they attach to their self-image and their expectations of social identity ( Petrulaitiene and Jylha, 2015 ). In the context of social media use, when users feel the need to respond positively to positive interactions, they may feel guilty if they fail to respond effectively, and will therefore respond positively through interactions in order to gain approval and get attention from others. This psychological commitment drives users to perceive that they are needed, which in turn leads to social attachment to social media.

Secondly, entertainment value refers to individuals finding interesting contents to spend their free time on and to interact with friends for pleasure ( Lee et al., 2014 ). The study of Jin et al. (2019) finds that entertainment value can effectively influence the occurrence of attachment in intimate relationships and has a specific impact on their behavior in virtual socialization, and that the long-term interactive behavior engaged in between users and virtual communities can satisfy users’ need for emotional pleasure and stimulate positive emotions, fondness and passion, etc., toward that virtual platform. Thus the long-term interactions between users and virtual communities can satisfy users’ need for emotional pleasure, stimulate positive emotions, love and passion, and thus create attachment to the virtual platform ( Jin X. L. et al., 2021 ). It can be seen that in the context of social media use, social attachment is formed by factors such as the user’s entertainment value to be satisfied, and has a specific impact on their individual behavior.

Thirdly, information value indicates the degree of practical convenience that users bring to themselves through their use of social media. Users can find news and other information to keep them informed and to enhance their relevant skills that interest them from social media platforms ( Cheung et al., 2014 ), which in turn generate positive emotions or feelings. Users are able to access more valuable and relevant information in a timely manner, and can share the activities they participate in on the social media platform through functions such as commenting and retweeting, and the level of convenience in accessing the information value ( Wang et al., 2017 ; Jin Y. et al., 2021 ). The higher the actual level of convenience perceived by users and the greater the information value obtained, the higher the level of attachment of users to social media.

Based on the above reasoning, we hypothesize that:

Hypothesis 1a: Users’ social value is positively related to social attachment.

Hypothesis 1b: Users’ entertainment value is positively related to social attachment.

Hypothesis 1c: Users’ information value is positively related to social attachment.

Perceived Value and Sense of Belonging

Research has shown that the perceived value of social media users has a significant effect on their sense of belonging ( Tirukkovalluri et al., 2020 ). Davis (2015) examined the relationship between belongingness and perceived value based on social and behavior theoretical perspectives in a study on the willingness and behavior of sustained engagement on social networking sites. The study was conducted on Facebook and data was collected from 403 Jordanian undergraduate and postgraduate students through a questionnaire, and the extended theory was tested using statistical analysis, which showed a significant effect of perceived value on belongingness ( Al-Debei et al., 2013 ). Al-Debei et al. (2013) ’s study further found that a sense of belonging facilitates users’ continued use behavior. Building on Al-Debei et al. (2013) ’ s study, Zhang et al. (2017) examined the effects of direct and indirect network externalities on users’ perceived value (including social value, information value, emotional value and hedonic value), sense of belonging and persistence intention based on a survey of WeChat users, using structural equation modeling to analyze the data. The results confirmed the mediating role of belongingness in the influence of perceived value on persistence intentions. It can be seen that users’ perceived value has an influential role in the sense of belonging.

A sense of belonging reflects an individual’s experience of participating in an environment, an experience that makes the individual feel integral to that environment, a feeling that arises from the influence of the external environment on the individual, and the individual’s behavior in the external environment is a result of that influence ( An and Liu, 2014 ; Gao et al., 2017 ). Belongingness has been extensively studied in both physical and online virtual environments ( Zhao et al., 2012 ). However, unlike traditional virtual community usage contexts, this study focuses on the contexts of social media use and explores the emotional responses of perceived value affecting the emotional bond between users and social media. There are multidimensional content characteristics of users’ perceived value in social media use contexts. In summary, users’ perceived value contains social value, entertainment value and information value, etc., and the higher the degree of perceived value during usage, the stronger the users’ sense of belonging to the social media ( Hsu and Lin, 2016 ; Yang et al., 2021b ).

First, social value refers to a subjective evaluation and feeling of individuals toward social media, and reflects not only a certain value attribute inherent in the social media itself, but also a user’s self-perception of the social media ( Zhang et al., 2017 ). In the process of social media use, when the perceived social value is strong, users focus more on learning about other users’ behavior and develop herding behavior, and stronger sense of identification and belongingness to social media use driven by herding behavior ( Balakrishnan and Shamim, 2013 ; Kim and Lee, 2016 ). Therefore, individuals’ identification with other individuals is enhanced under the effect of herding behavior, which consequently leads to an increase in the degree of belongingness of individuals ( Yang et al., 2021b ). Therefore, the social value of users has a significant impact on their sense of belonging.

Second, in today’s society, the use of social media has become a priority which enables users to gain physical and mental relaxation and increases the entertainment value of their social situations ( Wang and Huang, 2017 ). Therefore, in the process of human-computer interaction, the individual is also able to experience leisure and entertainment in the real environment, which makes the users comfortable and satisfied as if there is no real-life interpersonal communication and interaction at stake ( Jarman et al., 2021 ). When users are immersed in a social media use context, good entertainment value is generated ( Li and Gao, 2019 ; Yang et al., 2021b ). Entertainment value can give users a sense of presence and enhance their entertainment experience during the use of social media. Therefore, users’ entertainment value has a significant impact on their sense of belonging.

Third, the information value not only helps individuals better perceive the presence of others involved in short video topics, but also allows them to obtain or gather more information through the perception of others’ presence ( Yin and Li, 2017 ). Individuals can further master or enrich their self-understanding of the required knowledge and skills through the relevant information, enabling users to make more accurate judgments about the information and knowledge of the short video itself and other situations, which can enhance their sense of belonging to the social media platform ( Yang et al., 2021b ). According to relevant research in social psychology, individuals choose to trust and accept the influence of others by observing the way people with intimate relationships behave and by choosing to trust and accept others ( Walker, 2020 ). Therefore, users improve their knowledge of social media and the wealth of information it provides through intimate behaviors between users, thereby enhancing their sense of belonging. It can be seen that the information value has a significant impact on users’ sense of belonging.

Based on the above statements, we hypothesize that:

Hypothesis 2a: Users’ social value is positively related to sense of belonging.

Hypothesis 2b: Users’ entertainment value is positively related to sense of belonging.

Hypothesis 2c: Users’ information value is positively related to sense of belonging.

Sense of Belonging and Social Attachment

In the study of social media, belongingness can be defined as the engagement with and perception of social media ( Chai and Kim, 2012 ). It reflects the user’s attachment to the social media ( Lin et al., 2014 ) and describes well the psychological states experienced by social media users or their emotional responses to social media during interpersonal interactions ( Guo et al., 2016 ). Research has highlighted the important role of belongingness in the context of social media use ( Zhao et al., 2012 ; Lin et al., 2014 ). Chai and Kim (2012) found that a sense of belonging positively influenced individuals’ knowledge sharing behaviors on social media, and Lin (2008) found that belongingness predicted loyalty among online social media members, and Chou et al. (2016) found that social media users’ sense of belonging positively influenced knowledge contribution behaviors and citizenship behaviors on virtual platforms, and Lin et al. (2014) found that a sense of belonging was an important indicator of users’ continued use of social media.

Some studies have shown that with the popularity of the Internet and the development of information technology, social media has become a major tool for users to make friends, chat and disseminate information online, and virtual socializing has become a major lifestyle for the public, satisfying individuals’ needs for social interaction ( Osatuyi, 2013 ), with higher controllability for users ( Gao et al., 2017 ), and in a more convenient form. In this context, although the masses are superficially becoming more friendly and more engaged, the spiritual level of interaction and communication between individuals is gradually decreasing and users are becoming emotionally distant from each other. This partly explains why more and more individuals are seeking a sense of belonging in social media and finding new objects of attachment through interpersonal interactions in social media platforms ( Duffett, 2020 ; Yang et al., 2021b ). Currently, new social relationships are being regrouped around social media as a result of information technology, reconfiguring new social relationships and focus of life between people. The tendency and trend of weakening the real life of the masses, offline social and interactive relationships are weakened by virtual social and interactive connections, individuals need to communicate with each other and reconstruct their self-identity through social media and in the process forming attachments to social media ( Ifinedo, 2016 ). Users who have formed a strong sense of belonging to social media will feel empty and lonely staying away from social media, and need to express their existence value and emotional relationship through a sense of “belonging” as a ritual. This is why research has found that users with a strong attachment to social media want to be recognized and accepted by the social media, making them become part of the social media platform, which is essentially a sense of belonging to the social media ( Hsu and Lin, 2016 ). Belongingness enhances the social attachment between the social media and the users, allowing them to immerse themselves in this virtual environment without being aware of it, thus creating a social attachment to the social media ( Yang et al., 2021b ).

The relationship between users’ sense of belonging and social attachment has been examined through data from the perspective of empirical studies. Related studies by foreign scholars point out that users with a higher sense of belonging are more willing to maintain various types of social relationships on social platforms and have a higher level of attachment to social platforms ( Lee et al., 2013 ). Users can interact, communicate and exchange with others through social media platforms, expressing themselves, seeking care, support, recognition and sympathy in virtual social interaction, thus stimulating a sense of belonging to the social media, which in turn has a positive effect on users’ social attachment to the social media ( Baumeister and Leary, 1995 ). Lee et al. (2013) ’s study also shows that users’ sense of belonging can, to some extent, indicate their level of emotional response to social platform use, and that this behavior tendency to reflect the level of emotion can lead users to reach an attachment relationship to the social platform. The implication of this is that there is a relationship between an individual’ s sense of belonging and the attachment feelings of social media users. This view has been further tested and supported by domestic scholars. Taking the popular short-video social media in China as the research object, Yang et al. (2021a) explore the relationship between users’ perceived value and their attachment to the social media and find that users’ sense of belonging has a significant positive effect on their attachment, and the stronger the degree of belonging of short-video social media users, the stronger their attachment to the continued use of short-video social media. Therefore, it is known that the user’s sense of belonging in the context of social media use can have an influential effect on social attachment.

Hypothesis 3: Users’ sense of belonging is positively related to social attachment.

Mediating Role of Sense of Belonging

Based on the above analysis of the effect of perceived value on the sense of belonging, it is clear that users’ perceived value is conducive to their sense of belonging. Also, based on the above analysis of the effect of belonging on social attachment, it can be seen that users’ sense of belonging can positively influence their social attachment. Therefore, it can be inferred that users’ sense of belonging plays an important mediating role in the relationship between perceived value and social attachment. It has been found empirically that perceived value positively influences the attachment relationship between users and social media through the mediating role of belongingness, and that the higher the degree of perceived value, the stronger the users’ social attachment ( Yang et al., 2021b ). Belonging theory suggests that individuals have a strong need of belongingness ( Baumeister and Leary, 1995 ) and therefore users are motivated to engage in interpersonal interactions to satisfy their need to belong in social media contexts. The use of social media creates a convenient, immediate and fast interaction environment for the public, and the entertainment, informational and functional values that users derive from their interactions positively influence their satisfaction and engagement with the social media, which in turn influences and enhances their sense of belonging to the social media. In other words, users satisfy their need for a sense of belonging through perceived value. An individually fulfilling sense of belonging can lead to positive emotions ( Baumeister and Leary, 1995 ), enhance users’ stickiness and attachment to social media ( Kim and Lee, 2016 ), and promote strong social attachment to social media during interactions. Belongingness reflects the psychological state of users in the context of social media use (e.g., joy, emotion and happiness) and the social attachment they develop to the social media. It is evident that belongingness, as an emotional connection and emotional affiliation created in the use of social media, connects the user’s perceived value and social attachment. Further research finds that when users perceive great benefits from social media in the course of using it, its social, entertainment and information values can satisfy their need for belongingness ( Mwencha et al., 2014 ), which in turn enhances and promotes their social attachment ( Kim and Han, 2009 ).

First, social values facilitate the development of social relationships between users during the use of social media, and high levels of social values help to strengthen emotional bonds between users and are predictable in reducing and alleviating individuals’ feelings of loneliness, thereby increasing their sense of belonging and attachment to social media. Clearly, social value is also an important antecedent factor influencing the continued usage of social media by users. On one hand, studies on herding behavior have argued that belonging is a major reason for individual herding, and in social media use contexts, the social value generated by users’ interpersonal interactions through social media platforms under the influence of herding behavior enhances their sense of belonging to social media and has a positive impact on their social and usage behavior ( Balakrishnan and Shamim, 2013 ). On the other hand, the recognition users receive from others on social media, such as likes, positive comments, retweets and video downloads inspires their confidence in continued use and creates social attachment to the social media through a sense of belonging. Thus, perceived value positively influences the attachment relationship between users and social media through the mediation of a sense of belonging. In other words, the sense of belonging plays an important mediating role in the relationship between social values and social attachment.

Second, entertainment value can immerse users in the context of social media use, and acquiring entertainment value in the process reflects a clear willingness to continue using social media, i.e., users have a stronger sense of belonging to social media ( Petrulaitiene and Jylha, 2015 ). As an integral dimension of user perceived value in the context of social media use, entertainment value is the ability of users to enhance their positive emotions, which in turn influences their outward behavior and performance. Therefore, entertainment value helps to improve the users physically and mentally, enhances the emotional bond between the users and the social media, and promotes the formation of a sense of belonging to the social media ( Gefen and Straub, 2004 ). In addition, the immersion that comes with entertainment value helps to increase the engagement and perception of social media by willing users, i.e., it enhances users’ sense of belonging to the social media, which in turn enhances the efficiency and meaningfulness of users’ communication, allowing for a rich feedback and emotional experience, and then a great sense of attachment ( Koufaris, 2002 ). It can be seen that user entertainment value has a significant effect on belongingness, which in turn has a significant effect on social attachment. Thus, belongingness plays a connecting role in the relationship between users’ entertainment value and social attachment. In other words, the sense of belonging mediates the relationship between users’ entertainment value and social attachment.

Third, information value is one of the most basic perceived values that users acquire in the process of using social media ( Zhao and Zhou, 2017 ). In the context of social media use, information value refers to maximizing users’ access to knowledge or information they need at minimal cost ( Cheung et al., 2014 ). On one hand, users’ efficient and timely search for knowledge or information reflects their need to access to information. This efficient need influences users’ positive attitude and behavior intentions, which can promote a strong sense of belonging to the social media. Furthermore, the sense of belonging itself reflects the extent to which users understand the purpose and willingness to use social media ( Sit and Birch, 2014 ). On the other hand, it has been suggested that a sense of belonging is an important factor influencing users’ use of social media, and that users with a strong level of belongingness will enhance their positive evaluation of and trust in social media, thus further contributing to their sense of attachment to social media ( Wang and Huang, 2017 ). And Yen (2012) ’s research shows that when users perceive the information value to be more useful, they develop a greater sense of belonging to the social media, increase the reliability of the information source, and in turn strengthen their social attachment by increasing their level of belongingness. Thus, information value positively influences social attachment through the mediating role of belongingness. In other words, belongingness plays an important mediating role in the relationship between information value and social attachment.

Based on the above analysis, it is clear that perceived value has a significant effect on belongingness in the context of social media use, which in turn has a significant effect on social attachment. It can be seen that sense of belonging plays a connecting role in the relationship between users’ perceived value and social attachment. Therefore, sense of belonging can be found to play an important mediating role in the relationship between perceived value and social attachment.

In view of this, the following hypothesis is proposed in this study:

Hypothesis 4a: Users’ sense of belonging plays a mediating role between users’ social value and social attachment.

Hypothesis 4b: Users’ sense of belonging plays a mediating role between users’ entertainment value and social attachment.

Hypothesis 4c: Users’ sense of belonging plays a mediating role between users’ information value and social attachment.

Moderating Role of Privacy Concern

Privacy concern is an individual’s awareness and assessment of the risks associated with the invasion of privacy ( Tan et al., 2012 ; Peng et al., 2018 ; Chung et al., 2021 ). Cho et al. (2019) state that privacy concern occurs and is stimulated in specific contexts, and that individuals’ privacy concern is most prominent in situations where personal interests are at stake. Specifically, when an individual’s level of privacy concern is high, he or she will worry about the negative consequences of his or her privacy, which causes the individual to restrain his or her behavior, such as inhibiting the individual from uploading work on social media platforms and discussing issues with other users ( Schomakers et al., 2019 ). Conversely, individuals are more willing to express themselves, demonstrate expertise, and share knowledge in virtual environments when their privacy concern is weak. In the study of virtual contexts, privacy concern plays an important role in the behavior of individuals in the context ( Li et al., 2019 ), and empirical research on privacy concern is becoming a focus and topical issue for scholars ( Jin X. L. et al., 2021 ). Although it has been suggested that perceived value, which measures users’ perceived preference and overall evaluation of social media, affects users’ social attachment ( Mikulincer and Shaver, 2007 ; Yang et al., 2021b ), social attachment between users and social media can be strong or weak, and only strong perceived values are associated with strong emotional, fond and passionate attachments ( Bowlby, 1982 ). This means that the prediction of attachment maintenance between users and social media is confounded by other factors, and the moderating role of privacy concern draws sufficient attention to this. In particular, with the increasing use of social media for information sharing, the extent to which users are concerned about privacy directly affects the extent to which perceived value is related to attachment to social interaction. Therefore, this study further explores the moderating role of individual differences in privacy concern in the context of social media use, based on an examination of the influence of perceived value on social attachment.

Increased privacy concern negatively moderates the relationship between perceived value and social attachment ( Mahmoodi et al., 2018 ; Punj, 2019 ). Research has found that the effect of user perceived value on social attachment in social media use contexts is not necessarily negatively moderated by privacy concern ( Peters et al., 2015 ). This may be due to the fact that as users’ perceived value increases, the benefits (i.e., perceived value) they gain in terms of entertainment, social relationship capital, and emotional support are higher than the risks associated with privacy disclosure, thus somewhat attenuating or ignoring the negative effects of users’ privacy concern ( Xu et al., 2019 ), so the impact of perceived value on social attachment is not weakened by privacy concern. The impact of perceived value on social attachment is not reduced by the weakening of privacy concern. In other words, users’ lack of awareness of privacy protection results in their privacy concern not playing a negative moderating role in relationships where perceived value influenced social attachment. Regarding the lack of privacy protection for social media users, relevant studies have provided an explanation, and Kehr et al. (2015) argue that the increase in users’ perceived value drives them to be too positive and optimistic about the benefits brought by using social media, thus interfering with their final judgment, which leads them to underestimate the risk of privacy leakage. Therefore, although users are aware of the privacy leakage problem in social media, they still continue to choose to use the social media based on the positive influence of perceived value ( Li et al., 2018 ), i.e., the influence of users’ perceived value on social attachment fails to be moderated by the negative effect of privacy concern.

However, it has also been suggested that for those individuals who focus on privacy concern, their privacy concern can diminish the role of perceived value in influencing social attachment. For example, Muhammad et al. (2018) , in evaluating the impact of social media disclosure and privacy options on users’ privacy control, find that users choose to discontinue sharing personal information on social platforms due to concerns about the potential disclosure of private information, as they are more concerned about the inconvenience of privacy disclosure in their lives, which in turn negatively moderates users’ perceived value. Wang et al. (2020) argued that privacy concerns become more serious as individuals become more concerned and attentive to privacy leaks and a large amount of personal information is exposed to social media platforms. As a result, users with higher level of privacy concerns are worried about the collection, control and use of personal information in the process of using social media, thus creating a perceived loss factor of using that social media. This implies that users with higher levels of privacy concerns expect social media to enhance privacy protection in order to eliminate anxiety and concerns about personal privacy disclosure, thus negatively moderating the relationship between perceived value influencing social attachment. In particular, as the level of users’ privacy concern increases, so does its negative moderating effect on perceived value influencing continued willingness to social media use.

From the above analysis, it is inferred that the negative moderating effect of privacy concern on the relationship between perceived value and social attachment is not significant for users with low levels of privacy concern in the context of social media use. In contrast, users with high levels of privacy concern have a significant negative moderating effect of privacy concern in the relationship between perceived value and social attachment, but do not have the same lack of privacy protection and security awareness as users with low levels of privacy concern. Therefore, the relationship between perceived value and social attachment is found to be negatively moderated by privacy concern, but the moderating effect of privacy concern on the role of perceived value in influencing social attachment has not yet received sufficient attention and discussion.

Hypothesis 5a: Users’ privacy concern plays a negative moderating role between users’ social value and social attachment.

Hypothesis 5b: Users’ privacy concern plays a negative moderating role between users’ entertainment value and social attachment.

Hypothesis 5c: Users’ privacy concern plays a negative moderating role between users’ information value and social attachment.

Overview of the Present Research

To test our theoretical model depicted in Figure 1 , we have conducted two studies on user samples using complementary designs to verify our hypotheses. Study 1 uses a sample study of a cross-sectional sample of mainland China and Macau Tik Tok users to verify whether the relationship between perceived value and social attachment can mediate the role of belongingness. Study 2 extends the mediation model of Study 1 by examining privacy concern as a boundary condition, and further verifies the moderating role of privacy concern in relationship between perceived value and social attachment. The model is designed to be tested with samples of Tik Tok users in mainland China collected at two time points. Study 1 tests the mediation model (Hypothesis 1-4), and Study 2 further includes privacy concern to test the entire model (Hypothesis 1-5). Considered together, these two studies comprise a mix of different designs and samples that provide a nice combination of internal and external validity evidence for our theoretical model.

Figure 1. Theoretical model.

Participants and Procedure

Participants in Study 1 (Tik Tok users) are recruited through https://www.wjx.cn (questionnaire) from mainland China and Macau. The company operates a professional online questionnaire survey platform that focuses on providing users with powerful and user-friendly online designs, a series of services for questionnaires, data collection, and survey results analysis. Compared with traditional survey methods and other survey websites or survey systems, https://www.wjx.cn (questionnaire star) has obvious advantages of custom questionnaire background/logo, red envelope lottery/custom prizes, and automatic data statistical analysis. The validity of using this online questionnaire has been verified in previous studies, and these studies have proved its feasibility and reliability ( Jin et al., 2013 ; Peng and Xie, 2016 ; Xu and Ma, 2016 ). Participants access the questionnaire via the hyperlink included in the invitation. Before answering the questionnaire, participants are prompted to carefully read the information sheet, which informed them that participation is voluntary and anonymous, and that only adults living in mainland are eligible to participate. More importantly, this study selected TikTok mass users as the research samples. We chose Tik Tok for the current research for several reasons. First, Tik Tok, as the largest leading social platform in China, has been proved to be feasible and reliable in previous studies. Secondly, Tik Tok is a representative APP, which is a leader in the market segments of social media and possesses the typical characteristics required by the research work. Thirdly, if research findings are supported by the data of TikTok, the current study can just provide management suggestions to improve the commercial practice of social media. Therefore, from this perspective, the use of TikTok public users to conduct data surveys is compatible with our original research purpose.

In order to further ensure that the participants are our target subjects, two filtering questions are used at the beginning of the survey to check the eligibility of the participants (that is, to exclude participants under 18 years old and those with no longer than 6 months of social media use). Since we have pre-screened in the https://www.wjx.cn (questionnaire star) system and only invite adults, no participants are disqualified when the interviewees are double-checked through these two qualification screening questions. Because researchers believe that online questionnaire surveys may cause participants to divorce from practice, we insert three trap questions in the survey as the basis for judging the validity of the questionnaire, which is consistent with the best practices adopted in previous studies ( Smith et al., 2016 ). These trap questions are very simple and have the same format, for example, “Please select ‘2’ for this item”. Only surveys where all trap questions have been answered correctly are considered valid questionnaires. Of the 600 participants, 10.17% ( n = 61) do not answer the trap question correctly and are therefore excluded from the analysis. Among 539 participants, female accounted for 55.66% and male accounted for 44.34%. The average age is 27 and 23.21% participants were under 20 years old, 38.62% between 21 to 30 years, and 19.52% between 30 to 40 years. Over 41 years old accounted for 18.65%. Unmarried participants accounted for 68.67% and the married accounted for 31.33%.

The measurement items in this study adopt existing mature scales, and carry out translation verification according to the recommendations of the back-translation method, so as to ensure the quality of the questionnaire and its applicability in Chinese context. The measurement items in this study are all measured by Likert 7-point scale. The variables are measured as follows:

Social attachment

A 16-item scale, proposed by Yang et al. (2021a) , were adopted to measure three dimensions of social attachment, among which 5 items were used to measure social connection, 5 items for measuring social identity and 6 for assessing social dependence. This scale is rated on a 7-point response scale ranging from 1 (strongly disagree) to 7 (strongly agree).

Perceived value

The perceived value scale of this study contains three sub-facets and a total of 12 items. Among them, the social value scale refers to related studies by Hagel et al. (1997) , including 4 items; the entertainment value scale refers to Overby and Lee (2006) ; De Vries and Carlson (2014) , Kim and Han (2009) including 4 items; the information value mainly refers to the research of Papacharissi and Rubin (2000) ; Cheung et al. (2014) , including 4 items. This scale is rated on a 7-point response scale ranging from 1 (strongly disagree) to 7 (strongly agree).

Sense of belonging

The sense of belonging scale of this research mainly refers to the research views of Teo et al. (2003) and Lin (2008) , mainly to measure users’ use of social media and sense of belonging, including 4 items. This scale is rated on a 7-point response scale ranging from 1 (strongly disagree) to 7 (strongly agree).

Control variables

In the basic personal background information part of the questionnaire, this part is divided into gender, age, marital status, education, occupation, monthly consumption level and usage time according to the characteristics of Tik Tok users, a total of 7 items.

Data Analysis Method

In this study, Mplus7.0 is used to do Structural Equation Modeling (SEM) analysis on the collected data. The data analysis includes measurement model analysis and structural model analysis ( Bagozzi and Yi, 1988 ). Specifically, the data analysis methods of this study are described as follows:

First, perform Confirmatory Factor Analysis (CFA). This research uses CFA to test the research model, including item reliability (Item Reliability), composition reliability (Construct Reliability), average variance extraction (Convergence validity), etc., to judge the convergence validity of each aspect. Second, perform discriminant validity analysis. In this study, a more rigorous AVE method is used to test the discriminative validity of the measurement model to verify whether the correlation between the two different aspects is statistically different. Fourth, perform Structural Model Analysis. Including model fit, research hypothesis significance test and explainable variance ( R 2 ) and other results. And on this basis, further analyze the mediating role and moderating role. Third, on the basis of the above analysis, further analyze the mediation effects.

Confirmatory Factor Analysis

Confirmatory Factor Analysis (CFA) is a part of SEM analysis. The variable reduction of CFA measurement model in this study is based on Zhang et al. (2021) ’ s two-stage model modification. The measurement model must be tested before performing the structural model evaluation. A complete SEM model report can only be carried out if the measurement model is reasonably acceptable.

In this study, CFA analysis is performed on all dimensions, and the results are shown in Table 1 . The standardized factor loadings of all dimensions are between 0.596 and 0.906, and the composite reliability is between 0.794 and 0.912. Convergence Validity is between 0.542 and 0.675, meeting all the standards of Fornell and Lacker (1981) with standardized factor loadings greater than 0.50, Composite Reliability greater than 0.60, and Convergence Validity greater than 0.50 ( Verbeke et al., 2014 ; Hair et al., 2017 ). Therefore, the model meets the standard, and all aspects have good convergence validity.

Table 1. Confirmatory factor analysis.

Discriminant Validity

The discriminant validity analysis is to examine whether different two variables in the statistics are different or not. In this study, the AVE method is used to evaluate the discriminative validity. Fornell and Lacker (1981) propose the square root of the AVE with the correlation between the construct and other constructs in the model, which means that the variables have discriminative validity. As shown in Table 2 , the square roots of the AVE on the diagonal are larger than the correlations between constructs, indicating acceptable discriminant validity. Therefore, study 1 has good discriminative validity.

Table 2. Discriminant validity for the measurement model.

Model Fit Degree

In this study, the model fit degree index refers to the model of model fitness analysis, and the 9 most extensive fitness indicators are used for analysis ( Jackson et al., 2009 ). Since the SEM sample is larger than 200, it is easy to cause the chi-square value to be too large and lead to poor fit, so the fit value needs to be corrected by Bootstrap ( Bollen and Stine, 1992 ). After passing the Bollen-Stine Bootstrap correction model, all the fitness indicators in this study have been passed (as shown in Table 3 ), indicating that the results of this study are acceptable.

Table 3. Model fit criteria and the test results.

Regression Coefficient

In this research model (as shown in Table 4 ), social value (SV) ( b = 0.340, p < 0.001), entertainment value (EV) ( b = 0.085, p < 0.001) and information value (IV) ( b = 0.585, p < 0.001) significantly affect the sense of belonging (SOB). Social value (SV) ( b = 0.663, p < 0.001), entertainment value (EV) ( b = 0.208, p < 0.01), information value (IV) ( b = 0.168, p < 0.05), and sense of belonging (SOB) ( b = 0.612, p < 0.01) significantly affected social attachment (SA). Therefore, all H1∼H3 are established.

Table 4. Regression coefficient.

Mediating Effect Analysis

In order to calculate the mediation effect more accurately, this study uses the confidence interval method (Bootstrap Distribution of Effects) to analyze and test the mediation effect. The Bootstrap estimation technique is used to analyze the confidence intervals of the total effect, the indirect effect and the direct effect, and then the significance level of the mediation effect is further calculated ( Hayes, 2009 ). The upper and lower limits of the Bias-corrected 95% confidence interval do not contain “0,” which means the effect is passed. The results of this study show (as shown in Table 5 ) that the total effect of social value on social attachment is 0.251. At the 95% confidence level, the confidence interval of Bias-corrected is 0.146∼0.386, and the confidence interval of Percentile is 0.138∼0.363, not including 0, so the total effect is established. The indirect effect is 0.069, the confidence interval of Bias-corrected is 0.013∼0.158 at the 95% confidence level, and the confidence interval of Percentile is 0.017∼0.172, which does not contain 0, so the indirect effect is valid. The direct effect is 0.182, the confidence interval of Bias-corrected is 0.061∼0.330 at the 95% confidence level, and the confidence interval of Percentile is 0.031∼0.297, which does not contain 0, so the direct effect is valid. Therefore, it is assumed that H4a holds and is a partial intermediary. In the same way, H4b is established as a partial intermediary. H4c is also established and is a complete intermediary.

Table 5. The analysis of mediation effect.

Study 1 provides some evidence for the relationship between perceived value and social attachment. The results of these samples show that when users use social media in the context of social media use, the three dimensions of perceived value (i.e., social value, entertainment value, and information value) have great differences in the effects and mechanisms of social attachment. Specifically, social value can positively affect social attachment, in which the sense of belonging plays a part of the mediating role. Entertainment value can positively affect social attachment, and the sense of belonging plays a part of the mediating role. Information value can positively affect social attachment, in which the sense of belonging plays a completely mediating role. Therefore, when users are in the context of social media use, the sense of belonging plays an extremely important role in the strength of the attachment relationship between the individual and the social media.

Although Study 1 provides preliminary support for the mediating role of belonging between perceived value and social attachment, it has a major limitation in that the key variables are self-reported at the same time, and all variables in the research model are from the same data source. Therefore, the results are affected by the variance of commonly used methods. Although studies have confirmed that its impact is small, it may still increase the reported effect size ( Podsakoff et al., 2012 ). Therefore, in Study 2, we follow the recommendations of empirical sampling research and use the time interval between variables as a method to solve the common method variance problem in empirical research ( Ohly et al., 2010 ; Beal, 2015 ).

Study 1 verifies the positive effect of sense of belonging on social attachment in the context of social media use. In Study 2, we try to further verify the application of the mediation model in different groups and its boundary conditions. In addition, the more important point is that in Study 2, we include privacy concern to test the entire model, further enriching and expanding existing research fields.

Participants are users of social media in China, and they are mainly recruited through Tik Tok, a short video platform that is popular in the Chinese market. As the largest leading platform in China’s domestic social media industry, this platform has proved its feasibility and reliability in previous studies ( Paolacci and Chandler, 2014 ; Wu et al., 2018 ; Wang, 2020 ). At the same time, this study also releases questionnaire recruitment information through WeChat. That is, this study collects data through multi-source surveys. Participants access the questionnaire through a hyperlink. Before answering the questionnaire, they are instructed to read the information sheet. The information tells them that participation is voluntary and anonymous, and only users using Tik Tok for more than 6 months are eligible to participate. In order to ensure that the respondents are our target audience, two filtering questions are used at the beginning of the survey to determine the eligibility of participants (that is, to exclude users under the age of 18 and users who are not continuous user).

In order to reduce common method variance ( Podsakoff et al., 2012 ), we collect data at two time points, where the time interval is 2 weeks. In the first survey, participants report demographic information, perceived value, privacy concern, and sense of belonging. In the second survey conducted two weeks later, participants report the extent of their emotional attachment performance in social situations. In order to stimulate participants’ attention, a monetary reward of $3 is offered, to ensure that the completed questionnaire is returned immediately. We conducted a questionnaire survey on 500 Tik Tok users at time 1, and received questionnaires from 436 respondents (response rate of 87.20%), of which 385 respondents (response rate of 88.30%) responded at time 2 available questionnaires. The average age of these respondents (72.21% women) is 29.25 years (SD = 9.91), and the average use time is 1.32 years (SD = 6.84). Among them, 73.41% is unmarried; 38.44% of the sample has a college diploma (including a high school diploma), followed by a bachelor’s degree (37.66%), a master’s degree (21.04%), and only a few respondents has a doctoral degree (2.86%). According to the independent sample test, among the valid respondents at time 1, those who missed time 2 ( n = 51) and there is no difference among those who completed the two surveys ( n = 385) with gender ( t = −0.32, n.s.), age ( t = −0.51, n.s.) and usage time ( t = −0.28, n.s.).

Privacy concern

We use Son and Kim (2008) ; Shin (2010) , and Tan et al. (2012) ‘ s privacy concern scale, the measurement items for privacy concern was translated from English into Chinese following the back-translation procedure advocated by Cha et al. (2007) , and according to the actual use situation of social software, which is modified into a measurement item of privacy, mainly used to evaluate the privacy concern of users in the context of social software use. There are 4 items in total. This scale is rated on a 7-point response scale ranging from 1 (strongly disagree) to 7 (strongly agree).

Perceived value, social attachment, and sense of belonging are measured using the same scales as in Study 1. All measurement items except for demographic questions are responded to on a Likert-type scale ranging from 1 (strongly disagree) to 7 (strongly agree).

We have sorted and classified the returned official questionnaires, eliminated invalid questionnaires, and then registered and coded the questionnaires one by one. Specifically, the data analysis methods in this study were as in Study 1.

Data Analysis and Results

To ensure that the developed questionnaire questions are valid, discriminatory is a very important task in scale development. Therefore, a pre-test is conducted of the data using SPSS 24.0 on the sample collected. The aim is to confirm the semantic fluency of the scale questions, the absence of typos and the appropriateness of the layout. One of the most important tasks is to do an item analysis. Its purpose is to remove topics (or variables) that are not discriminating and use them as a basis for topic improvement.

As in Study 1, we have performed CFA analysis on all facets, and the results are shown in Table 6 . In this study, the evaluation and reduction of CFA measurement model variables are revised based on the two-stage model proposed by Zhang et al. (2021) . If the measurement model fit is acceptable, the full SEM model report can be followed.

Table 6. Confirmatory factor analysis.

There are eight constructs in this research model, namely entertainment value, information value, privacy concern, social connection, social dependence, social identity, sense of belonging and social value. According to the standards proposed by Anderson and Gerbing (1988) , CFA analysis is performed on all constructs. Following the standard proposed by Fornell and Lacker (1981) ; Verbeke et al. (2014) , and Hair et al. (2017) , convergent validity is tested with standardized factor loadings greater than 0.50, the composite reliability higher than 0.60, and the average variance extracted higher than 0.50. Therefore, according to the results shown in Table 6 , each variable of this study has a good reliability and polymerization validity.

Table 7 reports the Discriminant validity for the measurement model, the square roots of the AVE are reproduced on the diagonal. Discriminant validity is the extent to which the measure is not a reflection of some other variables. It is indicated by low correlations between the measure of interest and the measures of other constructs. We have examined discriminant validity using Fornell and Lacker (1981) ’s recommendation that the square root of the average variance extracted for each construct should be higher than the correlations between it and all other constructs. Table 7 shows that the squared root of average variance extracted for each construct is greater than the correlations between the constructs and all other constructs. As shown in Table 7 , our results support Fornell and Lacker (1981) ’ requirement of discriminant validity.

Table 7. Discriminant validity for the measurement model.

This study reports 9 model fit degree indicators: χ2, DF, Normed Chi-square (χ2/DF), RMSEA, SRMR, TLI (NNFI), CFI, GFI and AGFI, and the results are shown in Table 8 . The results show that the model fit degree well, and the research model constructed by the sample data is not significantly different from the actual situation. Therefore, it can be used to interpret the actual observation data.

Table 8. Model fit criteria and the test results.

As shown in Table 9 , in Study 2, social value (SV) ( b = 0.186, p < 0.001), entertainment value (EV) ( b = 0.210, p < 0.001) and information value (IV) ( b = 0.316, p < 0.001) significantly affect the sense of belonging (SOB). Social value (SV) ( b = 0.182, p < 0.001), entertainment value (EV) ( b = 0.259, p < 0.001), information value (IV) ( b = 0.090, p < 0.05), and sense of belonging (SOB) ( b = 0.369, p < 0.01) significantly affected social attachment (SA). Therefore, H1∼H3 are established.

Table 9. Regression coefficient.

We use Bootstrap estimation technology to test the mediation effect according to the recommendations of Hayes (2009) , and the research results show (see Table 10 ) the total effect of social value on social attachment is 0.251. At the 95% confidence level, the confidence interval of Bias-corrected is 0.146∼0.386, and the confidence interval of Percentile is 0.138∼0.363, which does not contain 0, so the total effect is established. The indirect effect is 0.069, the confidence interval of Bias-corrected is 0.013∼0.158 at the 95% confidence level, and the confidence interval of Percentile is 0.017∼0.172, which does not contain 0, so the indirect effect is valid. The direct effect is 0.182, the confidence interval of Bias-corrected is 0.061∼0.330 at the 95% confidence level, and the confidence interval of Percentile is 0.031∼0.297, which does not contain 0, so the direct effect is valid. Therefore, it is assumed that H4a holds and is a partial intermediary. In the same way, H4b is established as a partial intermediary. H4c is also established and is a complete intermediary.

Table 10. The analysis of mediating effect.

Moderating Effect Analysis

In this research model, privacy concern is the moderating variable. The analysis results are shown in Table 11 . It can be seen that the moderating effect of SV ∗ PC on SA is 0.017 ( z = | 0.280| > 1.96, p = 0.779 > 0.05), indicating that the moderating effect does not exist. The moderating effect of EV ∗ PC on SA is 0.019 ( z = | 0.324| > 1.96, p = 0.746 > 0.05), indicating that the moderator effect exists. The moderator effect of IV ∗ PC on SA is –0.123 ( z = | −2.355| > 1.96, p = 0.019 < 0.05), which means that the moderator effect exists, which means that for every additional unit of the modulating variable privacy relationship (PC), IV will affect SA The slope of will increase negatively by 0.123 units, that is, negative moderating effect. The result is shown in Figure 2 .

Table 11. The analysis of moderating effect.

Figure 2. Privacy concern moderating the relationship between social attachment and information value.

With the collected data from multi-source survey, results of Study 2 demonstrate that perceived value produces a positive impact on user’s social attachment through sense of belonging. This effect depends on the user’s privacy security, which verifies and expands the results of Study 1. It is worth noting that, unlike Study 1, privacy concern in Study 2 does not all mitigate the overall direct relationship between perceived value and social attachment. There are some potential reasons for this result.

Firstly, compared with Study 1, the further evidence in Study 2 shows that information value can positively affect social attachment, in which the sense of belonging plays a completely mediating role, and privacy concern plays a negative moderating role. Therefore, the user’s sense of belonging to social media becomes more intense, driven by the user’s perceived value and evaluation of social media, which triggers the generation of social attachment. Meanwhile, when an individual, in case of social media use scenarios, has a higher level of privacy concern, the relationship between information value and social attachment is weaker. The higher the level of privacy concern, the weaker the user’s attachment to social media, and the lower the impact of perceived value on social attachment. Conversely, once users do not pay attention to privacy concern, the more various beneficial values and benefits they perceive for social media, then the stronger the user’s attachment to social media. Therefore, as expected, privacy concern acts as a buffering condition and plays an indirect relationship between the information value and social attachment guided by positive emotions.

Secondly, compared to Study 1, further evidence from Study 2 suggests that social value and entertainment value are able to positively influence social attachment, with self of belonging playing a mediating role, but privacy concern does not play a regulatory role. One potential reason why privacy concern has not played a moderating role may be some of its limitations. Privacy in the context of social media use itself does not provide users with effective tools to counter social value and entertainment value. When a person strengthens social media privacy protection measures, and realizes that he or she does not change the perceived value degree, as well as his or her behavioral tendencies and emotional relationship toward social media, although time is consumed, he or she may perceive the benefits brought by social value and entertainment value, this dilutes the reconstruction and protection functions provided by privacy concern. Since preventing these perceived values and their impact on social attachment in the context of social media use may require more powerful solutions, it may be difficult for privacy concern in Study 2 to show buffering.

Research Results and Discussion

Theoretical contributions.

Compared with the existing literature, this article is innovative in the following aspects:

Firstly, this article combines perceived value with social attachment, which is an interdisciplinary research. The research on perceived value is currently mainly concentrated in the field of marketing, while social attachment belongs to the field of psychology. Although at the two-way level of theory and practice, the impact of perceived value on social attachment has begun to appear, the theoretical system is still not perfect, and the specific impact mechanism is not fully verified, and it is mostly concentrated in their respective fields. This research breaks the gap of previous related research perspectives, and for the first time clearly focuses on perceived value and social attachment, verifies the impact of perceived value on social attachment, and explores the underlying influence mechanism to inspire further research.

Secondly, this paper explores and examines the boundary conditions of privacy concern while affecting social attachment, under perceived value atmosphere. It is the first time privacy concern as moderator is introduced in social media use scenarios, expanding the existing research on perceived value impact on social attachment and its moderating mechanism, which confirms that there is weakness in the relationship establishment between the users and social media. This study finds that although users are aware that privacy in social contexts may be attacked in many ways, they will not change their privacy preferences and behaviors, in addition to the suppression of the information value on social attachment. This indicates that there is a disconnection between their desire to protect privacy and their privacy control behavior; this phenomenon is called the privacy paradox ( Chung et al., 2021 ). This study enriches the boundary conditions of the effect of perceived value on social attachment.

Thirdly, this article takes social value, entertainment value and information value as three kinds of perceived value for research, which enriches the related research of value theory. Although existing studies have also paid attention to the issue on the unclear relationship between different dimensions and construction of perceived value, and believed that different dimensions can be studied as separate perceived value, they have mainly focused on the impact of perceived value on continued willingness. Research on the attachment relationship between users and social media is still scarce. And this research expands the boundaries of existing research on perceived value theory by exploring the relationship between “how value affects users’ continued use behavior,” and enables new development and application in the context of social media use.

Practical Implications

This research provides a valuable reference for enhancing users’ perceived value and users’ social attachment establishment, as described below.

Firstly, social media can stimulate social attachment by enhancing users’ perceived value. For social media developers, in order to maintain and improve the perceived value of users, social media can consider implementing relevant management practices. Upgrade and improve short video platform functions, innovate and make breakthroughs in short video content marketing, convert content value and IP value into brand value, identify young people’s consumption desires and consumption ideas, and meet user entertainment needs (such as comedy/jokes). In order to kill time, people enjoy relaxing entertainment in the video swiping process, or get recreational services, which enhances the user’s entertainment value sensing capability and meets the needs of people’s social lives (key opinion leaders and hot content creators). In order to gain recognition and to maintain social relationships, people tend to get information from social talks, which enhances their social value sensing ability and meets their information needs (such as dry goods sharing, celebrities’ adverting of goods and 7-day hottest dynamic product information). In order to be useful, people tend to gain trustworthy and reliable information while swiping short video, which enhances their information value sensing capability. Therefore, relying on the differences in content creation ecology, fan preferences and typical celebrities to match the different needs and motivations of different users, social media can stimulate social attachment by enhancing users’ perceived value.

Secondly, social media can indirectly enhance social attachment by establishing a high-quality sense of belonging. This study shows that users’ perceived value makes use of the mediating role of sense of belonging, and then produces a positive direct impact on social attachment. Just like Maslow’s point of view in “Needs Hierarchy Theory,” “needs of belonging and love” are important psychological needs for people. Only by satisfying “needs of belonging and love” can people realize “self-value.” Therefore, social media platforms can relieve users’ pressure and loneliness through the creation of high-quality content to generate the recognition for social media, to get warmth, help and love from it, thereby eliminating or reducing loneliness, and gaining a sense of security. On the social media platform, by knowing more friends through the platform, users can maintain communication and contacts, and even gain friendship, support and respect, thereby gaining identity and attachment to social media.

Thirdly, when social media platforms strive to improve social attachment by developing perceived value, special attention should be paid to the differences in users’ cultural values (privacy concern). This study shows that when the level of privacy concern is high, users’ privacy concern plays a negative moderating role between users’ information value and social attachment. This reminds social media platforms of attaching great importance to the construction of privacy, security and control in the construction of user perceived value. Launching new functions for privacy issues, such as setting the privacy concern level function, automatically reporting the privacy risks to users, reducing the sense of exposure and intrusion of users’ information, can effectively reduce the main source of privacy concern. Strengthening users’ privacy control awareness, promoting the mode of information disclosure in social networks (for example, unpopular links, links provided in social media platforms showing some information about a certain individual who does not intend to disclose this information) and focusing on the impact of privacy leakage strengthen users’ trust in social media, weaken the negative impact of privacy risks, and build a good social trust.

Previous studies have shown that perceived value has a positive effect on users’ social attachment in social media usage contexts ( Wang et al., 2017 ; Li et al., 2019 ). To develop and enrich existing research fields, we have analyzed the driving effect of perceived value on social attachment in the scenarios of social media use, dug how and when users’ perceived value affects users’ social attachment in social context.

Based on privacy concern theory, this research constructs a new theoretical model, uses structural equation model to explore the relationship between perceived value and social attachment, introduces privacy concern to explain the specific impact mechanism, and at the same time pays attention the role that perceived value plays in it. We believe that the perceived value generates a positive impact on user’s social attachment through sense of belonging, and this impact depends on the user’s privacy concern.

There are two research components in this study, and Mplus7.0 is used for measurement model and structural model analysis, as follows:

Study 1 is a questionnaire survey on 600 Tik Tok users from mainland China and Macau, using Mplus7.0 for data analysis. The results support the mediating role of the sense of belonging, and find that perceived value has an indirect positive effect on social attachment through the mediating role of the sense of belonging. Study 2, apart from conducting the two-wave data survey on 500 Tik Tok users to confirm the mediating role of sense of belonging, also verifies the moderating role of privacy concern. However, the moderating role of privacy concern between perceived value and social attachment has not been fully supported. Specifically, except that the relationship between information value and social attachment is inhibited by privacy concern, the relationship between entertainment value and social value with social attachment is not regulated by privacy concern.

Research Limitations and Future Research Directions

As with any other research, the findings of our study should be interpreted with certain limitations in mind.

On one hand, this study treats social attachment as a general holistic construction to test its influence mechanism. Although it is a common practice in the literature to reduce the sub-facets of the second-order facets through the weighted average method in the analysis, this may cause deviations in the analysis results. This kind of conclusion, although it could reveal the positive interest of perceived value on social attachment in the social context, is difficult to reveal the differences of the different dimensions in social attachment. In consequence, future research can start from the perspective of user perceived value, especially distinguishing the different dimensions of social attachment, and examine the influence of perceived value on social connection, social attachment and social identity and the mediating role of sense of belonging in these relationships.

On the other hand, the questionnaire data of this study comes from a single questionnaire survey website platform, which may threaten the external validity of the research results. “Questionnaire Star” is one of the most popular survey websites, it provides functions equivalent to Amazon Mechanical Turk (MTurk). Although our careful choice of academic research study site “Wenjuan Xing/Questionnaire Star” (a very professional survey questionnaire site in China) alleviates this worry, due to the new virus Covid-19 pandemic caused by the crown restrictions, we cannot confirm whether the results of the current study is universal under other contexts. Therefore, we urge future researchers to replicate this research in other contexts to conduct cross-crowd testing, conduct multi-group comparative analysis, verify the promotion of the research results, and provide appropriate marketing strategies for different sub-groups.

Thirdly, although this study provides preliminary support for the mediation hypothesis, the key variables in this study are self-reported at the same time. Therefore, the hypothesis results of the study are affected by the variance of commonly used methods. Although the effect is statistically confirmed to be small, it is still possible to increase the reported effect size ( Ohly et al., 2010 ). In future research, we propose to address these limitations by using dual-wave online panel samples. In addition, we should also note that for social attachment such psychological phenomenon that contains a strong individual experiences and feelings, to only make quantify research from the horizontal viewing and the relatively static angle is clearly not enough, not all the particular dynamic belonging to social attachment can be perceived. We encourage researchers to adopt research methods with dynamic advantages, such as qualitative research, to better capture and describe the contextual process of social attachment development in detail.

Data Availability Statement

The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author/s.

Author Contributions

MY and WZ involved in conceptualization and involved in writing the review and editing and performed formal analysis. MY and QW involved in data curation. WZ and QW performed investigation. MY, WZ, and QW involved in writing the original draft. All authors have read and agreed to the published version of the manuscript. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords : attachment theory, perceived value, social attachment, sense of belonging, privacy concerns

Citation: Wang Q, Yang M and Zhang W (2021) Accessing the Influence of Perceived Value on Social Attachment: Developing Country Perspective. Front. Psychol. 12:760774. doi: 10.3389/fpsyg.2021.760774

Received: 18 August 2021; Accepted: 06 September 2021; Published: 14 October 2021.

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*Correspondence: Maosheng Yang, [email protected]

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COVID-19 has transformed customer behavior, notably in FMCG retailers. Although online stores grow, retail mix instruments remain essential for traditional shops, as these affect customer value perceptions and engagement. While previous studies suggest that customer value perceptions and engagement are linked, little is known about the effects of retail mix instruments on customer value perceptions and engagement. This study aims to fill this knowledge gap. In this study, the stimulus-organism-response (S-O-R) framework was used to propose the a priori conceptual framework, which was further employed in investigating the phenomena and the three concepts: the impact of retail mix instruments (S) on consumer value perceptions (O) and customer engagement (R). Interviews were conducted with 40 informants recruited by convenience sampling and snowballing techniques. They were Gen-X and Gen-Y and had experience visiting two FMCG retailers in Thailand. A thematic analysis was undertaken to analyze the obtained data. The a priori conceptual framework had been revised iteratively according to the emerging theme, resulting in a new conceptual framework containing descriptive details in terms of significant themes identified from the field data and potential relationships among the three concepts. Findings revealed 12 retail mix instruments and the effect of COVID-19, which were found to affect six types of customer value perceptions, resulting in four customer engagement behaviors. The proposed conceptual framework, the study’s primary theoretical contribution of the study, is used to guide potential future research agenda. To suggest how FMCG retailers may leverage the proposed conceptual framework to design strategies to promote customer engagement behaviors, an application of sales promotions is illustrated and suggests how to use sales promotion activities to induce customer value perception and their engagements.

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Introduction.

During the COVID-19 pandemic, online stores became popular because consumers perceived online shopping as safer than visiting a physical store (Verhoef et al. 2023 ). In the aftermath, a recent market survey found that consumers preferred to return to physical retail stores for many reasons (e.g., seeing products and feeling the social aspect of shopping); however, they perceived a less enjoyable experience (Theatro 2023 ). Additionally, the current slowing economy, inflation, and decreased consumer spending influence the retail industry (Deloitte 2023 ). These highlight the importance of brick-and-mortar stores and fierce competition in the following standard era.

In the fast-moving consumer goods (FMCG) industry, retailers also faced a high competition level not only before the pandemic (Mittal and Jhamb 2016 ) but also in the aftermath period (McKinsey 2022 ) and their everyday challenges involve maintaining patronage and sales rates (Wang et al. 2020 ). Customers have more choices when shopping, and customers may not be keen to shop from FMCG retailers who engage them intensely if no unique value proposition is offered (Javornik and Mandelli 2012 ; Mittal and Jhamb 2016 ). How can FMCG retailers sustain these upcoming trends? One classical practice is developing a business strategy that delivers customer value and satisfaction, including customer engagement (Javornik and Mandelli 2012 ; Sweeney and Soutar 2001 ). Research suggests that value proposition is essential to a physical retail store (Javornik and Mandelli 2012 ) because retail customers are value-driven (Levy 1999 ); thus, they always work to establish customer value through the retail marketing mix (Blut et al. 2018 ; Moore 2005 ), and the retail mix is an instrument used to influence customer behavior (Chen and Tsou 2012 ), create customer experiences (Rintamäki and Kirves 2017 ), and increase customer engagement (Blut et al. 2018 ; Pansari and Kumar 2017 ).

All the foregoing prompted us to conduct a literature review on the retail marketing mix, customer value, and customer behavior. It was found that previous studies investigated the effects of retail mix instruments on customer engagement (Blut et al. 2018 ; Moore 2005 ) and on customer value perceptions (O’Cass and Grace 2008 ), including the effects of customer value perceptions on customer engagement (Wongkitrungrueng and Assarut 2020 ). The review results did not identify the interrelationships between these concepts. Understanding the customer decision-making process is more critical than focusing on the ultimate purchase decision (Hunt 2014 ). According to the stimulus-organism-response (S-O-R) framework (Mehrabian and Russell 1974 ), this study proposes that retail mix instruments (stimuli) can activate customer value perceptions (cognitive mechanisms), which results in customer engagement (responses). In other words, customer value perceptions may play a mediating role between retail mix instruments and customer engagement. To the best of our knowledge, this study is the first to explore the potential relationships between retail mix instruments, customer value perceptions, and customer engagement.

However, there are some key challenges when exploring these three constructs. First, there are various retail mix instruments (Blut et al. 2018 ; Paul et al. 2016 ), and different retail contexts have different sets of retail mix instruments. Customer value perceptions are also multi-dimensional, as customer experience involves more than one value aspect (Zeithaml et al. 2020 ); thus, a single retail mix instrument may result in many customer value perceptions. Different value perceptions may result in various aspects of customer engagement, which can be approached from diverse perspectives (Yu et al. 2022 ).

This study will fill the gaps in retail literature by exploring the customer decision-making process regarding the potential effects of retail mix instruments on customer value perceptions and engagement. However, the scope is narrowed down to only the FMCG context. Specifically, the main research question is to explore the effects of retail mix instruments that are attractive to FMCG’s customers and can influence their value perceptions and engagements. Employing a qualitative approach led us to generate rich data that explains the complex phenomena involving these three constructs. A conceptual framework, the paper’s primary contribution, is then proposed. To provide an application of the proposed framework, the authors revisited the field data and presented a case of sales promotion (one of many retail mix instruments) as an example of marketing practice, which may hint at ideas for retailers to design a compelling retail mix to suit the customers’ behavior and decision process (Hanaysha et al. 2021 ).

The following section introduces the S-O-R framework, which is employed as an overarching theoretical foundation of this study and presents a review of literature on the FMCG retail context concerning retail mix instruments, dimensions of customer value, and customer engagement. Then, the research methodology used in the study is presented and followed by findings, which are synthesized to develop and propose a conceptual framework, research propositions, and recommendations for future studies. Practical discussions that may benefit marketing practice are also suggested. The last section summarizes the study’s contributions and limitations.

Literature review

The stimulus-organism-response (s-o-r) framework.

The S-O-R framework is a behavioralist theory developed to understand human behavior concerning external factors (Mehrabian and Russell 1974 ). The framework consists of stimuli in the environment (S) that affect the organism (O), or more specifically, consumers’ emotions and cognitive mechanisms, which result in the behavioral responses (R). In the retail context, the S-O-R framework has long been applied to various situations, such as the shopping field (Robert and John 1982 ), online shopping (Eroglu et al. 2001 ), luxury retails (Cheah et al. 2020 ), and shopping during the pandemic (Laato et al. 2020 ).

In the context of this study, stimuli are retail mix instruments that customers interact with when they visit physical stores. The organism aspect of S-O-R should be customer value perceptions because retail mix instruments can influence customers’ cognitive and affective mechanisms (Liu-Thompkins et al. 2022 ). Once customers have a certain level of magnitude of perceptions, they should show some behavioral responses such as intention (Laato et al. 2020 ), engagement (Chen and Tsou 2012 ), and loyalty (Terblanche 2017 ).

Retail mix instruments used in the FMCG context as retail’s stimuli (S)

Various retail mix instruments are reported in the retail literature, and different sets of retail mix instruments are suitable for use in different retail contexts. Mittal and Jhamb ( 2016 ) provided a set of retail mix instruments (e.g., an assortment of merchandise, improved quality, and proper display) that could be used in a shopping mall. For the context of three retail stores (supermarket, clothing, health, beauty, and lifestyle store), Terblanche ( 2017 ) proposed the 6Ps of a retailer’s products, promotion efforts, personnel, presentation, place, and price. Aparna et al. ( 2018 ) suggested retail mix instruments used in six retail stores context (department stores, hypermarkets, supermarkets, specialty stores, discount stores, and convenience stores): assortment, price, transactional convenience, and experience.

According to Blut et al. ( 2018 ), they concluded seven sets of common-used retail mix instruments, namely, product (product range and quality of products), service (customer service, maneuverability, orientation, parking, retail tenant mix, service tenant mix, and shopping infrastructure), brands (branding product level and corporate brand), incentives (monetary and non-monetary incentives), communication (advertising, atmosphere, and personal selling), price (low prices and perceived value), and distribution (access from parking, access from the store, proximity to home, proximity to work, spatial distance, and temporal distance). Apart from Blut et al. ( 2018 ), other studies (e.g., Arenas-Gaitan et al. 2021 ; Hanaysha et al. 2021 ) proposed retail mix instruments, but there is no significant difference from previous studies.

Customer value as a customer’s organism (O)

The aspect of a customer’s organism regarding the retail mix instruments can be understood through customer value (Blut et al. 2018 ; Moore 2005 ). Customer value perception is defined as an individual’s evaluation of an object (Holbrook 1994 ). In this study, it is defined as a customer’s evaluation of an FMCG retail mix instrument. Customer value is multi-dimensional and can be measured in many ways because it involves more than one aspect of value simultaneously in any given situation (Holbrook 1994 ; Zeithaml et al. 2020 ). Thus, it can be expected that one retail mix instrument may affect various aspects of value dimensions.

Marketing and service literature have suggested many aspects of value dimensions (see examples in Zeithaml et al. 2020 ); however, in the retail literature, only utilitarian and hedonic (emotional) values have long prevailed (Rintamäki and Kirves 2017 ). While utilitarian value reflects shopping with a work mentality, hedonic value is more subjective and personal (Hirschman and Holbrook 1982 ). Considering the retail shopping experience, utilitarian value consists of task-related, instrumental, and rational, but hedonic value involves recreational, self-purposeful, bargain, and emotional (Babin et al. 1994 ). Diep and Sweeney ( 2008 ) argued that both utilitarian and hedonic value dimensions are derived from stores and products. The former is related to the store’s performance and value for money, while the latter involves emotional and social aspects. Rintamäki and Kirves ( 2017 ) noted that utilitarian value can be perceived from prices paid and time and effort saved; meanwhile, hedonic is feelings and emotions aroused by shopping experiences.

Apart from the two prevailing value dimensions, some researchers suggested functional and economic value as distinct values rather than considering both as utilitarian value (Rintamäki et al. 2007 ; Sheth et al. 1991 ). Functional value involves quality and price (Carlson et al. 2019 ; Sheth et al. 1991 ). Economic value can be perceived as money savings, economical products, reduced prices, lower prices, or the best deal that a retailer offers (Rintamäki and Kirves 2017 ; Zeithaml 1988 ). In addition, social value was proposed as one critical value perception within the retail context where customers are associated with one or more social groups, such as family and friends (Lin and Huang 2012 ; Sheth et al. 1991 ). It also involves communication and information (Robertson 1967 ) when customers ask about product details (Lin and Huang 2012 ). Epistemic value is another value dimension that refers to curiosity, novelty, and knowledge (Sheth et al. 1991 ); specifically, knowledge has been recognized to influence the customer’s decision in retail (Lin and Huang 2012 ). Finally, conditional value is the effect of seasonality, situations, time, and place that moderate the level of other value perceptions (Lin and Huang 2012 ; Sheth et al. 1991 ).

Customer engagement in the FMCG context as a customer’s response (R)

The concept of customer engagement has been introduced for two decades. The roles and value of customer engagement received particular attention from scholars and business practitioners (Brodie et al. 2011 ). However, customer engagement is concentrated prominently in service marketing journals but not retail journals (Ng et al. 2020 ). Although there is no consensus on definitions and conceptualizations of customer engagement, this concept can be examined from four approaches (Ng et al. 2020 ). Customer engagement as a behavioral manifestation involves any manifestations beyond purchase that result from motivational drivers (van Doorn et al. 2010 ). Customer engagement as a psychological state occurs through interactive and co-creative customer experiences (Brodie et al. 2011 ). Customer engagement as a disposition to act is an internal state involving a willingness to engage and leading to a behavioral manifestation (Storbacka et al. 2016 ). Customer engagement as processes or stages of customer decision-making involves, for example, experience, attitude, and behavior factors that represent rent stages of an engagement process (Maslowska et al. 2016 ).

Ng et al. ( 2020 ) indicated that customer engagement as a behavioral manifestation had been studied most. From this point of view, customer engagement is observed from any behaviors resulting from motivational drivers (van Doorn et al. 2010 ). Such behaviors include purchases (Kumar and Pansari 2016 ) and any others that go beyond purchases, such as word of mouth, loyalty, customers’ reviews and recommendations, customer-to-customer interactions, peer-to-peer information sharing, attention and absorption, and customer feedback (Dessart et al. 2016 ).

Relationships between retail mix instruments (S), customer value perceptions (O), and customer engagement (R)

The relationships between retail mix instruments and customer value dimensions have been identified in the retail literature. Studies have a long tradition of testing the effects of multiple retail instruments when creating customer value perceptions. For instance, O’Cass and Grace ( 2008 ) identified the impact of store service provision on the customers’ perception of value for money. Rintamäki et al. ( 2007 ) and Kumar et al. ( 2010 ) reported that store atmosphere could develop store image and enhance customer value perceptions. Turel et al. ( 2010 ) found that customer value perception was built from individual experiences and product/service interactions that were associated with emotional value (Lin and Huang 2012 ). Tandon et al. ( 2016 ) revealed that customers visited retail for economic pursuits. Unsurprisingly, each study was quantitative and explored only some pre-determined retail mix instruments and value dimensions. Considering marketing practices, marketers should not use only one retail mix instrument but should create a compelling retail mix to suit the customers’ behavior and decision process (Hanaysha et al. 2021 ). This is because the retail mix combines various elements that fulfill customer demand, delight them, and excite their emotion when shopping (Aparna et al. 2018 ). Therefore, it would benefit practitioners if this study could identify the potential effects of a set of retail mix instruments on various customer value perceptions.

Next, some studies identify the relationships between retail mix instruments and customer engagement. For instance, Ryu and Feick ( 2007 ) presented that sales promotions encourage customer participation in engagement, such as customer referrals. Home delivery service (Roy Dholakia and Zhao 2010 ) and retail location (Solomon 2010 ) were indicated as essential factors influencing customer engagement. Customer engagement was found to be related to product quality (Gudonavičienė and Alijošienė 2013 ) and product variety (Dubihlela and Dubihlela 2014 ). Blut et al. ( 2018 ) identified from their meta-analysis that 24 retail mix instruments could influence patronage.

Finally, customer perceived value can influence customers’ behaviors at the post-purchase stage, such as customer-to-customer interactions, referrals, and repurchases (Parasuraman and Grewal 2000 ). Customer perceived value is specific to the object of evaluation (Holbrook 1994 ). Specifically, from the perspective of S-O-R, it is subject to stimuli. For example, Cheah et al. ( 2020 ) indicated the effect of price image (a customer’s attitude toward price) on customer perceived value. In the FMCG context, the authors found no article suggesting this relationship.

All the studies above highlight interplays among retail mix instruments, customer value perceptions, and customer engagement. According to the S-O-R theory, this study proposes that retail mix instruments (stimuli) can activate the customer value perceptions (cognitive mechanisms), which results in customer engagement (responses) (Fig. 1 ). In the next section, a qualitative investigation will be used to explore the potential relationships between these three constructs.

Source Authors adapted from Mehrabian and Russell ( 1974 ).

Research methodology

This study aims to identify the potential effects of retail mix instruments on customer perceived value and engagement. By using the context of FMCG retail and integrating and extending previous works more comprehensively, the study also aims to add descriptions to the three constructs in the a priori conceptual framework, i.e., to identify themes related to retail mix instruments, customer value perceptions, and customer engagement. A qualitative approach was used to generate rich data. Retail customers can be varied, and different generational cohorts perceive different retail experiences (Parment 2013 ). Generational cohorts are individuals born in the same period, likely to have similar life patterns, and share similar values (Lyons et al. 2005 ). This study focused on Generation X (Gen-X) and Y (Gen-Y) due to two reasons: (1) taking a closer look at specific cohorts can offer specific insights for developing future research agenda and contributes to retail marketing practices (Parment 2013 ) and (2) Gen-X and Gen-Y are deemed essential for consumer behavior studies (Shaw and Fairhurst 2008 ).

The FMCG retail existing in Thailand includes hypermarkets, supermarkets, and convenience stores (Tunpaiboon 2021 ). While the convenience stores are small size and the supermarkets focus primarily on fresh foods (Tunpaiboon 2021 ), this study examined the hypermarkets, specifically the two key players in Thailand: Store-A and Store-B. Convenience sampling and snowballing techniques were used. The first author (hereafter, the researcher) contacted peers and asked the peers to find the others. All contacted persons were screened with two screening questions: their ages and visiting frequency. The informants were Gen-X and Gen-Y and had experience visiting both stores. The researcher explained the research objective, ethical conduct, and their rights and asked informants for consent and if they would participate. In February 2023, interviews were conducted by two means: face-to-face online and on-site at a store location. The informants who joined online were asked to remind them of their recent in-store experiences. Before the interview began, an informant was asked to keep their answers to one retail location.

Interview questions were developed according to (Spradley 1979 ) (Supplementary Appendix A ). The researcher started with questions used to establish rapport with the informants. After connection had been established, open-ended questions related to the study’s research question were employed, starting from exploratory questions, and following questions that specifically emerged after the researcher repeated the informant’s previous answers (i.e., reasons and positive/negative experience regarding retail mix instruments). Specific questions were used to explore smaller aspects of experience regarding retail mix instruments. Sales promotions, a vital instrument for FMCG retail, was selected as an example because customers are often sensitive to this instrument, and marketers often find difficulty when determining sales promotion campaigns (Abolghasemi et al. 2020 ; Pauwels 2007 ; Senachai et al. 2023 ). Delving down into sales promotions may help marketers prioritize sales promotion activities. In addition, to see whether the retail mix instruments proposed in the literature need to be revisited or not due to the impact of COVID-19, the researcher asked the informants’ expectations regarding what the store should do after the COVID-19 ceases its impact.

Field notes were taken, and all interview dialogs and the informants’ answers were recorded. A mixed range of adequate informants led to a broad range of answers at the beginning but seemed to contain similar key information later once the informant pool increased (Hoffman and Maier 1961 ). A data saturation point was indicated at around the 28 th -30 th informants. In total, 40 informants were interviewed: 12 informants were interviewed at the store locations, and 28 informants were interviewed online (Supplementary Appendix A ). Scholars suggested that saturation is likely to occur around 5-30 informants (Guest et al. 2006 ).

All interview data was translated verbatim. Following Braun and Clarke ( 2006 ), a thematic analysis was conducted to conceptualize themes related to the elements of the a priori conceptual framework. Analyzing and coding were conducted line by line and through every line in the interview transcripts to generate initial codes that were further grouped into categories, and finally, significant themes were indicated. The data sources obtained from the online versus on-site interview approaches were triangulated and mostly showed similar findings (i.e., the first draft of findings).

To propose a conceptual framework of this study, the authors first identified retail mix instruments, dimensions of value perceptions, and engagement behaviors and then added information into the a priori conceptual framework. The authors acted as two investigators who held the social constructionist paradigm and iteratively interpreted and discussed the information in the first draft and revised emergent themes. An extensive literature search was undertaken to provide evidence to support the study’s empirical findings and helped strengthen the final draft of the findings, which is presented in the next section. An inter-judge reliability was estimated (Weber 1990 ), resulting in a reliability level of 90% and indicating an acceptable level. Finally, a conceptual framework of the study was proposed (see Section “Discussions”).

Marketers must create a compelling retail mix to match the behavior of their customers (Hanaysha et al. 2021 ). To provide an application of this study, the authors revisited the field notes and analyzed them based on the proposed conceptual framework. The focus was on the application of sales promotions, especially on how sales promotions should be used to encourage the customer’s perceptions and their engagements.

Findings in this section will be presented based on the S-O-R theory but narrated to represent the complex reality of the phenomena investigated rather than reported concerning each S-O-R component. As emphasized previously in the literature section, the main reason is that a retail mix instrument could stimulate a customer to perceive more than one value dimension and further lead them to more than one engagement behavior. Thus, reporting each retail mix instrument and explaining its effects along the narrative is deemed appropriate. In total, the data revealed 12 retail mix instruments that affected six types of value dimensions and the informants’ engagement behaviors. Empirical evidence is provided in Table 1 .

Store reputation

Store reputation refers to the customer’s overall evaluation of a retail store (Berg 2013 ). Although the informants perceived that Store-B and Store-A sold equivalent items from similar suppliers, they perceived the store’s reputation differently. Each store had its unique value propositions. Customers, especially women shoppers, perceived that Store-A offered superior quality products, except fresh vegetables and fruits. From the informants’ perspectives, Store-A’s reputation for product quality resulted in customers perceiving functional value. Although most informants knew that both stores’ brands had similar or slightly different product prices, they perceived Store-B offered lower prices than Store-A. This led customers to perceive Store-B’s reputation as a better store with lower prices. Evidence showed that the store’s reputation and its product’s quality are interrelated (Yuen and Chan 2010 ). In addition, the reputations of product quality and prices could be explained by perceived functional and economic value. These store’s value propositions attracted the informants’ interest and were the most effective strategy for the retail understudy.

Product quality

Product quality is a competitive retail advantage; if retailers provide the right products to customers, this can lead to the customer’s future responses and interactions (Blut et al. 2018 ). Product quality had a relationship with customer engagement and was thus a primary concern of retailers (Yuen and Chan 2010 ). The findings of this study revealed that product quality was essential when choosing shopping places. The informants would continue to shop at the specific store if it promised good quality products.

Product and brand variety

Low on-shelf availability results in a loss of revenue (Roussos et al. 2002 ). The findings indicated that, although product variety was associated with higher inventory levels, it could increase sales rates. Most informants emphasized that a store with various products and brands was perceived as convenient for them when shopping, as they could save time and effort, resulting in continued shopping. This can be considered as functional value (convenience) for customers, which could predict their future visits (Dubihlela and Dubihlela 2014 ), purchase intention (Gupta and Kim 2010 ; Zeithaml 1988 ), and retention (Parasuraman and Grewal 2000 ).

Store layout and shelf arrangement

A simple layout enhanced the speed and efficiency of grocery shopping (Terblanche 2017 ). The findings indicated that a good layout made it easier for the informants to find products without spending extra time and effort, resulting in increasing their perceived functional value (convenience and time-saving). Some informants also preferred to revisit the store because they knew the layout. Additionally, an improper store layout and shelf arrangement could devalue product quality. One informant saw that the clearance products were not properly arranged, as these looked so cheap, dirty, and damaged. This decreased the perceived functional value of the store’s clearance products.

Store ambiance

The store ambiance increased the customer’s enjoyment (Kent and Omar 2003 ; Teller et al. 2016 ), customer experience (Tandon et al. 2016 ), customer retention (An and Han 2020 ), and customer engagement (Blut et al. 2018 ; Pansari and Kumar 2017 ). In this study, most informants evaluated the store ambiance based on light, air, and cleanliness; however, this was subjective to individuals who valued the atmosphere differently.

The store ambiance had an impact on the informants’ emotions during shopping and their future decisions to revisit the stores. Some informants felt negative emotions resulting from the cleanliness of the toilet, the dim lighting that made it difficult to find products, and the musty air that made them uncomfortable. The ambiance could also affect the store’s reputation (Kumar et al. 2010 ). Some informants perceived Store-A as a high-end store, compared with Store-B, as its ambiance and atmosphere looked better.

Location and parking facility

Retail location can influence customer engagement (Blut et al. 2018 ; Solomon 2010 ). Similarly, the results revealed that the informants often visited the store close to their houses or offices. This locational proximity’s main benefit is a time-saving and shorter journey (Arenas-Gaitan et al. 2021 ), specifically, functional value or perceived convenience. The informants who preferred shopping on weekdays often visited the store close to their office, while those who enjoyed shopping on weekends went to those close to their houses.

The informants also considered parking facilities when evaluating the store’s location. Parking facilities increase their perceived convenience (functional value) and could reduce their irritation when they go shopping (emotional value). Conversely, they would be dissatisfied and might stop visiting the store if they could not park their cars.

Store variety

Customers might get bored when they come to stores and see the same products, services, and offerings, and this can reduce their spending (Tandon et al. 2016 ). Retailers must consider having many shops in their locations, as this can increase engagement behaviors (Gilboa et al. 2020 ). This study defines store variety as a store that groups various shops and other entertainment. The findings of this study further revealed that having many other shops in the store (e.g., restaurants, home decoration shops, and cinemas) increased the informants’ positive feelings towards the stores. Some favored Store-A over Store-B because the former had a cinema and more restaurants. Besides shopping, they could engage in additional activities with their family and friends, resulting in enjoyment and future engagement behaviors. Thus, having a variety of shops in the stores could increase the informants’ perceptions of the function value (i.e., they could do many activities in one place), social value (i.e., they did activities with their peers and family), and emotional value (i.e., gain positive emotions and a sense of belonging), as suggested by Elmashhara and Soares ( 2020 ).

Sales promotions

Retailers focus more on selling activities and sales promotions (Pantano 2014 ). Customers visit the store primarily for economic pursuits (Tandon et al. 2016 ). The findings suggested that sales promotions helped customers reduce costs, empower their economy, induce actions, and produce superior shopping experiences. The informants perceived that the promoted products they had purchased from the stores were valued for money, regarding the price they paid (economic value), and this resulted in revisiting the store. Additionally, during the COVID-19 pandemic, Store-A ran discount campaigns for two and a half months, so-called raka-maha-chon (in Thai), by applying a price discount to a product unknown to the customers. Some informants were excited and curious whether their household products would be discounted.

Retailers offer sales promotions for a limited time in an emerging sales promotion strategy (Vakeel et al. 2018 ). The results in this study indicated that the sales promotions were applied based on four types of time: daily (ready-to-eat), monthly (discount), yearly (membership), and occasionally ( raka-maha-chon ). According to Sheth et al. ( 1991 ), these are considered as conditional values. The findings also highlighted a negative outcome of period-related sales promotions. Sales promotions launched within a limited period (e.g., discount coupons) that expire before customers can use them could negatively affect their emotional value (Vakeel et al. 2018 ).

The findings highlighted that sales promotions were interrelated with product quality. The informants, who preferred buying quality products from Store-A for themselves or their families, perceived that such products even had more quality if promoted with sales promotion activities. Specifically, the product was even better when discounted compared to when it was sold at a regular price. This means the product has its own functional value, increasing with sales promotions. Additionally, the sales promotions were intertwined with the store’s reputation. Although both stores had similar sales promotion activities, some informants believed that Store-B offered a lower price because of its value proposition regarding everyday low prices. Besides, the more frequently sales promotions offered by Store-B, the more the customers perceived gaining their accumulated economic value. Some also sensed a positive emotion towards the store’s reputation.

When the stores offered sales promotions to the informants, they felt they were essential to the stores and increased their awareness of self-value, resulting in positive emotions towards the store. In sum, sales promotion activities could create economic, emotional, and social value (i.e., recognizing the value of customers), resulting in revisiting the stores, additional purchasing, and following the store’s news. However, the customer’s preference towards sales promotions differed across generational cohorts, suggesting that demographics may affect the customer’s value perceptions.

The findings indicated that sales promotions could negatively impact perception. Some female informants felt the product was less quality when running ready-to-eat food promotions (i.e., half price of ready-to-eat food when the store was nearly closed). The food had been cooked long before the discounts were applied, which was not good during the pandemic. Thus, running lower-price campaigns in some situations could decrease the customer’s perception of product quality. Once again, product quality is intertwined with sales promotions.

Advertising

The informants received both stores’ information from traditional media (television, brochures, stores’ boards, SMS, and posts) and online (Facebook, Line, and the store’s media applications). This information, including clearance spots, price tags, and active sales promotions, was important to the customers. The findings also showed that traditional media were powerful for Gen-X informants, but Gen-Y informants preferred digital media. The SMS even annoyed some Gen-Y male informants. This highlights that using the wrong media with the wrong generational cohorts might decrease perceived emotional value.

Advertising creates interactions between customers and the store (Brodie et al. 2019 ) and can lead to customer engagement (So et al. 2014 ). Advertising through social media has become popular and gained much acceptance by most informants. Providing the store’s advertisements, especially sales promotions, through its critical customer touchpoints (e.g., Facebook) created more customer-store interactions and increased the customer’s expertise in shopping, resulting in the customer’s referral (i.e., advertising the store’s information on their individual online community). Additionally, communication channels played a significant role in transferring customer messages. Customers who missed the store’s messages could perceive a decrease in value perception (e.g., emotional, economic, and functional).

Staff service

Most businesses are concerned about service quality (Parasuraman et al. 1988 ). The results showed that staffs played a vital role in FMCG retail, especially their service mindset and behaviors that affected the customer’s buying experience. The information which the staffs told the customers could lead to specific value perceptions. Most informants in this study noted that training the staffs to service them, especially during peak periods, and informing them of shopping-related information (e.g., the current active sales promotion activities) were essential to the store’s service level. In this case, the information about sales promotions led some informants to perceive the economic and functional value. Interactions between customers and staffs led to additional purchases and customer recommendations (Blut et al. 2018 ). Thus, the store’s staffs were a vital communication channel in transferring customer messages. The informants in this study claimed that staffs were the store’s competitiveness and could increase their engagement.

Delivery service

The delivery service influences the customer’s attitude and engagement (Crosby et al. 1990 ; Roy Dholakia and Zhao 2010 ). The findings revealed further that it helped the customers achieve their shopping plans, especially the informants who did not have time to shop on-site. They enjoyed shopping online because it was convenient; thus, they wanted the store to deliver products quickly. If the store can serve their delivery needs, they will continue to shop at the specific store. The delivery was related to functional value (convenience and logistic), resulting in their retention and engagement.

Not only home delivery service that has an impact on the customer’s channel selection, but also click-and-collect such as drive-through stations (Hübner et al. 2016 ). The specific delivery method allows customers to buy a product anywhere, from their computers or mobile devices, and collect it at the store without leaving their vehicles (Tamulienė et al. 2020 ). The drive-through stations are common in Europe, such as France (Hübner et al. 2016 ), but new for Thais. After the COVID-19 outbreak, the informants needed the store to establish a drive-through service, as this allowed them to keep healthy during the pandemic.

Self-service

Self-service encourages customers to participate actively in the exchange process (Regan 1960 ) and can help customers reduce time and shopping process as well as makes buying goods convenient (Gauri et al. 2021 ). The use of self-service kiosks (SSKs), a type of self-service technology, could impact sale patronage (Lee and Lim 2009 ). In Thailand, SSKs were not widely used in the retail sector before COVID-19. The informants noted that the stores should install SSKs to keep them healthy and increase their convenience.

Discussions

Theoretical discussions.

The findings have increased our in-depth understanding of the effect of retail mix instruments on customer perceived value and engagement behaviors. Based on the findings narrated in the previous section, a conceptual framework is proposed by extending the a priori one (Fig. 2 ) and used to identify potential future research agenda (Table 2 ).

A proposed conceptual framework.

The findings revealed 12 retail mix instruments acting as stimuli that triggered the customer’s decision process. They are grouped into two: (1) the integrated marketing communication (IMC) tools (sales promotions, advertising, and staff service) and store characteristics (store reputation, product quality, product and brand variety, store layout and arrangement, store ambiance, location and parking facility, store variety, delivery service, and self-service). Although academics and practitioners know these instruments, the classification is novel to the literature. The rationale supporting this classification is provided as follows.

First, marketers use the IMC tools to manage marketing activities and the customer’s needs and move the customers to various stages of the decision process (Raman and Naik 2010 ). Thus, the IMC is a set of instruments, including advertising, public relations, direct marketing, personal selling, and sales promotions, that retailers use to stimulate the customer’s decision-making (Vantamay 2011 ). In the proposed framework, all instruments are aligned with what has been suggested in the literature. However, it must be noted that “staff service” is the same as personal selling, which refers to the personal communication of information that aims to persuade customers to buy products (Janjua et al. 2022 ).

Second, the rest of the instruments are defined as store characteristics and the data show the most common store characteristics suggested in previous studies: quality, variety, availability, environment cues, ambiance, and design (Baker et al. 2002 ; Tyrväinen and Karjaluoto 2022 ; Uusitalo 2001 ). Some others, such as children’s play areas, could affect the customer’s perceived enjoyment (Rajagopal 2009 ). However, this was not indicated in this study perhaps because of the impact of COVID-19.

Furthermore, the findings highlighted potential interactions between the IMC tools and the store characteristics, resulting in more engagement behaviors; for example, applying sales promotions could increase the perception of product quality compared to the price, resulting in sales rates. While there were few studies revealed the impact of three services (staff service, delivery service, and self-service) on perceived value and engagement behaviors, the findings of this study provided some insights and suggested researchers to investigate further.

Situational factors are proposed as the other stimulus. The impact of COVID-19 was an external stimulus affecting the customer’s decision-making. Recent studies in the retail context identified the impact of COVID-19 as a situational factor influencing the customer’s decision process (Nguyen et al. 2020 ; Tyrväinen and Karjaluoto 2022 ). In this study, COVID-19 stimulated the customers to perceive some infectious risks, resulting in demanding service innovations (i.e., drive-through stations and self-service kiosks). These innovations helped guarantee their hygiene and created their perceived functional value, which would increase their future purchases and engagements. Apart from COVID-19, there might be other external stimuli (e.g., customer-to-customer interactions) (Lin et al. 2019 ), and situational factors (e.g., recession economies, wars, and protests) affecting the retail’s marketing strategies and the customer’s decision-making. These were not found in the current study and should be explored further.

Apart from stimuli, the figure shows that the six types of customer value perceptions (economic, functional, emotional, social, epistemic, and conditional) were the consequences of the 12 retail mix instruments and the impact of COVID-19. The primary driver of consumer choice is functional value (product quality, variety, sales promotions, and convenience), as if they believed shopping was a work to be accomplished. Some researchers argued that customers did not consider the epistemic and conditional value dimensions when purchasing durable goods (Sweeney and Soutar 2001 ). The findings provided evidence in contrast: sales promotions available for a period could create conditional value. Even when the discount applied to the product unknown to the customer, this led to the customer’s curiosity (epistemic value). There may be other value perceptions, such as environmental value (perceiving that the store’s operation is environmentally friendly) (Kumar 2014 ), that were not found in this study and might need further investigation.

This study identified some effects of demographics on customer value perceptions, similar to Sheth et al. ( 1991 ). Gen-X sometimes selected specific stores due to the availability of other shops, i.e., restaurants where they could dine with family. Thus, retail mix instruments may be intertwined with the customer’s demographic, and both may affect their value perceptions. Furthermore, value dimensions might not be independent but interrelated, as suggested by Sweeney and Soutar ( 2001 ). While a few studies observed such relationships (Gallarza et al. 2017 ; Leroi-Werelds 2019 ), the findings of this study provided some insights. For example, sales promotions initially affect the customer perceived economic value and might consequently affect their functional value. More specifically, the customer observes a discount price tag and perceives the economic value; they later evaluate the money paid against the expected utility they might obtain from the product, resulting in the perceived functional value.

Finally, the customers under investigation experienced the retail mix instruments holistically, shaping their perceptions and choices as Holbrook ( 1999 ) suggested. The findings revealed four engagement behaviors; however, some others (e.g., loyalty, customer-to-customer interactions, and customer feedback) did not emerge from the study and should be explored further. Furthermore, the proposed framework should be extended to include other concepts that are essential to retail strategic management, for instance, customer satisfaction (Bowden 2009 ), customer experience (Javornik and Mandelli 2012 ), and customer journey (Gauri et al. 2021 ).

Marketing practices

Researchers suggested that salespersons are essential in creating customer engagement (Dubihlela and Dubihlela 2014 ; Solomon 2010 ). However, sales promotions and communication are critical to retail (Arenas-Gaitan et al. 2021 ; Mohd-Ramly and Omar 2017 ). This study showed that the three IMC tools and the store’s characteristics were the retailers’ competitive advantages and affected all six consumption values. For instance, staff informing the customers about sales promotions produced economic and functional value and encouraged them to continue shopping at the stores, buy more, recommend the stores to their families or peers, and follow store news. This may be useful for marketers when creating a strategized mixture of both categories to manage their customers.

Marketers have long been investigating what motivates customers to shop at a store and desire to explain and predict customer behaviors (Sheth et al. 1991 ). Using an example of sales promotions, this research reports how FMCG retailers may leverage the proposed framework to design strategies that may be used to promote customer engagement behaviors. A list of sales promotion activities that the informants considered necessary is provided in Supplementary Appendix A , and an application of the top-four activities is illustrated in Table 3 to show how marketing strategists may use each sales promotion activity to induce customer value perception and engagement behaviors.

FMCG retailers should offer unique value propositions to customers (Javornik and Mandelli 2012 ). Previously, researchers suggested that sales promotions could enhance the customer’s perception of the best value for money and augment their shopping experience (Roussos et al. 2002 ). Table 3 shows that the heart of creating the stores’ value propositions originated from sales promotions, resulting in all value perceptions. All promotional activities created functional and economic value dimensions, while some generated specific value perceptions. Perceived conditional value in terms of time-limited discounts created benefits to both the store (i.e., inducing customers to purchase quickly) and the customers (if they used the discount in time). FMCG retailers should not ignore this value dimension. Offering gifts that the customers wanted could create positive emotions, but the customers might perceive negative emotions if the gift was not of their interest. Memberships could create the customer’s perceived epistemic value, which seems to be the only one inducing their curiosity and encouraged them to follow the store’s news.

The success of sales promotions depends upon the store’s two fundamental abilities: (1) the ability to select a promotional mix that suits target markets and (2) the ability to accurately identify the demographic and behavioral characteristics of target consumers (Gedenk et al. 2010 ). Based on the findings of this study, a strategized mixture of sales promotions is presented in Table 4 . FMCG retailers may use the sales promotions presented in the table to create short and long-term customer engagement behaviors.

This study sought to understand how retail mix instruments influenced customer perceived value and engagement behaviors and to reveal descriptive insights of each concept. Two FMCG retail stores in Thailand were chosen, and forty informants were approached to provide in-depth information about their shopping experiences at the stores. The findings reported descriptive insights into various retail mix instruments, value perceptions, and engagement behaviors and were conceptualized to form a conceptual framework, which is the main theoretical contribution of this study. The future research agenda was proposed to move forwards and the paper’s secondary theoretical contribution.

Contributing to retail marketing practices, sales promotions were chosen to validate an application of the proposed framework and illustrate how marketers may develop a strategized mixture of sales promotion activities. This may initiate an idea for FMCG retailers to develop marketing plans that suit their customer segments.

As with all research, this study has limitations. The proposed conceptual framework needs to be validated with qualitative data. Further study should employ the framework to explore a wider group of customers. The customers may be the other generational cohorts and those with different incomes living in Thailand. The framework may serve as a guideline when exploring customers in other countries. Finally, future research should investigate the retail context beyond the FMCG.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Prarawan Senachai

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Puthipong Julagasigorn

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Senachai, P., Julagasigorn, P. Retail mix instruments influencing customer perceived value and customer engagement: a conceptual framework and research agenda. Humanit Soc Sci Commun 11 , 145 (2024). https://doi.org/10.1057/s41599-024-02660-y

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Is college worth it? Here’s what this national study says

As economic outcomes have improved for young americans with and without college degrees in the past decade, pew research center finds perceived value of college is a mixed bag.

By Marjorie Cortez

Just 1 in 4 American adults say it’s extremely or very important to have a four-year college degree to get a well-paying job in today’s economy.

Nearly one-third of U.S. adults say the cost of college is not worth it if someone has to take out loans.

These were just two of the findings of a Pew Research Center study that queried more than 5,200 U.S. adults on their views of the value of a college degree. The survey had a 2.1% margin of error.

The online survey, conducted Nov. 27 to Dec. 3, 2023, revealed stark differences in perceptions depending upon political affiliation.

According to survey results made public on Thursday, Republicans and Republican-leaning independents are more likely than Democrats and Democratic leaners to say it’s not too or not at all important to have a four-year college degree in order to get a well-paying job, which was the perception of half of the Republican and 30% of Democrats who responded to the survey.

The survey also found that it is “extremely or very likely” that someone without a four-year college degree can get a well-paying job. Forty-two percent of Republican and Republican-leaning independents agreed with that perception, as did 26% of Democrats and Democratic leaners.

Geoffrey Landward, Utah’s new Commissioner of Higher Education, during his recent confirmation hearing before a committee of the Utah Senate, extolled the “demonstrated benefits” of higher education.

“I believe that at no other time in higher education’s history have we faced such an existential crisis that higher education, long viewed as a pillar of American society and exceptionalism, is now viewed with distrust and it’s value doubted, all contrary to objective data,” Landward said.

“There isn’t a single person in this state who would not benefit from earning a certificate or degree from one of our institutions. Completion of a post-secondary credential is as valuable as ever. Postsecondary education remains strongly correlated with increased job security, lifetime earnings, civic engagement and personal health and happiness,” he said.

Rising earnings over the past decade — for those with and without college degrees — is another factor that has influenced perceptions of the value of a college degree, according to the report.

“After decades of falling wages, young U.S. workers (ages 25 to 34) without a bachelor’s degree have seen their earnings increase over the past 10 years. Their overall wealth has gone up too, and fewer are living in poverty today,” the report states.

Over the same period, economic outcomes have also improved for young college graduates.

“As a result, the gap in earnings between young adults with and without a college degree has not narrowed,” according to the study.

Survey responses also varied with respect to education attainment.

Thirty percent of college graduates said having a college degree is extremely or very important, compared to 22% of respondents with less education.

The percentage was even higher among postgraduates, with 35% responding that it is extremely or very important to have a four-year college degree in order to get a well-paying job, and 39% saying it’s more important to have a college degree today than it was 20 years ago.

Darin Brush, president of Davis Technical College, said the nation’s strong and stable economy may also play into perceptions about higher education.

“Most of our students have not lived through a period where they had to really compete for work. They only know plentiful job opportunities and that changes as we know. Resilience, in so many ways, depends on your credentials and your skills. Finishing that credential and certificate, finishing that degree we know also leads to greater resilience in the economy and longer and better attachment,” he said.

The college strongly encourages students who earn certificates and credentials to further their education at Weber State University. A student who trains to become a licensed electrician can earn a handsome living but also obtaining an associate degree would give them the skills they need to start their own successful business, Brush said.

Brush said he is a firm believer in higher education because he knows how earning undergraduate and graduate degrees opened doors in his career.

“I wouldn’t be here if I didn’t have that. I wouldn’t be in a position to do the work I’m doing if I hadn’t learned about the world and learned some things that you can only get, I fundamentally believe, you can only get through pursuit of a degree,” he said.

• Open access
• Published: 27 May 2024

Interfaces of ‘being healthy and being Ill’: how is health being perceived by individuals with non-communicable chronic conditions?

• Nilanjan Bhor 1 &
• P Omkar Nadh 1  

International Journal for Equity in Health volume  23 , Article number:  108 ( 2024 ) Cite this article

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Accommodating chronic care into the everyday lives of individuals diagnosed with non-communicable chronic conditions often poses significant challenges. Several studies in public health literature that addressed the question of non-adherence to treatment by turning their gaze towards individual’s perception of their own health restricted the use of perception exploration to visceral states and corporeality without adequately acknowledging the mutual permeance of socio-biological worlds. This study explored the socio-economic genealogies of individuals, to understand the role of structural and intermediate factors that determine health perceptions, by attempting to answer the question ‘how do individuals with non-communicable chronic conditions perceive their health as healthy or ill’?.

This study was conducted in a low-income neighbourhood called Kadugondanahalli in India using qualitative research methods. A total of 20 in-depth interviews were conducted with individuals diagnosed with non-communicable chronic conditions. Individuals were recruited through purposive and snowball sampling.

The participants predominantly perceived their health as being healthy and ill in an episodic manner while adhering to their treatment and medications for chronic conditions. This was strongly determined by the factors such as presence of family support and caregiving, changes in work and occupation, changes in lifestyle, psychological stress from being diagnosed, and care-seeking practices. This episodic perception of illness led to the non-adherence of prescribed chronic care.

Conclusions

Due to the episodic manner in which the participants experienced their illness, the paper recommends considering health and illness as two different entities while researching chronic conditions. It is important for the health system to understand and fix the healthy and ill episodes, which often lead to switching between controlled and uncontrolled states of diabetes and hypertension. To do so, it is important to consider the social, economic, behavioural and psychological factors in an individual’s health outcome. The interplay between these factors has socialized health perception and various related practices from the individual to the community level. Therefore, the health system needs to re-strategize its focus from individual to community level interventions to address the determinants of health and NCD risk factors by strengthening the NCD prevention approach.

Introduction

Non-communicable diseases (NCDs), often considered as the diseases of the wealthy, are fast becoming prevalent among low-income groups in developing countries like India. The escalating burden of NCDs in India is evident from the recent estimates: 49% of all-cause mortality and 47% of all cause Disability Adjusted Life years reported in 2017 [ 24 ]. The need for chronic care in the everyday lives of individuals diagnosed with NCDs often pose significant challenges, particularly for those from vulnerable and disadvantaged socio-economic backgrounds. Policymakers have, more often than not, been misguided by the assumption that NCDs are diseases of the affluent and have not paid enough attention towards designing health systems keeping in mind low-income communities [ 17 , 32 ]. As a result, the public healthcare system does not sufficiently accommodate the needs of low-income households while taking into account their socio-psychological factors.

The impact of NCDs, however, is not just about the health system. How should we understand the ways in which NCDs affect low-income communities? Beyond their epidemiological impacts, NCDs, like all illnesses, also have socio-cultural effects. This paper argues that socio-psychological factors shape and in turn get shaped by the individual perception of health in terms of ‘being healthy’ and ‘being ill’, which in turn determine care seeking practices. We will focus on how this occurs specifically with NCDs in low-income communities.

Policymakers have rightly identified that care seeking practices and non-adherence to treatment are significant reasons for negative health outcomes among individuals diagnosed with NCDs in low-income communities [ 4 ]. However, only the addition of NCD treatment to existing health systems, which is a current policy practice, does not sufficiently address this problem. Several studies in public health literature have now begun to address this question of non-adherence to treatment by turning their gaze towards individual’s perceptions of their own health [ 14 , 15 , 25 ]. Nevertheless, these studies restrict their use of perception exploration to visceral states and corporeality without adequately acknowledging the mutual permeance of socio-biological worlds, i.e. considering the individual perceptions of health and illness in relation to the social environment. Such explorations often overlook the broader structural factors that play a determining role in shaping health perceptions. Therefore, this study attempts to move beyond this approach and understand perceptions of health in terms of ‘being healthy and being ill’ by taking into account the symbiotic socio-biological relationship involved. Following Das et al. ’s [ 9 ] idea on the notions of being healthy and being ill, where “the diseased state of an individual does not inevitably lead to ill-health and that absence of diseased state is also not an assurance for good-health”, we argue that an individual’s perception of health is shaped not just by physiological factors but also by a multitude of socio-psychological factors. We also further argue that the individual’s perceptions of their health plays a significant role in shaping their socio-economic conditions.

The study examines the socio-economic genealogies of the participants to understand the role of structural factors in determining perceptions of their own health and its attendant practices. It considers that ‘being healthy and being ill’ is not just shaped by the physiological/biological factors, but also social, economic and psychological factors, play an important role in shaping diagnosis, adherence to treatment and the very notion if one is ill. Additionally, the study addresses questions related to how the onset of chronic conditions reinforces the already existing structural inequalities in terms of diminishing degrees of freedom (biologically, economically, socially) and thereby life chances- ability to lead a decent life. Particularly, in the context of this study, our findings reveal that perspectives on being healthy and being ill are discursively articulated by individuals as relating to their family support, work and occupation challenges, lifestyles, prior knowledge of the condition and care seeking practices, all of which are significantly tied to the underlying social structures. Identifying and understanding the range of factors that shape the full care seeking cycle, from recognition and diagnosis to adherence to treatment and care seeking, is important to understand public health.

The study takes an anthropological approach to understand the perceptions of health through the categories of ‘being healthy and being ill’ in a low-income neighbourhood. For this purpose, KG Halli, one of the 198 administrative units of the city of Bangalore, was selected. KG Halli has a population of more than 34,842 individuals spread over 0.7 square kilometres [ 3 ]. It is largely a low-income settlement with a recognised slum. A majority of people follow Islam (60%) followed by marginalised caste Hindu groups. A significant number of intergenerational, interstate migrants also reside in the neighbourhood. As the socio-demographic data is not publicly available, we made conclusions based on our interaction with the residents over 1.5 years [ 3 ].

The participants, who consented to the interview, fell under three categories related to diagnosis of hypertension and diabetes: (i) self-reported and diagnosed: this refers to a chronic condition that has been self-reported by individuals and has also been confirmed by a health service provider (ii) diagnosed and currently receiving treatment: this refers to individuals are receiving some form of treatment (including medications) whether diagnosed or self-prescribed (iii) diagnosed without treatment (this refers to individuals who are diagnosed but are receiving no form of treatment). In this study, we adhere to the guidelines of the Consolidated criteria for reporting qualitative research (COREQ) checklist [ 33 ].

Data was collected from January 2020 to April 2021 using open ended in-depth interviews. A total of 20 in-depth interviews were conducted face-to-face with individuals diagnosed with either diabetes and/or hypertension who were recruited using a purposive and snowball sampling method. The number of interviews were decided based on the saturation levels reached during the course of conducting interviews. Care has been taken to ensure that the sample represents the socio-economic diversity of the neighbourhood. Interviews were conducted by both the researchers (authors). in Hindi, Kannada, Telugu and English languages. For Tamil language interviews, translation help from our additional project staff was sought. Participants (65% female and the rest male) of aged 40 years and above from different religious, caste and income backgrounds were interviewed in their own houses in the language of their choice (Hindi, Tamil, Kannada, Telugu, English-1 participant) with the help of an open-ended interview guide that covered aspects of their intergenerational socio-economic conditions, education and occupation details, prior knowledge of the conditions of hypertension and diabetes, treatment and care seeking practices. The interview guide was piloted and then implemented for data collection. The final interview guide was also improved based on information that emerged in the course of data collection. Consent was taken from participants to audio-record the interviews. Field notes were also documented systematically during each interview based on the themes of inquiry and analysed likewise. The average duration of each interview was about 30 min.

The recordings of these interviews were transcribed in the same language the interviews were conducted (i.e. in Hindi, English, Kannada, Tamil and Telugu) and then translated into English. Interviews conducted in English were directly transcribed into English (Only one female participant). Next, multiple readings of the transcripts were performed to generate codes and recognise the formal themes by using ATLAS.ti9 software. Data was broadly segregated and organised under various themes reflecting the participants’ intergenerational socio-economic status, their prior knowledge of the conditions, treatment and care seeking practices, the occupational burden of the chronic conditions, and family support and care giving. Each of these sub-themes were found to influence the perceptions of diabetes and hypertension among the participants. Data coding and analysis were performed by the researchers based on the thematic segregation. We examined the elements based on the extent of their recurrence and centrality to understand the relationships that determine the perceptions of being healthy or being ill by the participants.

Institutional ethics approval was obtained from Indian Institute for Human Settlements to conduct the research at KG Halli. Further informed verbal consent was obtained from each participant, who have given their autonomous decision on willingness to participate, before commencement of each interview and, at the same time, the process also entailed explaining the study information such as purpose and objectives of the research, confidentiality aspects, and rights to participate and withdraw from the interview. Verbal consent was documented using audio recorder where participant’s identity i.e., the names of the participants were replaced with unique identity numbers, and hence, participants names were kept confidential during the transcription and translation activities. Due to confidentiality, the study participant’s names are also not being used in this paper, and represented as ‘P’.

The study participants—who were diagnosed with either diabetes or hypertension or both—articulated their perceptions of health through the notions of being healthy and being ill. Our findings reveal that the study participants predominantly perceive being healthy or being ill in an episodic manner while adhering to treatment and medications for diabetes and hypertension. This episodic nature of being healthy and being ill leads to the non-adherence of the prescribed chronic care to manage NCDs. In this paper, we show that this perception of being healthy sometimes and being ill at other times that in turn determines care-seeking practices is influenced not only by the physiological imbalances through the controlled and uncontrolled state of diabetes and hypertension, but also by social, economic, behavioural, and psychological factors. The paper also delineates the role of perceptions in shaping these factors. Each of these factors and their relationships with individual perceptions of health are discussed in the following sections.

Health perceptions during diagnosis and management of NCDs

The perception of being healthy or ill is articulated by the participants before the diagnosis and during care-seeking. Before the diagnosis, “ takleef ” (physical discomfort), “stress” and “tension” were used to express being ill, which the participants have connected with their diagnosis of either diabetes and/or hypertension.

While the perception of being ill is strongly connected to physical discomfort among the participants, we observed that our participants typically consider this illness to be episodic. They initially normalised their physical discomfort and did not seek early care because of their lack of awareness that their symptoms could be of underlying chronic conditions like diabetes and hypertension. Our findings also reveal that the local healthcare providers too often overlooked this connection. As an immediate remedy to their episodic physical discomfort, an injection or symptomatic tablet that gives quick relief was prescribed. Therefore, care-seeking by the participants is affected by the combined effort of their perception of being healthy and the non-recognition of their symptoms by the healthcare providers. This in turn delays the early diagnosis and initiation of the treatment of diabetes and hypertension. Our observations revealed that the duration of this delay varies based on the economic conditions of the individuals and perception of their own health.

It used to hurt my knees and I used to face a lot of difficulty in sitting, standing up, walking and turning around. Even when I had to walk long distances, I used to sit on a big stone, take some rest in between and then continue walking. This has been the case for the last 5–6 years. Taking injections or medicine gives some relief for the time being but the problem persists P(3).

However, the majority of the participants with the continuous episodic recurrences have been diagnosed in much later stages from the onset of the symptoms. P(1) articulated as,

I didn’t even know that I had diabetes initially. I had BP and I used to take injections and go for check-ups. Then my knees used to hurt and I used to go take injections twice, thrice a week. Later I went to a public hospital for a check-up and I was diagnosed with diabetes.

As is evident from the above quotes, participant’s inability to distinguish the episodic physical discomfort as a symptom, from a normalized pain in everyday life resulted in the lack of diagnosis of diabetes and/or hypertension and when to seek care.

In addition, stress due to livelihood struggles, familial problems and life events such as deaths or other illnesses among family members, were also commonly stated by the participants as shaping their perceptions of illness. One participant, whose brother was suffering from mental illness, said

He [participant’s brother] was mentally affected. He was drinking and smoking also. He was taking tablets from NIMHANS hospital. With the tablets he did all these things so he was mentally affected. So we shifted him to a hospital. I’m the younger sister. We were tense. At that time, moving here and there, with the tension I got it [blood pressure] P(8).

Participants also used terms like taqdeer (fate) to describe their social and economic circumstances and their psychological problems. P(5), who lost their spouse and considered losing spouse as fate, articulated this as,

It’s my fate. After my husband’s death, my elder daughter came to me with her girl child. Looking at her [daughter] condition, I used to get stressed and that gave me diabetes, BP and thyroid problems.

Further, the diagnosis of diabetes and/or hypertension itself led participants perceive their health as being ill. We understood from the interviews that recurring episodic illnesses led local health practitioners who were immediate care providers in the neighbourhood to recommend diagnostic tests. P(4) articulated “ after I was told [by the doctor] I had it [BP and sugar], I automatically began feeling weak and I began wondering, why did it happen to me? … I have been weak since then .”

Management of the chronic conditions as an everyday exercise also influenced in participants perceiving their health as being ill that is not associated with actual physical discomfort

P(2) said, “ This [managing medicines] keeps reminding me every morning, evening and night. Whenever I have to take the tablet I am reminded of it that I am ill. If in any way taking the tablet stops, then this memory will go away, the thought itself will go away” .

This influenced perception of being ill sometimes acts against continuing regular care and adhering to the “course” of medicines. According to P(10), medicines are not required if BP/sugar level is under control, “ If BP measure is normal there is no need to take medicine. If BP goes out of control, then I take medicine .” Another participant P(8) intentionally did not consume her routine tablets, said that “ I deliberately keep missing my BP tablet for a few days. I miss it, questioning the need to take so many medicines. ” This irregular intake of medicines due to the perception of being healthy is likely one of the main reasons for diabetes and hypertension being uncontrolled.

However, all the participants had medicines stored in a typical box as a response to their episodic symptoms as stated during the interviews. For instance, P(3) stated, “ I keep a stock of medicines. There is paracetamol and calcium tablets [including BP and Sugar tablets]. If I have slight pain or fever or cold then I consume medicines. ” Symptomatic medicines are sought as a quick relief from physical discomfort and other short-term morbidities.

Few participants also recognised the importance of regular intake of medicines for diabetes and/or hypertension due to persisting physical discomfort that most often than not generates a feeling of illness. P(12) articulated

“ Every morning I have to consume these two tablets for certain or else I have pain in my knees and my back. Nothing makes sense to me when I am in pain. Doctor advised that I don’t miss my medication so I take them regularly” .

Perceiving health through family support and caregiving

Family support and caregiving were social factors that strongly influenced the perception of being healthy or being ill. The support and care-giving reflected through the presence or absence of active support, from family members, especially children (mostly married children). P(12) articulated this as “ I spend my days very peacefully without any tension. My daughter-in-law doesn’t let me do any work and takes good care of me. My son also takes good care of me ”. Participants tended to acknowledge their illness when family support existed.

Though there are distinctions between the participants’ perception of their health and how family members perceive their health, different kinds of support and care from family members led to participants perceiving their health as being healthy. But family members perceived them as being ill, and limited their parenting and mobility due to the higher likelihood of accidents and hospital expenditures as a result. This led the majority of the participants to become economically dependent for their health condition, especially for buying medicines, on their children. According to P(6).

“Now I am feeling a little better, so the medical expenditures were borne by my son. He keeps asking me what medicines I need and procures them for me. The medicines that I don’t get nearby, I ask him to get them for me from where it’s available, like the thyroid medicine which is not available nearby. It costs Rs 500 per month for my medicines ”.

Even though the majority of the participants received economic support from their children, few participants continued to work (explained in detail in the work and occupation section below). These economic and non-economic engagements led participants to perceive their health as healthy as they were able to take care of their own household expenditures.

Family caregiving was also reflected in whether they were accompanied when seeking care. Few participants were accompanied by their children when going to the doctor, P(5) stated, “My elder daughter takes care of me. She takes me to the doctor for my check-ups and also gets me the necessary medicines ”. In addition to medicines, participants also said that their family maintenance is fully supported by their children P(8) said,

“I have two children who will take care of me and our family economically. We have got them married and we are a bit peaceful now. If there’s tension, we sit as a family and talk and that helps relieve it. I can’t earn at this age and my husband’s eyesight also is deteriorating ”.

Few participants said if their children are not living with them, then they stay with their grandchildren P(14) elaborated,

“Our son got married and lives elsewhere. Both my daughter and daughter-in-law take good care of us. Sometimes my BP goes high; I had to be admitted to the hospital two or three times. I still have trouble so I got one of my granddaughters, who is studying in the 9th standard, to stay with me and help me. She doesn’t want to study beyond SSLC, so she stays with me and studies Arabi Quran. I help her study the Quran and she helps me ”.

The presence of grandchildren provides emotional support along with support in household chores as P(7) articulates “ She is a child but gives me a lot of moral support. She keeps saying don’t stress yourself, Allah will take care of everything. That makes me feel better ”. Therefore, family support and caregiving in the form of belonging, care-seeking and economic support towards medicines and household expenditure have allowed participants, to an extent, to deal with and manage their conditions.

On the other hand, other participants also expressed receiving no or very limited support and care from their children. This lack of psychological and economic support played a role in enhancing the already existing feeling of illness P(10) articulated “No one takes care of me. If my son doesn’t take care of me, who will take care? ”

Health perceptions through work and occupation

Participants articulated their perception of being healthy or being ill based on their ability to perform work (including both paid and unpaid) before and after their diagnosis. Although the perception of being healthy or ill was articulated in terms of the ability to perform work, we also witness that the decision to continue occupations depended on one’s perception of their own health.

Among the participants interviewed, majority of them were previously working in paid jobs. All the women participants, except for one, were engaged in unpaid domestic work in addition to their occupation, while the same was true for just one man, who had to raise his children after the death of his wife. All the participants with an occupation were engaged in informal work or enterprises such as hospital housekeeping staff, electrician, beedi making, incense stick making, basket weaving, household domestic labour, tailor, contract bus driver, hat seller, owner of a small kirana store shop, barber in men’s saloon. One-woman participant was engaged solely in unpaid domestic work and considered herself as a homemaker. Most participants were only able to make their ends meet with the help of income generated from their occupation which ranged from INR 2000–3000/- per month in the case of household help to INR 10,000/- for the contract bus driver.

With the onset of the chronic disease, except for two participants, the nature of their work transformed. The majority of them have left their occupation. The commonly cited reason was “ susst ” (tiredness) and “ kamjori ” (weakness), which indicate that they perceived their health as being ill after their diagnosis. The contract bus driver, who took a voluntary retirement from the service, when asked about leaving work, said:

I retired because of diabetes. I used to physically feel weak and I was afraid that if some unfortunate incident took place, I would lose the retirement perks of my job and also, I did not want to risk the people’s lives. So, I took early retirement from the job P(8).

When asked how their chronic conditions impacted the ability to work, most participants equated their occupation with their life. This was one of the most common responses irrespective of gender. One participant mentioned,

With diabetes, life changes. Earlier I used to work for 8 h and not get tired. Now, with diabetes, even if I work for 5 h I get tired and my body needs to rest P(9).

When asked further to describe the bodily reaction, he continued,

I feel some kind of rush from inside and my body muscles stop functioning. I sweat so much that the cloth I use to wipe my sweat becomes very wet P(16).

A similar response was received from another participant who had both diabetes and hypertension,

After being diagnosed with diabetes, I started feeling weakness in my hands and legs. The amount of work I used to do before, I cannot do it now. Even hypertension affects me. If I go into the sun, I face difficulty. If I feel any stress my BP shoots up. Earlier this was not the case, I used to work for many hours P(12).

In the case of their own household work, except in one case where the participant lost his wife, it was only women, either daughters, daughter-in-law’s or granddaughters- who were engaging in domestic labour along with their occupation. In the case of the one male participant who was diagnosed with diabetes and lost his wife, responsibility of household work was transferred to his newly married daughter-in-law.

After the onset of the disease, in the majority of the women’s participant’s homes, domestic labour was either fully or partially passed on to their daughters and granddaughters.

There was no one to perform household chores. My elder son got married and now stays separately. My younger son stays with me and I used to take care of him by cooking and helping him with his daily needs. Performing these household chores used to make my BP increase and I was admitted in the hospital a couple of times. After these incidents, I got one of my granddaughters (daughter’s child) to stay with me and help me with household chores P(7).

Similarly, another participant shares how her granddaughter helps her as follows;

This is my elder daughter’s child. Because of my health condition she stays with me and helps me with household chores like cooking and going to college. She is in her second year of college now P(5).

It was also noticed in a few cases that children discouraged the diagnosed parent from continuing their previous occupation and instead helped them set up a small enterprise, mostly local kirana stores, adjoining their homes so that they could continue to earn with a reduced workload.

While in almost all cases it was the children who took over family responsibilities, in the case of one participant, it was his wife who started working when her husband was diagnosed with hypertension and got partially paralysed. The participant, when asked if he was okay with his wife working outside home, he responded, “ What other option do we have? ‘’ He also went on to add, “ What is the necessity for my wife to go and work outside if I am able ?”

From the above narratives it can be understood that the participants’ perceptions of their health depend on their ability to work, and are expressed through words such as susst and kamzori . Likewise, one’s perception of health also determined one’s decision making process of continuing occupation.

Health perceptions through lifestyle

The perception of health is also shaped by changes in the participants’ lifestyles after the diagnosis of diabetes and hypertension. Participants highlighted how the diagnosis and adherence to the treatment for diabetes and/or hypertension brought changes in their lifestyle. P(3) stated, “I used to eat everything before I was diagnosed with diabetes and BP. Even now I eat sweets, but it is limited. Because of BP, I reduced my salt intake through food ”. Another participant P(7) added.

“ I reduced consumption of meat, sweets and everything. Some people consume everything even after diagnosis, but I don’t behave that way. I always have my child on my mind. If something happens to me, he will suffer a lot mentally and economically because he has to admit me in the hospital and take care of me ”.

Participants also remarked on the lifestyle changes due to medicine intake after diagnosis. P(10) articulated, “Nothing changed actually and everything’s normal. Earlier I didn’t take medicine and now I have to—that’s the only change. Earlier there was no BP so I didn’t have to take tablet, now I have to take it every day, that makes me a little weak ”. Changes in lifestyle by daily intake of medicines led participants perceive their health as being ill.

Participants also highlighted the difficulties in maintaining behaviour changes in their drinking habits, physical activity, and food habits. Though participants did not elaborate much on tobacco consumption and drinking habits, overall there was a reduction in tobacco and alcohol consumption after the diagnosis. Drinking was found mostly among male participants, and was partially or fully stopped after the diagnosis. P(11) articulated “ Now I am under treatment, so I don’t consume alcohol ” P(15) added “ If it’s on my mind to drink, then I drink or else I don’t”.

In the case of physical activity, a majority of the participants expressed that they do not have a fixed time allocated for walking. Participants connected physical activity with their household chores, occupation and physical discomfort. P(1), who runs a kirana shop, remarked, “I get to walk here only a lot. At 6:30 in the morning I walk to get milk. Several times in the day I walk to get other things such as groceries and vegetables. If it’s a little far, I stop for short rests in between. I generally don’t take the auto rickshaw, bus or other motor vehicles unless it’s too far” . The interface of being healthy and ill is reflected through the participants weakness during walking and their willingness towards walking.

Another participant P(8) expressed relief from their taqleef (discomfort) due to active walking which led the participants perceive their health as being healthy, “It’s better if I walk, otherwise I feel pain. If I keep walking then there’s no issue but if I sit for long hours then I feel like my legs are getting stuck in one place ”. On the contrary, walking didn’t give relief to P(7) and continued to perceive health as being ill, who said, “I walk to work, so it covers my exercise needs. Earlier, I used to go for a walk irrespective of my work but then had to stop because of pain in my legs and back ”. Similarly, P(15) added, “I used to go for a walk in the morning and then stopped because it used to cause pain in my legs and breathing issues. If I climb down the stairs it gets difficult to breathe”.

Food habits also changed or remained unchanged after diagnosis for participants due to the adherence or non-adherence to the NCD-appropriate diet. It was difficult for few participants to strictly follow the doctor’s advice on their diet due to various reasons. One such reason was changes in taste due to continuous intake of medicines, P(19) articulated as “Because of medicines, my taste gets spoiled so I need something tasty. But then, I get scared that my BP may get high because of eating such food”. Here the eating habit, i.e., perceiving heathy while non-adhering to the NCD-appropriate diet and being ill while adhering to the diet, by the participants clearly reflect the interfaces of being healthy and being ill. Further, no changes in food preparation at household level led to non-adherence to the appropriate diet, but most of the participants said that they avoid outside food, P(7) articulated

“We prepare food in the home itself, and don’t consume outside food. We get groceries and vegetables and prepare it at home. Outside food does not sit well with me”. P(11) said, in case of food preparation, “ Even though I have BP, there’s no separate food prepared for me with less salt. There’s only one type of food prepared for everyone that has normal levels of spice and salt. If my health gets bad, then rice starch is made for me. Once I get better I eat “normal” food along with other family members”. Here too the perception of being healthy is reflected through eating normal food i.e., non-adhering to the NCD-appropriate diet.

A few participants were habituated with their prescribed diet, P(18) articulated

“ I eat roti mostly and I am used to it. If there’s no roti then I eat a little rice in the afternoon and that’s it. After being diagnosed with diabetes, I started avoiding rice and eating wheat roti ”.

A few participants also did not care about sticking to a diet at all due to the lack of sufficient food. One participant, P(9) said, “I eat whatever is available. There’s no access to better facilities. Whatever I get to eat, I believe it’s because of Allah” . Therefore, it is clear that adhering to an NCD-appropriate diet is given very less importance while adhering to treatment of diabetes and hypertension. Diet restriction is also difficult to maintain for many participants given their difficulties in eating food on time while at work and occupation, and further inadequate quantity of food and types of food in NCD-appropriate diet is inefficient to maintain a productive lifestyle.

Perception of health has been studied commonly in the context of communicable diseases [ 26 , 28 , 29 ], maternal [ 11 , 12 , 19 , 30 , 31 ] and child health [ 1 , 2 ]. In the context of NCD’s, there is a tradition of examining behaviours and perceptions through various lens such as self-perceived health [ 6 , 7 ], self-construction of illness [ 10 ] social construction of illness [ 8 , 13 , 18 , 34 ] health perceptions [ 5 , 20 , 23 , 27 ]. However, in the context of NCDs and associated chronic conditions, there is a serious dearth of research on low-income population in developing countries, which this study has attempted to address.

As discussed in the results section, the episodic nature of being healthy and being ill as experienced by most of the participants while undergoing treatment is a clear indication of the physiological imbalances through the controlled and uncontrolled state of diabetes and/or hypertension. This is strongly determined by the factors such as presence of family support and caregiving, changes in work and occupation, changes in lifestyle, psychological stress from being diagnosed and other familial problems. The diagnosis itself and intake of medicines made few participants perceive their health as being ill and acknowledge their illness. The perception of being healthy or being ill is captured mostly through these factors in a bi-directional manner i.e. the effect of social factors on perceptions of health and vice versa. Kleinman [ 16 ], and Mendenhall and colleagues [ 21 ] also point to similar findings through their studies, that individual experiences of health were influenced by a variety of cultural values and social norms that were collectively reinforced by the caregivers, healthcare workers and systems.

The episodic nature of being healthy and being ill is experienced by all the participants throughout their illness, even after recognising the severity of their symptoms before the diagnosis of diabetes or hypertension. Physical discomfort made participants perceive their health as being ill, but it is unlikely that the participants considered them as symptoms, especially since there was a significant delay in their diagnosis and the initiation of treatment before the diagnosis. After the diagnosis, the majority of the participants were much aware of the connections between symptoms involving discomfort and the controlled and uncontrolled state of diabetes and hypertension, for instance, that headaches lead to increased hypertension and dental problems lead to increased sugar levels. Physical discomfort is described by the participants as body pain, leg pain, headache, difficulty in walking, breathing problem, and tiredness, which they have experienced episodically or on a daily basis. But in most cases, this was ignored due to economic and non-economic demands. These demands increase psychological stress, and in turn lead to perceived health as being ill. But when social support from family members, especially children, was present, there was a temporary reduction in stress, which made participants perceive their health as healthy.

This study found that family support and caregiving have a strong impact on how participants perceive their health. Stress was found to be a common problem among all the participants and was reported as the main reason for getting a diagnosis with diabetes and hypertension. A few participants, however, who lost their spouse/children, had family members with illnesses/disabilities or were not supported by their children, experienced high levels of stress compared to the other participants. They, participants, described their situation as their taqdeer (fate) and with a sense of acceptance. To make up for the absence of family members, these participants either bring a granddaughter or a child (usually female) from their siblings to live with them. Alongside school, these children provide caregiving support, mainly by giving injections and psychological support, helping with household chores, and reminding participants about their medications. This kind of support led participants to feel better about their health. Further, there was a clear difference found between how participants perceive their health and how their family members perceive it. This study found that children and extended family members perceive the participants’ health as being ill and often attempted to limit the participants’ parenting activities and mobility to avoid possible future healthcare expenditures. This led to the participants discontinuing or switching their occupation and becoming fully or partially dependent on their children for care-seeking and purchasing medicines. But participants accepted this as care from their children, which led them to perceive their health as healthy. Besides, participants also perceived their health as being ill while connected to their inability to work. The diagnosis of diabetes and hypertension had a significant impact on their productivity, in both economic and non-economic engagements. But few participants continued to work (mostly irregular work) for income, that does not goes beyond their bodily limits i.e. uptake of activity based on their state of physical discomfort or normalizing their physical discomfort, since earning an income is the top priority to manage daily necessities including out-of-pocket health related expenditures for them and their family. This is an indication of them perceiving their health as healthy.

A study conducted by Mendenhall and colleagues [ 22 ] in Delhi revealed how diabetes is normalised in everyday life and not considered an illness. The majority of our study participants considered diabetes and hypertension as illnesses given their impact on their lives and lifestyle, like having to switch/leave their occupation, consume medicines, and adhere to lifestyle practices while undergoing treatment. But these behaviours fluctuated depending on whether the participants perceived their health as healthy or ill throughout the illness experience. Therefore, this study acknowledges it as normalizing health rather than normalizing an illness, i.e., normalizing the symptoms and behavioural actions and not the diabetes and/or hypertension. Their lifestyle changes, especially walking and following the appropriate diet, are influenced by socio-economic factors. This study found that variations in the participants’ perception of health is very evident from their behavioural practices. The participants who had left their occupation or switched to another occupation where mobility is restricted expressed that they do not have a dedicated time allocated for walking. Perceiving health as healthy and ill was often experienced through the ups and downs of physical discomfort, which led them to not walk, sit/rest while walking, walk slowly, and walk inefficiently and irregularly. Though few participants expressed that their physical discomfort reduces while they walk, there was no connection found between walking and body weight except one participant who articulated that obesity had led to reduced or no walking due to severe physical discomfort in the lower limb. Similarly, adhering to the diet was also followed by a majority of the participants but only while experiencing moderate or severe physical discomfort (which many times led to visiting a doctor). Thus, the perception of health fluctuates based on recognising physical discomfort. Overall, it was found from our analysis that participants perceived their health as being ill but the behavioural actions are mostly confined to being healthy except for very few cases. There was also a strong relationship found between socio-economic factors and these behavioural actions which streamline the behavioural actions to fluctuate between being healthy and being ill.

In conclusion, the decision-making for health through health perception began even before the diagnosis of diabetes and hypertension and continued throughout the illness experience. The participants’ perception of their health as healthy or ill strongly influenced this decision-making. This study found many interfaces of being healthy and being ill in an episodic manner while experiencing an illness. Therefore, it recommends considering health and illness as two different entities while researching chronic conditions. It is important for the health system to understand and fix these episodes, which often lead to switching between controlled and uncontrolled states of diabetes and hypertension. To fix the episodes of being healthy and being ill, it is important to improve the social, economic, behavioural and psychological factors. The interplay between these factors has socialized health perception and various related practices from the individual to the community level. Therefore, the health system needs to re-strategize its focus from individual to community level interventions to address the determinants of health and NCD risk factors by strengthening the NCD prevention approach. Further, this study also prompts rethinking how the health system can be strengthened towards addressing and considering the social, economic, behavioural, and psychological factors in improving an individual’s health outcome. Why doesn’t the health system speak in the same way as the people speak of chronic illness?

Availability of data and materials

Data sharing is not applicable to this article as no quantitative datasets were generated or analysed during the current study. The qualitative data is included to an extent in the result section of this manuscript.

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Acknowledgements

The author acknowledges the technical support and advice provided by Dr. Gautam Bhan throughout the research.

This article was completed with support from the PEAK Urban programme, funded by UKRI’s Global Challenge Research Fund, Grant Ref: ES/P011055/1.

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Bhor, N., Nadh, P.O. Interfaces of ‘being healthy and being Ill’: how is health being perceived by individuals with non-communicable chronic conditions?. Int J Equity Health 23 , 108 (2024). https://doi.org/10.1186/s12939-024-02188-2

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The secrets of outperforming family-owned businesses: How they create value—and how you can become one

These days, organizations across industries and geographies are doing everything they can to bounce forward from recent economic, geopolitical, and technological disruptions.

For them, resilience may be a relatively new concept.

About the authors

This article is a collaborative effort by Eduardo Asaf, Igor Carvalho, Acha Leke , Francesco Malatesta, and Jose Tellechea, representing views from McKinsey’s Private Equity & Principal Investor’s Practice and its Family-Owned Business Special Initiative.

For family-owned businesses (FOBs)—companies in which founders or descendants hold significant share capital or voting rights—it’s just business as usual. 1 Refers to companies in which the family controls at least 20 percent of owned capital share or voting rights; note that voting rights may be controlling or noncontrolling. Regardless of what the world throws at them, many of these companies have survived and thrived over multiple decades. Some, such as Levi Strauss and L’Óreal, have been operating for well over a century.

FOBs have long played an outsize role in the global economy—a role that often goes unnoticed or underestimated. They account for more than 70 percent of global GDP, and they generate turnover of between $60 trillion and $70 trillion annually. They are responsible for about 60 percent of global employment, and they play a critical role in supporting education, healthcare, and infrastructure development across their communities around the world. 2 "Empowering family businesses to fast-track sustainable development,” United Nations Conference on Trade and Development, April 13, 2021.

McKinsey’s own recent research confirms FOBs’ adaptability, resilience, and impact: they have the structures and best practices required to withstand business challenges in uncertain times. And in general, they exhibit stronger performance than businesses that are not family owned, although the extent and drivers of that outperformance vary (Exhibit 1).

To understand FOBs’ history of outperformance and how the best among them create value and impact, we analyzed 600 publicly listed FOBs, compared their performance with that of 600 publicly listed companies that are not family owned, and surveyed another 600 primarily private FOBs around the world. Additionally, we interviewed leaders of more than 20 FOBs globally.

The findings were surprising.

For instance, while it has been widely known that FOBs deliver higher total shareholder returns (TSR) compared with non-FOBs, the root causes of this outperformance have been less well-known—until now. Our analysis shows that the higher TSR results from better underlying operational performance by FOBs, as compared with non-FOBs. The research also demonstrates how the performance and value creation strategies of FOBs shift as these businesses get bigger and older.

The data tell a compelling story of outcomes and impact, but they also begin to reveal what the highest-performing FOBs are doing differently when compared with peers, in two areas: mindsets and strategic actions.

They demonstrate four mindsets that are common to all FOBs but that take on outsize importance within the high performers, allowing them to gain and sustain a competitive advantage. The critical mindsets are a focus on purpose beyond profits, a long-term view and emphasis on reinvesting in the business, a conservative and cautious stance on finances, and processes that allow for efficient decision making.

The high-performing FOBs then combine these mindsets with five strategic actions in ways that others do not. Specifically, they actively diversify their portfolios, and they dynamically reallocate resources to the most promising businesses, regions, and channels. They are both efficient investors and operators. They maintain a relentless focus on attracting, developing, and retaining talent, and they continually review their governance mechanisms to ensure strong business performance across generations.

We’ll unpack this “4+5” formula further in this article. It’s important to note that the formula and the lessons it imparts are applicable to both FOBs and non-FOBs alike—and our research suggests that deploying it effectively can pay off over the long term. When we applied the formula to the family-owned companies in our research base, we estimated that it could create a 2.5- to 5.5-times increase in economic profit for them.

Indeed, FOBs around the world that successfully follow this formula have an opportunity to quadruple their value over the next five to ten years—bolstering their market performance, sharpening the resilience edge that has allowed them to keep the lights on for generations, and making an even greater impact across their communities.

FOB outperformance by the numbers

Our research shows that FOBs have created more value and impact than non-FOBs over the past decade—a dynamic that has largely held true regardless of which metrics we used to assess companies’ performance and despite the unique challenges FOBs face (see sidebar, “Unique challenges on the road to outperformance”). 3 Non-FOBs are defined as any company that does not meet a 20 percent threshold for family ownership in either share capital or voting rights.

Between 2017 and 2022, FOBs posted an average TSR of 2.6 percent, compared with 2.3 percent for non-FOBs. In that same five-year period, FOBs achieved average economic profit of $77.5 million, surpassing the non-FOBs average economic profit of $66.3 million. 4 Economic profit is the difference between revenue received from the sale of goods and services and the costs of producing those goods and services, including opportunity costs. FOBs also generated (on average) an economic spread that was 33 percent higher than that of non-FOBs in the same period. 5 Economic spread is the difference between a company’s return on invested capital and its weighted average cost of capital.

Unique challenges on the road to outperformance

It’s important to acknowledge the unique challenges that all family-owned businesses (FOBs) face—all the better to appreciate how the very highest-performing FOBs in our research base have managed to ascend.

A cautious approach to finances is a trademark of FOBs that helps them weather economic shocks, although it can also delay their recovery. An aversion to taking on debt, for example, might constrain an FOB’s ability to enact critical process changes, or it could hinder expansion plans.

Additionally, FOBs tend to underinvest in R&D, which can limit innovation and entrepreneurial initiatives. This challenge can be compounded as the business moves further and further away from the founder’s entrepreneurial vision and prioritizes value preservation over high-risk business bets.

Family-owned businesses also face unique governance challenges relating to their ownership. For instance, all FOBs, regardless of size, industry, or regional focus, are confronted with succession-related questions as the business passes from one generation to the next. The founding generation may have been focused on aggressive growth, but subsequent generations may wrestle with maintaining or even transforming the company.

It has been posited that the largest wealth transfer in history will take place over the next 25 years, with an estimated $100 trillion moving from baby boomers to their heirs and charities. 1 The transfer of wealth from boomers to ‘zennials’ will shape the global economy,” Financial Times , August 22, 2023. Inheritors may find themselves grappling with several new challenges, including a changing global order , a push toward sustainable and inclusive investing, and the AI revolution. 2 “ Global flows: The ties that bind in an interconnected world ,” McKinsey Global Institute, November 15, 2022. How they lead through these disruptions will have a lasting impact on their companies, on business generally, and on society.

A broader look at performance among both FOBs and non-FOBs reveals further variations based on the size, age, and maturity level of these companies. For instance, the midsize FOBs in our research base, with annual revenues between $150 million to $5 billion, performed better than non-FOBs by being more efficient investors. They have delivered 10 percent higher capital turnover over the past five years compared with non-FOBs. Why? These midsize FOBs face fewer of the traditional market pressures to deliver short-term results. Their focus on the long term and their streamlined decision-making processes allow them to be more effective than non-FOBs at identifying investment opportunities that are in line with their purpose and goals, acting decisively, and quickly allocating resources against those opportunities.

Meanwhile, the large FOBs in our sample, with annual revenues between $5 billion and $100 billion, tend to be efficient operators that have delivered 1.5-percentage-point higher operating margins over the past five years compared with non-FOBs. The numbers likely reflect large FOBs’ ability to take advantage of process-related efficiencies and supply chain relationships developed over successive generations (Exhibit 2).

In addition, the family-owned businesses in our research base that are 25 years old and younger tend to have an aggressive growth mindset, increasing revenues twice as fast as non-FOBs as they channel the entrepreneurial energy of the founder. As they mature and transition into new generations of leadership, however, some FOBs start thinking less about big bets and more about preserving value. Others just lose the founder’s entrepreneurial edge. Their growth slows, falling more in line with that of non-FOBs (Exhibit 3).

4+5 equals FOB outperformance

Our research also revealed a notable gap in performance among FOBs and non-FOBs on our economic profit power curve , with a performance edge appearing across all quintiles. And the best-performing FOBs fared much better than the best-performing non-FOBs: the top two quintiles show a performance gap three times larger than the average of the lower quintiles. What’s more, the highest-performing FOBs capture the largest share of economic profit and drive outperformance across the entire FOB category (Exhibit 4).

Who are these outperformers? They comprise more than 120 FOBs in our research base, with ages ranging from under a decade to several centuries. They span ten sectors and operate across the world. Their average annual revenues range from $1 billion to $95 billion, with average economic profit of $730 million and average EBITDA margin of 20 percent.

Through our analyses, we learned that these top FOBs display four mindsets that are common to other FOBs but that are more pronounced in the outperformers. And, unlike most other FOBs, the outperformers combine the four critical mindsets with five strategic actions that help them achieve and sustain top-quintile performance that truly differentiates them (Exhibit 5).

Four critical mindsets of outperforming FOBs

Traces of the following four critical mindsets can be found in the DNA of all family-owned businesses, but these mindsets are more pronounced in the highest-performing FOBs relative to others.

1. They focus on purpose beyond profits

Our research shows that 93 percent of respondents from the highest-performing FOBs believe their company has a clear purpose beyond creating value for shareholders, as compared with 86 percent of the overall group of FOBs we surveyed. This sense of purpose can take many forms. It can be inward looking and focused on building the company’s legacy—for instance, by maintaining a strong reputation, protecting the brand image, or nurturing a strong company culture. Or it can be outward facing, focused on maximizing value for customers or generating positive impact in their communities. Whatever its nature, FOB respondents say they are willing to spend the time and resources needed to bring this purpose to life. Of the respondents from the highest-performing FOBs, 91 percent say they have formal mechanisms to ensure that employees understand, appreciate, and role model their purpose and values , as compared with 84 percent of the overall group of FOBs surveyed.

One place where this mindset is most strongly reflected is in the highest-performing companies’ efforts to support their communities. In our survey, leaders in 58 percent of the outperforming FOBs strongly agree with the assertion that their companies “embrace social responsibility and sustainability,” compared with 39 percent of leaders of other FOBs. One example of community support is a family-owned financial-services company in Latin America that tracks its environment, social, and governance efforts as closely as it does its financial performance. To foster transparency and accountability, it participates in all major market indexes that monitor sustainability and governance—both domestically and abroad.

The purpose-driven mindset is also reflected in the outperforming companies’ approach to hiring, promotion, and retention. Loyalty is a key value in most of these companies and, in our interviews, leaders revealed an ability to look “through the cycle” and avoid layoffs in crisis periods. One Indian conglomerate with roots dating back to the 1800s has basically adopted a “never fire” approach to talent management.

2. They take a long-term perspective and reinvest in the business

Leaders of outperforming FOBs cite their long-term perspective as one of the top three reasons for their success, alongside the ability to innovate and to expand into new markets and regions. They ruthlessly optimize for the longevity and resilience of the organization, even if it comes at the expense of short-term performance.

Ownership structure plays a critical role in the outperformers’ ability to maintain this long-term perspective: 92 percent of outperforming businesses in our research base have at least a 40 percent family ownership. Since they are not beholden to the demands of shareholders or the pressures of quarterly earnings reports, they can take a more patient and strategic approach to investing, which can ultimately lead to sustainable growth and success. One family-owned European retailer, for instance, had for decades remained resolutely focused on an “always buy, never sell” philosophy. In the late 1990s, it acquired an unprofitable brand, and, over a six-year period in which the acquired brand’s performance remained low, the company weathered public scrutiny and pressure to sell. Over time, however, the waiting game eventually paid off and the brand became one of the company’s most successful acquisitions.

Our research also revealed that FOBs, in general, tend to reinvest in the business rather than extract as much as they can from the company through dividends (Exhibit 6). They are not under the same pressures that non-FOBs are increasingly under to prioritize higher dividends to meet shareholder expectations. Indeed, over the past five years, FOBs worldwide delivered dividend yields that were 12 percent lower (on average) than those of non-FOBs.

3. They are financially conservative and cautious about debt and high-risk investments

In general, FOBs tend to be financially cautious, with leverage ratios that are, on average, six percentage points lower than those of non-FOBs. The outperforming FOBs have even lower leverage ratios, by nearly ten percentage points (Exhibit 7).

Interestingly, however, the outperformers say they take on more debt compared with other FOBs. For instance, about 40 percent of the outperformer respondents told us they use debt to finance more than 50 percent of their investments. By contrast, other FOB respondents told us they use debt to finance only 12 percent of their investments. Given that they are using their own money, FOBs often prefer to invest their funds in marketing, sales, manufacturing, and other parts of the business where there are clear paths for growth and some precedent for returns, rather than invest in high-risk areas such as R&D.

This cautious approach to finances also helps the outperformers weather significant economic shocks such as the 2008 global credit crisis and the recent COVID-19-triggered downturn—and emerge in better shape than other FOBs and non-FOBs. For example, a family-owned logistics business in Europe credits its financial conservatism as a critical factor in its relatively quick recovery from global supply chain shortages in 2021. Through the crisis period, the company held a steadfast focus on the long term and prioritized preserving its strong cash position, which allowed it to avoid bankruptcy the past few years while others were falling prey to industry contraction.

4. Their internal processes allow for efficient decision making

Our conversations with leaders in outperforming FOBs point to greater efficiency in decision making, in part because of two factors: centralized but flexible processes and engaged employees.

Despite the existence of investment committees, for instance, the big decisions taken by leaders and teams in outperforming FOBs are usually highly influenced by a single individual or several members of the family who can act more decisively than leaders in non-FOBs. The non-FOBs usually rely on multistage, multiparty processes that can be difficult and time-consuming to navigate.

Interestingly, the outperforming FOBs distinguish between efficient decision making and fast decision making: when family members agree, they make choices quickly. But when family members disagree, the outperformers take advantage of their flexible structures and processes to consider all the different points of view. They understand that decision making can be both quick and deliberate—and that the ability to adjust as needed is a true differentiator in performance.

The benefit of having engaged employees is that “once the CEO has a strategy in mind, it is easier to implement any changes,” leaders at one Japanese FOB told us. This approach to decision making has allowed the company to execute major category and market expansions every ten to 15 years.

Five strategic actions that set outperforming FOBs apart

Through our analyses, we discovered that the very best FOBs combine the four critical mindsets just described with five strategic actions that truly set them apart.

1. They actively diversify their portfolios

The outperforming FOBs in our research base have highly diversified portfolios. One conglomerate reaches more than one billion customers across its consumer goods, agriculture, and real estate divisions, among others. Another FOB started in waste management but has expanded into logistics, clean energy, and mobility solutions. Indeed, our research shows that 40 percent of the outperformers garner more than half of their revenues from streams outside their  core businesses . By contrast, only 7 percent of other FOBs had a similar share of noncore business revenues (Exhibit 8).

Moreover, 70 percent of the outperformers told us they will prioritize expansion beyond the core over the next five years by moving into new industries or geographies or by targeting disruptive businesses.

M&A seems to be the go-to diversification strategy for these organizations. Some 66 percent of respondents to our survey told us they pursued M&A to access new technologies, 63 percent to enter new industries, and nearly 60 percent to tap into new geographies.

Of course, not all M&A pursuits yield the same returns. Previous McKinsey research has found that programmatic M&A —that is, carefully choreographing a series of deals around a specific business case or M&A theme, instead of pursuing more organic, episodic, selective, or large transactions—is far more likely to lead to stronger performance and less risky for any organization. FOBs seem to be taking this message to heart: when asked about their M&A activity, about 40 percent of all FOBs told us they had pursued two or more small or midsize deals per year for the past ten years.

The current findings support previous McKinsey research  that shows FOBs tend to make smaller but more value-creating deals than non-FOBs. Leaders at a family-owned industrials company in Europe told us they actively try to avoid “core myopia.” For years, they said, they had failed to recognize growth opportunities in recycling and sustainability. Now, they prioritize and pursue small acquisitions that they think can enhance their market position. They decide which companies they intend to acquire and for how much, “remaining patient and avoiding rushing into transactions until the opportune moment arises.”

Further, many of the outperforming FOBs seemed more willing than peers to take bolder risks on occasion, with 58 percent indicating they had pursued at least one large deal in the past ten years, compared with 36 percent of other FOBs indicating the same.

2. They dynamically reallocate resources

Previous McKinsey research confirms that dynamic resource allocation   is one of the best ways to achieve growth in an organization. Companies that reallocate more resources more often have been shown to generate significantly higher returns to shareholders, experience less long-term variance on returns, and have a higher likelihood of avoiding acquisition or bankruptcy.

Our analyses show that outperforming FOBs aggressively and dynamically allocate their resources toward businesses, regions, and channels they believe will drive the most growth. In fact, about 60 percent of the outperformers said that, over the past five years, they had shifted more than 30 percent of their capital across businesses or regions, targeting higher-value opportunities. By contrast only 20 percent of other FOBs had done the same (Exhibit 9).

In general, FOBs enjoy an advantage in this area compared with non-FOBs. Their focus on purpose along with their longer-term perspective and efficient decision-making structures allow them to avoid the politics and inertia  that can drive allocation discussions off the rails.

Leaders from outperformer FOBs we spoke with say they take specific actions—in some cases, even cultural changes—to guard against inertia. A century’s worth of diversification has given one family-owned conglomerate in Asia footholds across a wide range of sectors—from petrochemicals to energy, retail, and telecommunications. But to balance out its strategic pursuit of growth, the conglomerate has also built into its finance and strategy discussions formal reevaluations of business performance. It periodically divests underperforming divisions and reduces its ownership interests while reinvesting those resources in higher-growth opportunities. This culture of growth through continuous improvement is so strong that last year the company announced a multibillion-dollar plan to transition from its core business in petrochemicals—which at one point accounted for more than three-quarters of the company’s revenues—to new opportunities in renewables.

Leaders attribute the company’s success to the founders’ direct, personal involvement in identifying big bets and building the financial, operational, and talent competencies required to reallocate resources and act on those bets.

3. They are efficient investors and operators

As mentioned earlier, at the outset of their tenures, FOBs tend to perform better than others because they can allocate capital more efficiently. But as they grow and scale, their outperformance tends to come more from efficient operations. Interestingly, the very best FOBs can do both.

Our data shows that the high-performing FOBs have a capital turnover ratio of 1.4—in line with that of outperforming non-FOBs and higher than that of all other FOBs in our sample. The high performers also report operating margins that are almost 10 percent higher than that of outperforming non-FOBs and nearly twice that of other FOBs in our research base (Exhibit 10).

Their higher-than-average investment and operating performance is driven by three factors. First is their operating DNA, which is passed down through generations and shapes the way their businesses operate, including decision making, customer service approach, talent management, and even developing functional expertise. In South Korea, for instance, the chairman of a family-owned apparel and footwear manufacturer has visited the production line daily for decades and knows each worker by name. Such direct involvement from the company founder has helped foster a sense of loyalty and ownership among employees. Through this access, workers are also getting a first-hand perspective on the operational challenges and opportunities across the organization—and, as a result, are deeply motivated to weigh in with potential solutions.

Second, compared with the other FOBs in our research base, the outperformers use a broader set of data to evaluate organizational performance. For instance, these businesses used more key performance indicators (KPIs) to measure executive performance, including top- and bottom-line figures and valuation metrics. When we asked all the FOB respondents in our research base which of seven designated metrics they had considered in evaluating executive compensation, the outperformers were 10 percent more likely, on average, to indicate that they were tracking all the KPIs we listed.

The last and arguably biggest differentiator is that outperforming FOBs focus on innovation. They invest twice as much in R&D as other FOBs do, and back up those investments with performance management systems. One US-based family-owned company that provides telecommunications and automotive services established a series of programs to support the creation of a tech-venture ecosystem in a part of the country that has not traditionally been a tech hub. The company launched an accelerator for tech start-ups and a not-for-profit program to drive job creation in adjacent industries. Through direct and indirect investments in these programs and companies, the company is helping others while ensuring its own access to top technology innovations and talent in the region.

4. They maintain a relentless focus on attracting, developing, and retaining talent

Talent management is an obsession for the highest-performing FOBs. In our survey, 86 percent of respondents at outperforming FOBs agree or completely agree that their company attracts the best talent. More than 90 percent either agree or completely agree that their company successfully identifies, trains, and develops top performers.

One family-owned luxury retailer in Europe takes an end-to-end approach to talent management. To attract recent graduates and younger workers, the company developed and launched a two-year, nine-part social media campaign—a series of “day in the life” posts filmed by and with existing employees. It also established a program to identify and train thousands of internal ambassadors to help and onboard newer workers. Partly due to these initiatives, the group has been voted a top employer among business school students for 18 years in a row in the retailer’s home country. At the senior-leader level, the company focuses on offering competitive salaries, which it benchmarks constantly. It also provides leaders exclusive proximity to members of the founder family, which creates a sense of personal attachment and accountability for the company’s results among senior leaders.

As a result of these efforts, the company boasts an average length of service between six and seven years—about three times higher than the typical tenure for employees at luxury retail companies. Almost one-quarter of the company’s workforce has been employed there for more than 15 years, and of these, more than 70 percent have been with the company for more than 20 years. The leaders’ perspective is that recruiting exceptional talent and retaining them for long tenures has allowed the company to build and maintain a strong culture of artistic expression, attention to detail, and long-term vision—traits that are crucial to success in a business that hinges on creativity and reinvention.

Also in our survey, more than 80 percent of outperforming FOB respondents report that their companies have built effective training programs to develop the next generation of family members. A family-owned electronics retailer in Africa, for instance, puts all family members interested in joining the company through a rigorous interview process (even tougher than their standard recruiting process) and places them in jobs that are aligned with their skill sets. An Asian FOB in the apparel industry mandates that family members do a series of role rotations, periodically tasking them with initiating new M&A deals, ventures, or resolving existing challenges to evaluate their problem-solving skills.

5. They continually review their governance mechanisms to ensure strong corporate performance across generations

Our research reveals that outperforming FOBs take the separation of family and business matters very seriously. About 80 percent of the outperformer company respondents reveal there is formal documentation in their companies with clear guidelines on the roles and responsibilities of family members. More than 90 percent of the outperformer respondents told us there is an effective and independent board of directors in place, compared with 72 percent of respondents from of all other FOBs who say the same. And 85 percent of respondents from outperforming FOBs report that their companies have a formal forum that meets regularly to discuss family and business issues, compared with only 66 percent of all other FOBs in our research base.

In interviews, leaders in the outperforming FOBs touted the benefits of having strict guidelines about family member roles and responsibilities, especially if the business is still family-led. At a second-generation 100 percent family-owned healthcare services business in the United States, two siblings share leadership roles. One is the president and focuses on strategic responsibilities across three business units, while the other is the chief growth officer and focuses on sales. Their positions very intentionally intersect but don’t overlap. And the siblings bring unique and complementary skills to the leadership team. Before they reached their current positions, however, the siblings spent time in different parts of the company to develop a sense of ownership and connection to the company culture, deepen their understanding of processes, develop their management skills, and most importantly, earn the trust and respect of the broader organization. What’s more, this pathway to leadership has been institutionalized at the company: a third-generation family member is on a similar development journey and currently serves as chief of staff.

Family governance, when well-executed, can be a powerful way to build corporate culture. However, FOBs may also want to look outside blood lines for leadership. Research has shown that professional management, when well identified and given the right conditions to prosper, can produce better results than family-only structures. 6 Nicholas Bloom, Raffaella Sadun, and John Van Reenen, “Family firms need professional management,” Harvard Business Review , March 25, 2011. Indeed, FOBs are increasingly tapping into the expertise of professionals from outside the family, and our research shows that the outperformers do so even more. For instance, 95 percent of the outperforming FOBs in our research base indicated that they actively involve nonfamily executives in setting portfolio strategy, compared with 85 percent of all other FOBs in the research base.

One outperformer, a CPG company based in Latin America, decided last year to break a generations-long sequence of family leadership and hire a CEO externally. A family-owned European pharmaceutical company did the same. Both organizations followed practices that would be standard for any company, family-owned or not. For example, both engaged a global recruiter to conduct their searches and asked them to focus on talent rather than cultural fit. As FOBs grapple with the question of succession, they would do well to keep their focus more on longevity of the business rather than on continuing family stewardship.

This formula of four critical mindsets plus five strategic actions can help to ensure that FOBs capitalize on the potential for significant, profitable, and sustainable growth. The value at stake is substantial: companies that have implemented this formula successfully have been able to climb higher on the economic-profit curve over the past five years, moving up one or two quintiles. Others that follow this formula can do the same and potentially realize a fourfold increase in value creation over the next decade, according to our estimates.

The implementation will of course look different depending on the organization. Companies facing imminent generational transitions may need to focus first on shoring up their governance mechanisms and succession planning. Businesses in stagnant or vulnerable industries may want to focus first on dynamic capital allocation practices to boost their investments in R&D, new business building, and M&A. The formula must be applied judiciously, and with careful attention to what will be most effective given their specific circumstances.

Regardless, the 4+5 formula provides a path for FOBs (and non-FOBs), of all sizes and ages, to improve their performance and continue to do what they have done for decades—support sustainable and inclusive economic growth, raise employment, and improve healthcare and education in communities around the world.

Eduardo Asaf is a partner in McKinsey’s Mexico City office, where Igor Carvalho and Jose Tellechea are consultants; Acha Leke is a senior partner in the Johannesburg office; and Francesco Malatesta is an associate partner in the Dubai office.

The authors wish to thank Aliyah Allie, Michael Birshan, Fredrik Dahlqvist, Gemma D’Auria, Heinz-Peter Elstrodt, Avinash Goyal, Franck Laizet, Ari Libarikian, David Quigley, Liz Hilton Segel, and Sergio Waisser for their contributions to this report.

This article was edited by Roberta Fusaro, an editorial director based in the Waltham, Massachusetts, office.

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Research involvement of medical students in a medical school of India: exploring knowledge, attitude, practices, and perceived barriers

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Introduction Research in the medical discipline significantly impacts society by improving the general well-being of the population, through improvements in diagnostic and treatment modalities. However, of 579 Indian medical colleges, 332 (57.3%) did not publish a single paper from the year 2005 to 2014," indicating a limited contribution from medical fraternity In order to probe in to the cause of this a study was conducted to assess the knowledge, attitude, practices (KAP) and perceived barriers to research among students of a medical school in Delhi, India.

Methods A cross-sectional study was conducted among medical students and the data on academic-cum-demographic information, assessment of knowledge, attitude, practices and barriers to research was collected using a pre-tested, semi-structured questionnaire. Chi-square test was used to check the association of various factors with the KAP of research. A p-value less than 0.05 was considered significant.

Results A total of 402 (N) subjects were enrolled in the study. Majority were male (79.6%) and from clinical professional years (57%). Majority (266, 66.2%) of the subjects had adequate knowledge. Of the study subjects (61,15%) having inadequate knowledge of research, sixty percent were from pre- and para-clinical years, while around 70 % of those having good knowledge were from clinical professional years. However, only 16.9% of the participants had participated in a research project, and only 4.72% had authored a publication. Sixty one percent of study subjects having a positive attitude towards research, were from pre- and para-clinical years. Among the study subjects having a positive attitude towards research, over 60% were from pre- and para-clinical years. The barriers for conducting research were mostly; lack of funds/laboratory equipment/infrastructure (85.1%), lack of exposure to opportunities for research in the medical (MBBS) curriculum (83.8%), and lack of time (83.3%). There was a statistically significant association between knowledge and attitude towards research with a professional year of study.

Conclusions The study revealed that while most of the students had a positive attitude towards research as well as an adequate knowledge of research, there was a poor level of participation in research. These challenges can be overcome by incorporating research as a part of the medical school curriculum from early years on, setting aside separate time for research, and establishing student research societies that can actively promote research.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The ethics committee of Dr Baba Saheb Ambedkar Medical College and Hospital, New Delhi gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Email id: jhaabhinav677{at}gmail.com , manas.shah1999{at}gmail.com , Ritikgoyal152{at}gmail.com , drdeepakdhamnetiya{at}gmail.com , apoorv1729{at}gmail.com , raviprakashjha{at}gmail.com , dr.prachi.obg{at}bsamch.in

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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