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Empirical Study Utilizing QFD to Develop an International Marketing Strategy

Department of Business and Information Technology, Missouri University of Science and Technology, Rolla, MO 65409, USA
Department of Engineering Management and Systems Engineering, Missouri University of Science and Technology, Rolla, MO 65409, USA
Author to whom correspondence should be addressed.
Academic Editor: Marc A. Rosen
Sustainability 2015, 7(8), 10756-10769;
Received: 25 June 2015 / Revised: 2 August 2015 / Accepted: 3 August 2015 / Published: 7 August 2015


Customer expectations can be extremely nebulous. This research identifies the demographic segmentations and their respective expectations for the spa market. Interviews were conducted and a subsequent questionnaire was employed to gather the voice of the customer and assess the expectations of spa clientele. All of the data was collected from luxury spas in Hawaii, and consisted of respondents from all over the world. Results of the survey suggest that while men want more tangible benefits of a spa, women prefer the experiential qualities of peace and rejuvenation. Additionally, those of lower to middle income focus on the atmosphere more than wealthier clients, who are looking for more long term spa benefits, such as a more youthful appearance.
Keywords: tourism; spa; Hawaii; customer satisfaction; marketing strategy; demographic segmentation tourism; spa; Hawaii; customer satisfaction; marketing strategy; demographic segmentation

1. Introduction

Spa, the very word has many connotations, such as relaxation and luxury. In general, a spa is a business that provides health and beauty services such as facials and massages. Underlying these connotations are the expectations of spa customers. What are those expectations? Could the spa market be segmented on expectations? In today’s market, it is of the utmost importance to understand the expectations of the market and ultimately how to meet those expectations better than the competition to gain a competitive edge.
A major challenge for spa marketers is to stay abreast of the changes in the spa clientele, including both demographics and expectations [1,2]. While 70% of spa visitors are women, men are becoming a new target market and more than 70% of spas now offer services geared toward men [3,4,5]. Similar to the growth in the male population, Warren [6] indicates a growth in the number of youth patronizing spas. Equally important are the changing expectations of spa customers and the benefits that they seek [7].
This paper presents the findings of an assessment of the spa industry’s clientele, in an effort to determine if there are any actionable demographic segments within the spa industry. Interviews were conducted to gather the voice of the customer, a questionnaire was developed using responses from the interview process, and results were analyzed to determine what spa clientele expect from the spa experience. Thus, using both qualitative and quantitative research to determine what is important to consumers, this paper makes a substantial contribution to the literature and supplements research already performed in segmenting spa-goers by benefits sought [7]. In doing so, we have identified trends among a few demographic variables that will allow spa owners to communicate with spa clientele in a more targeted and appealing manner.

2. History and Definition of Spas

The term “spa” is actually an acronym for the Latin phrase “salus per aqua” which translates to “health via water” [8]. Spas are originally thought to have begun in Belgium in a small town where several hot mineral springs existed that held curative aids to many skin conditions [9]. Today, however, the International Spa Association’s definition of a spa is a place “devoted to overall well-being through a variety of professional services that encourage the renewal of mind, body, and spirit” [10].
Currently, a variety of kinds of spas exist, including destination spas, resort spas, club spas, salon spas, and medical spas (also known as medispas). A destination spa is targeted at people immersing themselves in the total spa experience for at least two to three nights. A resort spa is a part of many amenities at a resort, such as tennis, golf, or swimming. The same is the case with a club spa, as it is a part of a fitness center, making it one of many amenities, not a sole attraction. The medical spa is a relatively new business type that is growing in large cities. It offers treatments that require special supervision, such as laser resurfacing and Botox injections, in addition to traditional spa services [11].
Although spas were always considered a luxury, it took until the mid-1980s for forward thinking resort operators to start adding spas to resort properties [12]. Now, resort operators are realizing that it is a necessity to operate a spa on site to be competitive in the leisure market [13]. More progressive spa owners are going beyond that and finding a niche market, theme, or hook that can be used to draw in clients. Examples include a health and wellness spa that caters to the senior market or a spa in Arizona with a Native American theme that couples specialized services such as blue corn body polish with a Native American Shaman reading spirit cards [5,14].

3. Size and Growth of Spas

The spa industry ranks as a strong leader and trendsetter in the leisure and hospitality market place, and recently underwent a growth phase. In fact, spa locations jumped a staggering 380% in a single decade (from 2000 to 2010) and, according to the International Spa Association, there were 156 million spa visits in 2011 alone, an increase of 4.1% over visits in 2010 [15]. According to Bjorn Hanson, the head of PricewaterhouseCoopers’ hospitality and leisure group, spas are finding new ways to generate revenues and are doing more than just adding new locations [5,16]. In fact, even in the midst of tough economic times, in 2011, total revenue also increased 4.5% over 2010, to $13.4 billion annually [15].
Due to its positive growth and financial profits, many small players entered the business with various spa concepts, the most recent of which being the medispa. This change started to emerge in the 1960s and 1970s as the interest grew in non-western, non-traditional, and native medicine [17]. This has continued to be an area of growth around the world. In fact, the top medispa in the world, according to the Mayo Clinic, is in Bangkok, Thailand.
Tracking of spa growth was not prevalent prior to spas becoming popular around 2000. The spa industry in Hawaii grew by 481.82% during 2001–2007 [18] and continues to grow at a steady pace.

4. Literature Review

Beyond the increase of male and youth patronage of spa services, a review of the literature shows that the primary drivers for customers to patronize a spa are hedonism (pleasure, fun, appealing to senses), escape (de-stressing, relief from social pressures), relaxation, and self-improvement such as improving emotional state or beauty [7,19]. The spa industry has grown internationally in all types of spas, including day spas, hotel-based spas, resort spas, and destination spas; however, the economy can impact the industry’s growth and changes to spa offerings may need to be repackaged for continued success [20].
Snoj and Mumel [21] analyzed the service quality elements of health spas in Slovenia. The research utilized the service quality (SERVQUAL) methodology to understand the important health spa service components. In addition, the research analyzed the differences between the authors initial study in 1991 and those seen in 1999, as there was a major shift in the structure of the service elements during this time. These differences surround the service elements, perceived quality, and management practices.
Mak et al. [22] investigated the motivations for travellers to search for spa experiences using focus groups to identify their socio-demographic characteristics. The study was based in Hong Kong. The results found that the top four factors included relaxation and relief, escape, self-reward and indulgence, and health and beauty.
In 2010, a study of spa-goers was conducted and an importance-performance analysis was completed. The study showed that there are three primary customer segments of spas: hedonists, neutralists and escapists. The largest of the two groups were hedonists and escapists. They were very similar in their need to relax, have fun, feel healthier and rejuvenated, but hedonists want a very social experience, while escapists are looking for solitude. Neutralists are a small segment that are looking for relaxation and nothing else. They place little importance on the health benefits, social aspects or the experiential aspects of the treatment [7].
Setiowati and Putri [23] studied the percieved value for customer satisfaction and customer loyalty through the analyses of spas in Indonesia. The research utilized previous research and customer willingness to recommend and repurchase spa services. The study found that the five dimensions of perceived value (quality, emotional response, monetary price, behavioral price, and reputation) impact satisfaction. The research found that reputation is the most important factor follwed by emotional response, behavioral value, quality, and monetary price, respectively.
Chen et al. [24] also researched the important customer service factors; however, their research specifically addressed the customer segmentation of older visitors. The study focused on the perspectives of older adults and the operators in wellness tourism in hot springs by conducting information through face-to-face interviews. The study found seven customer service factors including mental learning, experience of unique tourism resources, complementary therapies, relaxation, healthy diet, and social activities. Using these service factors, the researchers categorized the guests using a cluster analysis into a holistic group, physiocare group, and leisure and recreation group.
Similar to these studies mentioned above, our study also examines ways to segment spa-goers. Uniquely, however, this paper focuses on the demographic segments and their specific expectations. In understanding the demographic segments, spa owners will have a more clear cut path to target advertising because most traditional media have already detailed their audience using demographic data.

5. Methodology

This study was conducted on the island of Hawaii; eight undergraduate business students served as the researchers under the guidance of one of the authors. The population of the big island of Hawaii is highly diverse, providing an opportunity to study broad cultural differences. Spas are very common in Hawaii and their services are in high demand, with services varying considerably from one location to another. Spa clientele in vacation locations, such as Hawaii, include both locals and tourists, increasing the diversity of the customer base. In addition to spas, Hawaii tourists have been researched in a variety of other contexts [25,26], such as gaming [27], and sporting events [28].
The process for assessing the wants and needs of spa clientele began with interviewing 39 customers or potential customers on spa services in order to obtain the initial voice of the customers in their own words. The structured in-depth interviews used a standard set of interview questions, and followed up with probing questions to obtain desired expectations (wants or benefits from use) from the potential customer, rather than just attributes that are physical characteristics of the service. The responses were sorted and grouped into “consequences.” Consequences were written in the form of a sentence including “I” or “My” as much as possible to make them more concrete so that future respondents would respond to items according to what was particularly important to them personally. Examples are “I get professional service” and “I get plenty of attention”.
After the consequences were written from the 39 interviews, a questionnaire was created from these consequences. The questionnaire was developed from the voice of the customer obtained through the interviews to measure the perceived importance of consequences of spa use and ratings of existing spas that the respondents had visited. The consequences were divided into two groups representing those that occurred as part of the time spent at the spa, such as feeling comfortable, and those that resulted from the spa treatment, such as relaxation.
The questionnaire was distributed to 149 customers or potential customers, using convenience sampling. The respondents were asked to rate the importance of each consequence using an anchored scale. Respondents were asked to assign a value of “ten” to the most important consequence to them and then rate all other consequences relative to the one that was most important to them. More than one consequence could be given the same rating; for example, two consequences could be rated equally at a value of “nine”. An average importance rating was then calculated for each consequence. The second part of the survey asked respondents to provide the names of spas they had visited and rate them on the same consequences. The questionnaire participants were asked to use a five-point Likert scale to indicate their level of agreement that the spa successfully provided each consequence. The final section of the questionnaire used itemized scales to collect demographic information about the respondents.

6. Results and Discussion

Of the 149 questionnaires distributed, 111 provided complete and valid information (74.5% response rate). A valid sample size was ensured by using a standard sample size calculation (z = 90%, s = 1.1, e = 0.20), which determined that 81 responses were needed. Since 111 responses were obtained, the sample size is considered to be valid.
Since the focus of this study was to assess the needs and wants (expectations) of spa clientele, the demographics of the respondents are reported in detail. The spa clientele population must be well understood in order to know how to market to the overall clientele as well as each specific group. The majority of the respondents in this study were female (61%) and 60% were single, 28% were married, and 9% were divorced. A very small number were either widowed or neglected to provide their marital status.
Of the 111 respondents, 51% were between the ages of 18 and 27, 5% were younger than 18, 18% were between 28 and 37, 18% were between 38 and 47, and only 8% were over 48.
Ethnicity was highly varied; 36% of the respondents named more than one ethnicity. Caucasian (European descent) was most common as the first selection with 27% and native Hawaiian (16%) and Japanese (13%) in second and third place, respectively (see Figure 1).
Figure 1. Frequency of ethnicity.
Figure 1. Frequency of ethnicity.
Sustainability 07 10756 g001
The sample was well educated: 33% had completed only high school, 21% had an associate’s degree, 41% had completed a bachelor’s degree and 5% had a graduate degree. In terms of employment, most (54%) worked full time; while 33% worked part time. Income levels varied as well, 37% earn an average annual salary of less than $20,000, 17% made between $20,000 and $39,999, 18% earn between $40,000 and $59,999, 15% made between $60,000 and $79,999, 7% made between $80,000 and $99,999 and only 6% made $100,000 or more.
As outlined earlier, each respondent was asked to provide feedback on what was important to them in a spa experience. Responses from 39 personal interviews were extracted and grouped together to form 44 “consequences.” These consequences were stated in the form of “I” or “My” as much as possible, such that respondents were telling the interviewer things that were particularly important to them personally—such as “I get professional service” or “I get plenty of attention.” The 44 consequences are listed in Table 1. In the questionnaire, respondents were asked to rate the importance of each consequence using an anchored scale. Respondents were asked to assign a value of “ten” to the most important consequence to them and then rate all other consequences relative to the one that was most important to them. More than one consequence could be given the same rating; for example, two consequences could be rated equally at a value of “nine”. A mean importance rating was then calculated for each consequence. The means indicate relative importance of the consequences to the entire 111 spa clientele who responded (Table 1).
An analysis of variance (ANOVA) was conducted to compare means among the demographic groups. The two most important consequences of visiting a spa (“I feel relaxed” and “My stress is relieved”) were important to everyone, regardless of age, gender, income, marital status, ethnicity, or employment as indicated in Table 1 by the p-values. While the analysis of variance showed significant differences based on income for the third most important consequence (“I get what I paid for”), a post-hoc test showed no differences between income groups on their ratings of importance.
Table 1. p-values for differences in mean importance ratings by demographics.
Table 1. p-values for differences in mean importance ratings by demographics.
ConsequenceImportance RatingANOVA p-values by demographics
GenderAgeMarital StatusEducationEmploymentIncomeEthnicity
I feel relaxed8.940.1340.7300.6060.6360.5830.6120.565
My stress is relieved8.810.4910.1610.2420.4850.7320.3240.359
I get what I paid for8.670.6860.0570.0710.5700.7690.0140.497
I feel rejuvenated8.640.0190.2500.3020.5510.3390.2680.047
Massage is pleasurable8.610.7040.8410.0000.3970.6970.2310.533
The spa is peaceful8.590.0380.0160.6100.4460.1400.0020.013
I feel calm 8.580.3900.5910.5190.1710.0330.0200.643
I feel happy8.580.7680.1550.6380.3900.4790.4240.022
I get professional service8.570.5660.3460.1040.1980.6330.2150.398
I feel rested8.530.1170.0210.2770.0180.0140.0520.121
I feel refreshed8.450.3950.5210.1270.3190.3270.0560.137
I get relief from aches and pains8.410.2650.1980.1490.1610.1240.0000.182
I am comfortable getting a massage8.390.7810.1830.0450.7990.3720.0570.315
I don’t feel rushed8.370.4990.3530.9120.5060.4550.2900.166
I am comfortable8.310.8680.2660.0260.9280.4310.0520.353
I am not bothered by children8.040.5310.0550.2570.0410.9130.5570.009
I feel good about myself physically8.020.9400.1920.2030.4510.3500.0400.012
My circulation improves7.90.3070.1950.0330.0300.0430.0610.474
I can go in anytime7.820.7470.0020.0410.8000.9370.0700.000
The location is convenient7.820.9650.0920.0250.8740.8220.2540.024
I feel secure there7.770.0770.0430.0230.0390.5740.0940.184
I can get away from the real world7.770.3640.1510.8660.3580.9230.5100.482
My skin is softer7.630.1930.2230.2020.0000.0130.0000.086
I get plenty of attention7.460.6000.6080.1030.7570.2430.0400.884
My skin is clean7.430.4650.0360.7950.0000.0040.0400.129
My pores are cleaner7.250.4220.0020.6620.0050.3560.2740.051
I feel like royalty7.090.4250.0450.7400.7050.2130.0530.454
I get something special7.070.3380.4360.1750.0020.9250.4210.099
I feel thin/trim7.060.9230.4940.3300.1700.7680.1160.033
I look radiant6.850.5940.5500.3500.0060.4670.1040.014
I don’t feel greasy6.840.4990.0800.4610.0120.4590.0020.079
I can exercise6.820.5690.0200.1340.8170.9310.0820.060
I look attractive6.780.9370.0080.1340.1920.4580.1050.003
I smell good6.650.5690.0000.1440.0020.0080.0110.019
My muscles are toned6.590.1010.0000.0430.6320.7470.1010.008
My feet look nice6.550.8270.4680.0000.0380.7590.0110.013
I build muscle6.450.0290.0000.2990.5310.7690.1210.003
I look younger6.380.4300.0500.0100.0000.4880.0000.000
I lose weight6.150.4970.0030.0900.5070.9330.1720.001
The employees help sell the spa5.890.3330.0060.6040.6430.1920.0010.004
I can eat healthy food while there5.270.2200.1140.0750.2970.1930.0770.081
I can drink healthy beverages while there5.250.8700.0010.0850.3450.4430.1010.029
I can get tanner4.810.0440.0810.1830.0130.9400.2400.019
Six consequences were rated at approximately 8.6 on importance as indicated in Table 1. “I get professional service” was not rated significantly different based on any demographic measure. The remaining five consequences rated 8.6 all showed significant differences on a single demographic variable. Ratings of “I feel happy”, “I feel rejuvenated”, and “The spa is peaceful” all differed significantly among different ethnic groups. “Massage is pleasurable” was rated differently based on marital status and “I feel calm” was rated differently based on employment status.

7. Segmenting Through Demographics

7.1. Age

Those aged 48 and above (n = 11) tended to rate the importance of all items lower than the other age groups. According to the Tukey’s B post hoc test, this oldest group rated the importance of the following items significantly lower than the other age groups:
  • I feel like royalty
  • I feel secure there
  • I can exercise
  • I build muscle
  • I can go any time
  • I feel rested
  • My pores are cleaner
  • I look attractive
  • My muscles are toned
  • I lose weight
Those under 18 (n = 7) tended to rate the importance of most items higher than other age groups as indicated in Table 1. This youngest group rated the importance of the following items significantly higher than other age groups:
  • The employees help sell the spa
  • The spa is peaceful
  • My muscles are toned
The 18 and under group did not rate any item as significantly less important than the other groups.
Beyond the tendencies of these two groups, a few other findings from the post hoc analyses are worth noting. Generally, “I smell good” was more important to younger age groups, as well as consequences such as “I feel rested”, “My skin is clean” and “My pores are cleaner”.
Given this data, spa owners should consider targeting facial treatments to younger clientele. While many spas target their facial treatments to older women who want to look younger, there seems to be a market for young women who feel it is important to keep their skin healthy.

7.2. Gender

The two genders showed a significant difference in importance ratings on only four items. As shown in Table 1, females rated “I feel rejuvenated” and “The spa is peaceful” as more important while males rated “I can get tanner” and “I build muscle” higher in importance. In short, women feel that spas are more experiential and men feel the spa is more of a service provider. This suggests that promotions endorsing an experience such as a “spa escape” may be more appropriate for females, and while more research would be needed to confirm male spa goer’s preferences, it seems that the consequences related to specific services may mean that they are more susceptible to targeted service advertising, competitive price points, and convenience features.

7.3. Income

The most notable result within the income category is that those of higher income rated “I look younger” more important than those of lower income in a linear fashion, as shown in Table 1. Similar trends, but not as clean, were found for:
  • I feel like royalty (higher income tended to give higher ratings)
  • I feel calm (higher income tended to give higher ratings)
  • I feel good physically (higher income tended to give higher ratings)
  • My skin is softer (higher income tended to give higher ratings)
The highest income group ($100,000 and over, n = 8) rated “The spa is peaceful” lower than any other group. This leads us to believe that as the income level goes up, the spa industry is less about an experience and more about a promise. In essence, it is the benefit or promise of the spa that is alluring; promises such as “looking younger”, “feeling good”, and “feeling calm”. Potential reasons for this could include the fact that for people of middle to lower incomes, the spa is a treat and, as such, they are looking for the experience or escape. Those with a greater income may be regular spa-goers and, thus, the experience may seem more routine. In this case, it is about the benefit the spa provides, the promise of youth and radiance.

7.4. Marital Status, Education, and Employment

In two of these cases, there were significant differences between groups as shown in Table 1; however, the differences were not easily grouped or explained in a way that would aid spa-owners in adequately targeting one group over another.
For instance, those who were divorced had significantly lower ratings than those who were married or single on:
  • I feel secure there
  • I can eat healthy food while there
  • I look younger
  • My feet look nice
  • My muscles are toned
Those who were married rated “I can eat healthy food while there” and “my muscles are toned” significantly higher than single or divorced individuals. In these cases, it is difficult to draw an over-arching conclusion because identifying patterns among the significant results has proved difficult.
Similarly, the education results were also difficult to explain. While we did find some significant differences between groups, patterns among them were not easily identified. In fact, despite the fact that some groups rated a particular consequence significantly different than another group, there were no general trends. For instance, the more educated someone was did not increase or decrease the rating of a particular consequence.
In the case of employment, none of the employment groups rated any of the items significantly different than any other group. Therefore, despite the fact that Table 1 highlights significant differences based on employment for six of the consequences, post hoc tests showed no differences between employment groups on their ratings of importance.

7.5. Ethnicity

The analysis of variance was performed on the first ethnic category selected by each individual. The results were very complicated. Table 2 provides the mean importance rating on each item by ethnic group. The items in bold are those in which significant differences were found using ANOVA.
Table 2. Mean Importance Rating by Ethnicity.
Table 2. Mean Importance Rating by Ethnicity.
AfricaAsia(oth)ChinaEuroHawainHispanicJapanNative AmerPacific RimPhillipinoOtherTotals
Professional service10.07.679.
Employees sell4.
Paid for9.808.009.608.638.148.868.569.448.479.187.868.63
Comfortable spa9.407.677.408.178.688.718.287.117.939.557.578.26
Comfortable massage10.007.677.408.238.599.008.618.568.678.006.718.35
Go anytime10.006.674.606.708.558.578.678.677.878.736.577.80
Get away6.607.446.807.337.917.867.948.677.
Good physically8.808.
Skin soft8.207.565.406.377.598.297.838.117.075.557.577.14
Skin clean8.408.444.606.777.958.577.678.007.476.097.147.36
Pores clean8.407.784.206.407.458.717.507.788.
Look younger7.607.444.404.276.738.867.678.785.735.915.436.31
Muscles toned7.007.004.605.437.594.576.946.896.878.734.866.54
Lose weight7.407.443.605.337.
Relief from aches9.007.788.008.309.059.148.446.788.079.277.438.37
Smell good4.808.003.405.577.738.
Sleep 8.407.448.007.038.739.438.678.
Note: * Bold items indicated that the items was significant between groups at p ≤ 0.05.
For those 20 items, the ethnic group giving the highest importance score by item were:
  • Employees help sell the spa—Philippines
  • I can drink healthy beverages—Other Asian
  • I can get tanner—Native American
  • I build muscle—Philippines
  • I can go anytime—African American
  • The location is convenient—African American
  • I am not bothered by children—Philippines
  • The spa is peaceful—Philippines
  • I feel thin/trim—Native American
  • I feel happy—Native American
  • I feel rejuvenated—Native American
  • I feel good about myself physically—Philippines
  • I look younger—Hispanic
  • I feel radiant—Native American
  • I look attractive—Native American
  • My feet look nice—Native American
  • My muscles are toned—Philippines
  • I lose weight—African American and Other Asian
  • I smell good—Hispanic
  • I am able to get more/better sleep—Hispanic
Table 2 can be used to identify the items that are most important to any ethnic target group. The research conducted utilized a large sample size and with diverse ethnicities. While there are no published research studies similar, other studies indicated similar findings [3,4,7,13,25,26,29].

8. Conclusions

Just as in any industry, there are many ways to segment the market. Previous research looked at benefit segmentation in spas [7], but this paper focuses on customer demographic segmentation. Demographics is a very basic way to segment customers; however, if profitable segments can be found, it often makes creating advertising and selecting media very straightforward. This research utilized both qualitative and quantitative research to determine what is important to consumers by identifying trends among a few demographic variables that will allow spa managers to provide more targeted and appealing communication.
We propose that spas can segment younger consumers with “healthy” treatments which include facials, muscle toning massages, etc. For those of lower to middle income, data suggests using an experiential tactic, touting the “relaxation and escape” properties of the spa. For those with higher incomes, focusing on long term benefits of using a spa such as “looking younger”, “feeling better”, etc. seems to be an appropriate message. Lastly, women seem to want the experiential qualities of a spa (relaxation, rejuvenation, and peacefulness); while men want tangible outcomes (to be tanner and build muscle). This should result in very different marketing messages as spas should consider targeting men with very tangible, factual information about benefits and outcomes.

9. Limitations and Implications

Just as with any research, it is important to discuss not only the strengths of this research but also the areas of limitation. For instance, we have a strong sample size (n = 111); however, it is important to note that this is a convenience sample collected in Hawaii. Despite the fact that this is a convenience sample, we feel we should reiterate that the respondents were highly diverse, with 36% listing more than one ethnicity and 14 different ethnicities reported. That said, while our sample size was large enough, for most data analysis, a larger sample size would have provided us with a method of more clearly seeing differences among ethnic groups. Spa managers should consider using a large and diverse sample size when conducting similar research to ensure adequate responses. In addition, a longitudinal study should be considered for future research to show trends.
This research provided some potential demographic segments for spa owners to pursue; future research should look at this data in addition to the benefit segmentation work that had already been performed [7]. For instance, a more comprehensive look at the benefit segments to try to further link them to demographics would be helpful. In addition, looking at the benefit segments and gaining insight into their media habits would be useful for targeting and communicating with potential clientele. In particular, spa managers should determine the most effective means of communication.


No known funding was received for this paper.

Author Contributions

Caroline Fisher conceived of this research and collected the data regarding the spa industry in Hawaii. Both Caroline Fisher and Cassandra Elrod analyzed the data collected in preparation for this manuscript. Sarah Stanley, Cassandra Elrod, and Elizabeth Cudney prepared the manuscript for publication.

Conflicts of Interest

There are no known conflicts of interest.


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