Influence of cultural factors and user engagement motives on value co-creation dynamics between healthcare service providers and users

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Purpose Previous research identifies multiple motives as drivers of value co-creation but reports inconsistent findings across national contexts. This study examines how national culture shapes healthcare service users’ motives and engagement in value co-creation, addressing calls to better contextualize service interactions in healthcare. Design/methodology/approach We adopt a conceptual research design and develop an integrative framework that brings together service-dominant logic, value co-creation motives, healthcare service provider–user relationship dynamics, and cultural value dimensions. We discuss a set of propositions that explain how culture and relationship expectations influence active and passive co-creation behaviors. Findings Drawing on our findings, we develop a framework that reconciles several persistent inconsistencies instead of introducing additional isolated explanations. This framework indicates that these discrepancies primarily reflect culturally embedded expectations regarding authority, autonomy, and uncertainty, which shape healthcare relationships. Engagement motives and behaviors are not universally activated; rather, they become salient only when aligned with culturally informed relationship norms and expectations. Consequently, the same co-creation practice may foster empowerment and collaboration in one healthcare setting, yet generate discomfort, passivity, or resistance in another. Practical implications Healthcare organizations may benefit from adapting engagement practices, communication styles, and decision-making processes to culturally grounded expectations in order to support service user involvement and well-being. Originality/value The paper provides an integrated perspective on culturally embedded drivers of value co-creation in healthcare service interactions. The study contributes to the existing literature by conceptualizing national culture as a boundary condition that influences co-creation motives and relationship dynamics in healthcare services. Our framework helps explain inconsistent findings in existing research conducted in different national contexts. It extends existing value co-creation theory by incorporating cultural context.

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