Empirical research on Kano's model and customer satisfaction

Public demand and optimization of smart government service platform from the perspective of service life cycle based on the Kano model: A Chinese case study

BACKGROUND

Smart government is an effective way to promote government innovation and public services. However, in China, there is a mismatch between the development of smart government service platform and the demands of the public. Therefore, this study aims to clarify the categories and priorities of public demands in smart government services from service life cycle perspective.

METHODS

Based on the service life cycle perspective, 29 public demands in government services were summarized. A self-designed questionnaire was designed and distributed to the public using the "Jingtong" smart government service platform in Beijing. Based on 648 valid questionnaires collected, the Kano model was used to analyze the category attributes of demands, and the traditional classification and other two coefficient analysis methods were used to prioritize the demands.

RESULTS

The analysis of the collected questionnaires shows that personal privacy should be prioritized as it is the prerequisite for the widespread use of smart government services. Then, one-dimensional quality and attractive quality should be satisfied such as decision-making and intelligent scheduling demands, as they are central to the capability leap of smart government services. Additionally, must-be quality should be satisfied such as information sharing demand, as they are foundation of smart government services. Lastly, the quick response demand should be transformed into other demand types.

CONCLUSIONS

This study analyzes public demands at various stages from the perspective of the service life cycle, based on the prioritization of demands, proposes targeted optimization strategies for smart government service platform in the guide, interaction, processing, and evaluation periods. This provides important references for the overall construction of smart government.

Supporting teams with designing for dissemination and sustainability: the design, development, and usability of a digital interactive platform

BACKGROUND

Designing for Dissemination and Sustainability (D4DS) principles and methods can support the development of research products (interventions, tools, findings) that match well with the needs and context of the intended audience and setting. D4DS principles and methods are not well-known or used during clinical and public health research; research teams would benefit from applying D4DS. This paper presents the development of a new digital platform for research teams to learn and apply a D4DS process to their work.

METHODS

A user-centered design (UCD) approach engaged users (n = 14) and an expert panel (n = 6) in an iterative design process from discovery to prototyping and testing. We led five design sessions using Zoom and Figma software over a 5-month period. Users (71% academics; 29% practitioners) participated in at least 2 sessions. Following design sessions, feedback from users was summarized and discussed to generate design decisions. A prototype was then built and heuristically tested with 11 users who were asked to complete multiple tasks within the platform while verbalizing their decision-making using the 'think aloud' procedure. The System Usability Scale (SUS) was administered at the end of each testing session. After refinements to the platform were made, usability was reassessed with 7 of 11 same users to examine changes.

RESULTS

The interactive digital platform (the D4DS Planner) has two main components: 1) the Education Hub (e.g., searchable platform with literature, videos, websites) and 2) the Action Planner. The Action Planner includes 7 interactive steps that walk users through a set of activities to generate a downloadable D4DS action plan for their project. Participants reported that the prototype tool was moderately usable (SUS = 66) but improved following refinements (SUS = 71).

CONCLUSIONS

This is a first of its kind tool that supports research teams in learning about and explicitly applying D4DS to their work. The use of this publicly available tool may increase the adoption, impact, and sustainment of a wide range of research products. The use of UCD yielded a tool that is easy to use. This tool's future use and impact will be evaluated with a broader sample of community partners and projects and the tool will continue to be refined and improved.

Keeping the Customer Satisfied: Applying a Kano Model to Improve Vaccine Promotion in the Philippines

INTRODUCTION

The success of global health interventions heavily relies on reaching populations in a way that aligns with their priorities and needs. This warrants novel approaches to determine the design of meaningful interventions and targeted delivery pathways. To date, global health scholarship and practice have largely underused approaches already established in fields that emphasize customer satisfaction, such as quality management or consumer psychology.

METHODS

In our study, we apply Kano methodology-originally designed to understand how product attributes nonlinearly influence customer satisfaction-to inform design decisions regarding a video-based vaccine intervention in the Philippines. Between September 2021 and April 2022, we administered a Kano questionnaire to 205 caregivers of small children. Data were analyzed following routine Kano approaches, supplemented by cultural consensus analysis (CCA), which is an approach used largely in anthropology to identify distinct cultural groups and competencies.

RESULTS

Applying Kano and CCA methodologies allowed us to make informed design decisions in terms of optimizing accessibility and credibility of an intervention that ultimately proved successful in bolstering vaccine intentions. Results guided us to include national and international logos, to appreciate the value of summarizing key messages, and to recognize the importance of fact- or story-based communication as attributes that influenced respondent satisfaction one-dimensionally. We found that involving trusted messengers and including text-based information were required to avoid dissatisfaction. Interacting with someone after viewing the product and creating opportunities to share the promotional material via social media were attractive attributes whose presence would increase satisfaction but would not spark severe dissatisfaction if omitted. Other attributes (short duration, video- or animation-based intervention, delivering the intervention at health centers or in group settings) played a limited role in respondent satisfaction.

CONCLUSIONS

Global health research and practice can benefit from applying approaches established in other fields when making evidence-based prioritization decisions to tailor interventions.

A Kano model-based demand analysis and perceived barriers of pulmonary rehabilitation interventions for patients with chronic obstructive pulmonary disease in China

BACKGROUND

Pulmonary rehabilitation (PR) has been recognized to be an effective therapy for chronic obstructive pulmonary disease (COPD). However, in China, the application of PR interventions is still less promoted. Therefore, this cross-sectional study aimed to understand COPD patients' intention to receive PR, capture the potential personal, social and environmental barriers preventing their willingness of receiving PR, and eventually identify demanding PR services with the highest priority from patients' point of view.

METHODS

In total 237 COPD patients were recruited from 8 health care facilities in Zhejiang, China. A self-designed questionnaire was applied to investigate patients' intention to participate in PR and potentially associated factors, including personal dimension such as personal awareness, demographic factors, COPD status and health-related literacy/behaviors, as well as social policies and perceived environmental barriers. The demand questionnaire of PR interventions based on the Kano model was further adopted.

RESULTS

Among the 237 COPD patients, 75.1% of COPD patients were willing to participate in PR interventions, while only 62.9% of the investigated patients had heard of PR interventions. Over 90% of patients believed that the cost of PR services and the ratio of medical insurance reimbursement were potential obstacles hindering them from accepting PR services. The multiple linear regression analysis indicated that the PR skills of medical staff, knowledge promotion and public education levels of PR in the community, patients' transportation concerns and degree of support from family and friends were significantly associated with willingness of participation in PR interventions. By using the Kano model, the top 9 most-requisite PR services (i.e., one-dimensional qualities) were identified from patients' point of view, which are mainly diet guidance, education interventions, psychological interventions and lower limb exercise interventions. Subgroup analysis also revealed that patients' demographics, such as breathlessness level, age, education and income levels, could influence their choice of priorities for PR services, especially services related to exercise interventions, respiratory muscle training, oxygen therapy and expectoration.

CONCLUSIONS

This study suggested that PR-related knowledge education among patients and their family, as well as providing basic package of PR services with the most-requisite PR items to COPD patients, were considerable approaches to promote PR attendance in the future.

Design Research to Embed mHealth into a Community-Led Blood Pressure Management System in Uganda: Protocol for a Mixed Methods Study

BACKGROUND

Uncontrolled hypertension is a leading risk factor for cardiovascular diseases. In Uganda, such diseases account for approximately 10% of all deaths, with 1 in 5 adults having hypertension (>90% of the hypertensive cases are uncontrolled). Although basic health care in the country is available free of cost at government facilities, regularly accessing medication to control hypertension is difficult because supply chain challenges impede availability. Clients therefore frequently suspend treatment or buy medication individually at private facilities or pharmacies (incurring significant costs). In recent years, mobile health (mHealth) interventions have shown increasing potential in addressing health system challenges in sub-Saharan Africa, but the acceptability, feasibility, and uptake conditions of mobile money approaches to chronic disease management remain understudied.

OBJECTIVE

This study aims to design and pilot-test a mobile money-based intervention to increase the availability of antihypertensive medication and lower clients' out-of-pocket payments. We will build on existing local approaches and assess the acceptability, feasibility, and uptake of the designed intervention. Furthermore, rather than entering the study setting with a ready-made intervention, this research will place emphasis on gathering applied ethnographic insights early, which can then inform the parameters of the intervention prototype and concurrent trial.

METHODS

We will conduct a mixed methods study following a human-centered design approach. We will begin by conducting extensive qualitative research with a range of stakeholders (clients; health care providers; religious, cultural, and community leaders; academics; and policy makers at district and national levels) on their perceptions of hypertension management, money-saving systems, and mobile money in the context of health care. Our results will inform the design, iterative adaptation, and implementation of an mHealth-facilitated pooled financing intervention prototype. At study conclusion, the finalized prototype will be evaluated quantitatively via a randomized controlled trial.

RESULTS

As of August 2023, qualitative data collection, which started in November 2022, is ongoing, with data analysis of the first qualitative interviews underway to inform platform and implementation design. Recruitment for the quantitative part of this study began in August 2023.

CONCLUSIONS

Our results aim to inform the ongoing discourse on novel and sustainable pathways to facilitate access to medication for the management of hypertension in resource-constrained settings.

TRIAL REGISTRATION

German registry of clinical trials DRKS00030922; https://drks.de/search/en/trial/DRKS00030922.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/46614.

Effect of Short, Animated Video Storytelling on Maternal Knowledge and Satisfaction in the Perinatal Period in South Africa: Randomized Controlled Trial

BACKGROUND

Innovative mobile health (mHealth) interventions can improve maternal knowledge, thereby supporting national efforts to reduce preventable maternal and child mortality in South Africa. Studies have documented a potential role for mobile video content to support perinatal health messaging, enhance maternal satisfaction, and overcome literacy barriers. Short, animated storytelling (SAS) is an innovative, emerging approach to mHealth messaging.

OBJECTIVE

We aimed to measure the effect of SAS videos on maternal knowledge and user satisfaction for mothers enrolled in antenatal care programs at 2 public health facilities in the Tshwane District of South Africa.

METHODS

We used a randomized controlled trial with a nested evaluation of user satisfaction. Participants were randomized 1:1 into Standard-of-Care (SOC) Control, and SAS Intervention groups. The intervention videos were delivered through WhatsApp, and 1 month later, participants responded to telephone surveys assessing their knowledge. The intervention group then participated in a nested evaluation of user satisfaction.

RESULTS

We surveyed 204 participants. Of them, 49.5% (101/204) were aged between 25 and 34 years. Almost all participants self-identified as Black, with the majority (190/204, 93.2%) having completed secondary school. The mean overall knowledge score was 21.92/28. We observed a slight increase of 0.28 (95% uncertainty interval [UI] -0.58 to 1.16) in the overall knowledge score in the intervention arm. We found that those with secondary education or above scored higher than those with only primary education by 2.24 (95% UI 0.76-4.01). Participants aged 35 years or older also scored higher than the youngest age group (18-24 years) by 1.83 (95% CI 0.39-3.33). Finally, the nested user satisfaction evaluation revealed high maternal satisfaction (4.71/5) with the SAS video series.

CONCLUSIONS

While the SAS videos resulted in high user satisfaction, measured knowledge gains were small within a participant population that was already receiving perinatal health messages through antenatal clinics. The higher knowledge scores observed in older participants with higher education levels suggest that boosting maternal knowledge in younger mothers with lower education levels should continue to be a public health priority in South Africa. Given the high maternal satisfaction among the SAS video-users in this study, policy makers should consider integrating similar approaches into existing, broad-reaching perinatal health programs, such as MomConnect, to boost satisfaction and potentially enhance maternal engagement. While previous studies have shown the promise of animated video health education, most of this research has been conducted in high-income countries. More research in underresourced settings is urgently needed, especially as access to mobile technology increases in the Global South. Future studies should explore the effect of SAS videos on maternal knowledge in hard-to-reach populations with limited access to antenatal care, although real-world logistical challenges persist when implementing studies in underresourced South African populations.

TRIAL REGISTRATION

Pan African Clinical Trials Registry PACTR202203673222680; https://tinyurl.com/362cpuny.

Orthopaedic and trauma surgeons' prioritisation of app quality principles based on their demographic background

BACKGROUND

Although apps are becoming increasingly relevant in healthcare, there is limited knowledge about how healthcare professionals perceive "quality" in this context and how quality principles that can aid them in assessing health-related apps may be prioritised. The objective was to investigate physicians' views of predefined (general) quality principles for health apps and to determine whether a ranking algorithm applied to the acquired data can provide stable results against various demographic influences and may thus be appropriate for prioritisation.

METHODS

Participants of an online survey of members of two German professional orthopaedics associations conducted between 02/12/2019 and 02/01/2020 were asked about their perception of a set of quality principles for health apps (i.e., "practicality," "risk adequacy," "ethical soundness," "legal conformity," "content validity," "technical adequacy," "usability," "resource efficiency," and "transparency"). Structured as a Kano survey, for each principle, there were questions about its perceived relevance and opinions regarding the presence or absence of corresponding characteristics. The available data were evaluated descriptively, and a newly developed method for prioritisation of the principles was applied overall and to different demographic strata (for validation).

RESULTS

Three hundred eighty-two datasets from 9503 participants were evaluated. Legal conformity, content validity, and risk adequacy filled ranks one to three, followed by practicability, ethical soundness, and usability (ranks 4 to 6). Technical adequacy, transparency, and resource efficiency ranked last (ranks 7 to 9). The ranking based on the proposed method was relatively stable, irrespective of demographic factors. The principles were seen as essential, with one exception ("resource efficiency"). Only those with little to no interest in digitisation (22/382, 5.8%) rated the nine principles indifferently.

CONCLUSIONS

The specified quality principles and their prioritisation can lay a foundation for future assessments of apps in the medical field. Professional societies build upon this to highlight opportunities for digital transformations in medicine and encourage their members to participate.

Innovate or game over? Examining effects of product innovativeness on video game success

In recent years, the video game industry has invested significant amounts in the development of innovative elements for its products. However, it is still subject to debate whether these R&D investments always pay off. While prior research has confirmed that enhancing product innovativeness increases business performance in certain industries, corresponding findings for the video game market are lacking. This might be a result of missing theoretical conceptualizations and adequate empirical operationalizations of game innovativeness. Addressing this research gap, this study provides the first conceptualization and operationalization of game innovativeness, shedding first light on its performance effects. Based on longitudinal data on 351 computer games, our findings confirm that innovations in the game's presentation and principle enhance short-term success, whereas innovations in a game's storyline can be more of a hindrance than a godsend for companies. However, our results also show that performance effects of game innovativeness diminish over time.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12525-022-00521-7.

Evaluating caregivers' service quality perceptions: impact-range performance and asymmetry analyses

BACKGROUND

This study aimed to analyze family caregivers' (FCs) dementia care service perceptions to identify the various attributes impacting FCs satisfaction and dissatisfaction.

METHODS

This is a cross-sectional survey study using convenience sampling methods. A self-completion questionnaire was developed from the Service Quality scale and distributed using a convenience sampling method to family caregivers in community-based dementia care centers to determine their perceptions of service quality in dementia care. Both exploratory factor analysis and reliability analysis were conducted to confirm the validity and factor structure of the scale. This study employed Impact Range Performance Analysis (IRPA) and Impact Asymmetry Analysis (IAA) to analyze the data obtained from FCs across five attribute dimensions (Tangibles, Reliability, Responsiveness, Assurance, and Empathy). Priorities for service improvement were derived using a three-step analytical framework.

RESULTS

This study reported that the overall perceived performance of service provided is high. The results indicated that practitioners should focus on attributes such as demand coordination, appropriate services, timely service, barrier-free environment, care-giving process, fire and safety compliance, professional knowledge, and reliable services, which have a higher range of impact on customer service and low impact-asymmetry and attribute performance scores.

CONCLUSION

This study used expectation and perceived performance to suggest that the priorities for improvement and resource allocation in dementia care centers vary across different attributes. Thus, attentiveness toward satisfying user demand could improve patient care and caregiver satisfaction. The dimensions and attributes identified by our study can serve as basic data for future research on the long-term care system.

Demand analysis of an intelligent medication administration system for older adults with chronic diseases based on the Kano model

Objectives

Gerontechnology has great potential in promoting older adults’ well-being. With the accelerated aging process, gerontechnology has a promising market prospect. However, most technological developers and healthcare professionals attached importance to products’ effectiveness, and ignored older adults’ demands and user experience, which reduced older adults' adoption intention of gerontechnology use. The inclusion of older adults in the design process of technologies is essential to maximize the effect. This study explored older adults’ demands for a self-developed intelligent medication administration system and proposed optimization schemes, thus providing reference to developing geriatric-friendly technologies and products.

Methods

A cross-sectional survey was conducted to explore older adults’ technological demands for the self-developed intelligent medication administration system, and data were analyzed based on the Kano model. A self-made questionnaire was administered from July 2020 to October 2020 after participants used this system for two weeks. The study was registered with the Chinese Clinical Trial Registry (ChiCTR2000040644).

Results

A total of 354 older adults participated in the survey. Four items, namely larger font size, simpler operation process, scheduled medication reminders and reliable hardware, were classified as must-be attributes; three items, namely searching drug instructions through WeChat, more sensitive system and longer battery life, as attractive attributes; one item, viewing disease-related information through WeChat, as the one-dimensional attribute; and the rest were indifferent attributes, including simple and beautiful displays, blocking advertisements automatically, providing user privacy protection protocol, viewing personal medical information only by logged-in users, recording all the medications, ordering medications through WeChat. The satisfaction values were between 0.24 and 0.69, and dissatisfaction values were between 0.06 and 0.94.

Conclusion

This study suggested that older adults had personalized technology demands. Including their technological demands and desire may assist in decreasing the digital divide and promoting the satisfaction of e-health and/or m-health. Based on older adults’ demands, our study proposed optimization schemes of the intelligent medication administration system, which may help developers design geriatric-friendly intelligent products and nurses to perform older adults-centered and efficient medication management.

How can human-centered design build a story-based video intervention that addresses vaccine hesitancy and bolsters vaccine confidence in the Philippines? A mixedmethod protocol for project SALUBONG

INTRODUCTION

Since the onset of a dengue vaccine controversy in late 2017, vaccine confidence has plummeted in the Philippines, leading to measles and polio outbreaks in early 2019. This protocol outlines a human-centered design (HCD) approach to co-create and test an intervention that addresses vaccine hesitancy (VH) via narrative and empathy with and among families and healthcare workers. METHODS AND ANALYSIS: 'Salubong' is a Filipino term that means to welcome someone back into one's life, reinforcing notions of family ties and friendships. We apply this sentiment to vaccines. Following the phases of HCD, guided by a theoretical framework, and drawing from locally held understandings of faith and acceptance, we will conduct in-depth interviews (IDIs) and focus group discussions (FGDs) in rural and urban Filipino communities that witnessed dramatic increases in measles cases in recent years. During qualitative engagements with caretakers, providers, and policymakers, we will collect narratives about family and community perceptions of childhood vaccinations, public health systems and opportunities to restore faith. IDIs and FGDs will continuously inform the development of (and delivery mechanisms for) story-based interventions. Once developed, we will test our co-created interventions among 800 caretakers and administer a VH questionnaire prior to and immediately following the intervention encounter. We will use the feedback gained through the survey and Kano-style questionnaires to further refine the intervention. Considering the data collection challenges posed by the ongoing COVID-19 pandemic, we have developed workarounds to conduct data collection primarily online. We will use systematic online debriefings to facilitate comprehensive participation of the full research team.

ETHICS AND DISSEMINATION

Ethical approval has been granted by the Institutional Review Board of the Research Institute for Tropical Medicine (number 2019-44) and Ethical Commission of Heidelberg University, Faculty of Medicine (S-833/2019). Study findings will be disseminated in scientific conferences and published in peer-reviewed journals.

Palindromic rheumatism: a unique and enigmatic entity with a complex relationship with rheumatoid arthritis

INTRODUCTION

Palindromic rheumatism (PR) is a form of relapsing/remitting arthritis that may evolve to chronic rheumatic disease, mainly rheumatoid arthritis (RA). The exact nature of PR is unclear, as it may be considered a disease in itself, an abortive form of RA or just a pre-RA stage.

AREAS COVERED

The authors review the most relevant epidemiological and clinical aspects of PR, especially the pathogenetic role of autoimmunity in PR, with most patients having a characteristic autoantibody profile similar to that observed in RA. The role of autoinflammation is also discussed. A literature review on the rate of RA progression and its prognostic factors was analyzed. Data on the efficacy of drug therapies used to treat PR are presented. PubMed was searched using the terms 'palindromic rheumatism' OR 'palindromic arthritis'.

EXPERT OPINION

PR is a disease entity with a close but unclear relationship with RA. In PR there is an unmet need, which is to clarify the clinical spectrum and elucidate the risk factors for evolution to RA. The role of autoimmunity and the autoinflammatory component should be investigated. Since most patients evolve to RA, PR may display a unique therapeutic opportunity to avoid this evolution.

Demand Analysis of Telenursing for Community-Dwelling Empty-Nest Elderly Based on the Kano Model

Background: In recent years, the increasing number of empty-nest elderly has become a significant global social problem, and the rapid development of medical technology and information technology has improved the feasibility of telenursing. However, few studies have been conducted on needs of telenursing among the empty-nest elderly. The aim of this study is to explore the needs of telenursing for community-dwelling empty-nest elderly who are completely independent in activities of daily living (ADL), or who are mildly disabled, and to provide a reference for improving the remote care quality. Methods: A questionnaire survey aiming to explore telenursing needs of the elderly was conducted among 268 community-dwelling empty-nest elderly who were selected using random sampling and then data were analyzed based on the Kano Model. Results: Chi-square goodness-of-fit test showed that there were significant differences between actual and expected counts for each item of telenursing needs (p < 0.01 for all), indicating that the sample had specific individual preference for the Kano category. The desired degree of telenursing service ranged from 48.37% to 80.86%, the better values (satisfaction) were between 57.09% and 67.56%, and the worse values (dissatisfaction) were between 11.92% and 37.93%. The items, remote one-button emergency caller and remote emergency assistance arrangement, were considered to be one-dimensional qualities by empty nesters and the rest were attractive qualities. In the quadrant analysis diagram, all the remote care services were categorized as attractive qualities. Discussion: The community-dwelling empty-nest elderly with ADL independence or mild impairment have positive attitudes toward telenursing services, especially the needs of remote first aid nursing. Medical policy makers and nursing managers can provide targeted telenursing services according to empty nesters' requirements, thus improving nursing care quality and satisfaction of the elderly.

Observing Pictures and Videos of Creative Products: An Eye Tracking Study

The paper offers insights into people’s exploration of creative products shown on a computer screen within the overall task of capturing artifacts’ original features and functions. In particular, the study presented here analyzes the effects of different forms of representations, i.e., static pictures and videos. While the relevance of changing stimuli’s forms of representation is acknowledged in both engineering design and human-computer interaction, scarce attention has been paid to this issue hitherto when creative products are in play. Six creative products have been presented to twenty-eight subjects through either pictures or videos in an Eye-Tracking-supported experiment. The results show that major attention is paid by people to original product features and functional elements when products are displayed by means of videos. This aspect is of paramount importance, as original shapes, parts, or characteristics of creative products might be inconsistent with people’s habits and cast doubts about their rationale and utility. In this sense, videos seemingly emphasize said original elements and likely lead to their explanation/resolution. Overall, the outcomes of the study strengthen the need to match appropriate forms of representation with different design stages in light of the needs for designs’ evaluation and testing user experience.

Customer satisfaction analysis of the healthy elderly to investigate the association among happiness, health status, and well-being using the Happiness & Health Feeling Scale

[Purpose] In this study, we aimed to analyze customer satisfaction as a tool to investigate the association among happiness, health status, and well-being using the Happiness & Health Feeling Scale. [Participants and Methods] We included 17 elderly participants and measured the happiness and health statuses using the Happiness & Health Feeling Scale. We analyzed customer satisfaction by correlating subjective well-being with the questionnaire scores. [Results] The results showed a negative correlation between subjective well-being and the score on each questionnaire (correlation coefficient= -0.476). The elderly participants showed lower scores associated with self-esteem, including external appreciation and self-love, whereas high scores associated with eating and pleasure. The Cronbach's alpha was 0.814. [Conclusion] This study showed an inverse correlation between Happiness & Health Feeling Scale score and well-being, presumably because of low scores associated with self-esteem, which should be prioritized for improvement. The additional use of customer satisfaction analysis using the Happiness & Health Feeling Scale could be helpful to elucidate the subjective association between happiness and health-related factors.

An Assessment Model for Evaluating Asymmetric Effects of Attribute-Level Performance on Satisfaction

The effects of attribute performance on satisfaction have been widely addressed in the discussion on satisfaction. In traditional view, customer satisfaction should be enhanced by improving product or service attribute performance. However, as theoretical and empirical studies have shown, the linkage between attribute performance and overall satisfaction is asymmetric and nonlinear, which means that it is not a definite relationship between high performance of attribute and satisfaction. Regarding the research on delivering asymmetric effects, the Kano model was utilized extensively in the previous studies. But this method suffers from lacking a validity testing and failing to take account of the degree of attribute’s importance. To get a more effective access to measuring the asymmetric and nonlinear effects of attributes on customer satisfaction, this study presents an integrated approach which can express asymmetric effects through evaluating the significance of different attributes to satisfaction based on response surface analysis and importance grid analysis methods. In this paper, an empirical study on rural tourists’ satisfaction was undertaken using this integrated method. Furthermore, compared with the regression with a dummy variable method, this proposed approach shows more responsive to enhancing attribute performance and makes allowance for improving a certain target attribute in the customer satisfaction improvement process.

Facilitating public and patient involvement in basic and preclinical health research

Involving patients in research broadens a researcher's field of influence and may generate novel ideas. Preclinical research is integral to the progression of innovative healthcare. These are not patient-facing disciplines and implementing meaningful public and patient involvement (PPI) can be a challenge. A discussion forum and thematic analysis identified key challenges of implementing public and patient involvement for preclinical researchers. In response we developed a "PPI Ready" planning canvas. For contemporaneous evaluation of public and patient involvement, a psychometric questionnaire and an open source tool for its evaluation were developed. The questionnaire measures information, procedural and quality assessment. Combined with the open source evaluation tool, researchers are notified if public and patient involvement is unsatisfactory in any of these areas. The tool is easy to use and adapts a psychometric test into a format familiar to preclinical scientists. Designed to be used iteratively across a research project, it provides a simple reporting grade to document satisfaction trend over the research lifecycle.

A New Methodology for Improving Service Quality Measurement: Delphi-FUCOM-SERVQUAL Model

The daily requirements and needs imposed on the executors of logistics services imply the need for a higher level of quality. In this, the proper execution of all sustainability processes and activities plays an important role. In this paper, a new methodology for improving the measurement of the quality of the service consisting of three phases has been developed. The first phase is the application of the Delphi method to determine the quality dimension ranking. After that, in the second phase, using the FUCOM (full consistency method), we determined the weight coefficients of the quality dimensions. The third phase represents determining the level of quality using the SERVQUAL (service quality) model, or the difference between the established gaps. The new methodology considers the assessment of the quality dimensions of a large number of participants (customers), on the one hand, and experts’ assessments on the other hand. The methodology was verified through the research carried out in an express post company. After processing and analyzing the collected data, the Cronbach alpha coefficient for each dimension of the SERVQUAL model for determining the reliability of the response was calculated. To determine the validity of the results and the developed methodology, an extensive statistical analysis (ANOVA, Duncan, Signum, and chi square tests) was carried out. The integration of certain methods and models into the new methodology has demonstrated greater objectivity and more precise results in determining the level of quality of sustainability processes and activities.

Novel Method for Perceiving Key Requirements of Customer Collaboration Low-Carbon Product Design

Low-carbon product design is an important way to reduce greenhouse gas emission. Customer collaborative product innovation (CCPI) has become a new worldwide product design trend. Based on this popularity, we introduced CCPI into the low-carbon product design process. An essential step for implementing low carbon CCPI is to clarify key low carbon requirements of customers. This study tested a novel method for perceiving key requirements of customer collaboration low-carbon product design based on fuzzy grey relational analysis and genetic algorithm. Firstly, the study considered consumer heterogeneity, allowing different types of customers to evaluate low carbon requirements in appropriate formats that reflected their degrees of uncertainty. Then, a nonlinear optimization model was proposed to establish the information aggregation factor of customers based on the genetic algorithm. The weight of customers was obtained simultaneously. Next, the key low carbon requirements of customer were identified. Finally, the effectiveness of the proposed method was illustrated with a case related to a low carbon liquid crystal display.