Public trust in Chinese elder-care social enterprises: common awareness and diverse perspectives from key stakeholders

The study examines how the public perceives and trusts Chinese elder-care social enterprises (SEs), a new hybrid organizational form lacking specific legal status and marked by ambiguity. SEs combine social missions with business activities; in China the sector has grown rapidly but remains weakly institutionalized, risking misunderstanding and uncertainty. Focusing on elder-care SEs—a prominent and prototypical SE category—the paper frames public trust via a stakeholder-specific perspective and poses the core research question: How do key stakeholders of Chinese elder-care SEs trust this hybrid organization? The purpose is to identify stakeholder-specific trust assessments across social and business dimensions, capture commonalities and differences among stakeholders, and thus articulate a public trust landscape for elder-care SEs in China.

The paper reviews the emergence and institutionalization of SEs in China, highlighting limited legal recognition, uneven regional development, and blurred boundaries with nonprofits, CSR, and for-profits. It situates elder-care SEs within the marketization of elder services since the 1980s and the documented failures of government, market, and nonprofit provision that fuel interest in hybrids. Drawing on institutional theory and hybrid organizing, SEs are portrayed as spanning logics, balancing social mission and commercial revenue, and facing tensions such as mission drift and accountability challenges. The trust literature is reviewed, distinguishing dimensions of trustworthiness (ability, benevolence, integrity) and extending to organizational trust attributes (transparency, value congruence). Public trust is conceptualized at a collective level, and stakeholder trust is introduced as a practical lens for assessing public trust in SEs, given stakeholders’ varied loci and intensities of relationships with organizations. The authors synthesize SE stakeholder management and hybridity literature to construct a heuristic framework that aligns five trustworthiness attributes with SEs’ social and business dimensions.

A qualitative, multi-method design was employed to capture perceptions, judgments, and awareness across key stakeholders. Data collection occurred mainly from March to December 2022, with additional data in May 2023 and January 2024. Methods included 17 semi-structured interviews (20 minutes to 2 hours each) and 3 participatory observations. Purposive sampling targeted five stakeholder groups defined by locus (internal/external) and interaction intensity: internal (founders, employees) and external (intermediary organizations, investors, customers). Internal stakeholders were drawn from certified elder-care SEs (A–F) of varying sizes and maturity. Intermediary organizations with regional influence (notably in Chengdu, Sichuan) and investors from domestic social financing communities (impact-oriented foundations and an SE incubator) were selected. Customers (older adults and family members) resided in regions with SE certification systems and had experience with elder-care providers. Interview guides were built from the heuristic framework integrating five trustworthiness attributes (ability, benevolence, integrity, transparency, value congruence) across business and social dimensions. Participatory observations included two SE webinars by an intermediary organization and stakeholder interactions therein. Transcripts (translated to English by the first author) were coded using thematic analysis with Atlas.ti, combining inductive theme generation with deductive categorization into common awarenesses (shared across multiple stakeholders) and diverse perspectives (stakeholder-specific differences).

• Common awarenesses:
  • Public unawareness and confusion: Across stakeholders—especially customers—there is weak awareness of the SE concept and difficulty distinguishing elder-care SEs from other providers. A prevailing binary view (public vs. private) obscures SE identity. Founders, investors, and intermediaries reported limited public understanding and a lack of legal status as barriers to signaling SE identity. Trust attributes implicated: transparency and value congruence.
  • Conceptual positivity but weak consensus: Stakeholders generally respond positively to the hybrid concept, particularly its prosocial aspects (benevolence, integrity). However, there is no clear consensus on SE definitions, standards, and implementation in China. Intermediaries and investors differ on eligibility, criteria, and policy interpretations; founders vary in how they enact hybridity in management routines. Trust attributes implicated: benevolence, integrity, value congruence.
• Diverse perspectives by stakeholder group:
  • Founders: All embrace hybrid identity but adhere to it heterogeneously. Larger, more market-mature SEs prioritize business competitiveness; smaller, community-embedded SEs emphasize social performance and accountability; some integrate dual goals explicitly (e.g., separate nonprofit and business arms). Trust attributes: integrity, benevolence, value congruence, with differing emphases on business vs. social ability.
  • Employees: Two patterns of leader–subordinate relations. In traditional hierarchies, employees have limited decision roles, higher turnover, and weak familiarity with SE norms. In partnership models, employees are value-driven, more competent, and engaged in co-decision-making, fostering broader organizational trust. Trust attributes: ability, benevolence, integrity, value congruence.
  • Intermediary organizations: Apply balanced criteria across social mission management (clear beneficiaries, stable goals, mission drift avoidance) and business capacity for sustainability; also weigh entrepreneurs’ prosocial mindset and competence. Trust attributes: ability, benevolence, integrity, transparency, value congruence.
  • Investors: Use rigorous and varied criteria; foundations focus on social impact (with differences in desired innovation and business potential), incubators prioritize social problem-solving while providing resources. Processes include in-depth founder interviews, expert juries, and post-investment impact evaluations centered on social value rather than financial returns. Trust attributes: ability, benevolence, integrity, transparency, value congruence.
  • Customers: Do not distinguish SEs from other providers; trust judgments are single-faceted and need-based—quality of care, medical capability, freedom and activities for healthier seniors, proximity, safety, respectful service, transparency to families, and moderate prices. Trust attributes: ability, benevolence, transparency, value congruence.
• Framework proposition: The authors propose a stakeholder trust matrix based on hybridity adherence (commitment to dual social-business dimensions) and rigor (stringency of assessment), yielding four quadrants (single vs. dual dimension; rigorous vs. lenient). Most stakeholders in this study exhibited dual-dimension adherence with lenience; others showed rigorous dual-dimension assessment; none fell into single-dimension lenience among sampled groups. The framework captures how different stakeholders calibrate trust in elder-care SEs’ hybridity.
• Notable data points: 17 semi-structured interviews; 3 participatory observations; five stakeholder groups examined; elder-care SEs constitute 9.2% of certified SEs nationally (background).

Findings address the research question by showing that public trust in Chinese elder-care SEs is best understood through stakeholder-specific lenses that reflect varied relationships, expectations, and assessments across SEs’ social and business dimensions. Weak public awareness and legal ambiguity undermine transparency and value congruence, complicating the public’s ability to recognize and evaluate SE trustworthiness. Yet, prosocial signals elicit positive orientations (benevolence and integrity) even when formal SE identity is indistinct. Diverse stakeholder rigor and adherence to hybridity explain heterogeneous trust judgments: intermediaries seek balanced, sustainability-focused standards; investors impose more rigorous, project-contingent evaluations emphasizing social impact (and sometimes innovation or business potential); customers prioritize service ability and safety over form; founders and employees reveal internal variation in how hybridity is enacted. The adherence–rigor framework integrates these patterns, highlighting where trust can be built (e.g., clearer mission management, transparent reporting, aligned values) and where tensions remain (e.g., uneven standards, mission drift risks, market vs. social trade-offs).

The paper contributes empirical evidence on public trust in an emerging, hybrid organizational form—Chinese elder-care SEs—by reframing public trust through stakeholder-specific trust. It identifies shared public unawareness and confusion alongside generally positive perceptions of hybridity’s prosocial aspects, yet a weak societal consensus on SE definitions and norms. It reveals stakeholder-specific differences in adherence to and rigor toward hybridity, and proposes an adherence–rigor framework to classify stakeholder trust characteristics. This framework offers practical guidance to SE practitioners, intermediaries, and investors on where to strengthen ability, benevolence, integrity, transparency, and value congruence across social and business dimensions. Future research should broaden stakeholder coverage (e.g., governments, collaborators, civil society, industry associations), expand samples across regions, and employ quantitative designs to test and generalize the framework and findings.

• Conceptual scope: Public trust is framed via stakeholder-specific trust across five key stakeholder groups; other relevant actors (e.g., local governments, collaborators, civil society organizations, industry associations) were not included. Variation within stakeholder categories suggests further within-group analyses are needed.
• Sampling and generalizability: Regional concentration (notably Chengdu, plus Beijing and Shanghai) and small sample sizes limit generalizability. The limited overall population of certain stakeholder types (intermediaries, investors) also constrained sampling. Future studies should apply the framework in other regions, expand samples, and complement with quantitative surveys or panel data.