Lan Snell, Charles Sturt University
Lesley White,  Charles Sturt University
Tracey Dagger, Monash University

Purpose: Adherence is a critical factor for success for both the health of the customer and the financial outcomes of the firm. Central to the success of adherence behavior is the co-productive role of the customer which is determined by service perceptions as well as individual attributes. Based on social cognition theory, this paper examines the factors that influence past adherence behavior and whether past adherence behavior predicts future intentions.

Design/methodology/approach: We tested our model using structured equation modeling on a sample of 771 weight loss customers.

Findings: The authors show how service quality influences role clarity which leads to increases in self-efficacy. The study also demonstrates the role of emotional intelligence (EI) in increasing efficacious beliefs. Past adherence behavior was found to predict future intentions.

Research limitations/implications: This study was undertaken with a single service industry and based on data which was collected at a single point in time.

Practical Implications: Our findings suggest that interventions to promote health outcomes should target customer skills in service consumption. By providing quality interactions, providers can increase customer role clarity which produces efficacious beliefs. Interventions should also address EI training in customers given its role in influencing self-efficacy.

Originality/value: The simultaneous examination of traditional service factors and socio-cognitive factors contributes to theory by considering the individual health and organizational outcomes of these factors. The finding of a direct path between past adherence behavior and future intentions provides a unique insight into the prediction and control of behavior in a number of domains.


Snell, L., White, L., & Dagger T. (2013). A Socio-Cognitive Approach to Customer Adherence in Health Care, European Journal of Marketing, (forthcoming).