Date of Conferral







Joseph Barbeau



Word-of-mouth (WOM) personal referrals are more efficient and influential than other forms of

advertising; however, there is a lack of information regarding the value of referral programs. The

purpose of this qualitative case study was to explore the perceptions of business owners, staff,

and customers of alternative health care organizations in a Midwestern U.S. state about efficient

referral strategies, measuring the effect of those strategies, and motivations of consumers to

make referrals. Maslow's hierarchy of needs theory of motivation and customer decision-making

theories provided the conceptual framework. The research questions addressed how industry

leaders perceived and ranked referral strategies and addressed customers' perceptions and

motivations to make personal referrals. Data collection consisted of semistructured interviews

with 4 business owners, 2 staff members, and 10 client participants. Data were analyzed using

constant comparative analysis methods, and member checking enhanced the accuracy of the

findings. Results indicated that participants viewed WOM personal referrals as the most efficient

nontraditional strategy to make or receive referrals, and they perceived referrals from impartial

and trustworthy sources as the most valued information. This research has implications for

positive social change. Findings may be used to enhance business owners' understanding of the

value of personal referrals in their marketing mix, and of the motivation for customers to make

referrals. WOM personal referrals may be used as a marketing strategy to increase sales and

lower costs of formal advertising, which may contribute to the growth of the business.