Unlocking the secrets of nutraceutical dining: Scale development of traditional Chinese medicine restaurant

Journal of Tourism, Heritage & Services Marketing, Vol. 11. No. 2, 2025, 42-53 42 C Copyrigh t © 200 © 2025 Authors. Published by International Hellenic University ISSN: 2529-1947. UDC: 658.8+338.48+339.1+640(05) http://doi.org/10.5281/zenodo.17284842 Published online: 1 December 2025 www.jthsm.grpyright © 200 Some rights reserved. Except otherwise noted, this work is licensed under https://creativecommons.org/licenses/by-nc-nd/4.0 Unlocking the secrets of nutraceutical dining: Scale development of traditional Chinese medicine restaurant Ja Young (Jacey) Choe City University of Macau, China Jong-Hyeong Kim Arizona State University, USA Seongseop (Sam) Kim The Hong Kong Polytechnic University, Hong Kong Abstract: Purpose: This study aims to develop and validate a multidimensional scale that identifies the attributes influencing dining experiences at nutraceutical restaurants, specifically those based on Traditional Chinese Medicine (TCM). It addresses gaps in hospitality literature by clearly defining nutraceutical restaurants and providing a comprehensive measurement tool. Methods: The research employed a rigorous multi-step scale development process, including literature review, qualitative interviews, expert reviews, and empirical validation. Data were collected from 993 Chinese diners who had recently patronized TCM restaurants, using a stratified random sampling approach. Exploratory and confirmatory factor analyses, conducted with SPSS and Smart PLS software, ensured the scale’s reliability and validity. Results: The study identified five key dimensions of TCM restaurant attributes: interior design/furniture/tableware, food quality, food recommendation, service quality, and atmosphere. Statistical analyses demonstrated strong internal consistency, convergent validity, discriminant validity, and nomological validity. Importantly, food attributes showed the highest influence on customers’ revisit intentions mediated through place attachment. Implications: This validated scale provides restaurant managers and researchers with an actionable framework to enhance customer loyalty and dining satisfaction. Future research could extend this scale’s application across diverse cultural contexts and different types of health-oriented dining establishments. Keywords: Nutraceutical restaurants, traditional Chinese Medicine, restaurant attributes, scale development, dining experiences, place attachment, customer revisit intention JEL Classification: L83, M31, Z32 Citation: Choe, J.Y., Kim, J-H., & Kim, S. (2025). Unlocking the Secrets of Nutraceutical Dining: Scale Development of Traditional Chinese Medicine Restaurant. Journal of Tourism, Heritage & Services Marketing, 11(2), http://doi.org/10.5281/zenodo.17284842 Biographical note: Jacey Choe is an Associate Professor at the Faculty of International and Tourism Management at City University of Macau. Her research interests include restaurant marketing and management, innovative services in hospitality, and tourism sustainability ([email protected]). Jong-Hyeong Kim is an Associate professor and Associate Director at HNU-ASU Joint International College, China. His research interests include consumer behaviour in tourism and hospitality industry, with a focus on memorable experiences (Jong-Hyeong.Ki[email protected]du). Seongseop Kim is a Professor at the School of Hotel & Tourism Management, The Hong Kong Polytechnic University. His research interests include tourism impacts, sustainability, new technology and tourism, event/convention tourism, and tourism and hospitality marketing ([email protected]). Corresponding author: Jong-Hyeong Kim ([email protected]). 1 INTRODUCTION As life expectancy increases, there is a growing trend toward adopting a balanced and healthy diet that can sustain individuals’ health and nurture their overall well-being (Kim et al., 2025a). Many consumers are interested in the complementary therapeutic effects of food to improve their health (Wu & Liang, 2018). Such foods are referred to as “nutraceuticals,” which is a combination of the words “nutrition” and “pharmaceuticals” (Kim et al., 2024a). A nutraceutical restaurant is one that provides food with medical benefits, such as preventing disease or improving individuals’ UNLOCKING THE SECRETS OF NUTRACEUTICAL DINING: SCALE DEVELOPMENT OF TRADITIONAL CHINESE MEDICINE RESTAURANT 43 health status (Kim et al., 2024a). The concept of nutraceutical food can be found in the Traditional Chinese Medicine (TCM) theory, which holds that food and medicine are isogenic (Zhao et al., 2021). Approximately 1.5 billion people use Chinese medicine worldwide, and the TCM industry continues to develop in China (Yuan et al., 2016). In the restaurant industry, the chefs at Mira, a Cantonese restaurant in Hong Kong, have regular consultations with TCM doctors to get advice on how to maintain and present the health balance of the food on the menu (Sun & Wong, 2024). Furthermore, a restaurant in Hangzhou, China, uses the medicinal properties of herbs to maximize the health benefits of dishes that are paired with medicinal wines or nutritious beverages (Michelin Guide, 2024). To keep abreast of this growing trend of consuming nutraceutical foods or a healthy diet, the food/restaurant service literature has researched various themes such as consumers’ subjective well-being in vegan restaurants (Lim et al., 2022), business principles of serving organic food in restaurants (Poulston & Yiu, 2011), consumer acceptance of reduced calories and fat in menus items (Rahamat et al., 2022), and the effectiveness of TCM diets (Zhang et al., 2021). However, the extant literature has the following research gaps. First, the majority of the previous studies conceptualized a healthy food restaurant as a form of vegan or organic restaurant. While these restaurants focus on offering dishes made from plant-based ingredients and food with nonchemical fertilizers and pesticides (Kolasa, 2018), nutraceutical restaurants emphasize providing meals to support customers’ health and cater to specific dietary needs, based on concrete theory and practice such as TCM (Shen et al., 2010). Second, the majority of previous food therapy studies based on TCM theory are clinical research (Shen et al., 2010; Zhang et al., 2021). For example, Shen et al. (2010) used a special menu of Chinese foods based on TCM theory as a treatment for hypertensive patients with Yin-deficiency and claimed that applying TCM theory helped to restore the Yin-Yang balance and improve their health significantly. However, topics relating to TCM diets in restaurants have not been examined from the restaurant management perspective. Third, identifying the attributes of nutraceutical restaurants is critical in response to a significant increase in contemporary consumers’ interests in culinary medicine and healthy food that can prevent disease or improve health (Kim et al., 2024a; Sun & Wong, 2024). However, what makes a nutraceutical restaurant different from other food service operations has received little attention in the food/restaurant service literature. For example, no research has attempted to identify the characteristics of nutraceutical restaurants in terms of definition and dimensionality. Additionally, few efforts have been made to develop a reliable and valid scale of attributes of nutraceutical restaurants. The hospitality literature documents various instruments to capture the key attributes of restaurants, such as SERVQUAL (Heung et al., 2000), DINESERV (Chun & Nyam-Ochir, 2020), DinEX (Antun et al., 2010), and other measurement items (Bujisic et al., 2014; Karamustafa & Ülker, 2020; Liu & Tse, 2018). However, those scales measuring restaurant attributes (e.g., SERVQUAL and DINESERV) are limited to capturing the salient attributes of restaurants as they mainly focus on service aspects (Kivela et al., 1999; Gadelrab & Ekiz 2019). Moreover, the extant scale development studies in food/restaurant literature focus on customer experiences (Ali, 2022), and consumption value (Choe & Kim, 2019), not the cognitively perceived stimuli of a special-themed restaurants. Therefore, we aim to bridge these research gaps. The research objective of this study is to develop a scale for identifying attributes of TCM-based nutraceutical restaurants. More specifically, this study has the following research questions: (1) What are the attributes of TCM restaurants from the perspective of Chinese diners? (2) How do Chinese diners perceive and prioritize the various attributes of TCM restaurants? (3) How valid and reliable are the developed measurement items in relation to theoretically based outcome variables such as place attachment and revisit intention? Chinese diners were chosen as the sample because they are familiar with the concept of TCM theory, and the increasing popularity and success of TCM in the food and restaurant service industry is evident in China (Wang, 2023). The results of this study can help to increase understanding of customers’ preferred attributes in newly-emerging nutraceutical restaurants for both academicians and industrial practitioners. 2 LITERATURE REVIEW 2.1. Attributes of Nutraceutical Restaurants Although the term “nutraceutical restaurant” is still new, the concept of food as medicine is gaining popularity in Western society (Kim et al., 2025a). Nutraceutical or medicinal restaurants provide dishes that have medicinal properties. For example, Le Botaniste is a plant-based organic restaurant that follows the motto “Food is thy medicine” in the US. Each dish on the menu is meticulously described, detailing its nutritional functions, which is in line with the restaurant’s commitment to using food as medicine (Salazar, 2023). While the history of nutraceutical restaurants in the Western region is relatively short, the history of food as medicine in Asia is much longer, and the concept of ‘medicine food’ is familiar to many consumers. Particularly in China, TCM is a well-established medical system that has been used for over 3000 years to treat various diseases (Kim et al., 2024a). It offers a unique approach to the treatment of illness based on a combination of theoretical and practical principles (Zou, 2016). TCM restaurants are food and beverage operations that provide TCM diets for customers (Kim et al., 2024a). TCM diets integrate herbs and food with the aim of preventing diseases or improving health status, based on the guidelines of TCM theory (Wu & Liang, 2018). Interestingly, applying the concept of TCM in the business sector is now considered “trendy” and “cool” by many young Chinese. They consume medicine-infused food and drinks because they think is a fashionable way to maintain health (Wang, 2023). In line with this, more studies of TCM application in the hospitality service sector should be conducted (Wu & Liang, 2018; Kim et al., 2024a). In the hospitality literature, food-related, service staff-related, and ambiance-related quality are the three most widely agreedupon attributes of restaurants (Song et al., 2021). Food-related quality refers to the taste of food, freshness, portion size, menu variety, temperature, and food presentation (Kim et al., 2021). Service staff-related quality means whether the staff provide reliable, responsive, caring, professional, and tangible services (Chun & Nyam-Ochir, 2020; Parasuraman et al., 1988). Ambience-related quality indicates both the soft (e.g., comfort, style, and impression) and hard (cleanliness, safety, noise, and 44 Ja Young (Jacey) Choe, Jong-Hyeong Kim and Seongseop (Sam) Kim space) dimensions of restaurants (Bujisic et al., 2014). Additionally, researchers have investigated other restaurant attributes that are related to customers’ perceived benefits and values, such as price, convenience, social belonging, positive emotions, and health benefits (Antun et al., 2010; Choe & Kim, 2018; Kim et al., 2019). Kankam-Kwarteng et al. (2020) find that differentiation strategies significantly influence restaurant performance under conditions of competitive intensity. While health-related attributes are increasingly important as consumers become more concerned with the caloric and nutritional content of their restaurant meals (Karamustafa & Ülker, 2020; Wu & Liang, 2018), existing measurement scales are not well-suited to identifying the specific characteristics of nutraceutical restaurants that can cater to customers’ health concerns specifically or individually. After reviewing the food and restaurant literature with the application of TCM theory and existing restaurant attribute studies, potential constructs of TCM restaurant attributes are discussed in the following sections. Environmental harmony with food TCM explains that individuals’ food consumption should be in alignment with environmental factors such as the season, weather, and geographical location (Shen et al., 2010; Wu & Liang, 2018). For example, five cereals (rice, sesame seeds, soya beans, wheat, and millet), five fruits (jujube, plum, chestnut, apricot, and peach), five animals (beef, dog meat, pork, mutton, and chicken), and five vegetables (marrow, chive, bean sprouts, shallot, and onion) are foods that have therapeutic effectiveness (Wang, 1997, as cited in Shen et al., 2010). Such foods can be consumed properly by considering environmental harmony to provide nourishment, supplement nutrition, give advantages, and aid in recovery (Shen et al., 2010). Dishes in TCM restaurants should emphasize the importance of consuming foods that are in harmony with the natural environment to maintain diners’ health and well-being. Food balance The “Yin (cold) and Yang (hot)” theory represents the philosophical guidance of TCM, and it serves as a perspective that accounts for the origins and variations of the universe (Zou, 2016). The characteristics of moving, bright, and progressing pertain to “Yang”, while anything that has stillness, darkness, and degeneration represents “Yin”. Any pathological changes in the human body can be explained by the “Yin-Yang” theory (Berrino, 2014; Zou, 2016). TCM food therapy is based on the principles of balancing the Yin and Yang properties of ingredients, cooking techniques, and the harmonious combination of the five fundamental flavors of food (spicy, sweet, sour, bitter, and salty) (Berrino, 2014; Zou, 2016). TCM therapy recommends to avoid the constant intake of extremely “Yin” food, such as sugar, alcoholic beverages, and refined flours and extremely “Yang” food, such as red meat, salty food, and processed meat. In summary, TCM restaurants should provide a balanced diet in terms of Yin and Yang properties, flavors, and cooking methods to promote the overall well-being of customers. Suitability for own physique Providing TCM food tailored to each individual’s unique body constitution is essential for addressing deficiencies and enhancing overall health (Wu & Liang, 2018). According to TCM theory, functional foods can slow down the aging process (e.g., Chinese yam, lotus seed), improve the luster of facial skin (sesame seed, honey), reduce excessive body fat (e.g., bamboo shoots, green cabbage), treat hypertension (e.g., oats, mung bean sprouts), and treat diabetes (e.g., tomato, wolfberry) (Weng & Chen, 1996). In Shen et al.’s (2010) study, a group of hypertensive patients was educated to consume food with cold properties to clear away heat and produce body fluids, such as celery, jellyfish, oyster, and banana, while they avoided consuming mutton, black pepper, onion, and ginger. These functional foods were found to be effective in treating hypertensive patients. However, if the same foods were taken by others with a different health status, the result might not be the same. Therefore, customizing TCM cuisine to an individual’s specific body type and health status is one of the important features of TCM restaurants. Food recommendation Food recommendations in TCM restaurants are critical because customers may not have adequate knowledge about TCM theory and food medicine. Frontline personnel play a key role in creating satisfactory touchpoints between customers and service providers (Kim et al., 2024b). With regard to frontline employees’ service, professional menu knowledge is considered one of the important factors that affect customers’ positive experiences at TCM restaurants (Alhelalat et al., 2017). Guo et al. (2023) explained that food recommendation by service staff is a very important attribute of TCM restaurants and customers appreciate the tailored cuisine based on food therapy. By explaining the cooking process, ingredients, and functions of the cuisine, service staff in TCM restaurants can effectively assist customers with menu choices. Service Quality As previously mentioned, food, service, and ambiance are the three key important aspects that customers expect in restaurants (Song et al., 2021). TCM restaurants are not an exception. Other than TCM-related attributes, a restaurant should provide decent service to customers. Service quality significantly influences customer loyalty and long-term patronage of restaurants (Brady & Cronin, 2001). The SERVQUAL model is typically adopted in the context of restaurants to measure staff’s reliability, assurance, responsiveness, tangibles, and empathy (Kim et al., 2021; Parasuraman et al., 1988). Therefore, service quality in TCM restaurants can be evaluated by customers’ perceptions of staff as delivering accurate, prompt, professional service in a caring manner. Atmosphere It is well known that the ambiance of a restaurant can affect diners’ emotions and experiences (Tsaur & Lo, 2020). The atmosphere and surroundings are considered critical in creating a positive dining experience for customers (Kim et al., 2024b). For example, researchers have noted that sensory cues that create atmosphere, such as olfactory cues (e.g., unique aromas) and auditory indicators (e.g., music representing a restaurant’s theme) significantly influence dining experiences (Cao et al., 2019; Alves et al., 2022). Accordingly, soothing background music and pleasant aromas of Chinese herbs that help customers feel comfortable while dining are important atmospheric cues at TCM restaurants. Interior design, furniture and tableware Interior design, furniture, and tableware are important tangible elements that can create a positive environment for diners in UNLOCKING THE SECRETS OF NUTRACEUTICAL DINING: SCALE DEVELOPMENT OF TRADITIONAL CHINESE MEDICINE RESTAURANT 45 restaurants (Im & Seo, 2024). They are particularly crucial when a restaurant has a specific theme to convey to customers (Kim et al., 2024b). The design can effectively communicate the core message the restaurant aims to share with its patrons. When restaurants successfully communicate with customers through appropriate interior design, they can create a more harmonious and comfortable environment, allowing patrons to fully enjoy their experience (Song et al., 2021). Therefore, interior design, furniture and tableware reflecting the TCM theme are important restaurant attributes. Price Price refers to a reasonable price for to the food and related services that customers obtain in a restaurant (Liu & Tse, 2018). The objective of a food service operation is to arrive at a price the customer is willing to pay and that will produce the desired profit for the restaurant (Barrish, 2020). From a customer’s point of view, if they do not perceive price fairness or value for money in restaurants, they will not have a positive attitude and will not return to the restaurant (Choe & Kim, 2018). Kwon et al. (2020) applied machine learning-based natural language to analyze a vast number of online customer reviews of restaurants. They found that price is one of the most frequently mentioned attributes in restaurant reviews. Thus, customers have a noticeable tendency to see price as a cost from their trade-off perspective, and an essential attribute that determines their dining experiences. Table 1: Potential constructs of restaurant attributes affecting TCM restaurant customers’ dining experiences 2.2. Influences of Restaurant Attributes on Dining Experiences The previous literature indicates that restaurant attributes contribute to creating positive experiences for diners (Karamustafa & Ülker, 2020). In Tsaur and Lo’s (2020) study, excellent service behavior, exquisite and delicious cuisine, an amazing physical environment, unique atmosphere, and high perceived value were considered important factors in generating memorable dining experiences. Karamustafa and Ülker (2020) demonstrated that attributes related to menu, employees, physical evidence, cleanliness, atmosphere, and supporting services were influential in affecting diners’ overall experiences. Alhelalat et al. (2017) found that personal (e.g., tidiness, hospitality, and caring manner) and functional (e.g., menu knowledge, menu recommendation, and communication skills) aspects of service employee behavior played a significant role in creating customer satisfaction. Additionally, a culturally rich and traditionally themed atmosphere comprised of unique aromas, comforting music, lighting, and surroundings positively affected customers’ dining experience (Chen et al., 2020). The way a restaurant is decorated, the mood it creates, and the arrangement of furnishing, equipment, and space all contribute to how customers feel, and how they evaluate the overall dining experience (Kim et al., 2024b). In summary, when diners assess the various attributes of restaurants positively, they are more likely to have positive dining experiences, further creating positive feelings of affection for and loyalty to those restaurants. 2.3. Rationale for Scale Development As reported in Table 2, the extant scale development studies in restaurant service are mainly focused on customer experiences (Ali, 2022; Badu‐Baiden & Kim, 2022; Cao et al., 2019; Han & Jeong, 2013; Tsaur & Lo, 2020; Liu et al., 2022), perceived service quality (Chen et al., 2015; Cheng et al., 2019), and perceived value (Choe & Kim, 2019; Kim et al., 2019). These studies have advanced our understanding of important factors forming dining experiences and customer perceptions. However, researchers argue that individuals develop their cognitive and emotional responses based on their interpretation of stimuli (Mehrabian & Russell, 1974; Song & Kim, 2021). Thus, one problem in the hospitality literature is a lack of information on restaurant attributes that affect customers’ dining experiences. Such information would help restaurateurs develop guidelines to assess restaurant attributes that would convey pleasant dining experiences. Table 2. Extant scale development studies in restaurant service Furthermore, we attempted to address the specific characteristics and needs of nutraceutical restaurants, distinguishing it from widely used scales like SERVQUAL, DINESERV and DinEX. Specifically, SERVQUAL (Heung et al., 2000; Parasuraman et al., 1988) mainly focuses on the quality of the staff at the restaurants. Therefore, SERVQUAL may not be able to capture the distinctive characteristics of nutraceutical restaurants, such as providing food with environmental harmony and the balance of Yin and Yang. DINESERV (Chun and Nyam-Ochir, 2020) has several dimensions such as food quality, service quality, atmosphere, and price, but again, most measurement items of DINESERV represent service aspects in general rather than capturing the core aspects of special-themed restaurants. DinEX (Antun et al., 2010) provides dimensions such as social factors, atmosphere, service factor, health factor, and food factors. However, their health factor measures a very simple aspect, such as providing low-calorie food options, rather than 46 Ja Young (Jacey) Choe, Jong-Hyeong Kim and Seongseop (Sam) Kim capturing the main features of medicine food relevant to climate, weather, and balance in nature. Moreover, the existing restaurant scales do not specifically have dimensions such as food recommendation, whether the staff’s professional knowledge about food medicine can help customers choose the dishes and appreciate the personalized experience. In summary, existing restaurant scales from earlier models are inadequate for addressing the unique characteristics of nutraceutical restaurants. Thus, there is a need to develop a new scale specifically tailored to TCM dining experiences. 3 METHOD This study thoroughly reviewed previous scale development research and followed a rigorous process to develop a scale instrument (Churchill, 1979; DeVellis and Thorpe, 2021). This process involves the following four major stages: 1) development of initial constructs and a pool of scale items; 2) experts’ review; 3) purification of scale items; and 4) validation of scale items. This four-stage process is listed in Table 3. Τable 3. Scale development process 3.1. Stage 1: Development of Initial Constructs and Scale Items Following Churchill’s (1979) recommendation, the first stage of scale development involved specifying the study constructs and generating a pool of scale items. We conducted a literature review on relevant studies, and in-depth interviews. First, from the literature review, eight restaurant attributes and 25 items were identified. The attributes were: environmental harmony with food, food balance, suitability of food for weather, suitability of food for personal physique, food quality, service quality, atmospheric factors, and price. Based on these findings, we developed a primary code book for the succeeding qualitative data analyses. We then conducted in-depth interviews with 50 Chinese customers who had dined at TCM restaurants. Qualified participants were recruited from Credamo, a Chinese panel data company. We included screening questions in the e-mail invitations (e.g., have you dined at a TCM restaurant in the past six months? and What is the name of the TCM restaurant you recently patronized?). The participants were asked to recall their most recent TCM restaurant experiences for a few minutes and interviewed to answer the following open-ended questions: Describe your experience and how would you evaluate this experience?; What are the important attributes when dining at TCM restaurants?; Why are they important?; How do these attributes influence your dining experience?; What is your expectation for each attribute?; What are the benefits brought by these restaurant attributes?, and What are the most important three attributes when dining at TCM restaurants? Overall, each interview lasted between 30 and 45 minutes. We had more female (60%) participants than males (40%). The participants’ ages ranged between 18 and 52. The majority of the participants held a bachelor’s degree (72%). The interview scripts were coded using NVivo software (version 14). Two researchers coded the data independently. After coding of restaurant attributes was completed, the researchers compared their codes to resolve any disagreement. Through this process, 78 different words describing restaurant attributes were identified and then reduced to 21 words under seven dimensions. By assembling the items from the literature review and interview data, a total of 35 items related to eight constructs were developed. 3.2. Stage 2: Experts’ Review To establish content validity and face validity (DeVellis and Thorpe, 2021), experts in TCM restaurant research evaluated the appropriateness and comprehensiveness of the initial scale items. The expert panel included three faculty members and two postgraduate students who were familiar with TCM principles and had conducted TCM restaurant research. The panel evaluated the initial scale items based on the definition of each construct and rated the appropriateness and content ambiguity of the items on a 7-point scale (1= not at all; 7= very much). Scale items evaluated as inappropriate or ambiguous by more than half of the experts were removed. Accordingly, a total of 31 items were retained for further analysis. 3.3. Data Collection Process and Sampling Empirical evaluation of the developed scale was conducted using data collected from Chinese TCM diners. The 31 items generated in the previous stage were transformed into a survey questionnaire. To ensure a diverse and representative sample, we employed a panel data approach using Weidiaocha, a professional survey company with a nationwide database of over 2.9 million Chinese consumers. This method enabled us to efficiently recruit a large pool of qualified Chinese customers from various regions across China who had recently dined at TCM restaurants. The use of panel data offered several advantages, including broad geographic coverage, enhanced sampling control, and improved data reliability, as participants were pre-screened based on relevant dining experience. This approach strengthened the generalizability of our findings and ensured that the responses reflected a comprehensive range of consumer perspectives within the TCM dining context. Employing a stratified random sampling procedure, the company sent an invitation with information about the study and the survey link to their panelists with an aim of collecting 1,000 usable responses. The same screening questions used for the pilot study were included to recruit qualified respondents. Respondents were asked to recall their most recent TCM restaurant experience and to evaluate the scale items on a 7point scale (1= strongly disagree; 7= strongly agree). After eliminating seven responses that reported the same rating for UNLOCKING THE SECRETS OF NUTRACEUTICAL DINING: SCALE DEVELOPMENT OF TRADITIONAL CHINESE MEDICINE RESTAURANT 47 over 90% of the items, we obtained 993 usable samples. Using Cochran’s (1977) formula, the sample size surpassed the required sample size when considering the population in China, 95% confidence interval, and ±5% margin of error. Of the 993 respondents, 56.9% were female. 4 RESULTS 4.1. Participants The respondents’ ages ranged between 18 and 73 years, with a median age of 33. The majority of respondents held a bachelor’s degree (64.5%), and 43.1% of them were company workers while 13.6% were self-employed. Regarding annual household income, the majority (64.8%) earned between 80,000RMB and 119,999RMB (US$ 10,965-16,447). About 45.1% of the respondents had dined at a TCM restaurant three or more times in the past 6 months. 4.2. Cross Validation of Data To ensure methodological rigor while making efficient use of the large sample (n = 993), the dataset was randomly split into two independent subsets: a calibration sample (n = 495) for exploratory factor analysis (EFA) and a validation sample (n = 498) for confirmatory factor analysis (CFA). This internal cross-validation approach was chosen because it allows for independent testing of the scale structure within the same study while minimizing the risk of overfitting (Choe & Kim, 2019; Otoo et al., 2021). Given that the total sample exceeded the recommended thresholds for both EFA and CFA, splitting the data preserved sufficient statistical power and provided a robust basis for validating the dimensionality and reliability of the scale. This procedure aligns with best practices in scale development research and enhances the generalizability of the findings (DeVellis & Thorpe, 2021). 4.3. Stage 3: Scale Purification and Refinement Following Churchill’s (1979) recommended scale purification process, item-to-total correlations were computed for all 31 items. Items that were poorly correlated (r value lower than 0.3) with the total score were eliminated. This process resulted in retaining 27 items out of the original 31 items. To assess the internal consistency of the scale, we used Cronbach’s alpha. The reliability of the 27-item scale was 0.947, indicating good internal consistency. EFA was then conducted on the 27 items using principal component analysis with promax rotation to identify the dimensionality of restaurant attributes. Employing both the Kaiser-Guttman criterion (i.e., eigenvalues greater than 1) and scree plot analysis, the EFA resulted in five factors. To retain items, the following criteria were adopted: 1) communalities greater than 0.5, factor loadings higher than 0.5, and cross loadings lower than 0.4 (Hair et al., 2019). Multiple rounds of EFA led to the removal of 5 items, including 2 items with low communalities, 1 item with low factor loading, and 2 items with high cross-loadings. Accordingly, 22 items corresponding to five factors remained. The final EFA was performed on the remaining 22 items. The KMO value was 0.930 and Bartlett’s test of sphericity was 6176.987 (p < .001), indicating the adequacy of the data for EFA. The five-factor model accounted for 67.209% of the total variance. Table 4 reports the five factors extracted from the EFA. The factors were labeled as design/tableware/furniture (5 items), food (5 items), food recommendation (4 items), service quality (4 items), and atmospheric (4 items). Table 4. Exploratory factor analysis (N= 495) 4.4. Stage 4: Scale Validation Confirmatory factor analysis Smart PLS (version 4.1.0.6) was used to conduct the confirmatory factor analysis (CFA). This software was selected due to its suitability for theory development and exploratory model testing, which aligns with the objectives of scale validation. Unlike covariance-based SEM tools, Smart PLS imposes fewer restrictions on data distribution and is wellequipped to handle complex models involving multiple constructs and indicators (Hair et al., 2019). In this study, the Shapiro–Wilk test results indicated significant non-normality (p < .001), further justifying the use of PLS-SEM for model estimation. As shown in Table 5, Cronbach’s alpha values ranged from 0.807 to 0.877, indicating adequate reliability. Furthermore, all the factor loadings ranged from 0.729 to 0.885, while DijkstraHenseler’s rho (ranging from 0.809 to 0.882) and composite reliability values (ranging from 0.874 to 0.910) were above the threshold of 0.7 (Hair et al., 2019). Additionally, average variance extracted (AVE) values ranged from 0.603 to 0.670. These results supported the convergent validity. To assess the discriminant validity, the Fornell–Larcker criterion (Fornell and Larcker, 1981) and the heterotrait–monotrait (HTMT) ratios of the correlations (Henseler et al., 2015) were examined. As reported in Table 6, the square root of AVE values exceeded the interconstruct correlations. Additionally, all the HTMT values were lower than the threshold of 0.85 (Henseler et al., 2015). Thus, discriminant validity was established. 48 Ja Young (Jacey) Choe, Jong-Hyeong Kim and Seongseop (Sam) Kim Τable 5. Confirmatory factor analysis (N= 498) Τable 6. Discriminant validity assessment Model comparisons To confirm the best conceptualization of restaurant attribute dimensions, this study compared three alternative models. Model 1 was one first-order factor model with 22 indicators. Model 2 was a five first-order factor model. Model 3 involved one second-order factor with five first-order factors. We examined model fit indices to determine the best fitting model. As reported in Table 7, Model 2 conceptualizing restaurant attributes as five first-order factors showed a better fit than Model 1 or Model 3. Τable 7. Model comparisons Nomological validity Nomological validity refers to the degree of a measured construct that makes prediction of other theoretically related constructs (Hair et al., 2019). To test the nomological validity of the restaurant attributes scale, two theoretically based outcome variables were considered: place attachment (based on responses to the following statements: I would feel good if the restaurant was successful in its operations; I would feel happy if I were to hear a good review of the restaurant; I felt it was more enjoyable to eat here than at other restaurants; and I had a connection to the traditional Chinese medicated diet restaurant) adapted from Kim and Lee (2022) and revisit intention adapted from Dedeoglu et al. (2018) (based on responses to the following statements: I would like to dine again at this TCM restaurant; I would choose to go to this TCM restaurant rather than other TCM restaurants; and this TCM restaurant would be my first choice compared to other TCM restaurants). Τable 8. Nomological validity of restaurant attributes scale Grounded in the Stimulus–Organism–Response (S-O-R) model (Mehrabian & Russell, 1974), this study tested a structural model in which five restaurant attributes (stimuli) indirectly influence revisit intention (response) through place attachment (organism) (see Figure 1). VIF values ranged from 1.44 to 2.94, indicating no serious multicollinearity issues existed in the data (Hair et al., 2019). CFA results showed that all the factor loadings were greater than the 0.7 threshold. As shown in Table 8, the model satisfactorily explained the variance of place attachment (R2= 0.52) and revisit intention (R2= 0.54). Furthermore, all five restaurant attributes significantly influenced place attachment: design/furniture/tableware ( b = 0.170, t= 3.423, p < 0.001), food ( b = 0.295, t= 5.790, p < 0.001), food recommendation ( b = 0.126, t= 2.491, p < 0.01), service quality ( b = 0.175, t= 3.259, p < 0.01), and atmospheric ( b = 0.121, t= 2.128, p < 0.05). Additionally, place attachment significantly affected revisit intention ( b = 0.732, t= 32.991, p < 0.001). Thus, nomological validity was supported. Regarding the comparative influence of restaurant attributes on revisit intention, the specific indirect effect of each attribute was calculated. The results showed that food had the greatest impact on revisit intention ( b = 0.216) followed by service quality ( b = 0.128), design/tableware/furniture ( b = 0.124), food recommendation ( b = 0.092), and atmosphere ( b = 0.089). !"#A%CDE%! F%*+I -.E%"CI/".M1#2I !C"#P.EQRAI!! CQ"ST! !8! 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Structural model for nomological validity test. 5 DISCUSSION Worldwide, nutraceutical consumption has grown exponentially for the purposes of promoting health and wellness. In contemporary society, nutraceutical consumption is an approximately 713 billion USD industry with a predicted compound annual growth rate of 8.4% between 2024 and 2030 (Grand View Research, 2024). A popular form of nutraceutical consumption in China is TCM diets. Accordingly, there are over 78,600 enterprises participating in TCM restaurants and the medicinal wine industry (Guo et al., 2023). Despite the importance of this market, empirical insights into customers’ perceptions regarding restaurant attributes affecting their dining experiences at TCM restaurants remain scant. Therefore, this study aimed to develop a reliable scale instrument to measure the restaurant attributes that influence dining experiences. Following a rigorous multistep scale development processes (Churchill, 1979), this study developed a 5-dimensional scale comprising 22 items. 5.1. Theoretical Implications This study makes several important theoretical contributions. First, it introduces a new research direction in restaurant literature by integrating TCM and hospitality management through the lens of nutraceutical consumption. Previous research on healthy eating is mostly scattered and does not comprehensively capture restaurant attributes affecting diners’ experiences. For example, prior research conceptualized healthy food restaurants as a form of vegan or organic restaurant (Lim et al., 2022). However, customers in these markets are more concerned about healthy lifestyle and sustainability than improvement of health conditions based on medical theory and practice (Guo et al., 2023; Friedmann & Brooks, 2024). Thus, this study bridges the research gap by providing salient insights into restaurant attributes that affect dining experiences at healthy food restaurants. Second, the extant restaurant literature documents various instruments measuring customer experiences (Ali, 2022; Badu‐Baiden & Kim, 2022; Cao et al., 2019; Liu et al., 2022), perceived service quality (Chen et al., 2015; Cheng et al., 2019) and value perceptions (Kim et al., 2019). However, there is no instrument that conceptualizes the antecedents of these outcome factors (i.e., restaurant attributes). Given that customers’ perceptions of stimuli trigger cognitive and emotional responses, it is important to understand the restaurant attributes affecting dining experiences. Thus, this study contributes to the literature by developing a measurement scale for restaurant attributes in the TCM restaurant context. Third, this study found that restaurant attributes affecting dining experiences at TCM restaurants included the following five dimensions: Interior design/furniture/tableware, food, food recommendation, service quality, and atmosphere. Of the five restaurant attributes, “service quality” recorded the highest mean score (grand mean= 5.81). The service quality items indicate that service employees’ empathy, responsiveness, and hospitableness are important in TCM restaurants. This finding corroborates previous research that identified the crucial role of service quality influencing customer loyalty in diverse restaurant contexts (Kim et al., 2021; Song et al., 2021; Csapó & Kusumaningrum, 2025). A high mean value for “food” (grand mean= 5.64) supported the finding that the primary motivation for dining at TCM restaurants is consuming healthy food (Kim et al., 2024a). Furthermore, in line with the TCM principle, customers were concerned about food harmony with the natural environment (including season and weather) and the Yin-Yang of food ingredients as well as cooking methods (Wu & Liang, 2018; Zou, 2016). Since the dimension “food” reflects one of the unique characteristics of TCM restaurants well, this enriches the understanding of TCM restaurants and adds new insights into the existing dining-related scales. The restaurant attribute of “interior design/furniture/tableware”, highlighting the tangible elements in a service environment had the third highest mean value (grand mean= 5.59). Kim et al. (2024a) noted that interior design, tableware, and furniture create a more harmonious environment at nostalgia restaurants. Likewise, this study corroborates existing studies that when a restaurant has a special theme, restaurateurs should pay attention to physical interior furnishings and decorative items in the restaurant (Kim et al., 2025b). “Food recommendation” had a relatively high mean value (grand mean= 5.54). Alhelalat et al. (2017) noted that service staff’s professional knowledge about food offerings determine customers’ positive dining experience. Accordingly, food recommendations from restaurant staff are an important attribute of TCM restaurants where customers require professional knowledge to choose a specific dish that will benefit their health condition. “Food recommendation” is a new dimension that represents one of the important aspects of TCM-based nutraceutical restaurants, which is differentiated from existing restaurant models. The restaurant attribute labeled as “atmosphere” has been discussed as an important factor affecting restaurant patrons’ emotions and dining experiences in the previous studies (Tsaur & Lo, 2020). The current study also found “atmosphere” is an important dimension that need to be included when investigating nutraceutical restaurants. Particularly, this study found that music and aromas reflecting Chinese culture and Chinese medicine/herbs comprise the atmosphere of TCMbased nutraceutical restaurants. However, it should be noted that among the five dimensions, the influence of “atmosphere” on place attachment was the weakest, despite its significance (= 0.121, t= 2.128, p < 0.05). A plausible explanation for this result is that TCM diners are largely motivated by utilitarian purposes (i.e., health promotion) rather than hedonic feelings (Kim et al., 2024a). 50 Ja Young (Jacey) Choe, Jong-Hyeong Kim and Seongseop (Sam) Kim Finally, the results from the nomological validity test confirmed the theoretical mechanism proposed by the S-O-R model, which explains how restaurant attributes influence revisit intention through an internal psychological state—place attachment. Previous researchers have argued that external stimuli evoke emotional or cognitive responses, which in turn shape behavioral intentions (Mehrabian & Russell, 1974; Kim & Song, 2024). In this study, the five restaurant attributes served as environmental stimuli that triggered emotional attachment to the dining environment, ultimately influencing customers’ intention to revisit. The choice of the S-O-R framework was guided by its strength in capturing the holistic and experiential nature of dining in TCM-based nutraceutical restaurants—settings where sensory, symbolic, and cultural elements play a central role (Kim et al., 2025a). Unlike alternative theories such as the Theory of Planned Behavior (Ajzen, 1991) or Expectation-Confirmation Theory (Oliver, 1980), which emphasize rational decision-making or satisfaction judgments, the S-O-R model enables a more nuanced exploration of how multisensory stimuli contribute to emotional bonding and behavior. Notably, this study contributes to the literature by employing place attachment as the organism—a theoretically appropriate but underutilized construct in hospitality research. Place attachment reflects the emotional bond between customers and a specific dining environment (Kim & Lee, 2022), which is especially relevant in the context of TCM restaurants that often involve repeated, meaningful visits tied to health and cultural identity. The results showed significant indirect effects of all five restaurant attributes on revisit intention through place attachment, validating both the proposed model and the utility of the S-OR framework in this unique dining context. 5.2. Practical Implications This study also has several important practical implications. This multi-dimensional scale provides key restaurant attributes, which require interventions and improvement to increase customer loyalty at TCM restaurants. First, the food offered at TCM restaurants is the most critical factor stimulating revisit intention. Thus, the menu and dishes should be carefully designed and prepared based on TCM theories (e.g., environmental harmony and yin-yang balance). For example, TCM theory suggests consuming sweet food (e.g., Chinese yam and sweet potato) in spring to nourish growth; gourd and lotus seeds in summer to invigorate and treat heat; sour food (e.g., ginger and scallion) in autumn, and mutton and chicken in winter to deal with the cold weather (Wu & Liang, 2018). It is important for chefs at TCM restaurants to possess not only culinary skills but also a professional understanding of TCM theories to fully integrate food balance and health benefits into their menus. Second, TCM restaurant patrons perceive the quality of service provided by restaurant staff as an important attribute. Therefore, TCM operators should invest in comprehensive training programs for their employees to ensure they deliver customer service that is both professional and congenial. By doing so, they can increase diners’ level of attachment to the restaurant, finally leading to customer loyalty. Third, it is suggested that TCM restaurateurs pay full attention to physical decorate items, interior design, and tableware to reflect TCM culture. For example, medicinal herbs and equipment to brew medicinal herbs can be decorative items in the restaurants. The use of medicine packets as a decorative item can be also helpful. Utilizing natural materials like wood and stone, along with selecting tableware such as ceramics or traditional Chinese items, can help customers appreciate the restaurant’s effort to establish its identity as a TCM restaurant. Fourth, at TCM restaurants, the staff’s knowledge of the health effects of various ingredients and their ability to recommend specific dishes based on customers’ health conditions are essential for delivering health benefits for customers. Therefore, TCM restaurant operators should provide regular training for their employees on medicinal herbs and their health benefits. Restaurant operators can also hire TCM professionals to diagnose customers’ health condition and make recommendations on food dishes. Fifth, atmosphere was found to be significant factor that affects place attachment. It is recommended for TCM restaurateurs to make a playlist of traditional Chinese music that fits the restaurant’s theme and can assist customers in enjoying their dining experience in a pleasant way. We also suggest that TCM restaurants use herbal infusers or traditional pots to gently waft spices, enhancing customer engagement. However, in terms of priority, atmosphere can be addressed later in the process. We suggest allocating restaurant resources primarily to “food” and “service quality,” first. Then, “design/furniture/tableware,” “food recommendations,” and finally, “atmosphere” can be enhanced. The scale instrument in this study can be used to evaluate TCM restaurants’ ability to deliver pleasant dining experiences. For example, a customer satisfaction survey using the restaurant attribute scale can help restaurateurs to understand their performance in each of five dimensions. Restaurateurs can then decide what aspects should be improved to gain competitive advantage in the market. Finally, the scale can be used to develop effective marketing promotions by translating the restaurant attributes into marketing strategies. For example, food prepared based on TCM theories, restaurant staff’s professional knowledge about medicinal herbs and food ingredients, and a service environment congruent with TCM culture should be emphasized in promotional materials. 5.3. Limitations and Future Research This study has several limitations. First, it was conducted in China with Chinese TCM restaurant patrons. To assess the scale’s generalizability, future research should survey other Asian or Western countries, where TCM food consumption is prevalent. The scale could also be tested in other health food restaurants (e.g., vegan and organic restaurants). Second, many of the participants in this study (45.1%) had dined at TCM restaurants three or more times in the past six months. Thus, they may have already developed positive attitudes toward TCM food. Follow-up research is necessary to examine whether the same dimensions of restaurant attributes are important to first-time visitors (Giousmpasoglou 2022). Additionally, future research could explore the moderating roles of demographic variables (e.g., age, gender) and price sensitivity in shaping customers’ perceptions of TCM restaurant attributes (Manosso et al., 2021). For example, prior studies suggest that younger consumers may be more responsive to atmospheric cues and experiential novelty, whereas older diners may emphasize health-related benefits and service quality (Kim et al., 2021). That is, different age groups may have different levels of health interests, influencing the relationship between diners’ cognitively perceived stimuli of TCM restaurants and their affective and behavioral responses. Gender may also influence food preferences and sensitivity to wellness-related messaging (Choe & Kim, 2018). Similarly, perceived price fairness and value for money can affect customers’ attitudes toward health-