Sources of patient knowledge and financing of cataract surgery in rural China: the Sanrao Study of Cataract Outcomes and Up-Take of Services (SCOUTS), report 6.

AIM: To study patient sources of knowledge about cataract surgical services, and strategies for financing surgery in rural China. DESIGN: Cross-sectional case series. METHODS: Patients undergoing cataract surgery by local surgeons in a government, village-level facility in Sanrao, Guangdong between 8 August and 31 December 2005 were examined and had standardised interviews an average of 12 months after surgery. RESULTS: Of 313 eligible patients, 239 (76%) completed the questionnaire. Subjects had a mean (SD) age of 69.9 (10.2) years, 36.4% (87/239) were male, and 87.0% (208/239) had been blind (presenting visual acuity < or = 6/60) before surgery. Word-of-mouth advertising was particularly important: 198 (85.0%) of the subjects knew a person who had undergone cataract surgery, of whom 191 (96.5%) had had cataract surgery at Sanrao itself. Over 70% of subjects (166/239) watched TV daily, whereas 80.0% (188/239) "never" read the newspaper. Nearly two-thirds of suggestions from participants (n = 211, 59.6%) favoured either TV advertisements or word-of-mouth to publicise the programme. While the son or daughter had paid for surgery in over 70% of cases (164/233), the patient's having paid without help was the sole predictor of undergoing second-eye surgery (OR 2.27 (95% CI 1.01 to 5.0, p = 0.04)). DISCUSSION: Strategies to increase uptake of cataract surgery in rural China may benefit from enhancing word-of-mouth advertising (such as with pseudophakic motivators), using television advertising where affordable, and micro-credit or other programmes to enable patients to pay their own fees, thus increasing uptake of second-eye surgery.

The voice of the consumer speaks forcefully in brand identity: user-generated content forces smart marketers to listen

User-generated content (UGC) is attracting a great deal of interest - some of it effective, some misguided. This article reviews the marketing-related factors that gave rise to UGC, tracing the relevant development of market orientation, social interaction, word of mouth, brand relationships, consumer creativity, co-creation, and customization, largely through the pages of the Journal of Advertising Research over the last 40 (or so) of its 50 years. The authors then discuss the characteristic features of UGC and how they differ from (and are similar to) these concepts. The insights thus gained will help practitioners and researchers understand what UGC is (and is not) and how it should (and should not) be used.

A word of caution on calculating market-based minimum capital risk requirements

This paper demonstrates that the use of GARCH-type models for the calculation of minimum capital risk requirements (MCRRs) may lead to the production of inaccurate and therefore inefficient capital requirements. We show that this inaccuracy stems from the fact that GARCH models typically overstate the degree of persistence in return volatility. A simple modification to the model is found to improve the accuracy of MCRR estimates in both back- and out-of-sample tests. Given that internal risk management models are currently in widespread usage in some parts of the world (most notably the USA), and will soon be permitted for EC banks and investment firms, we believe that our paper should serve as a valuable caution to risk management practitioners who are using, or intend to use this popular class of models.

Potential sources of mouth drying in beverages fortified with dairy proteins: a comparison of casein and whey-rich ingredients

Oral nutritional supplement drinks (ONS) are beverages high in dairy proteins that are prescribed to individuals at risk of malnutrition. Consumption of ONS is poor in elderly care facilities, with patients commenting that the sensory attributes of these drinks reduce their enjoyment and willingness to consume. Mouth drying is an attribute of ONS found to build with repeated consumption, which may further limit liking of these products. This study investigated the sources of drying sensations by sequential profiling, with a trained sensory panel rating a range of model milk systems and ONS over repeated sips and during after-effects. Sequential profiling found that fortification of milk with both caseinate and whey protein concentrate significantly increased the perception of mouth drying over repeated consumption, increasing by between 35 and 85% over consumption of 40mL. Enrichment of ONS with either whey protein concentrate or milk protein concentrate to a total protein content of 8.7% (wt/wt) resulted in whey and casein levels of 4.3:4.4% and 1.7:7.0% respectively. The product higher in whey protein was substantially more mouth drying, implying that whey proteins may be the most important contributor to mouth drying in ONS. However, efforts to mask mouth drying of protein-fortified milk by increasing sweetness or fat level were unsuccessful at the levels tested. Increasing the viscosity of protein-fortified milk led to a small but significant reduction in mouth drying. However, this approach was not successful when tested within complete ONS. Further analysis is required into the mechanism of protein-derived mouth drying to mask negative sensations and improve the enjoyment and consumption of protein-rich ONS.

The efficacy of shopping value in predicting destination loyalty

Recognizing the importance of tourism's experiential aspects, this research examines how hedonic and utilitarian values relate to tourist's overall shopping experience satisfaction and destination loyalty. Study findings suggest both hedonic and utilitarian shopping values are strongly linked to overall shopping satisfaction. Overall shopping satisfaction fully mediates utilitarian shopping value's effect on destination repatronage intention (DRI), destination word-of-mouth (DWoM), and partially mediates hedonic shopping value's (HSV) effect on DRI and DWoM. Study results advance consumer behavior theory and offer managerial implications for retailers operating in a rapidly maturing tourism destination in Turkey's Mediterranean region.

The brand likeability scale: an exploratory study of likeability in firm-level brands

We develop a new measurement scale to assess consumers’ brand likeability in firm-level brands. We present brand likeability as a multidimensional construct. In the context of service experience purchases, we find that increased likeability in brands results in: (1) greater amount of positive association; (2) increased interaction interest; (3) more personified quality; and (4) increased brand contentment. The four-dimensional multiple-item scale demonstrates good psychometric properties, showing strong evidence of reliability as well as convergent, discriminant and nomological validity. Our findings reveal that brand likeability is positively associated with satisfaction and positive word of mouth. The scale extends existing branding research, providing brand managers with a metric so that likeability can be managed strategically. It addresses the need for firms to act more likeably in an interaction-dominated economy. Focusing on likeability acts as a differentiator and encourages likeable brand personality traits. We present theoretical implications and future research directions on the holistic brand likeability concept.

Symbolic consumption of tourism destination brands

Electronic word-of-mouth (eWOM) is recognised as a means of interpersonal communication and a powerful marketing tool. However, previous studies have focussed on related motivations, and limited attention has been given to understanding the antecedents of eWOM communication behaviour in the travel industry. This study proposes a full and partial mediation model, which brings together for the first time three key antecedents: adoption of electronic communication technology, consumer dis/satisfaction with travel consumption experience, and subjective norm. The model aims to understand the impact of these antecedents on travellers' attitude towards eWOM communication and intention to use eWOM communication media. The data were collected from international travellers (n = 524), and structural equation modelling is used to test the conceptual framework. The findings of the study suggest that overall attitude towards eWOM communication partially mediates the impact of the traveller's adoption of electronic communication technology and subjective norm, and fully mediates the impact of consumer dis/satisfaction with travel consumption experience on travellers' intention to use eWOM communication media.

Piloting the feasibility and effectiveness of print- and telephone-mediated interventions for promoting the adoption of physical activity in Australian adults

This study examined the feasibility and effectiveness for increasing physical activity of a print-based intervention, and a print- plus telephone-mediated intervention among mid-life and older Australian adults. A randomised controlled trial study design was used. In mid-2002, 66 adults (18 men, 48 women) aged 45–78 years, who identified themselves as underactive, were recruited through advertisements and word-of-mouth at two sites (Melbourne and Brisbane), and randomised to either the print or print-plus-telephone mediated intervention group. Participants in both groups attended an initial briefing session, and over the 12-week intervention period received an instructional newsletter and use of a pedometer (both groups), and individualised telephone calls (print-plus-telephone group only). Self-reported physical activity data were collected at baseline, 12 and 16 weeks. Measures of self-reported global physical activity, moderate-vigorous intensity activity and walking all showed increases between baseline and 12 weeks for both intervention groups. These increases were generally maintained by 16 weeks, although participants in the print-plus-telephone group maintained slightly higher levels of global reported activity and walking (by approximately 30 mins/wk) than those in the print group. These interventions show potential for promoting initial increases in physical activity among mid-life and older Australian adults, and should be evaluated across more extended time periods.

Antecedents of recommending infrequently purchased services: a conceptualisation and an empirical analysis

This project aimed to conceptualise and analyse empirically the antecedents of word-of-mouth in the context of an infrequently purchased service (tourism special events). The relationships examined included those between involvement, past experience, overall satisfaction, interest in attending next time, likelihood of attending next time, and the likelihood of recommending to others that they attend the event. There was some support for the overall model, in that the regressing of likelihood of recommending on the other variables produced an equation containing measures of most of the key variables, viz., revisit intention, satisfaction, revisit interest, and involvement. However, involvement appeared to operate in the opposite direction to that hypothesised.

The robustness of the behavioural-intentions battery in services scenarios

The consensus among researchers is that loyalty is a very complex construct (Javalgi & Moberg 1997). Various typologies have been developed to measure the loyalty construct (e.g., Curassi and Kennedy 2002; Hoare 2000; Knox 1998; Zeithaml, Parasuraman & Berry 1996). Zeithaml, Berry & Parasuraman (1996) developed a service loyalty framework comprising 13 items across five dimensions: “loyalty”, “switch”, “pay more”, “external responses”, and “internal responses”. This framework was criticised by Bloemer, de Ruyter & Wetzels (1999) for having conceptual and empirical limitations. Upon re-examination of the same 13 items, they concluded that the loyalty construct comprised only four factors: “word-of-mouth”, “purchase intentions”, “price sensitivity”, and “complaining behaviour”. Questions remain as to the precise dimensionality of the service loyalty construct as proposed by Zeithaml, Parasuraman & Berry (1996), and its stability or robustness generically, i.e., to what extent is there an invariant factor structure across the range of marketing contexts to which the battery may be applied? This paper reports on the testing of the goodness-of-fit of the five and fourfactor models to data collected in a study of consumer reaction to the service supplied by an Australian Internet Service Provider (ISP), through a series of hypothetical scenarios. In addition, comparisons were conducted with the results of exploratory factor analyses of the eight scenarios. The results suggested that factor structures are unstable across the data subsets, thereby limiting the generalisability and utility of the proposed models.

Student satisfaction : impact of age and gender on satisfaction among international postgraduate students from Asia

Customer satisfaction is a core-marketing concept. It is considered as a major outcome of marketing activity and serves to link processes, culminating in purchase and consumption with post-purchase phenomena such as attitudinal change, customer retention, repeat purchase, brand loyalty, positive word-of-mouth communication. Student satisfaction is a strategic factor in developing a competitive advantage in the highly attractive and globally competitive international education market. Market forecasts indicate a seven-fold increase in the number of students seeking higher education overseas by 2025 and given the competitiveness of the industry, universities will need to focus on variables influencing student satisfaction in order to address areas where improvements in service quality are required.

A sample of 371 postgraduate students from China, India, Indonesia and Thailand, is investigated. The study highlights the development of a scale to measure international postgraduate student satisfaction. The scale demonstrates the importance of four predominant factors influencing university choices - Education Resources; Communication and Guidance; Customer Value and Study Outcomes; and Image, Prestige and Recognition. Using logistic regression and chi square testing, this paper investigates the impact of age and gender on satisfaction among international postgraduate students from four Asian countries studying in universities in Victoria, Australia, on theses factors. The results indicate that age has a positive relationship with satisfaction among postgraduate students while the influence of gender has no effect on influencing satisfaction among postgraduate students from Asia.

Customer citizenship behaviours : towards the development of a typology

Eight types of customer citizenship behaviours were extracted from the existing marketing literature, and the more developed organisational citizenship behaviour literature. These included: positive word of mouth behaviour; suggestions for service improvements; participation in organisation events/activities; benevolent acts of service facilitation; policing of other customers; flexibility; voice and displays of relationship affiliation. Although citizenship behaviours such as positive word-ofmouth and voice have established empirical measures, the other types of customer citizenship behaviours do not. The objective of this study, therefore, was to source, adapt and derive measures for each of the eight identified citizenship behaviours. Using exploratory and confirmatory factor analysis, these measures were validated across three service contexts.

Utilizing and adapting leisure constraints models to enhance 'short-break' vacations : case study of Melbourne, Australia

Short-break tourism is likely to continue as a popular vacation for time-, income- and special interest conscious tourists. With the competition for visitors, destinations need to consider the constraints and facilitators associated with tourist decision-making for short-break vacations. This study presents the application of a leisure model toward better explaining such vacation choices. This study found key constraints, such as time and awareness, inhibited visitors from visiting attractions. The importance and influence of word-of-mouth recommendations plays a key role in gaining the attention of future visitors.