Despite marketing scholars exploring consumption practices in crises and disasters using the lens of liminality (Cheung & McColl-Kennedy, 2015; Kennett-Hensel, Sneath, & Lacey, 2012), little is known about service value co-creation during pregnancy-induced liminality. During a liminal period the individual is in an ambiguous state where disequilibrium occurs before passage to a relatively stable subsequent state with new roles and new identity (Beech, 2011; Turner, 1969). As pregnant women’s service needs move away from traditional repositories of knowledge and into expectations of 24/7 service and information, digitalised platforms and online interfaces have increasing appeal, particularly for the growing number of digital natives stepping into motherhood (Lupton, 2016; Prior, 2016). The convenience, immediate availability, freedom to access service, and at any time, add to the usefulness of digital platforms as part of an enterprise’s value co-creation practices (Ramaswamy & Ozcan, 2018). The purpose of this research is first, to explore how pregnant women realise value outcomes through their engagement with midwifery websites, and second, how midwives use their websites as online engagement platforms for value co-creation.

Complex decisions, many of which have scientific uncertainty, are required during a woman’s pregnancy (Stevens et al., 2016). Additionally, pregnancy-induced liminality requires a shedding of old roles and yet to be developed new roles of motherhood. During this transition, distress, confusion, or disequilibrium may be experienced. Part of this experience is associated with being overwhelmed with information and the tension between expert advice, peers/family influences, and instinctive behaviours (Song et al., 2012). Midwife websites, providing critical support to help pregnant women transition through liminality, are a valuable tool for maternity service delivery.

Study 1, based on a literature-derived thematic framework of woman-centred care (continuity of care, empowerment and relationships), is a content analysis of 70 midwife websites examining midwives’ service philosophies communicated through images, text and videos within these themes. Study 2, face-to-face interviews, uses purposive sampling to recruit 16 women and 3 midwife participants. The interviews took a projective-elicitation approach (Rohani, Aung, & Rohani, 2014) and interpretive data analysis.

Drawing from the results, pregnant women use sophisticated and conscious information searching and sharing (often beyond expert, families and friends) as support through their pregnancy-induced liminality, confirming earlier research (Wexler et al., 2020). They engage with multiple digital platforms in promoting their own health and health of baby. However, midwives underestimate the important support role their website interface plays in women’s participation and connection in reducing liminality-induced disequilibrium. We provide a framework linking service-generated conditions (midwifery system processes, time pressure) and self-generated conditions (social dislocation, search for ‘new village’, physical toll, emotionally charged) with provider and consumer practices for the pregnant woman’s safe passage to a non-liminal state. While consumer autonomy, access and capability are cornerstones of successful resource integration the service provider also organises the practices of value co-creation, connecting resources and value opportunities for co-creation. Theoretically, the concept of liminality is an important dimension in maternity services value co-creation. Practically, we identify opportunities for midwives to enhance transformative service outcomes through their websites.

An ongoing shift from disease-centric to person-centric health care brings the concept of person centricity to the forefront. Prior research shows that person centricity has advantages for both patients and health care providers, but its conceptualization remains ambiguous. This research aims to reconceptualize person centricity from a service marketing perspective by building on the first principles of marketing proposed by Palmatier and Crecelius: (1) all customers differ, (2) all customers change, (3) all competitors react, and (4) all resources are limited. To achieve this end, this qualitative research combines insights from in-depth interviews with different health care actors (n=48) and a scoping review (n=27).

The findings reveal that person centricity - which refers to tailoring offerings to people’s unique preferences and needs - manifests itself in the domains of participation, experience, and connection. These preferences and needs vary between persons (i.e., patient heterogeneity) and within persons (i.e., patient dynamics). These insights led to the development of the PEC-model (Participation - Experience - Connection).

The findings also indicate that person centricity’s implementation is challenged by the coexistence of different logics. Specifically, we disentangle two logics related to the strategic advantages (i.e., competitive advantages principle) when actors implement person centricity: (1) a competitive logic (to improve the hospital’s competitive position), and (2) a transformative logic (to enhance people’s well-being). Meanwhile, two logics emerge regarding the costs that go along with implementing person centricity (i.e., limited resources principle): (1) an investment logic (a focus on the positive returns-on-investment), and (2) an expense logic (the belief that person centricity is an expense).

Additionally, normative judgments about the advantages and costs that specific patient preferences and needs (e.g., the belief that active participation is better for patient well-being) may restrain the implementation of person centricity if actors adopt (1) a paternalistic logic (holding on to normative judgments of specific preferences and needs) whereas the opposite holds for actors with (2) a reflexive logic (critically reflecting upon normative judgments in relation to person centricity).

By proposing the PEC-model and unraveling the logics that affect its implementation, this research provides guidance to researchers and practitioners interested in implementing person centricity in healthcare and beyond. First, this research contributes to our understanding of person centricity by identifying six dimensions which are - in contrast to prior work - not prescriptive and absolute but depend on the individual wishes, preferences, and needs of the patient (i.e., accounts for between and within patient group heterogeneity). Second, this research contributes to the implementation of person centricity, which has been identified as a key challenge. Specifically, our findings reveal the existence of different logics related to person centricity. Each of the logics entails rules, norms, and beliefs that may guide the actions of health care providers and, as a result, enable or hinder the implementation of person centricity.

In the last years, the healthcare sector has experienced a transformation, and increasing attention has been paid to the concept of the well-being of all actors involved (Mugion and Menicucci, 2020). Healthcare service ecosystems evolve continuously and are characterised by high levels of complexity (Frow et al., 2019). Moreover, the pandemic represents an unprecedented public health emergency in modern history (Ornell et al., 2020), and it confirmed the universal value of health and its nature as a fundamental public good. The relevance of the healthcare future is also highlighted by Goal 3 in the 2030 Agenda. Against the above backdrop, the present study aims to identify the contribution of Transformative Service Research (TSR) to the healthcare sector by performing a Systematic Literature Review (SLR). Specifically, the analysis of the TSR articles published so far aims to understand the main types of service studied, the actors involved, the activities/practices carried out, the well-being outcomes, and the transformative impacts, identifying potential pillars for creating a sustainable healthcare service ecosystem.
The role of services in affecting well-being has been recognised as a research priority (Ostrom et al., 2015), and the service community showed an increasing interest in TSR (Anderson and Ostrom, 2015). Healthcare is defined as transformative by design because it has a clear transformative mission (Rosenbaum et al., 2011), and it represents a rich field for investigation (Rai, 2018). Moreover, TSR is significantly related to healthcare because the service providers can impact individual and societal well-being (Anderson et al., 2013; Ungaro et al., 2021).
To address the study aim, a systematic literature review method is applied; specifically, the research adopts a systematic quantitative approach (Pickering & Byrne, 2014; Pickering et al., 2015). The keywords "Transformative Service Research", "Health*", and "Healthcare" were input in two research databases Scopus and Web of Science, and 32 articles published between 2011 and 2020 were analysed.
The more relevant transformative effects generated so far by previous research in the healthcare sector are categorised and analysed together with the primary well-being outcomes.
The authors provided an analysis of the paper's bibliometric characteristics. Then they presented a summary of the main healthcare services explored, the principal category of patients investigated, the focal actors involved and their activities. The authors observed that there are more empirical than conceptual research, and they also provided a map of the countries in which the studies were developed. Finally, the current gaps are identified, and an Agenda for future studies is provided.
It has emerged from the present paper that healthcare service providers need to provide an adequate and sustainable service because they play a significant role in affecting patients and other actors' well-being. Furthermore, researchers should develop more studies to investigate the transformative impacts of healthcare service and continue to expand this field.
The current paper is the first to perform a systematic quantitative literature review on TSR in the healthcare sector, synthesising the main articles' characteristics and identifying the activities performed, the actors involved and the impacts on the well-being.

The COVID-19 pandemic changed people’s lives around the world in early 2020. One of the most common recommendations during the pandemic was to ask people to stay at home in order to stop the coronavirus (COVID-19) from spreading. Social distancing, which is also called movement restriction, is used to protect individuals by restricting those situations where there is a potential for infection. It differs from isolation, which consists of removing an already infected person entirely from circulation (Brooks et al., 2020). There is evidence that traumatic events (e.g. war) influence emotions and consumer behavior (Clerides, et al., 2015; Stovall, 2008; Jebarajakirthy & Lobo, 2014). In the context of the quarantine, people have started looking for mechanisms that can help them deal with the negative effects of the pandemic. The social distancing process has had a negative effect on the well-being of individuals (Brooks et al., 2020) besides having the potential to influence their social relations and their emotions (Kowal et al., 2020). Social relations, in turn, has the potential to impact people's physical and mental well-being (Dozois, 2021) and potentially, consumer behavior. Rosenbaum and Russell-Bennett (2020) state that after the COVID-19 pandemic, shoppers probably will be experiencing more concern and fear about their safety avoiding being in crowd spaces without enough distance or the need of using common objects that was touched by other consumers. The changes in the relationships in the service context due COVID-19 have challenged service marketing researchers to better understand how service encounters will maintain the ability to engage costumers in relationships without important resources of sociability (Rosenbaum and Russell-Bennett, 2020) (i.e. facial emotions, physical contact, social distance). For service companies that aim to cater to consumers’ need, it is essencial to understand and react to these feelings and emotions. In this way, this current study evaluates consumers' feeling during pandemic (ie. spirituality, compassionate love, anxiety, and hope) and explores potential implications of these feeling on the services marketing management. To investigate the relationship between fear, anxiety, hope, compassionate love, spirituality, and well-being, we conducted a survey with 469 Brazilians who had been in quarantine for more than 45 days. Using a structural equation model, we found that hope is a mediator of the relationship between anxiety and fear. It has also a mediating effect in the impact of spirituality on anxiety. Moreover, we found that hope mediates the relationship between spirituality and well-being. As limitations, the sample included only Brazilian respondents, and pre-pandemic well-being was not measured. The findings of the present study suggest that the adoption of practices related to spirituality during an extreme, stressful situation by services’ company has an influence on people’s hope and potentially mitigate anxiety. Increasing spirituality and hope can also benefit perceptions of consumers’ well-being. Service companies in general can benefit of using these findings to better management their relationships with consumer during and after COVID-19 pandemic.