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Proceeding Paper

How to Improve Customer Loyalty in the Health Industry? †

Department of Sport Management, National Taiwan University of Sport, Taichung City 40401, Taiwan
Presented at the 2nd International Electronic Conference on Healthcare, 17 February–3 March 2022; Available online:
Med. Sci. Forum 2022, 10(1), 12;
Published: 18 February 2022
(This article belongs to the Proceedings of The 2nd International Electronic Conference on Healthcare)


Fitness clubs have emerged and become famous in response to Taiwanese health needs. Improving service quality and increasing customer loyalty to enhance competitive advantage in the market is a major topic for fitness industry owners. The purpose of this research is to verify the relationship between service quality and customer loyalty in Taichung fitness clubs. This study adopted the questionnaire survey method. The questionnaire was developed based on previous studies. Respondents were selected by convenient sampling within large-scale chain fitness clubs, small gyms, and national sports centers. This study used online and hard-copy questionnaires to collect data, and a total of 94 valid questionnaires were obtained. The collected data were analyzed by descriptive statistics, correlation analysis, and partial least squares structural equation modeling. It was found that the service qualities of tangibility, reliability, responsiveness, certainty, and empathy are all significantly positively correlated with customer loyalty; responsiveness and empathy also significantly influence customer loyalty. The conclusions of this study indicate that although service quality has a positive correlation with customer loyalty, responsiveness and empathy are important factors to improve customer loyalty in fitness clubs.

1. Introduction

The fitness industry has experienced significant growth in Taiwan over the past two years, with the number of gyms in Taichung City increasing from 42 to 93 from 2019 to 2021, representing a 220% growth rate. For gym owners, customer retention is crucial, as keeping 5% of old customers can lead to a profit increase of 25% to 75% and reduce the cost of finding new customers by approximately 500% [1,2]. Service quality is defined as the gap between customer expectations and perceptions of service performance [3]. Excellent service quality has been shown to lead to customer satisfaction and loyalty [4]. Loyalty includes consumers’ repurchase intentions and positive word-of-mouth advertising [5], and excellent service quality is crucial in enhancing customer loyalty and retention.
Previous studies have focused on customer behavior and satisfaction regarding fitness services, but the relationship between service quality and customer loyalty remains underexplored, particularly in Taichung. The present study aims to examine the relationship between service quality and customer loyalty in Taichung fitness clubs.

2. Materials and Methods

2.1. Respondents

The primary study respondents were between 18 and 50 years of age and had been gym members for at least 3 months, training between 1 and 7 times a week with a median training frequency of 2 to 3 times per week.

2.2. Procedures

In this study, data was collected using both online and hard-copy questionnaires. Online questionnaires were distributed using SurveyCake and shared on Facebook fitness groups, while hard-copy questionnaires were distributed outside of the fitness center for respondents after training. A total of 96 questionnaires were distributed, of which 94 were found to be valid. The effective response rate was 97%.

2.3. Date Processing

In this study, for the questionnaire survey and the collection of various funding information, descriptive statistics (i.e., PLS-SEM) and SPSS for Windows version 20.0 software (IBM, New York, NY, USA) were used for conducting statistical analysis.

3. Results

3.1. Demographic

Table 1 presents the descriptive statistics for customers’ background items in fitness centers of Taichung city. A majority of the respondents were male, accounting for 59.4% of the sample, while the remaining 40.6% were female. The age range of 18–25 years accounted for the highest proportion of respondents (58.5%), followed by the age range of 26–35 years (31.9%), and those over 35 years of age (9.6%). In terms of education, 76.6% of the respondents had completed university-level education, while the remaining 23.4% had completed high school or lower education. Among the respondents, 31.9% were currently students, while 68.1% were employed. Regarding training frequency, 41.5% of respondents trained 2–3 times per week, followed by 29.8% who trained 4–5 times per week, and 28.7% who trained once a week or less. The most popular time for gym visits was between 6 p.m. and 10 p.m., which accounted for 46.8% of the respondents. Finally, a vast majority of the respondents (93.6%) self-trained, while the remaining 6.4% received guidance from a personal trainer.

3.2. Service Quality and Customer Loyalty Scale

Table 2 presents the descriptive statistics of the service quality scale and the customer loyalty scale. The service quality scale was composed of five dimensions: tangibility, reliability, responsiveness, assurance, and empathy. The mean score of all dimensions combined was 3.99, indicating an above-average level of service quality. Among the five dimensions, tangibility had the highest mean score (M = 4.24) followed by reliability (M = 4.04).
The customer loyalty scale was composed of two dimensions: repurchase intention and word-of-mouth recommendation. The mean score of all dimensions combined was 3.59, indicating an average level of customer loyalty. The dimension of repurchase intention had a higher mean score (M = 3.63) than the dimension of word-of-mouth recommendation.

3.3. Fitness Centers in Taichung City Their Differences in Service Quality and Customer Loyalty

Figure 1 implies the path coefficients of the five dimensions of service quality. Responsiveness (β = 0.308, p < 0.05) and empathy (β = −0.158, p < 0.05) significantly influence customer loyalty. Tangibility (β = 0.077, p > 0.05), reliability (β = 0.197, p > 0.05), and certainty (β = 0.377, p > 0.05) influence customer loyalty insignificantly. Customer loyalty (R2 = 0.544) in a range of 0.330–0.670 indicated a moderate effect [6].

4. Conclusions

Based on the PLS analysis, this study concludes that the responsiveness and empathy dimensions of service quality have a positive impact on customer loyalty in the context of fitness clubs. This finding is consistent with those found in previous studies by Marandi and Harris [7] and Butcher et al. [4]. The managerial implication of this study is that fitness clubs should focus on providing effective services, paying attention to customer needs, and responding quickly to customer inquiries in order to improve customer loyalty.
However, this study is limited by the restricted diversity of the respondents. Further research with a larger and more diverse sample is needed to replicate and extend these findings.


This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Not applicable.

Conflicts of Interest

The authors declare no conflict of interest.


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Figure 1. PLS-SEM. Note: Statistical significance is indicated by *.
Figure 1. PLS-SEM. Note: Statistical significance is indicated by *.
Msf 10 00012 g001
Table 1. Respondents.
Table 1. Respondents.
Age18 to 25 years old5558.5
26 to 35 years old3234
36 to 50 years old77.4
Level of educationHigh school22.1
Master’s degree2021.3
Training frequency per week0 to 1 time2829.8
2 to 3 times3941.5
4 to 6 times2425.5
7 times or above33.2
Time of visit6 a.m. to 10 a.m.44.3
10 a.m. to 2 p.m.1516
2 p.m. to 6 p.m.2728.7
6 p.m. to 10 p.m.4446.8
10 p.m. to 6 a.m.44.3
Training classSelf-training8893.6
Group class22.1
Personal training44.3
Table 2. Service qualities and customer loyalty factors construct the surface of the descriptive analysis.
Table 2. Service qualities and customer loyalty factors construct the surface of the descriptive analysis.
Scale ContentnMS.DSequence
Service qualitytangibility944.240.613
Customer loyaltyCustomers
repurchase willingness
recommendations to others943.540.862
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MDPI and ACS Style

Kwok, K.H. How to Improve Customer Loyalty in the Health Industry? Med. Sci. Forum 2022, 10, 12.

AMA Style

Kwok KH. How to Improve Customer Loyalty in the Health Industry? Medical Sciences Forum. 2022; 10(1):12.

Chicago/Turabian Style

Kwok, Ka Ho. 2022. "How to Improve Customer Loyalty in the Health Industry?" Medical Sciences Forum 10, no. 1: 12.

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