Introduction

World global prevalence of male circumcision in 2016 was 38,7% conducted by Morris et al, circumcision is the most common and oldest simple urological procedure in the globe where often done in the countries where the majority Muslim and Jewish people as part of their religion and tradition. Throughout history, men in societies in Africa, Australia, the Americas, and other parts of the world have been circumcised with no connection to a Muslim or Jewish faith. Much research has gone into the origins of these rituals and how they evolved. Beside male circumcision demonstrated the multiple medical and health benefits. Health services are not only from the medical aspect but also from the wellbeing aspect in which there are certain psychological factors. Therefore, apart from technical quality, services also need to look at other aspects such as emotional and social factors, access to and the need for information (Dupret, 2012; Morris et al., 2019).

Nowadays there is many factors influence parental decision to performed circumcision for their son, therapeutic, prophylactic, religious, aesthetic, cultural, social, and psychological emotional reason, although we need to understanding circumcision in the perspective of consumer and healthcare provider and also the access the need of information. The question remains: What is the main determining factor for perceived value on circumcision clinic decision choice (Hoe et al., 2018).

The increasing number of circumcision clinics are growing, making clinic owners have to continue to maintain the quality and quality of the circumcision services they offer so that they can still be able to make millennial parents interested in coming to take advantage of circumcision services at their clinics. The circumcision clinic in maintaining its quality is certainly not an easy thing. Many millennial parents will be more interested in coming to other circumcision clinics if they have better facilities and infrastructure, of course this will be detrimental (Fonda & Antonio, 2020).The circumcision clinic certainly has a target or desire to be achieved, namely being able to meet the desires and needs of millennial parents as consumers. one way is to create value (perceived value). The value referred to here is the value perceived by millennial parents based on the difference between the costs they incur to get a product or service and the benefits to be received. When millennial parents perceive the value and benefits they get are greater than the costs, they will be satisfied and are likely to repurchase, but on the contrary when they get the value and benefits are less than the costs they incur, the satisfaction they get will be reduced, so it is likely that they will stop using it and switch to another clinic (Mukarramah et al., 2020).

Perceived value, is the difference between prospective customers' assessments of all the benefits and costs of an offer to its alternatives (Kotler et al., 2022). Perceived benefits are a combination of a number of aspects, namely: physical attributes, service attributes and technical support obtained in using the product. Meanwhile, the perceived sacrifice consists of all purchase costs incurred at the time of purchase; for example the purchase price, acquisition costs, transportation, installation, handling, repair and maintenance costs, and the risk of failure or poor performance. Meanwhile, Ariany and Lutfy (2021) in their research concludes that perceived value the perception of the overall assessment of the utility of a product or service based on what is received and what is given. Where Perceived value, according to Sweeney & Soutar, consists of four main aspects, namely emotional value, social value, performance (functional value), and price/cost/value of money (economic value). These aspects of perceived value can influence the decision of a consumer to use or buy goods or services. The better perceived value, the higher the consumer's purchase decision, where perceived value is something that can be considered in influencing consumer purchasing decisions (Sweeney & Soutar, 2001).

The aim of this study to explore male circumcision in parental or consumer perspective as decision maker for the procedure, we note the study of circumcision in parental or consumer perspective is still limited although Indonesia is one of the biggest Muslim populations in the world. The research conducted healthcare provider in clinic, the choice of clinic based on accessibility and reached every level society. The findings of this research will provide new insights for clinical managers or management.

Research Methods

The objects in this study are all the variables that exist in the study's conceptual framework. The object in this study will be analyzed further to answer the questions in this study (Ahn & Back, 2019). The dependent variable is percived value milenial parent consumer choice behavior. The independent variable from this research model consisting of six variables namely Epistemic Value (EP), Religious Value (RG), Functional Value (FC), Emotional Value (EM), Social Value (SC), and Economic Value (EC).

In order to understanding millennial parents’ circumcision clinic decision choices, this study aimed to explore male circumcision in parental or consumer perspective as decision maker for the procedure.This study was carried out as quantitative with a survey and data were taken purposively from inclusive criteria. This research is included in quantitative research with cross sectional design.

Survey and data were taken purposively from inclusive criteria. Data were obtained from milennial parent samples who have used the circumcision services at the circumcision clinic. Data was collected through an online questionnaire with a Likert scale of 1 to 6 points as instrumen of research in period September 2022.

The Likert scale for this study has six alternative answers: strongly disagree, disagree, slightly disagree, slightly agree, and strongly agree. Then the answer is given a score to determine which is higher and which is lower. The way of scoring on the Likert scale is 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5= strongly agree. This research using non-probability sampling methodes with purposive sampling technique.

This study uses a data analysis method with a multivariate analysis approach. In this research model, there are six independent variables and one dependent variable. Therefore, we need an analytical method that can test the effect between variables simultaneously on the dependent variable. To meet the objective of the study, this model was tested with empirical data from samples of a potential customer.

Before the actual data collection is carried out in large numbers, a pre- test first as a preliminary study. The purpose pre-test is to test the indicators used in the study. This is to evaluate the questionnaire given not to cause confusion and bias in filling out respondents' opinions. If everything is correct, then the data generated will be more correct and the research analysis will be in accordance with the objectives that have been set. After the data is collected, the data will be tested first for reliability and validity, so that the data obtained is in accordance with the initial purpose.

This study uses multiple linear regression. Hypothesis testing in the form of determination test (R2), F-test, t-test, and correlation test between dimensions. The F statistical test is used to determine whether the independent variables contained in the regression model have joint or simultaneous effects on the dependent variable.

Results and Discussion

Respondents in this study were conducted by filling out questionnaires via the Google form which were distributed to a sample of respondents who are millennial parents who have sons and have been circumcised (270 respondents) from October to November 2022 and are willing to become research respondents by filling out a questionnaire the. An explanation of the demographic profile of the respondents will be explained in the table below:

Table 1. Respondent Profile

Characteristic	Category	Total	Percentage
Sex	Man	158	58,52%
Sex	Woman	112	41,48%
Age	26-36	50	18,52%
Age	36-41	220	81,48%
Education	S2	21	7,78%
	S1	242	89,63%
	High School	7	2,59%

Based on table 1 above, it shows that out of 270 respondents, 158 people (58.52%) were man, and the remaining 112 people (41.48%) were woman. Based on the age range, 50 people (18.52%) had an age range of 26- 36 years and 220 people (81.48%) had an age range of 36-41 years. Based on the level of education, 21 people (7.78%) had a Master's degree, 242 people (89.63%) had a Bachelor's degree and 7 people (2.59%) had a high school education.

Multicollinearity test aims to determine whether there is a correlation between the independent variables in the regression model. A good regression model should not have a correlation between independent variables. If the Tolerance value is > 0.1 and the VIF value is < 10, then the regression model does not have multicollinearity and vice versa. The results of the multicollinearity test can be seen in the following table:

Table 2. Multicollinearity Test Result

Variable Independent	Tolerance	VIF
Functional Value	0,769	1,300
Emotional Value	0,754	1,326
Social Value	0,857	1,167
Religious Value	0,856	1,168
Epistemic Value	0,670	1,493
Economic Value	0,743	1,346

It can be seen that the tolerance value for all independent variables value > 0.1 and VIF values for all independent variables < 10, it can be concluded that there is no multicollinearity between the independent variables.

Based on the results of the linear regression test, the results are as shown in the table below:

Table 3. Result of Multiple Linear Regression Test Analysis

	Unstandardized B
(Constant)	5,345
Functional Value (X1)	(-)0,072
Emotional Value (X2)	0,053
Social Value (X3)	0,316
Religious Value (X4)	0,109
Epistemic Value (X5)	0,159
Economic Value (X6)	(-)0,010

Based on the table 3, the regression coefficient value is 0.053 or 5.3%, meaning that if the emotional value variable (X2) increases by 1 point, the value of the decision choice variable (Y) will increase by 0.053. This shows that the regression coefficient of the emotional value variable (X2) has a positive effect on decision choice (Y). Based on the table 3, the regression coefficient value is 0.316 or 31.6%, meaning that if the social value variable (X3) increases by 1 point, the value of the decision choice variable (Y) will increase by 0.316. This shows that the regression coefficient of the social value variable (X2) has a positive effect on decision choice (Y). Based on the table 3, the regression coefficient value is 0.109 or 10.9%, meaning that if the religious value variable (X4) increases by 1 point, the value of the decision choice variable Y) will increase by 0.109. This shows that the regression coefficient of the religious value variable (X4) has a positive effect on decision choice (Y). Based on the table 3, the regression coefficient value is 0.159 or 15.9%, meaning that if the epistemic value variable (X5) increases by 1 point, the value of the decision choice variable (Y) will increase by 0.159. This shows that the regression coefficient of the epistemic value variable (X5) has a positive effect on decision choice(Y). The results of the statistical t test can be seen in the table 4 below:

Table 4. t Test Result

	t-count	Sig.
(Constant)	2,799	0,006
Functional Value	-1,709	0,089
Emotional Value	1,313	0,190
Social Value	5,939	0,000
Religious Value	2,084	0,038
Epistemic Value	3,104	0,002
Economic Value	-0,226	0,821

Based on the table 4, for social values it is known that t count is 5.939 > t table is 1.968; and the significance value is 0.000 <0.05. This means that social values have a positive influence on the decision choice of millennial parents in choosing a circumcision clinic. Based on the table 4, for religious values it is known that t count is 3.104 t table is 1.968; and the significance value is 0.038 <0.05. This means that religious values have a positive influence on the decision choice of millennial parents in choosing a circumcision clinic. Based on the table 4, for epistemic values it is known that t count is 2.084 > t table is 1.968; and the significance value is 0.002 <0.05. This means that epistemic value has a positive influence on the decision choice of millennial parents determining the circumcision clinic.

Discussion

Functional Value Influence on Millennial Parents for Circumcision Clinic Decision Choice

Based on the results of the hypothesis testing, it is known that the functional value variable significance 0.089 > 0.05, it can be concluded that the functional value variable has no influence on the decision choice variable on millennial parents in determining the circumcision clinic. Functional or utilitarian value is related to how well the characteristics, usability, or performance of the product (goods or services) or how well the products (goods or services) function. Ahn & Back (2019) states that functional values are values that consumers want that are tangible, such as convenience, quality and others. Functional value involves consumer perceptions of the quality and performance of a product (Ahn & Back, 2019).

The functional value variable test results is not significant, this indicate that the functional value of a circumcision clinic is not a consideration for millennial parents in choosing a circumcision clinic. This can happen because the respondents already know about the quality or service provided by the circumcision clinic in the city of Banjarmasin, so that the respondents feel they already know the quality of the circumcision clinic they will choose later so that the functional value of a circumcision clinic is not a consideration for millennial parents. Based on research conducted by Lin et al (2012) functional value does not significantly affect consumer habits in choosing a product. In line with this research, (Khan & Mohsin, 2017)also said in his research that functional value does not have a significant effect on consumer behavior in choosing products. Adhitiya (2019) in his research also argued that functional value or product quality is not a consideration for consumers in choosing a product (Adhitiya & Astuti, 2019; Khan & Mohsin, 2017; Lin & Huang, 2012).

Emotional Value Influence on Millennial Parents for Circumcision Clinic Decision Choice

Based on the results of the hypothesis testing conducted, it is known that the emotional value variable has a significance value of 0.190 > 0.05, it can be concluded that the emotional value variable has no influence on the decision choice variable in millennial parents in determining the circumcision clinic. Emotional value is measured on a profile of feelings associated with the alternative. Emotional value can affect consumer perceptions of goods and services. thoughts or emotions of the customer can affect the consumer's response to the service. Positive feelings accompanied by feelings of satisfaction, joy, and happiness will increase consumer satisfaction. conversely, the emergence of negative things such as sadness, depression, regret will have the possibility of reducing the level of satisfaction with service use. According to (Wong et al., 2019) emotional value is defined as a utility that comes from the affective or consumer feelings towards a product. The emotional value of a circumcision clinic can be seen from how the clinic can foster a sense of relief, joy and a sense of security for parents who use their services. This can happen if the clinic has communicative and friendly staff (Wong et al., 2019).

The results of the insignificant emotional value variable test show that the emotional value of a circumcision clinic is not a consideration for millennial parents in choosing a circumcision clinic.This could be because the respondents were parents with an average undergraduate education level, which made them more emotionally and psychologically stable, so they felt that the emotional value aspects offered by a circumcision clinic did not influence their decision to choose a circumcision clinic. These results are in line with research conducted by (Nisrina et al., 2019) which says that emotional values do not have a significant effect on consumers when choosing for using services. This is also similar to the results of (Metra et al., 2020) which states that emotional factors do not have a significant effect on consumer decisions in choosing products (Metra et al., 2020; Nisrina et al., 2019)

Social Value Influence on Millennial Parents for Circumcision Clinic Decision Choice

Based on the results of the hypothesis testing conducted, it is known that the social value variable has a significance value of 0.000 < 0.05, this means that social values have a positive influence on the decision choice of millennial parents in choosing a circumcision clinic. The positive influence here means that if a circumcision clinic pays attention to the social values of their circumcision clinic, the higher the desire of millennial parents to make the circumcision clinic their choice. The social value of the circumcision clinic here can be seen from how the circumcision clinic is recommended by people, besides that it can also show the social status of the parents who use the circumcision clinic services and also if the parents who use the circumcision clinic services share their experiences with others, will be able to cause a sense of pride. Then also, the social value of a circumcision clinic can be seen from how often the clinic appears in various advertisements or social media. Millennial parents who have used the services of a circumcision clinic then feel the social value of the surrounding social environment, of course they will tend to return to the circumcision clinic and will recommend it to their family or friends. This is a consideration for circumcision clinics to pay attention to social values. Social value is used as a basis for market segmentation because members of different classes reflect different consumption patterns (Durmaz & Tasdemir, 2014).

Religious Value Influence on Millennial Parents for Circumcision Clinic Decision Choice

Based on the results, it is known that the religious value variable has a significance value of 0.038 <0.05, this means that religious values have a positive influence on the decision choice of millennial parents in choosing a circumcision clinic. The positive influence here means that if a circumcision clinic pays attention to the religious values of their circumcision clinic, the higher the desire of millennial parents to make the circumcision clinic their choice. Religious value of a circumcision clinic can be seen from the facilities and circumcision process they perform. These things include the use of equipment, consumables and medicines that have a halal label, have prayer room facilities and recite bismillah before starting the circumcision process. Things like these become the religious values of the circumcision clinic which can increase the desire of millennial parents to choose to use the clinic's services. The research respondents who live in the city of Banjarmasin, are the majority Muslim, who are known to be religious. With these characteristics, of course they will choose a circumcision clinic that does have religious values, and this shows that aspects of religious value can affect consumer tastes and dislikes. Some consumption behaviors related to religiosity are the prohibition of Muslims from consuming products that contain pork and alcohol. Religiosity is a dogma that must be practiced for every adherent (Niswah, 2018).

Similar with the research conducted by (Aisyah, 2015) she said that religious value is significantly correlated with the desire to choose halal products (Aisyah, 2015). (Briliana, 2016) in her research also shows similar results, namely consumers with a high level of religiosity and who are educated are very concerned about halal labels (Briliana, 2016). The religious practices influence the imminence sited on attitudes and factual life towards possessing and consuming goods and services. Religiosity, a central point of any religion, has a close association with consumer behavior. Thus, an exploration of religiosity allows in-depth investigation of consumer behavior. (Rakrachakarn et al., 2015) reported the noteworthy inference that religiosity influences numerous aspects of customers’ lifestyles that ultimately reshape the selection behavior (Rakrachakarn et al., 2015)

Epistemic Value Influence on Millennial Parents for Circumcision Clinic Decision Choice

Based on the results it is known that the variable epistemic value has significance value of 0.002 <0.05, this means that epistemic value has a positive influence on the decision choice of millennial parents in determining the circumcision clinic. The positive influence here means that if a circumcision clinic pays attention to the epistemic value of their circumcision clinic, the higher the desire of millennial parents to make the circumcision clinic their choice. The epistemic value of a circumcision clinic can be seen from how the clinic can provide explanations or information related to the circumcision process carried out, besides that the results of the circumcision carried out can satisfy its consumers like provide less bleeding during circumcision, provide rapid wound healing process after the circumcision procedure, provide minimal scar formation after the circumcision procedure, provide aesthetic form of penile shape after circumcision procedure. Respondents in this study on average have a bachelor's degree, of course. this will affect their mindset where they will have curiosity or curiosity regarding the services they will use. This aspect is an important factor in the service sector because it has a positive impact on consumer behavior (Choe & Kim, 2018). Epistemic value has a significant positive effect on consumer purchasing decisions (Khan & Mohsin, 2017).This aspect is a perceived utility derived from curiosity, providing novelty, or satisfying the desire for knowledge of a product (Khan & Mohsin, 2017) (Choe & Kim, 2018).

Research conducted by (Dassanayake, 2017)says that epistemic values contribute to selection in the decision-making process, when consumers use different types of products, they tend to gain new knowledge (epistemic value) which will lead to a better impression of the brand and consumers will consider which brand is the best (Dassanayake, 2017).

Economic Value Influence on Millennial Parents for Circumcision Clinic Decision Choice

Based on the results it is known that the economic value variable has a significance value of 0.821 > 0.05, this means that economic value has no influence on the decision choice of millennial parents in choosing a circumcision clinic. Economic Value or price is a comparison between the results that consumers want after obtaining a product with the economic value sacrificed to obtain a product or service.Economic value is the value that person places on an economic good based on the benefit that they derive from the good. It is often estimated based on the person’s willingness to pay for the good, typically measured in units of currency. Economic value is the worth that a person assigns to an economic good based on the benefit that the product provides. It is sometimes calculated based on the person's willingness to pay for the product, which is generally assessed in money units. The economic value of a circumcision clinic can be seen from how much it costs incurred by parents to pay for circumcision services at the circumcision clinic are the costs incurred commensurate with what they get (Lundgren & Wallentin, 2016)

The results of the insignificant economic value variable test show that the economic value of a circumcision clinic is not a consideration for millennial parents in choosing a circumcision clinic. This can be because the respondents are parents who have sufficient or more income levels, where this can be seen from the average education level of respondents who are undergraduates, which means they have the ability to get decent jobs with their level of education. By having a sufficient economic level, the respondents believed that the price they had to pay to the circumcision clinic was not a problem in order to obtain services from the circumcision clinic for their child. This is in line with research conducted by (Syaleh, 2017)who said in his research that economic value does not significantly influence purchasing decisions. The same thing was stated by (Mendur et al., 2021) that economic value has no influence on decision choice when purchasing product, because consumers who have the ability to pay do not look again at the price of a product they choose (Mendur et al., 2021; Syaleh, 2017).

Conclusion

Based on the results of the research conducted, the resulting conclusions are social value, religious value and epistemic value has a positive and significant influence on the decision choice of millennial parents in choosing a circumcision clinic.

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Copyright holder:

Noor Riza Perdana, Yohana Palupi Meilani (2024)

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Syntax Literate: Jurnal Ilmiah Indonesia

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