Dimensions of service quality in health-fitness clubs in China

International Journal of Environmental Research and Public Health Article Dimensions of Service Quality in Health-Fitness Clubs in China Karen Kaijuan Xu 1,*, Kenny Kuanchou Chen 2, Euisoo Kim 3, Jerónimo García-Fernández 4, John Nauright 5 and James J. Zhang 3   Citation: Xu, K.K.; Chen, K.K.; Kim, E.; García-Fernández, J.; Nauright, J.; Zhang, J.J. Dimensions of Service Quality in Health-Fitness Clubs in China. Int. J. Environ. Res. Public Health 2021,18, 10567. https:// doi.org/10.3390/ijerph182010567 Academic Editor: Paul B. Tchounwou Received: 23 August 2021 Accepted: 7 October 2021 Published: 9 October 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1School of Economics and Management, Shanghai University of Sport, Shanghai 200438, China 2College of Sport Management, National Taiwan Sport University, Taoyuan 333, Taiwan; [email protected] 3Department of Kinesiology, University of Georgia, Athens, GA 30602, USA; [email protected] (E.K.); [email protected] (J.J.Z.) 4Research Group of Management and Innovation in Sport Services, Leisure and Recreation (GISDOR), University of Seville, 41013 Seville, Spain; [email protected] 5Richard J. Bolte, Sr. School of Business, Mount St. Mary’s University, Emmitsburg, MD 21727, USA; [email protected] *Correspondence: [email protected]; Tel.: +86-13788995780 Abstract: The purpose of this study was to explore the dimensions of service quality in fitness clubs in China and examine their impact on customer satisfaction. In Phase I of the study, we collected qualitative data from online comments related to service quality in 30 Tera Wellness clubs in Shanghai (k = 6252). Conducting content analysis, we synthesized the information and identified preliminary themes and formulated measurement statements. Phase II implemented a series of quantitative research procedures to examine the measurement properties of statements developed in Phase I. Conducting exploratory factor analysis, confirmatory factor analysis, and structural equation modeling analyses based on responses of club members (N= 533), we identified a total of 27 items in six dimensions: service recovery, service assurance, facility function, program operation, instructor quality, and staff performance. These factors significantly (p< 0.05) predicted customer satisfaction with fitness clubs in China. The findings highlight the importance of high-quality service delivery, service recovery, and service assurance and pinpoint specific areas for improvement. Keywords: customer satisfaction; health-fitness clubs; Chinese market; service recovery 1. Introduction During the recent economic downturn, the Chinese government has chosen the sport industry as an important channel to boost business growth. Under a new economic policy, the fitness and leisure industry has gained recognition as “sun-rising” industry and received unprecedented support from the Chinese government. Consequently, the number of healthfitness enterprises has increased, including corporate fitness, fitness studios, 24-h gyms, and virtual fitness services. This fast-paced development has led to some growing pains; for instance, club managers regularly need to evaluate club operations in order to maintain or improve service quality and adapt to constantly changing business surroundings [1,2]. In the fitness industry, customer retention remains a key factor in success, and service quality continues to have a strong impact on that retention. Service quality in a fitness club directly relates to profit margin and overall club development in a competitive marketplace [ 3 – 5 ]. Effective management of service quality increases customer satisfaction, loyalty, and positive word-of-mouth [ 6 , 7 ]. Although several scholars have addressed the importance of service quality in managing fitness clubs (e.g., [ 4 , 8 ]), none has explored fitness service quality in the Chinese market. Previous findings suggest that no single model can measure service quality universally because clients from different cultural backgrounds are likely to have different expectations and needs [ 9 , 10 ]. As services expand Int. J. Environ. Res. Public Health 2021,18, 10567. https://doi.org/10.3390/ijerph182010567 https://www.mdpi.com/journal/ijerph Int. J. Environ. Res. Public Health 2021,18, 10567 2 of 17 globally, understanding how to measure service quality in different countries becomes increasingly important. Due to the political climate and cultural differences, Chinese customers might have different perceptions and expectations of fitness club service quality than Western customers [11]. China’s rapid rise to economic and political power has generated various social changes. For example, competition in China’s fitness industry has intensified. Recently, consumers have come to expect fitness clubs to be disciplined and honest and to expect service recovery and service assurance [ 12 , 13 ]. More generally, studies about service quality management in China feature descriptive statistics and fall short on reliability and validity assessment. Contextualized studies that target the dimensions of fitness club service quality and reveal variables that influence fitness club operations in China are crucial, especially in light of recent changes in Chinese economic conditions [ 12 , 14 ]. Some of these dimensions and variables are likely to overlap the ones that are relevant in Western fitness settings, while others are likely to differ in substantial ways. The purpose of this study was to explore the dimensions of service quality in China’s fitness clubs and examine their impact on customer satisfaction. The findings should contribute to the literature by revealing variables that affect effective operation of fitness clubs in China. Some of those variables are likely to reflect sociocultural, political, and economic differences between China and the rest of the world. The findings should also help fitness club managers elevate service quality and better satisfy the needs and wants of Chinese consumers. 2. Review of Literature In one of the earliest service quality studies, Parasuraman, Zeithaml, and Berry [ 15 , 16 ] proposed 10 criteria for evaluating service quality: credibility, safety, accessibility, communication, understanding of customers, reliability, sensitivity, ability, and etiquette. They categorized these criteria into five dimensions: tangibility, reliability, responsiveness, assurance, and empathy. Then, using exploratory factor analyses of retail organizations, they developed the SERVQUAL instrument. In the context of the current study, service quality in fitness clubs has two types, one based on the five generic dimensions of SERVQUAL and one that accounts for the unique characteristics, functions, features, and activities of health-fitness clubs [4,17,18]. Scholars have argued that SERVQUAL does not measure the specific operations of various service sectors. Health-fitness clubs, especially those in China, have unique features. For example, fitness clubs sell experiences, not goods. Personalized service plays a much more important role in fitness clubs today, given increasing market competition and shifting consumer demands [ 19 ]. Moreover, fitness clubs and consumers usually sign long-term contracts in China, anywhere from one to three years to life long. Given this significant commitment, consumers understandably consider as many factors as possible when selecting a club. These factors include, but are not limited to, distance to the club, equipment provided, atmosphere, staff, and cost of converting to other clubs [ 4 , 12 ]. The reality is that without an extraordinary reason (e.g., going abroad, pregnancy, job change, or accidental injury), fitness club consumers in China can rarely change to a different club [ 12 ]. Another important factor when promoting consumer loyalty is encouraging customers make an emotional investment in the club [20]. Constructs in a measure reflect the theoretical structure of a concept, which would be the case for service quality in health-related fitness clubs. Scholars have developed a number of measures to assess the service quality of fitness clubs in various settings. The Scale of Attributes of Fitness Services (SAFS) includes 30 items in five dimensions for evaluating service quality in Canadian fitness clubs [ 21 ]. The Center for Environmental and Recreation Management-Customer Service Quality (CERM-CSQ) model includes four factors: core service, staff quality, general facilities, and secondary service [ 22 ]. In a follow-up study, scholars condensed these four factors into three: employees, core service, and secondary services [ 23 ]. Kim and Kim [ 24 ] established the Quality Excellence Int. J. Environ. Res. Public Health 2021,18, 10567 3 of 17 of Sport Centers (QUESC) scale, which has 33 items for 11 factors of service quality in Korean sport centers: service environment, service staff attitude, service staff reliability, information provided, course items, personalized service, discounts, price, mood for relaxation, incentive, and convenience. Although the scale provides a wide spectrum of features, it might not be the most effective. Three factors (i.e., price, privilege, and incentive) contain only one item, and several other factors had an internal consistency coefficient lower than 0.70 [ 25 ]. These shortcomings emerged in a study by Papadimitriou and Karteliotis [ 26 ], who applied the QUESC model in the context of Greek sport and fitness clubs. Instead of an eleven-factor model, the findings suggested a four-factor model, which included instructor quality, facility function, program operation, and other services. The Scale of Service Quality for Recreation Sport (SSQRS) includes four factors: program quality, interaction quality, outcome quality, and physical environment quality [ 27 ]. SSQRS was adopted to assess perceived service quality of regular users of gyms in public sports centers in the UK, and physical environment perspectives (i.e., ambience and facility function) were found to be the most predictive of customer satisfaction, with equipment being generally more important than all other aspects (Polyakova & Ramchandani, 2020) [ 28 ]. Alexandris et al. [ 28 ] used catering, staff, water facilities, accessibility, dry facilities, and cleanliness factors to measure service quality in fitness clubs in England. Lam et al. [ 4 ] established the Service Quality Assessment Scale (SQAS) model, which includes 40 items under 6 dimensions for evaluating service quality in U.S. fitness clubs, including staff quality, course project, dressing room, physical environment, fitness equipment, and child care area. The SQAS scale has been widely adopted in various research investigations into service quality issues in health-fitness clubs. García-Fernández et al. used facilities, employees, and programs factors to explore fitness center consumer loyalty and found that customers in private low-cost fitness centers put a greater weight in the quality of facilities and employees and customers in public fitness centers put a greater weight in programs. The authors suggested that fitness centers should conduct detailed analyses and monitoring of the provided service and take into consideration customer background characteristics when taking managerial actions to meet the needs and wants of customers [ 29 ]. According to Polyakova and Mirza, one criticism of Lam et al.’s scale is that it does not offer the measurement of overall perceived service quality and does not include an inter-client interaction aspect nor the outcome quality proposed by several other service quality models [ 30 ]. Leon-Quismondo conducted an importance–performance analysis of fitness center services quality while taking into consideration gender and age background of club members. The findings show that the level of congruence between importance and performance of fitness clubs was more evidently relevant to women than men. Female members emphasized more on core elements of club services, such as the variety and frequency of activity program offerings, personal training, quality of fitness equipment, and particularly provision of swimming pool and aqua-programs. Meanwhile, older club members put greater emphasis on the importance, performance, and their congruence in the areas of cleanliness of activity spaces and the safety of lockers than younger members [ 31 ]. These findings illustrate that no single model can capture service quality universally because clients with different cultural backgrounds are likely to have different expectations and needs [9,10,29]. Scholars have effectively evaluated service quality in fitness clubs in different countries and discovered that evaluation scales can differ substantially across cultures. Yu, Zhang, Kim, and Chen [ 8 ] used staff, program, locker room, physical facility, and workout facility factors to assess service quality in health-fitness clubs for senior consumers in Korea. In China, fitness club operations have been widely mediocre, unstandardized, and disorganized in a market with extensive competition [ 12 , 14 ]. However, the situation has begun to change with the recent policies implemented by the central government. Contemporary Chinese fitness consumers are better informed and have higher expectations; increasingly, they desire better and more standardized services from health-fitness clubs [ 30 ]. Building on previous findings, we explored the following themes to examine service quality Int. J. Environ. Res. Public Health 2021,18, 10567 4 of 17 in fitness clubs in China: service assurance, service recovery, facility function, program operation, instructor quality, and staff performance. 2.1. Service Assurance The term “service assurance” refers to the ethical bottom line and code of conduct followed by clubs to minimize consumer doubts and risks during business activities. In China’s fitness industry, consumers now expect clubs to develop standardized and honest practices; they want psychological assurance and price assurance. Regarding psychological assurance, consumers often have to sign a contract that demands a personal commitment, but not any commitment on the part of the fitness club. Moreover, consumer information confidentiality has become an important indicator of service quality due to social media development. Psychological assurance also includes commitment to the consumers and follow-up treatment when employees leave and uncontrollable changes occur. The ability to make customers trust that fitness clubs have the means and the competence to deal with problems is a key part of psychological assurance. Price transparency is also critical to psychological balance. Uncertainty about price transparency, procedural fees (e.g., replenishment, card suspension, and membership cancellation), and reasonable rates have increased the perceived risk of losing money. Today, fitness club prices are largely open and transparent, and honest operation has become a consumer demand for currency security [30,31]. 2.2. Service Recovery The term “service recovery” refers to the process by which fitness clubs take action to make up for losses incurred through service mistakes in order to regain consumer trust. Service recovery management is a process of finding discrepancies and is an important source of information that clubs use to improve service quality. With the surge in consumer awareness of self-protection and rights protection, consumers expect clubs to take “emergency measures”, which exceed the standards of normal service. When a club does not fulfill its service pledge or properly resolve a customer complaint, a service error occurs [ 12 , 32 , 33 ]. Davidow [ 34 ] found that the speed of handling of customer complaints positively influenced word-of-mouth communication by customers. Thus, whether a club can quickly implement service correction directly affects perceived service recovery. 2.3. Facility Function The term “facility function” refers to the working condition of the main facilities and equipment that consumers use during workouts. High-quality equipment and supporting facilities attract new members, and subsequent maintenance is key to increasing member satisfaction. First, quantity and performance of new and old equipment encourage consumers to join specific clubs. In addition, consumer observations and comments indicate that post-maintenance and repair of facilities and equipment have caused widespread concern in consumers [4,17,35]. 2.4. Program Operation Fitness club trainers offer two types of programs: group and individual. Consumer judgments of program quality depend on curriculum setting and service delivery. The variety of programs and the novelty of program content attract consumer attention. The quality-of-service programs relate to the popularity and effectiveness of fitness clubs. In addition, fitness clubs face increasing competition from rapidly expanding boutique fitness studios and the emergence of tailor-made courses on the Internet. Convenient scheduling and control over course time, place, and attendance have become primary concerns of consumers [17,36]. Int. J. Environ. Res. Public Health 2021,18, 10567 5 of 17 2.5. Instructor Quality Personal trainers provide the most direct and frequent service to consumers. More and more clubs use personal education programs as special services to increase their competitiveness. These programs attract members who seek pain relief, improved posture, rehabilitation, dietary support, enhanced fitness, and higher mental capacity through specific exercise. Members hire personal coaches and have the freedom to choose from a wide variety of personalities, teaching methods, and professional skills. Of chief importance to consumers are professional skills, the ability to build fitness confidence and maintain interest, personality, and degree of seriousness [4,21,36]. 2.6. Staff Performance General staff include the front desk and sales staff who make up fitness club payrolls. In today’s market, consumers pay an increasing amount of attention to the protection of their self-interests. For this reason, staff should conduct sales promotions (e.g., telephone, WeChat) in ways that neither disgust nor disrupt consumers from their normal fitness routines and daily work schedule. Fitness clubs should also consider offering the same services to new and existing members (e.g., group purchase, access to programs). In addition, most consumers expect to establish a long-term relationship with their club of choice, so employee honesty and reliability will directly affect perceived credibility of the entire club [32,37]. 3. Method We used a multi-method and multi-stage design, which is consistent with a psychometric approach [ 38 ]. In Phase I, we developed scale items designed to map the conceptual properties of service quality and identified items that would indicate service quality in China’s fitness clubs and have acceptable reliability. In Phase II, we statistically tested and confirmed the following: (a) measurement variables representing the service quality construct, (b) convergent and discriminant validity of the service quality dimensions, and (c) the concurrent validity and reliability of the service quality measure. When designing the investigation procedures for the current study, we took into consideration that due to the rising of social media networks, many consumers would like express opinions via online forums, instead of going to express opinions directly to the company involved [ 39 ]. Whereas social networks can be used as an effective channel for marketing their products and services by organizations, they can also be used as the information source for third-party evaluations and even complaints as the networks help provide a platform for people to freely tell about their experiences, express their evaluative opinions, and communicate with their friends and even community connections at large [ 40 ]. Today, increasingly more government agencies, local authorities, and managers in organizations utilize information generated from social network communications in their decision making [ 41 ]. It is believed that gathering the details of social networks comments and use them to help make improvement in product delivery and service provision can help improve consumers’ satisfactions and in turn influence the overall success of enterprises [ 42 ]. For example, by analyzing online comments, Li assessed tourist satisfactions about the terracotta warriors scenic spot in Xi’an [ 43 ]. To study hotel consumer satisfaction, Xiong and Xu analyzed social network comments of hotel clients through conducted content analyses, which led to the formulation of a widely-adopted evaluation index system of hotel services [44]. 3.1. Phase I Sample and Data Collection. The health-fitness club is a profit-making organization that provide high-quality products, offer satisfactory customer services, and meet customercentric goals [ 45 ]. The purpose of Phase I study was to explore the preliminary dimensions of service quality in China’s fitness clubs. Int. J. Environ. Res. Public Health 2021,18, 10567 6 of 17 Content analysis of reviews on Dazhong Dianping, a Chinese version of Yelp, helped us determine how Chinese customers evaluate service quality in fitness clubs. According to the Shanghai Sports Bureau website, there are 564 fitness clubs in Shanghai, including 225 independently operated facilities and 11 franchises. As franchise brands have regional systematic operation methods, we selected franchise brands that (a) operate more than three fitness clubs in Shanghai and (b) had at least 50 reviews in Dazhong Dianping. We identified 152 fitness clubs that satisfied those criteria (see Table 1). We then collected comments posted on Dazhong Dianping about these 152 fitness clubs between over a period of two years. The final sample included 6252 customer comments. Table 1. Survey Samples in Dazhong Dianping in China. Samples Name Total Number of Fitness Clubs Selected Number of Fitness Clubs in This Study Selected Number of Reviews Sample 1 3 3 74 Sample 2 8 8 357 Sample 3 39 21 607 Sample 4 3 3 140 Sample 5 5 5 151 Sample 6 10 8 1492 Sample 7 7 6 253 Sample 8 34 29 1460 Sample 9 16 16 318 Sample 10 5 5 175 Sample 11 58 48 1225 Total 188 152 6252 Coding Process. Using earlier posted comments, two coders identified themes, shared coding results, discussed categories, resolved conflicts, and decided on six themes that were consistent with existing theory and terminology: service recovery, service assurance, facility function, program operation, instructor quality, and staff performance [ 4 , 21 , 22 ]. To improve content validity, we had an expert panel examine the relevance, representativeness, and clarity of each theme. We asked five sport management professors who were regular fitness customers to examine independently each theme. Based on a standard of 80% agreement among the panel members, we retained all of the themes (see Table 1). We first conducted open-coding analysis using Nvivo 12. As each review typically contained more than one theme, the coders freely assigned each review into multiple categories when deemed necessary. For example, the following comment contained three different themes: “the traffic is so bad, there is only the 946 bus line; the bus comes every 20 min, the area is very small, the club is on the ground floor, and the air is so bad”. Coding yielded 13,369 thematic fragments, which we then categorized into different items. For instance, the example fit into three items: “traffic”, “area”, and “ventilation”. Consequently, we categorized all 13,369 fragments into different items, and decisions about item retention depended on frequency. We conducted a well-planned training session to make sure that the coders fully understood the codebook. Each coder randomly coded 600 reviews (i.e., 10% of the total sample). Krippendorf’s Alpha, which we used to test inter-coder reliability, ranged from 0.88 to 1.00. The final interrater reliability trial met the criteria of 80% agreement and 0.70 kappa for mutually exclusive items. We conducted descriptive statistical analyses using SPSS Version 23 and reported frequencies and percentages for all categories. 3.2. Phase II Sample and Data Collection. The purpose of Phase II was to confirm and measure the dimensions of service quality by using the categories and themes derived from Phase I. Through a survey study, we conducted quantitative analyses to determine construct reliability and validity of the scale and to assess the impact of the dimensions on customer satisfaction. After approval from the Independent Ethics Committee at the university, we collected data from 30 randomly selected Tera Wellness clubs in Shanghai. Tera Wellness is Int. J. Environ. Res. Public Health 2021,18, 10567 7 of 17 the most well-known and biggest fitness franchise brand located in the various districts of Shanghai, with cumulative service of more than 1.0 million members and over 50,000 active members a day. The total number of Tera Wellness clubs was 58 in 2015, accounting for 25.7% of that franchise fitness clubs in Shanghai. As a part of the chain of clubs, these franchises are spread out throughout the city of Shanghai, in residential areas with different housing prices and residents of diverse income levels. After communicating with the CEO of Tera Wellness about the purpose of the study, we obtained permission to conduct the study from the CEO and from each of the branches. With the assistance from Tera Wellness, ten trained research assistants distributed the survey form to every tenth person entering the fitness clubs between July and September of 2015. Respondents first read informed consent forms, which promised anonymity and the right to refuse to participate. This process made sure that participation was voluntary. While a total of 600 individuals agreed to participate in the study, only 533 completed the survey form, representing a return rate of 88.8%. Of the 533 respondents, 246 (46.2%) were men, and 287 (53.8%) were women. A majority (89.83%) had at least a Bachelor’s degree, and the sample showed equal distribution across four age ranges: 19–25, 26–35, 36–45, and 46–55. Over half of them earned more than 10,000 yuan/month (52.7%). Most of them exercised 1–3 times a week (62.0%), and 56.5% had been a club member for 1–3 years, while 31.5% had been a club member for more than 3 years (see Table 2). Table 2. Sociodemographic Characteristics of Research Participants (N= 533). Variable Category n% Gender Male 249 46.8 Female 284 53.2 Academic Senior high school/vocational school/technical school and below 49 9.1 Undergraduate Education 380 71.3 Graduate Degree 104 19.6 Career Temporarily unemployed (including students; stay-at-home; retired) 89 16.7 Freelance (including self-employed) 100 18.7 Employees of enterprises and public institutions 255 47.9 Management of enterprises and institutions 89 16.7 Age 18 years or younger 14 2.6 19 to 25 years old 115 21.6 26 to 35 years old 270 50.7 36 to 45 years old 78 14.6 46 to 55 years old 40 7.5 56 years or older 16 3 Monthly income 6000 yuans or less 125 23.5 6001 to 8000 yuans 115 21.6 8001 to 12,000 yuans 115 21.6 12,001 to 15,000 yuans 48 9.0 15,001 to 30,000 yuan 84 15.8 More than 30,000 yuans 46 8.6 Measurement. We converted the categories, themes, and statements obtained in Phase I into the preliminary Scale for Fitness-Club Service (SFCS) that contained 40 survey items to assess the service quality factors. To test content validity, we asked five sport management professors specialized in fitness operation to examine the relevance, representativeness, and clarity of each item. Based on a standard of 80% agreement among the panel members [ 46 ], we retained all of the items, although we revised numerous items for clarity. To verify concurrent validity [ 38 , 47 ], we examined the service quality scale using an established service-related outcome variable: satisfaction [ 28 , 48 , 49 ]. We used the wellaccepted three-item satisfaction scale developed by Mano and Oliver [ 50 ]. The final survey contained 40 items: (a) service recovery (7 items), (b) service assurance (8 items), (c) facility function (4 items), (d) program operation (4 items), (e) instructor quality (4 items), (f) staff performance (5 items), (g) satisfaction (6 items), and (h) demographic information (5 items). We measured all items on a 5-point Likert-type scale (1 = strongly disagree; 5 = strongly Int. J. Environ. Res. Public Health 2021,18, 10567 8 of 17 agree) and used mean values for each variable. The questionnaire was originally in English, so we had two Chinese-English bilingual scholars translate the 42 items from English to Mandarin for the respondents living in Shanghai. The first author then translated the Chinese questionnaires into English, yielding some minor word changes. Data Analyses. We randomly split the sample into two sub-samples (266 respondents for exploratory factor analysis [EFA], 265 for confirmatory factor analysis [CFA]). We detected no missing data. First, EFA using 40 items determined the reliability and validity of the service quality scale. We implemented principal component analysis with varimax rotation. CFA using 265 samples and AMOS 23 further validated the latent structure. Structural equation modeling (SEM) established that the six factors of service quality had an impact on satisfaction. We used a number of goodness-of-fit statistics to evaluate the measurement model: chi-squared to the degrees of freedom ratio (1 < χ2 /df < 3), root mean square error of approximation (RMSEA < 0.08), and comparative fit index (CFI > 0.90) [ 51 ]. Furthermore, to verify concurrent validity, we followed a two-step procedure using AMOS 23 for all 533 samples. CFA indicated that the measurement model was sufficient. 4. Results We performed a frequency analysis of customer reviews to figure out the main categories of service quality in fitness clubs. As shown in Table 3, the two most popular categories were facility function (23.16%) and staff performance (22.07%), which were roughly equivalent. Regarding facility function, 10.81% of the reviews concerned “performance of equipment”, indicating that customers cared about equipment quality the most, and 7.12% concerned “supporting facilities in good condition”. Regarding staff performance, 9.84% of the reviews concerned “respect members’ needs”, and 8.75% concerned “moderate promotion”. Following facility function and staff performance, around 18.03% reviews mentioned instructor quality. Service assurance (15.86%) garnered slightly more responses than service recovery (12.43%), corroborating our suggestion that these two new categories are important service quality measures for China’s fitness clubs. Regarding service assurance, 3.27% reported “confidential information”, and 2.19% reported “practice verbal promise”. Regarding service recovery, 3.37% reported “solve problems within promised time”, and 1.86% reported “skill to handle complaint”. Program operation was the least mentioned category (8.46%). Table 3presents the distribution of categories and the themes in each category. To identify SFCS dimensions of service quality in fitness clubs in China, we first conducted EFA using 32 items from Phase I, utilizing principal component analysis and VARIMAX rotation. We found a five-factor solution explaining 75.26% of the variance. We adopted two metrics to determine factor retention and the respective items: (a) factors with an eigenvalue greater than or equal to 1.0 and (b) items with a factor loader greater than or equal to 0.40. The results revealed an eight-factor solution explaining 67.45% of the variance. We removed five items with cross-loadings on more than one factor [ 47 ]. Afterward, analysis revealed 27 items in six dimensions, with 66.6% of the variance explained: Service Recovery (7 items), Service Assurance (6 items), Facility Function (4 items), Program Operation (4 items), Instructor Quality (4 items), and Staff Performance (3 items). The second EFA achieved a more parsimonious scale. We named the six dimensions based on the content of the items within each one (see Table 4). Int. J. Environ. Res. Public Health 2021,18, 10567 9 of 17 Table 3. Coding Categories and Themes Derived from the Content Analyses (9147 items). Category Theme Classification N% % of Stores Service Recovery Skill to handle complaint 170 1.86 64% Simplicity of procedure when handle complaint 135 1.48 63% Announce progress of handle complaint 155 1.69 67% Effectiveness of remedial measures 102 1.12 73% Responsibility taken 137 1.50 63% Quickly handle complain 299 3.27 66% Solve problems within promised time 139 1.52 67% Sum 1137 12.43 Service Assurance Fulfillment contract 126 1.38 69% Confidential Information 290 3.17 94% Practice Verbal promise 200 2.19 71% Stability price 138 1.51 54% Reasonable price 137 1.50 60% Facility placement and spacing 152 1.66 56% Provision and implementation of emergency measures 100 1.09 49% Suitability of exercise numbers 308 3.37 95% Sum 1451 15.86 Facility Function Performance of equipment 989 10.81 95% Up-to-date equipment 245 2.68 61% Supporting facilities in good condition 651 7.12 89% Total number of equipment 233 2.55 71% Sum 2118 23.16 Program Operation Variety of programs 205 2.24 71% Professional of program 230 2.51 71% Program arrangement 189 2.07 55% Program reservation 150 1.64 57% Sum 774 8.46 Staff Performance Respect members’ needs 900 9.84 96% Moderate promotion 800 8.75 81% Consistent services 188 2.06 52% Reliable staff 131 1.43 61% Respect members’ needs 900 18.02 96% Sum 2019 22.07 Instructor Quality Professional skills of instructor 568 6.21 78% Knowledgeable guidance 124 1.36 45% Reliable instructor 456 4.99 45% Decent behavior 500 5.47 88% Moderate promotion 400 4.37 66% Sum 1524 18.02 We conducted CFA by using the 265-case sample and AMOS 23 to test the reliability and validity of the new service quality scale. In the first CFA iteration, the model showed marginal fit ( χ = 717.53, χ2 /df = 2.14; RMSEA = 0.05; CFI = 0.91). The factor loadings for all 25 items were between 0.62 and 0.83, and the composite reliability was between 0.77 and 0.89, showing satisfactory reliability of the scale [ 51 ]. Convergent validity was sufficient, based on factor loadings (r > 0.40) and average variance extracted (AVE > 0.50) [ 47 , 51 ] (see Table 5). Discriminant validity of the scale was also sufficient; AVE exceeded the squared correlations for all factors. Therefore, the service quality scale was acceptable for further examination. To verify concurrent validity, we examined the service quality scale using an established outcome variable of satisfaction. CFA verified the convergent and discriminant validity of the service quality factors. The solution indicated acceptable model fit (χ2/df = 2.78; RMSEA = 0.06; CFI = 0.90). 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