Value co-creation in social marketing wellness services

Customer perceived value is concerned with the experiences of consumers when using a service and is often referred to in the context of service provision or on the basis of service quality (Auh, et al., 2007; Chang, 2008; Jackson, 2007; Laukkanen, 2007; Padgett & Mulvey, 2007; Shamdasani, Mukherjee & Malhotra, 2008). Understanding customer perceived value has benefits for social marketing and allows scholars and practitioners alike to identify why consumers engage in positive social behaviours through the use of services. Understanding consumers’ use of wellness services in particular is important, because the use of wellness services demonstrates the fulfilment of social marketing aims; performing pro-active, positive social behaviours that are of benefit to the individual and to society (Andreasen, 1994). As consumers typically act out of self-interest (Rothschild, 1999), this research posits that a value proposition must be made to consumers in order to encourage behavioural change. Thus, this research seeks to identify how value is created for consumers of wellness services in social marketing. This results in the overall research question of this research: How is value created in social marketing wellness services? A traditional method towards understanding value has been the adoption of an economic approach, which considers the utility gained and where value is a direct outcome of a cost-benefit analysis (Payne & Holt, 1999). However, there has since been a shift towards the adoption of an experiential approach in understanding value. This experiential approach considers the consumption experience of the consumer which extends beyond the service exchange and includes pre- and post-consumption stages (Russell-Bennett, Previte & Zainuddin, 2009). As such, this research uses an experiential approach to identify the value that exists in social marketing wellness services. Four dimensions of value have been commonly conceptualised and identified in the commercial marketing literature; functional, emotional, social, and altruistic value (Holbrook, 1994; Sheth, Newman & Gross, 1991; Sweeney & Soutar, 2001). It is not known if these value dimensions also exist in social marketing. In addition, sources of value said to influence value dimensions have been conceptualised in the literature. Sources of value such as information, interaction, environment, service, customer co-creation, and social mandate have been conceptually identified both in the commercial and social marketing literature (Russell-Bennet, Previte & Zainuddin, 2009; Smith & Colgate, 2007). However, it is not clear which sources of value contribute to the creation of value for users of wellness services. Thus, this research seeks to explore these relationships. This research was conducted using a wellness service context, specifically breast cancer screening services. The primary target consumer of these services is women aged 50 to 69 years old (inclusive) who have never been diagnosed with breast cancer. It is recommended that women in this target group have a breast screen every 2 years in order to achieve the most effective medical outcomes from screening. A two-study mixed method approach was utilised. Study 1 was a qualitative exploratory study that analysed individual-depth interviews with 25 information-rich respondents. The interviews were transcribed verbatim and analysed using NVivo 8 software. The qualitative results provided evidence of the existence of the four value dimensions in social marketing. The results also allowed for the development of a typology of experiential value by synthesising current understanding of the value dimensions, with the activity aspects of experiential value identified by Holbrook (1994) and Mathwick, Malhotra and Rigdon (2001). The qualitative results also provided evidence for the existence of sources of value in social marketing, namely information, interaction, environment and consumer participation. In particular, a categorisation of sources of value was developed as a result of the findings from Study 1, which identify organisational, consumer, and third party sources of value. A proposed model of value co-creation and a set of hypotheses were developed based on the results of Study 1 for further testing in Study 2. Study 2 was a large-scale quantitative confirmatory study that sought to test the proposed model of value co-creation and the hypotheses developed. An online-survey was administered Australia-wide to women in the target audience. A response rate of 20.1% was achieved, resulting in a final sample of 797 useable responses after removing ineligible respondents. Reliability and validity analyses were conducted on the data, followed by Exploratory Factor Analysis (EFA) in PASW18, followed by Confirmatory Factor Analysis (CFA) in AMOS18. Following the preliminary analyses, the data was subject to Structural Equation Modelling (SEM) in AMOS18 to test the path relationships hypothesised in the proposed model of value creation. The SEM output revealed that all hypotheses were supported, with the exception of one relationship which was non-significant. In addition, post hoc tests revealed seven further significant non-hypothesised relationships in the model. The quantitative results show that organisational sources of value as well as consumer participation sources of value influence both functional and emotional dimensions of value. The experience of both functional and emotional value in wellness services leads to satisfaction with the experience, followed by behavioural intentions to perform the behaviour and use the service again. One of the significant non-hypothesised relationships revealed that emotional value leads to functional value in wellness services, providing further empirical evidence that emotional value features more prominently than functional value for users of wellness services. This research offers several contributions to theory and practice. Theoretically, this research addresses a gap in the literature by using social marketing theory to provide an alternative method of understanding individual behaviour in a domain that has been predominantly investigated in public health. This research also clarifies the concept of value and offers empirical evidence to show that value is a multi-dimensional construct with separate and distinct dimensions. Empirical evidence for a typology of experiential value, as well as a categorisation of sources of value is also provided. In its practical contributions, this research identifies a framework that is the value creation process and offers health services organisations a diagnostic tool to identify aspects of the service process that facilitate the value creation process.

Why perform pro-social behaviours? Understanding the key sources of perceived value in preventative health services

In maintaining quality of life, preventative health is an important area in which the performance of pro-social behaviours provides benefits to individuals who perform them as well as society. The establishment of the Preventative Health Taskforce in Australia demonstrates the significance of preventative health and aims to provide governments and health providers with evidence-based advice on preventative health issues (Preventative Health Taskforce, 2009). As preventative health behaviours are voluntary, for consumers to sustain this behaviour there needs to be a value proposition (Dann, 2008; Kotler and Lee, 2008). Customer value has been shown to influence repeat behaviour (McDougall and Levesque, 2000), word-of-mouth (Hartline and Jones, 1999), and attitudes (Dick and Basu, 2008). However to date there is little research that investigates the source of value for preventative health services. This qualitative study explores and identifies three categories of sources that influence four dimensions of value – functional, emotional, social and altruistic (Holbrook 2006). A conceptual model containing five propositions outlining these relationships is presented. This study provides evidence-based research that reveals sources of value that influence individuals’ decisions to perform pro-social behaviours in the long-term through their use of preventative health services. This research uses BreastScreen Queensland (BSQ), a cancer screening service, as the service context.

A proposal to change existing virus species names to non-Latinized binomials

A proposal has been posted on the ICTV website (2011. 001aG. N. v1. binomial_sp_names) to replace virus species names by non-Latinized binomial names consisting of the current italicized species name with the terminal word "virus" replaced by the italicized and non-capitalized genus name to which the species belongs. If implemented, the current italicized species name Measles virus, for instance, would become Measles morbillivirus while the current virus name measles virus and its abbreviation MeV would remain unchanged. The rationale for the proposed change is presented. © 2010 Springer-Verlag.

Middle schooling and scientific literacy : bringing the students to science

This study is about young adolescents' engagement in learning science. The middle years of schooling are critical in the development of students' interest and engagement with learning. Successful school experiences enhance dispositions towards a career related to those experiences. Poor experiences lead to negative attitudes and rejection of certain career pathways. At a time when students are becoming more aware, more independent and focused on peer relationships and social status, the high school environment in some circumstances offers more a content-centred curriculum that is less personally relevant to their lives than the social melee surrounding them. Science education can further exacerbate the situation by presenting abstract concepts that have limited contextual relevance and a seemingly difficult vocabulary that further alienates adolescents from the curriculum. In an attempt to reverse a perceived growing disinterest by students to science (Goodrum, Druhan & Abbs, 2011), a study was initiated based on a student-centred unit designed to enhance and sustain adolescent engagement in science. The premise of the study was that adolescent students are more responsive toward learning if they are given an appropriate learning environment that helps connect their learning with life beyond the school. The purpose of this study was to examine the experiences of young adolescents with the aim of transforming school learning in science into meaningful experiences that connected with their lives. Two areas were specifically canvassed and subsumed within the study to strengthen the design base. One area that of the middle schooling ideology, offered specific pedagogical approaches and a philosophical framework that could provide opportunities for reform. The other area, the construct of scientific literacy (OECD, 2007) as defined by Holbrook and Rannikmae, (2009) appeared to provide a sense of purpose for students to aim toward and value for becoming active citizens. The study reported here is a self-reflection of a teacher/researcher exploring practice and challenging existing approaches to the teaching of science in the middle years of schooling. The case study approach (Yin, 2003) was adopted to guide the design of the study. Over a 6-month period, the researcher, an experienced secondary-science teacher, designed, implemented and documented a range of student-centred pedagogical practices with a Year-7 secondary science class. Data for this case study included video recordings, journals, interviews and surveys of students. Both quantitative and qualitative data sources were employed in a partially mixed methods research approach (Leech & Onwuegbuzie, 2009) dominated by qualitative data with the concurrent collection of quantitative data to corroborate interpretations as a means of analysing and developing a model of the dynamic learning environment. The findings from the case study identified five propositions that became the basis for a model of a student-centred learning environment that was able to sustain student participation and thus engagement in science. The study suggested that adolescent student engagement can be promoted and sustained by providing a classroom climate that encourages and strengthens social interaction. Engagement in science can be enhanced by presenting developmentally appropriate challenges that require rigorous exploration of contextually relevant learning environments; supporting students to develop connections with a curriculum that aligns with their own experiences. By setting an environment empathetic to adolescent needs and understandings, students were able to actively explore phenomena collaboratively through developmentally appropriate experiences. A significant outcome of this study was the transformative experiences of an insider, the teacher as researcher, whose reflections provide an authentic model for reforming pedagogy. The model and theory presented became an adjunct to my repertoire for science teaching in the middle years of schooling. The study was rewarding in that it helped address a void in my understanding of middle years of schooling by prompting me to re-think the notion of adolescence in the context of the science classroom. This study is timely given the report "The Status and Quality of Year 11 and 12 Science in Australian Schools" (Goodrum, Druhan & Abbs, 2011) and national curricular changes that are being proposed for science (ACARA, 2009).

Palliative care and other physicians’ knowledge, attitudes and practice relating to the law on withholding/withdrawing life-sustaining treatment: Survey results

Background: To effectively care for people who are terminally ill, including those without decision-making capacity, palliative care physicians must know and understand the legal standing of Advance Care Planning (ACP) in their jurisdiction of practice. This includes the use of advance directives/living wills (ADs) and substitute decision-makers (SDMs) who can legally consent to or refuse treatment if there is no valid AD. Aim: The study aimed to investigate the knowledge, attitudes and practices of medical specialists most often involved in end-of-life care in relation to the law on withholding/ withdrawing life-sustaining treatment (WWLST) from adults without decision-making capacity. Design/participants: A pre-piloted survey was posted to specialists in palliative, emergency, geriatric, renal and respiratory medicine, intensive care and medical oncology in three Australian States. Surveys were analysed using SPSS20 and SAS 9.3. Results: The overall response rate was 32% (867/2702); 52% from palliative care specialists. Palliative Care specialists and Geriatricians had significantly more positive attitudes towards the law (χ242 = 94.352; p < 0.001) and higher levels of knowledge about the WWLST law (χ27 = 30.033; p < 0.001), than did the other specialists, while still having critical gaps in their knowledge. Conclusions: A high level of knowledge of the law is essential to ensure that patients’ wishes and decisions, expressed through ACP, are respected to the maximum extent possible within the law, thereby according with the principles and philosophy of palliative care. It is also essential to protect health professionals from legal action resulting from unauthorised provision or removal of treatment.

A proposal to change existing virus species names to non-Latinized binomials.

A proposal has been posted on the ICTV website (2011.001aG.N.v1.binomial_sp_names) to replace virus species names by non-Latinized binomial names consisting of the current italicized species name with the terminal word "virus" replaced by the italicized and non-capitalized genus name to which the species belongs. If implemented, the current italicized species name Measles virus, for instance, would become Measles morbillivirus while the current virus name measles virus and its abbreviation MeV would remain unchanged. The rationale for the proposed change is presented.

Coordination of platinum therapeutic agents to met-rich motifs of human copper transport protein1.

Platinum therapeutic agents are widely used in the treatment of several forms of cancer. Various mechanisms for the transport of the drugs have been proposed including passive diffusion across the cellular membrane and active transport via proteins. The copper transport protein Ctr1 is responsible for high affinity copper uptake but has also been implicated in the transport of cisplatin into cells. Human hCtr1 contains two methionine-rich Mets motifs on its extracellular N-terminus that are potential platinum-binding sites: the first one encompasses residues 7-14 with amino acid sequence Met-Gly-Met-Ser-Tyr-Met-Asp-Ser and the second one spans residues 39-46 with sequence Met-Met-Met-Met-Pro-Met-Thr-Phe. In these studies, we use liquid chromatography and mass spectrometry to compare the binding interactions between cisplatin, carboplatin and oxaliplatin with synthetic peptides corresponding to hCtr1 Mets motifs. The interactions of cisplatin and carboplatin with Met-rich motifs that contain three or more methionines result in removal of the carrier ligands of both platinum complexes. In contrast, oxaliplatin retains its cyclohexyldiamine ligand upon platinum coordination to the peptide.

Biological and physical interactions on a tropical island coral reef: Transport and retention processes on moorea, French Polynesia

The Moorea Coral Reef Long Term Ecological Research project funded by the US National Science Foundation includes multidisciplinary studies of physical processes driving ecological dynamics across the fringing reef, back reef, and fore reef habitats of Moorea, French Polynesia. A network of oceanographic moorings and a variety of other approaches have been used to investigate the biological and biogeochemical aspects of water transport and retention processes in this system. There is evidence to support the hypothesis that a low-frequency counterclockwise flow around the island is superimposed on the relatively strong alongshore currents on each side of the island. Despite the rapid flow and flushing of the back reef, waters over the reef display chemical and biological characteristics distinct from those offshore. The patterns include higher nutrient and lower dissolved organic carbon concentrations, distinct microbial community compositions among habitats, and reef assemblages of zooplankton that exhibit migration behavior, suggesting multigenerational residence on the reef. Zooplankton consumption by planktivorous fish on the reef reflects both retention of reef-associated taxa and capture by the reef community of resources originating offshore. Coral recruitment and population genetics of reef fishes point to retention of larvae within the system and high recruitment levels from local adult populations. The combined results suggest that a broad suite of physical and biological processes contribute to high retention of externally derived and locally produced organic materials within this island coral reef system. © 2013 by The Oceanography Society. All rights reserved.

The Morality of Harm

In this article, we discuss the range of concerns people weigh when evaluating the acceptability of harmful actions and propose a new perspective on the relationship between harm and morality. With this aim, we examine Kelly, Stich, Haley, Eng and Fessler’s (2007) recent claim that, contrary to Turiel and associates, people do not judge harm to be authority independent and general in scope in the context of complex harmful scenarios (e.g., prisoner interrogation, military training). In a modified replication of their study, we examined participants’ judgments of harmful actions in these contexts by taking into account their explanations for their judgments. We claim that both in terms of participants’ judgments and rationales, the results largely confirm our hypothesis that actions involving harm and injustice or rights violation are judged to be authority independent and general in scope, which is a modification of Turiel’s traditional hypothesis.

Folk Concepts of Intentional Action in the Contexts of Amoral and Immoral Luck

This paper concerns a recently discovered, puzzling asymmetry in judgments of whether an action is intentional or not (Knobe 2003a, b). We report new data replicating the asymmetry in the context of scenarios wherein an agent achieves an amoral or immoral goal due to luck. Participants’ justifications of their judgments of the intentionality of the agent’s action indicate that two distinct folk concepts of intentional action played a role in their judgments. When viewed from this perspective, the puzzle disappears, although the asymmetry remains

Unconscious Vigilance: Worldview Defense without Adaptations for Terror, Coalition or Uncertainty Management

Individuals subtly reminded of death, coalitional challenges, or feelings of uncertainty display exaggerated preferences for affirmations and against criticisms of their cultural in-groups. Terror management, coalitional psychology, and uncertainty management theories postulate this “worldview defense” effectas the output of mechanisms evolved either to allay the fear of death, foster social support, or reduce anxiety by increasing adherence to cultural values. In 4 studies, we report evidence for an alternative perspective. We argue that worldview defense owes to unconscious vigilance, a state of accentuatedreactivity to affective targets (which need not relate to cultural worldviews) that follows detection of subtle alarm cues (which need not pertain to death, coalitional challenges, or uncertainty). In Studies 1 and 2, death-primed participants produced exaggerated ratings of worldview-neutral affective targets. In Studies 3 and 4, subliminal threat manipulations unrelated to death, coalitional challenges, or uncertaintyevoked worldview defense. These results are discussed as they inform evolutionary interpretations of worldview defense and future investigations of the influence of unconscious alarm on judgment.

Supernatural Beliefs, Unconscious Threat and Judgment Bias in Tibetan Buddhists

Individuals who have been subtly reminded of death display heightened in-group favouritism, or “worldview defense.” Terror management theory argues (i) that death cues engender worldview defense via psychological mechanisms specifically evolved to suppress death anxiety, and (ii) that the core function of religiosity is to suppress death anxiety. Thus, terror management theory predicts that extremely religious individuals will not evince worldview defense. Here, two studies are presented in support of an alternative perspective. According to the unconscious vigilance hypothesis, subtly processed threats (which need not pertain to death) heighten sensitivity to affectively valenced stimuli (which need not pertain to cultural attitudes). From this perspective, religiosity mitigates the influence of mortality-salience only insofar as afterlife doctrines reduce the perceived threat posed by death. Tibetan Buddhism portrays death as a perilous gateway to rebirth rather than an end to suffering; faith in this doctrine should therefore not be expected to nullify mortality-salience effects. In Study 1, devout Tibetan Buddhists who were subtly reminded of death produced exaggerated aesthetic ratings unrelated to cultural worldviews. In Study 2, devout Tibetan Buddhists produced worldview defense following subliminal exposure to non-death cues of threat. The results demonstrate both the domain-generality of the process underlying worldview defense and the importance of religious doctrinal content in moderating mortality-salience effects.