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Empowering customers through participation is known to enhance brand promotion. A popular strategy involves asking customers to vote on marketing communication tactics, which activates empowerment effects through increased psychological ownership. Prior research has found that while winning voters experience empowerment effects, losing voters report lower psychological ownership, product evaluations, and demand. In this research, through four studies we develop and test a parsimonious common customer identity framework to understand and reduce the effects of losing. This research advances marketing communication theory by highlighting the distinctive processes underlying the empowerment versus losing effect and demonstrating the value of engaging losing voters by enhancing intergroup interdependence through the activation of cooperative mindsets. Specifically, the study identifies that framing a voting event as a collaborative (versus competitive) effort is effective in mitigating the losing effect, particularly among those with high self–brand connection. Therefore, this research offers managerial implications on managing empowerment strategies, which is potentially generalizable to other marketing communication channels involving customer participation. [ABSTRACT FROM AUTHOR]

Three studies examine the effectiveness of social norm messaging in a green consumption context. The overall goal is to identify theory-based ways to increase consumer choice of biodegradable take-out food packaging with an extra charge versus single-use plastic with no charge in the US and South Korea. Results indicate that descriptive norm messaging is superior to prescriptive norm messaging in both countries. Prescriptive norm messaging produced significantly higher reactance and more negative attitudes toward the packaging selection experience in the US, suggesting serious backfire effects in that country, but not in South Korea. Results advance theory regarding the use of social norm messaging to increase consumers' willingness to pay an additional charge for take-out food packaging that is biodegradable versus single-use plastic. Managerial and policy implications are discussed. [ABSTRACT FROM AUTHOR]

Prior research in international markets has yielded two seemly opposing views regarding customer engagement with local/domestic versus foreign-made brands: a preference for foreign brands based largely on country-of-origin effects or a preference for local/domestic brands based primarily on consumer ethnocentrism. In the present research, the authors contextualize the investigation across international markets and propose that, in two national markets with different cultural characteristics, a combination of local and foreign appeals leads to more favorable brand and product evaluations, compared with either local or foreign appeals alone, due to a heightened level of perceived brand globalness, a phenomenon called "the coalescence effect." The authors report results from seven studies conducted in China and the United States and discuss ways to design branding strategies that enhance customer engagement in an era of intensified global competition. [ABSTRACT FROM AUTHOR]

Informed and shared decision making are critical aspects of patient-centered care, which has contributed to an emphasis on decision support interventions to promote good medical decision making. However, researchers and healthcare providers have not reached a consensus on what defines a good decision, nor how to evaluate it. This position paper, informed by conference sessions featuring diverse stakeholders held at the 2015 Society of Behavioral Medicine and Society for Medical Decision Making annual meetings, describes key concepts that influence the decision making process itself and that may change what it means to make a good decision: interpersonal factors, structural constraints, affective influences, and values clarification methods. This paper also proposes specific research questions within each of these priority areas, with the goal of moving medical decision making research to a more comprehensive definition of a good medical decision, and enhancing the ability to measure and improve the decision making process., Author(s): Jada G. Hamilton [sup.1] , Sarah E. Lillie [sup.2] , Dana L. Alden [sup.3] , Laura Scherer [sup.4] , Megan Oser [sup.5] , Christine Rini [sup.6] [sup.7] , Miho [...]

In this research, four longitudinal studies investigate changes in post-purchase brand attitude. Following predictions based on adaptation theory, Studies 1a & 1b reveal that brand attitude declines over time after purchase. This research further identifies moderators that counteract post-purchase brand attitude decline. In the first two studies, long-term (versus short-term) temporal orientation is associated with relatively more positive post-purchase brand attitudes. In Studies 2 and 3, brand singularization exerts a similar effect. These studies also point to an important congruence effect such that brand attitude change is relatively more positive when consumers' long-term (short-term) time orientations are concordant with affiliative (autonomous) brand singularization. The positive congruency effect is mediated by self-brand connections. Overall, our study results advance theoretical and applied understanding of the understudied area of post-purchase brand attitude management., Author(s): Yi He[sup.1] , Qimei Chen[sup.2] , Dana L. Alden[sup.2] Author Affiliations: (1) College of Business and Economics, California State University, East Bay, 25800 Carlos Bee Boulevard, 94542, Hayward, CAUSA [...]

This study explores the 'boomerang effect' of self-referencing on message effectiveness. The results demonstrate that self-referencing message strategy activates biased message elaboration ('boomerang effect'), which jeopardizes the positive effect of self-referencing on message effectiveness by increasing biased elaboration. The results also suggest that representativeness of risk behavior can help mute the 'boomerang effect' and maintain positive self-referencing effect. In particular, when high-representative risk behavior is discussed in the healthcare message, biased elaboration is reduced and unbiased elaboration is facilitated, which in turn, lead to greater message effectiveness. Keywords: Self-Referencing, Elaboration, Representativeness, Self-Positivity Bias, 1. INTRODUCTION Self-referencing, as a healthcare message factor, is traditionally recommended as an effective method to increase health message effectiveness (e.g., Burnkrant and Unnava, 1989; Parrott, 1995). Recently, however, conflicting [...]

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1559-1816.2009.00514.x Byline: Dana L. Alden (*), Qimei Chen (*) Abstract: Despite extensive research on adults, we know relatively little about the factors and processes that influence adolescent satisfaction with clinical reproductive healthcare. In this study, survey responses from 135 adolescent clinic users in the western U.S. support a client-satisfaction model that differs from the traditional coping response framework by featuring negative emotions as a primary antecedent of service-quality evaluations, rather than a consequence. Quality evaluations directly impacted satisfaction, which, in turn, affected word of mouth and intentions to return to the clinic. This research represents an initial step toward better understanding of ways that adolescents may differ from adults on factors influencing satisfaction with clinical reproductive healthcare and, hence, holds both theoretical and managerial significance. Author Affiliation: (*)Shidler College of BusinessUniversity of Hawaii Article note: (1) Dana L. Alden, University of Hawaii, 2404 Maile Way, Honolulu, HI 96822. E-mail: dalden@hawaii.edu

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ijresmar.2006.01.010 Byline: Dana L. Alden (a), Jan-Benedict E.M. Steenkamp (b), Rajeev Batra (c) Keywords: Globalization; Global brands; Consumer attitudes; International marketing Abstract: This study examines relationships between a new measure of consumer attitudes toward consumption alternatives resulting from market globalization, several attitudinal antecedents (materialism, susceptibility to normative influence and consumer ethnocentrism), and a hypothesized consequence of these attitudes -- preference for global brands. Following validation of the new measure in three culturally distinct markets, South Korea, the US, and China, the hypothesized antecedents and consequence are tested in South Korea. Empirical findings broadly support hypotheses and provide important implications for future research on market globalization. Author Affiliation: (a) Marketing, College of Business Administration, University of Hawaii, 2404 Maile Way, Honolulu, HI 96822, USA (b) Kenan-Flager Business School, University of North Carolina, Chapel Hill, NC 27514, USA (c) Ross School of Business, University of Michigan, Ann Arbor, MI 48109, USA

Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction. Keywords.' Reproductive health; Satisfaction; Quality; Clinic management: Vietnam

The personal and social costs of unintended pregnancy and HIV infection point to the need for ongoing research designed to enhance the effectiveness of preventive advertising, particularly to those segments at greatest risk. One segment that appears to be at significant risk is comprised of individuals who experience high levels of guilt about sex. This study seeks to determine whether high sex-guilt (SG) individuals are unique in their processing, recall, and evaluative responses to advertising for condoms. Two hundred fifty-two college-aged men and women were randomly assigned to two versions of a condom advertisement that differed in terms of self-referencing vs. other-referencing in the message copy. A 2 x 2 x 3 (Gender x Self-Versus Other-Referencing Message Copy x High, Moderate, and Low Sex Guilt), between subjects ANOVA design was used to test hypothesized relationships. For female, but not male, participants, high SG was inversely related to depth of processing, recall, positive thoughts about the ad, and perceived credibility of the ad. For both genders, high SG was inversely related to perceived ad informativeness, attitude toward the ad, and attitude toward the brand. Message design interacted with SG and gender on an important outcome measure - purchase intention. Study implications are discussed, and avenues for future research are suggested.

Abstract Background Service franchising is a business model that involves building a network of outlets (franchisees) that are locally owned, but act in coordinated manner with the guidance of a central headquarters (franchisor). The franchisor maintains quality standards, provides managerial training, conducts centralized purchasing and promotes a common brand. Research indicates that franchising private reproductive health and family planning (RHFP) services in developing countries improves quality and utilization. However, there is very little evidence that franchising improves RHFP services delivered through community-based public health clinics. This study evaluates behavioral outcomes associated with a new approach - the Government Social Franchise (GSF) model - developed to improve RHFP service quality and capacity in Vietnam's commune health stations (CHSs). Methods The project involved networking and branding 36 commune health station (CHS) clinics in two central provinces of Da Nang and Khanh Hoa, Vietnam. A quasi-experimental design with 36 control CHSs assessed GSF model effects on client use as measured by: 1) clinic-reported client volume; 2) the proportion of self-reported RHFP service users at participating CHS clinics over the total sample of respondents; and 3) self-reported RHFP service use frequency. Monthly clinic records were analyzed. In addition, household surveys of 1,181 CHS users and potential users were conducted prior to launch and then 6 and 12 months after implementing the GSF network. Regression analyses controlled for baseline differences between intervention and control groups. Results CHS franchise membership was significantly associated with a 40% plus increase in clinic-reported client volumes for both reproductive and general health services. A 45% increase in clinic-reported family planning service clients related to GSF membership was marginally significant (p = 0.05). Self-reported frequency of RHFP service use increased by 20% from the baseline survey to the 12 month post-launch survey (p < 0.05). However, changes in self-reported usage rate were not significantly associated with franchise membership (p = 0.15). Conclusions This study provides preliminary evidence regarding the ability of the Government Social Franchise model to increase use of reproductive health and family planning service in smaller public sector clinics. Further investigations, including assessment of health outcomes associated with increased use of GSF services and cost-effectiveness of the model, are required to better delineate the effectiveness and limitations of franchising RHFP services in the public health system in Vietnam and other developing countries.

Background: Shared decision making (SDM) has long been advocated as the preferred way for physicians and men with prostate cancer to make treatment decisions. However, the implementation of formal SDM programs in routine care remains limited, and implementation outcomes for disadvantaged populations are especially poorly described. We describe the implementation outcomes between academic and county health care settings. Methods: We administered a decision aid (DA) for men with localized prostate cancer at an academic center and across a county health care system. Our implementation was guided by the Consolidated Framework for Implementation Research and the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. We assessed the effectiveness of the DA through a postappointment patient survey. Results: Sites differed by patient demographic/clinical characteristics. Reach (DA invitation rate) was similar and insensitive to implementation strategies at the academic center and county (66% v. 60%, P = 0.37). Fidelity (DA completion rate) was also similar at the academic center and county (77% v. 80%, P = 0.74). DA effectiveness was similar between sites, except for higher academic center ratings for net promoter for the doctor (77% v. 37%, P = 0.01) and the health care system (77% v. 35%, P = 0.006) and greater satisfaction with manner of care (medians 100 v. 87.5, P = 0.04). Implementation strategies (e.g., faxing of patients' records and meeting patients in the clinic to complete the DA) represented substantial practice changes at both sites. The completion rate increased following the onset of reminder calls at the academic center and the creation of a Spanish module at the county. Conclusions: Successful DA implementation efforts should focus on patient engagement and access. SDM may broadly benefit patients and health care systems regardless of patient demographic/clinical characteristics. [ABSTRACT FROM AUTHOR]

Background: The low completion rate of advance directives (ADs) has received attention in Japan and the United States, as policy makers and health care professionals face aging populations with multiple comorbidities. Among the barriers to AD planning, cultural values and attitudes appear to be particularly influential. A comparison of culturally distinct societies provides a deeper understanding of these barriers. Through such an approach, this study identifies strategies for increasing AD planning among late-middle-age Japanese and US individuals. Methods: After giving informed consent for the Institutional Review Board–approved study, Japanese and US respondents (45–65 y; 50% female) without ADs completed a language-appropriate online survey. Participants were asked to review a decision aid as part of a scenario-based physician consultation regarding artificial nutrition and hydration (ANH). Hypotheses were analyzed using multigroup structural equation modeling. Results: Important similarities were identified across the 2 groups. After reviewing the decision aid, both samples strongly preferred "no ANH." Respondents who strongly valued either self-reliance or interpersonal relationships experienced greater preparedness for AD planning. In both countries, greater decision preparedness and positive death attitude predicted greater confidence to discuss care options with a provider. Finally, cultural values predicted preference for family participation: respondents with a strong interdependent self-concept desired more family involvement, whereas high independents preferred less. Conclusions: Findings indicate the importance of documenting care preferences and accounting for individual differences. To increase AD adoption, providers should identify patient segments likely to benefit most from the interventions. Targeting individuals in both countries who value self-reliance and interpersonal relationships appears to be a good place to begin. Such individuals can be identified clinically through administration of validated measures used in this study. [ABSTRACT FROM AUTHOR]

The well-known gap between organ-donor supply and demand in the United States is particularly acute for Asian Americans. Lower participation in organ donation programs by Asian Americans has been hypothesized as one explanation for this observation. This study finds that, relative to European Americans, Asian Americans hold more negative attitudes toward and participate loss frequently in a large, urban organ-donor program. The study also hypothesizes and tests possible reasons for subcultural differences in attitudes toward donation. Two cultural belief constructs hypothesized to more strongly predict Asian American attitudes and behaviors appear to impact both groups equally. Reasons for these results along with public policy implications and future research directions are discussed.

Background. Research suggests that desired family involvement (FI) in medical decision making may depend on cultural values. Unfortunately, the field lacks cross-cultural studies that test this assumption. As a result, providers may be guided by incomplete information or cultural biases rather than patient preferences. Methods. Researchers developed 6 culturally relevant disease scenarios varying from low to high medical seriousness. Quota samples of approximately 290 middle-aged urban residents in Australia, China, Malaysia, India, South Korea, Thailand, and the USA completed an online survey that examined desired levels of FI and identified individual difference predictors in each country. All reliability coefficients were acceptable. Regression models met standard assumptions. Results. The strongest finding across all 7 countries was that those who desired higher self-involvement (SI) in medical decision making also wanted lower FI. On the other hand, respondents who valued relational-interdependence tended to want their families involved – a key finding in 5 of 7 countries. In addition, in 4 of 7 countries, respondents who valued social hierarchy desired higher FI. Other antecedents were less consistent. Conclusion. These results suggest that it is important for health providers to avoid East–West cultural stereotypes. There are meaningful numbers of patients in all 7 countries who want to be individually involved and those individuals tend to prefer lower FI. On the other hand, more interdependent patients are likely to want families involved in many of the countries studied. Thus, individual differences within culture appear to be important in predicting whether a patient desires FI. For this reason, avoiding culture-based assumptions about desired FI during medical decision making is central to providing more effective patient centered care. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper to use Self-Determination Theory (SDT) to explain the online brand community (OBC) identity internalization process through brand website interactivity. Secondary purpose of the research is to explore the role of several individual difference factors and brand-specific constructs in predicting brand website interactivity. Design/methodology/approach – This study proposes the OBC motivation development continuum of brand website interactivity. Thus, a national panel was collected by a reputable online survey firm and a structural equation model was used to test the proposed model. Findings – The authors examined four brand-related antecedents and mediators (brand engagement in self-concept, susceptibility of normative influence, opinion leadership, and consumer innovativeness) and found evidence of the differing roles that brand engagement in self-concept and purposive motives play as mediators to brand website interactivity. Practical implications – Marketing managers can use the proposed model as a useful tool for understanding ways to target and motivate segment specific consumers in ways that will increase the effectiveness of managers’ OBC building strategies. Originality/value – This study utilized SDT to explain the internalization process of brand website interactivity. Further, several individual difference factors were explored as antecedents and mediators of brand website interactivity. [ABSTRACT FROM AUTHOR]

Background: As the health care field moves toward patient-centered care (PCC), increasing emphasis has been placed on the benefits of patient decision aids for promoting shared decision making (SDM). This study provides a baseline measure of knowledge, attitudes, and practices (KAP) among Hawai'i's physicians with respect to patient decision aids (DAs). Physicians throughout the State of Hawai'i were invited to complete a survey assessing their knowledge, attitudes, and practices with respect to the clinical use of DAs. One hundred and seventy four valid surveys were analyzed. Reported awareness and use of DAs were low, but recognition of the benefits of SDM and openness to the use of DAs were very high. The leading perceived barriers to the implementation of DAs were lack of awareness, lack of resources, and limited physician time to learn about DA technology. However, a significant majority of the respondents reported that DAs could empower patients by improving knowledge (88%), increasing satisfaction with the consultation process (81%), and increasing compliance (74%). Among physicians currently employing DAs, use of brochures or options matrix sheets was the most common aid tool. However, leading recommended DA formats were paper-based brochures for clinic use (75%) and interactive online website programs for outside clinic use (73.5%). Given growing emphasis on the PCC model and the recognized desire of many patients to participate in the medical decision making process, positive responses toward SDM and the use of DAs by Hawai'i physicians are promising. [ABSTRACT FROM AUTHOR]

ABSTRACT Two studies examine the role of the cultural value orientation, self-construal, as a moderator of the relationship between social presence and service satisfaction. Cross-cultural data are collected in China and the USA to maximize variation on self-construal. Results suggest that social presence effects vary depending on the consumer's independent self-construal. Regardless of whether the service encounter is positive or negative, social presence increases the strength of satisfaction or dissatisfaction for low independents but not for high independents. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A field study with follow up investigations sought to: 1) determine whether cold packs (over-the-counter symptomtic treatments), coupled with in-office education, improve antibiotic-related knowledge, attitudes and behaviors more than in-office education alone in patient populations with high percentages of Asian Americans and Hawaiian/Pacific Islanders; 2) identify possible reasons for intervention outcomes as described by physicians who participated in the field study; and 3) explore potential future directions based on a large sample survey of physicians in the field study's highly ethnic county. The intervention resulted in a pre- to post-consultation decrease in perceived need for and an increase in knowledge about antibiotic risks but had no impact on frequency of reported receipt of an antibiotic prescription. Unexpectedly, in-office education alone was more effective in increasing knowledge than in-office education plus the cold pack. In-depth interviews of field study physicians and a large scale physician survey suggest that cold pack interventions targeting patient populations with high percentages of Asian Americans and Hawaiian/Pacific Islanders may be more likely to succeed if accompanied by mass public education regarding risks and physician training regarding effective ways to talk to patients. Use of in-office education with cold packs alone may not achieve desired results. [ABSTRACT FROM AUTHOR]

Background: Service franchising is a business model that involves building a network of outlets (franchisees) that are locally owned, but act in coordinated manner with the guidance of a central headquarters (franchisor). The franchisor maintains quality standards, provides managerial training, conducts centralized purchasing and promotes a common brand. Research indicates that franchising private reproductive health and family planning (RHFP) services in developing countries improves quality and utilization. However, there is very little evidence that franchising improves RHFP services delivered through community-based public health clinics. This study evaluates behavioral outcomes associated with a new approach - the Government Social Franchise (GSF) model - developed to improve RHFP service quality and capacity in Vietnam's commune health stations (CHSs). Methods: The project involved networking and branding 36 commune health station (CHS) clinics in two central provinces of Da Nang and Khanh Hoa, Vietnam. A quasi-experimental design with 36 control CHSs assessed GSF model effects on client use as measured by: 1) clinic-reported client volume; 2) the proportion of self-reported RHFP service users at participating CHS clinics over the total sample of respondents; and 3) selfreported RHFP service use frequency. Monthly clinic records were analyzed. In addition, household surveys of 1,181 CHS users and potential users were conducted prior to launch and then 6 and 12 months after implementing the GSF network. Regression analyses controlled for baseline differences between intervention and control groups. Results: CHS franchise membership was significantly associated with a 40% plus increase in clinic-reported client volumes for both reproductive and general health services. A 45% increase in clinic-reported family planning service clients related to GSF membership was marginally significant (p = 0.05). Self-reported frequency of RHFP service use increased by 20% from the baseline survey to the 12 month post-launch survey (p < 0.05). However, changes in self-reported usage rate were not significantly associated with franchise membership (p = 0.15). Conclusions: This study provides preliminary evidence regarding the ability of the Government Social Franchise model to increase use of reproductive health and family planning service in smaller public sector clinics. Further investigations, including assessment of health outcomes associated with increased use of GSF services and costeffectiveness of the model, are required to better delineate the effectiveness and limitations of franchising RHFP services in the public health system in Vietnam and other developing countries. [ABSTRACT FROM AUTHOR]

Social franchising, an effective social marketing business model, has increased the quality of health care services in developing and developed countries. Typically, private sector physicians and pharmacies are recruited by local or international nonprofit organizations into branded networks of clinics that benefit from economies of scale, a standardized business model, higher quality services, and sophisticated social marketing. While generally effective in the private sector, social franchising of public government operated clinics is very limited. As a result, the social franchise model is relatively untested as a means of enhancing the capacity and quality of public health care services for individuals with limited financial resources. Addressing the need for additional study, this case analysis traces development and launch of a social franchise network of reproductive health services through community public health clinics in two provinces in central Vietnam. Improvement of the clinic infrastructure, increased standardization of quality services, staff instruction on proactive relationship management, and promotion of a culturally relevant brand all appear to have contributed to the successful launch of the network in this case study. The decision to implement a standardized schedule of affordable service fees in one of the two provinces also appears to have improved perceived service quality. Implementation of planned staff incentives has proven to be the most challenging aspect of what is referred to as the government social franchise (GSF) model. Overall, initial evaluation suggests that significant improvement in reproductive health care service quality can be achieved through adaptation of the social franchise model to public sector context. [ABSTRACT FROM AUTHOR]

The relative impact of narrative versus factual message strategies on product evaluation was explored. The role of ad message involvement (AMI) as a mediator was also investigated. Narrative versus factual print ad copy resulted in more favorable product evaluations for two fictitious brands, one each from the cell phone and sunglasses product categories. Narrative print ad copy also elicited higher ad message involvement which, in turn, mediate the differential effect of narrative versus factual copy on product evaluations. The study demonstrated one of the major pathways through which the relatively more persuasive effects of narrative versus factual print ad copy appears to operate. © 2007 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]