CONFIRMATORY STUDY ON BRAND EQUITY AND BRAND LOYALTY: A SPECIAL LOOK AT THE IMPACT OF ATTITUDINAL AND BEHAVIOURAL LOYALTY Hardeep Chahal and Madhu Bala The purpose of the study is to examine relationships between brand equity and brand loyalty (comprising attitudinal and behavioural) which is not well explained in the marketing literature. Should brand loyalty be considered as dimension ofbrand equity or an outcome of brand equity or as a moderatingfactor that acts as a mediator between attitudinal loyalty and behavioural loyalty need to be confirmed? The present research is pursued to confirm such relationships. A'total sample of300 respondents was selectedfrom Jammu city in India to gather data on brand loyalty and brand equity from the users ofJammu healthcare services. Scaleitem analysis, both EFA and CFA analysis were appliedforfinalisation ofscale and model testing respectively. The findings of the study support all three hypotheses i.e. brand equity is the resultant factor ofattitudinal loyalty and results in behavioural loyalty (Modell), brand loyalty viz. both attitudinal loyalty and behavioural loyalty can be considered as an indicator as well as an outcome ofbrand equity in healthcare sector (Model2 and ModeI3). Major limitation of the study is the use of convenient sampling since no comprehensive and proper list was available for the persons residing in Jammu city. But at the same time respondents selected were appropriate as they have adequate knowledge about hospitals, being associated with them for more than one year. Key Words: Brand Equity, Brand Loyalty, Attitudinal Loyalty and Behavioural Loyalty INTRODUCTION eveloping and building brand equity is gaining significant attention among the academicians and practitioners. Strong brand with positive equity provides benefits like customer loyalty, higher market share, higher margins, communication effectiveness etc (Keller, 2001; Keller and Lehmann, 2003) to the firms. Today worlds' top brands namely Microsoft, IBM, GE, INTEL, Nokia etc. are well recognised world over and their brand value is much higher than any other brand (Interbrand, 2007). Efforts to develop such strong brands and to identify different aspects of brand equity like how to create, enhance and evaluate it etc., to ensure competitive image and advantage in the market, have been increasingly made by both practitioners and academicians (Motameni and Shahrokhi, 1998 and Seetharaman, Nadzir and Gunalan, 2001). However research has focused primarily in relation to physical D goods (Berry, 2000). Services brand equity, on the other hand, has received relatively little attention in the academic literature, despite the fact that services currently account for more than physical goods contribution to any country's economy. There are several examples ofservice brands which have created their place in the Indian visa-vis global markets. Jet, Kingfisher and Sahara in case of airlines; Airtel and Reliance in case of communication services; Apollo Group (largest healthcare service provider in Asia and third largest in the world) in case of healthcare, (Shanthi, 2006) are some best examples. The service brand equity, as similar to physical goods, can offer significant advantage to both consumers as well as service providers. From consumer perspective, it is primarily important because it associates product with better services, good image etc and helps them in processing information about particular brand (Krishnan and Hartline, 2001). Even though a lot of research has 2 • Chahal and Bala BRAND EQUITY, BRAND LOYALTY AND HYPOTHESES FORMULATION market the brand (Pitta and Katsanis, 1995). The literature on brand equity focuses on fmancial and marketing aspects of brand equity (Atlingan, Aksoy and Akinci, 2005; Kim, Kim and An, 2003; Calderon, Cervera amd Molla, 1995 and Lassar, Mittal and Sharma, 1995). Financial aspect of brand equity is concerned with determination of financial value of brand for accounting, merger and acquisition purpose (Pitta and Katsanis, 1995). Consumer's aspect of brand equity is also known as marketing perspective of brand equity. Marketing aspect of brand equity focuses on cognitive aspect of consumer's towards brand. It has been conceptualised differently by different authors. Aaker (1991) defined brand equity in terms of set of assets associated with the brand and these assets include brand loyalty, brand awareness, brand association and perceived quality. These assets were further tested and verified by other authors viz Atilgan, Aksoy and Akinci (2005) and Pappu, Quester and Cooksey (2005). Whereas Keller (1993) viewed brand equity in terms of brand knowledge that is brand awareness and brand image consumers responses to the marketing activities of a particular brand. Lassar, Mittal and Sharma (1995) conceptualised the construct of brand equity with the help of five dimensions such as performance, social image, value, attachment and trustworthiness. Similarly Kim, Kim and An (2003) measured brand equity with the application of brand loyalty, brand awareness, perceived quality and brand image. Out of these assets or dimensions of brand equity brand loyalty is considered as the strongest path that leads to brand equity (Atilgan Aksoy and Akinci, 2005). In fact building brand in real sense means enhancing the brand equity as the success of a brand in the long run depends on its regular and loyal buyers (Amine, 1998). Brand loyalty is the attachment of a consumer towards a brand and thereby reflecting his stickiness towards a brand even if the brand makes change in price or product features (Aaker, 1991). In the literature brand loyalty has been divided into two categories: behavioural loyalty representing repeat purchasing of a brand over a period of time by consumer. However behavioural loyalty alone is not considered enough to explain the various buying situations as there are personal motives that provoke the consumer to buy the same brand and therefore behaviour must be Brand equity 'refers to stored value that is built up in a brand to gain market advantage and this stored value can be conceptualised in a number of ways like new product trial and brand premium (McDonald, 1990). In other words it is the power of the brand that is built in the minds of the consumer on the basis of what he has learnt. seen, felt and heard about brand (Keller, 1998). It has been frequently described as the added value of a brand name to a product. Brand equity results from qualitative strengths needed to refers to strong cognitive elements of the consumer to continue to re-buy the same brand (Mellens, Dekimpe and Steenkamp, 1996 and Aaker, 1991). Although studies have explored relationship between brand loyalty and brand equity (Atilgon Aksoy and Akinci, 2005; Chaudhuri, 1995 and Aaker, 1991), evidence show that brand loyalty concept has not been explored well i.e. should it be considered as dimension ofbrand equity or as an outcome ofbrand equity been contributed a great deal of insight into brand equity in goods market (Mackay, 2001), there is limited understanding of brand equity concept and its measurement in service markets (Krishnan and Hartline, 2001). Yet it is important to evaluate brand equity in service markets as branding plays an important role in service companies by increasing consumes' trust and enabling them to evaluate intangible features of services and reducing risk in buying service (Krishnan and Hartline, 2001). To move on brand equity trajectory and to make a brand competitively different, the main objective of the service firms should be to focus attention on activities that contribute to service quality brand development. Besides, service firms are found keen in developing loyalty programmes to maintain long term relationship with the customers (Raimondo, Miceli and Costabile, 2008). As a well established brand name helps in preserving brand loyalty (Lau, Chang, Moon and Liu, 2006) and a strong brand loyalty helps in enhancing brand equity (Aaker, 1991 and Atilgan Aksoy and Akinci, 2005). However its contextualisation is still yet to develop for the service brands. This necessitates researchers, academicians and the providers to understand and to know what sources build a brand and this consequently demands service provider's attention to identify various sources of brand equity and how these sources affect service brand equity. This paper is organised in six sections. In the first section, we present the theoretical background of brand equity and brand loyalty and put forth a conceptual model to demonstrate relationships between brand equity and brand loyalty in a service (healthcare) sector. Next, we describe our research design and methodology along with a discussion on scale item analysis and sample design. This is followed by data analysis section on considering attitudinal brand loyalty as an antecedent, or as a reflecting indicator or as an output variable. Lastly, discussion, implications, limitations and future research of the study are discussed. accompanied with positive attitude. Thus attitudinal loyalty VISION-The Journal of Business Perspective· Vol. 14· Nos. 1 & 2· January-June 2010 Confirmatory Study on Brand Equity and Brand Loyalty • 3 or as a mediating variable between attitudinal and behavioural loyalty? For example Aaker (1991) considered brand loyalty both as source of brand equity and as an outcome of brand equity. On the other hand Lassar, Mittal and Sharma (1995) have viewed behaviour as a consequence of brand equity instead of considering it in brand equity construct. Again in 1995, Chaudhuri described the direct effects ofbrand loyalty on brand equity outcomes and indirect effect of attitude and habit on brand equity outcomes via intervening variable of brand loyalty. Keller (1998) on the other hand regarded brand loyalty as the consequence ofbrand knowledge. However more recently, Pappu, Quester and Cooksey (2005) has conceptualised brand loyalty on the basis of consumer perception and attitude and not on the basis of behaviour. Based on the reviewed literature, we therefore propose three brand equity-brand loyalty relationship models viz Modell, Model2 and Model3 that need to be addressed in the literature. Modell proposes that brand equity is the result of attitudinal loyalty which in tum contributes to behavioural loyalty or in other words, brand equity acts as a mediating variable between attitudinal and behavioural loyalty (Figure 1). Model 2 indicates that brand equity is the result of both behavioural loyalty and attitudinal loyalty (Figure 2). Model3 reflects brand equity as the indicator of both behavioural loyalty and attitudinal loyalty (Figure 3). Per se, the following hypotheses based are put forth to provide clear insight into the brand equity and brand loyalty relation in healthcare service context: and Steenkamp (1996) and Sheth (1970). The items were modified to fit in the healthcare sector. Attitudinal loyalty (Amine, 1998; Mellens, Dekimpe and Steenkamp, 1996; Sheth, 1970, Lassar, Mittal and Sharma, 1995; Kim, Kim and An, 2003; Atilgan Aksoy and Akinci, 2005; Pappu, Quaster and Cooksey, 2005 and Delgado and Munuera, 2005) were modified and selected to measure attitudinal loyalty. The third measure i.e. brand equity is generally measured in the studies using two items viz, excellent performance of the unit as compared to other units (2) continuously improved performance (Krishnan and Heartline, 2001 and Delgado and Munuera, 2005). Both items were retained as such to assess brand equity of healthcare units. Construction of Questionnaire RESEARCH DESIGN AND METHODOLOGY The finalisation of the scale was done in three stages. Initially on the basis of scale item generation, and discussions with academicians and medical professionals, brand loyalty comprised 23 statements and brand equity comprised 2 statements. In the second stage, pre-testing of the questionnaire was conducted on 135 consumers, which resulted in the selection of 17 items ofbrand loyalty grouped under attitudinal loyalty dimensions (9) and behavioural loyalty dimensions (8). The brand equity was measured using only 2 items. Likert scale was used with "'5" as "strongly agree" and "1" as "strongly disagree" response from the respondents for loyalty and equity constructs. Besides these, the respondents were asked to name the hospital which is known to them and are ready to provide relevant information regarding that hospital (this was an open ended question), the years of their attachment (multiple choice) and whether they have taken any service from the hospital last time (yes or no), type of treatment taken and demographic profile. Lastly, on the basis scale- item analysis (Table 2), discussed in the following section, brand loyalty scale finally comprised of 8 items i.e. 4 under attitudinal loyalty and 4 under behavioural loyalty. The brand equity is measured using the same two items. Generation of Scale Items Scale Item Analysis The measures needed for the study consisted of brand equity and brand loyalty comprising attitudinal loyalty and behavioural loyalty. The face and content validity of the scale was confirmed with the help of reviewed literature and discussions with prominent personalities. Brand loyalty is measured under two heads attitudinal loyalty and behavioural loyalty in the literature. The items to measure behavioural loyalty were selected from the studies undertaken by Amine, 1998, Mellens, Dekimpe The scale items are further refined using scale item analysis. Items with either less than 0.7 MSA or correlation less than 0.3 or cross loading on two Hypothesis 1: Brand equity is directly influenced by the attitude of the consumer and results in behaviour ofthe consumer (Figure 1). Hypothesis 2: Both behaviour and attitude results in brand equity (Figure 2). Hypothesis 3: Brand equity results in behaviour and attitude (Figure 3). subsequent factors Of factor loading less than 0.50 or item to total correlation (less than 0.50) were excluded in various stages and scale analysis and accordingly alpha values were determined for different stages. The behavioural loyalty which earlier consisted of 8 items was reduced to 5 items (in 4 stages) and attitudinal loyalty VISION-The Journal of Business Perspective • Vol. 14 • Nos. 1& 2 • January-June 2010 4 • Chahal and Bala comprised 9 items was reduced to 6 items in 4 stages on the basis of selected criteria. The cronbach alpha value ranged from 0.704 to 0.760 for behavioural loyalty and for attitudinal loyalty it ranged from 0.847 to 0.841 in . the last stage. The final brand loyalty scale consists of 13 items was finally analysed (Table2) along with the two items of brand equity which resulted in identifying three separate factors headed as behavioural loyalty, attitudinal loyalty and brand equity, which explained about 66.95% and 63.40% of variance (Table3). under these construct were based on theory underlying them, the need was to confirm that these items well confirm the hypothesised structure of the scales before the structural model is tested. The procedure followed to examine the same was explained as under; a. At the outset exploratory factor analysis was conducted individually for the three constructs (perceived quality, brand loyalty and brand image). b. Items that were poorly related to their hypothesised factors or those were associated with more than one factor were deleted. c. Using the cronbach alpha (?) estimate (less than 0.7), item to total correlation (less than 0.5), factor loading (less than 0.50) and cross-loadings criteria, items insignificantly related were deleted in respective sub constructs (Table 2 and Table 3). d. These steps were repeated until clear factor emerged under each construct (Table 2). e. Lastly overall exploratory factor analysis was conducted to see that these factors do not merge with other factors (to check the unidimentionality of the scale). At this stage 3 items were found to be cross loaded to more than one factor and were eliminated. This last step resulted in the formation ofthree factors i.e. attitudinal loyalty (with 4 items), behavioural loyalty (with 4 items) and brand equity (with 2 items). Sample Design For measuring brand loyalty and brand equity components in healthcare sector of India and thereby formulating various strategic action plans for maintaining and improving better services to the patient's, primary data was collected from 300 respondents who fulfill three criteria i.e. (i) age above 20 years (ii) he/his family member have visited the hospital (s) and (iii) minimum four years experience. The sample was selected from Jammu city only. In the beginning, a list of wards from Jammu municipality was taken to select the respondents (the total number ofwards turned out to be 71). The region was geographically divided into four zones and each zone was represented in four blocks i.e. block I, block II, block III and block IV. The wards falling in different areas were grouped in their respective block. To have significant representation from each geographical region, one ward each from each block was selected (i.e. block I, block II, block III and block IV) randomly (Table 1). About 75 respondents each from four blocks were contacted conveniently for data collection purpose, and thereby making the sample size as 300. A brief outline of the demographic information of the respondents is shown in Table 1. Out of the total respondents 163 were male (54.3 %) and 137 were female (45.7 %). Further, 29 respondents (9.7 %) were older than 50 years, 143 respondents (47.7 %) were between 35-50 years, 128 respondents (42.7 %) fell in the category of between 20-35 years. The monthly income of the respondents fall in the category of: below 5000 (15.7%), 5000-10000 (35.7%), 10000-15000 (37.7%) and above 15000 (10.7%). The type of treatment taken by the respondents like ENT (13.7%), skin (10.3), surgery (23.7%) and other services (52%) (Table 1). DATA ANALYSIS Unidimensionality, Reliability and Validity The measurement properties (reliability and validity) were analysed for attitudinal loyalty, behavioural loyalty and brand equity measures. As the development of items High loadings (above the threshold value of 0.50.) of all the items indicate convergent validity while loading on only one factor indicates unidimentionality of the construct. Lastly, no factors consist of two sets of items loading highly on it to indicate discriminant validity (Hair et al., 2003). It simultaneously checked unidimensionality of the measures. After establishing unidimensionality, the reliability of the scale was assessed with the usage of cronbach alpha (for internal consistency). The overall reliability alpha (?) value for final behavioural loyalty scale came out to be 0.760 and for attitudinal loyalty it came out to be 0.841 and for the overall scale it was .814. All the values indicate good reliability values, being above the threshold limit of 0.70 (Hair et al., 2003). Further composite reliability is examined for all three models. The composite reliability values for all the three latent models came out to be 0.78, 0.77 and 0.47 respectively. After examining the individual fitness, composite reliability for the three models was calculated (Model 1=0.87, Model 2=0.88 and Model 3=0.89) indicate high internal consistency of the models. VISION-The Journal of Business Perspective· Vol. 14· Nos. 1 & 2· January-June 2010 Confirmatory Study on Brand Equity and Brand Loyalty • 5 Relationships between Brand Loyalty and Brand Equity The exploratory factor analysis performed on the reduced scale identified three factors christened as behavioural loyalty, attitudinal loyalty and brand equity. The three proposed relationships between attitudinal and behavioural loyalty (components of brand loyalty) and brand equity (Figures I, 2 and 3) were examined for Modell, Model2 and Model3 with the aid of Structural Equation Model using AMOS (Analysis of Moments Software). The initial application of confirmatory factor analysis relationship indicated somewhat poor fit of the models. The improvement in the model fit as such is attained through the addition of model parameters. Using modification indices criteria greater than three (Diamantopoulos and Sigsaw, 2000), the covariance between the measurement errors of functioning of the hospital and overall performance of the hospital; usually availed services and recommend the hospital to friends and family, usually availed services and generally visited hospital and lastly excellent performance and improved performance in the first model in the respective order helped in the attairunent of fit model (Baggozi, 1983). The same procedure was adopted for checking the fitness of Models 2 and 3. It was interesting to mention that the covariance measurement error variables which were corelated in model I were also found to be correlated in models 2 and 3 (except excellent performance and improved performance). A methodological reason for them to be covariated might be because of presence of causal relationships and secondly all measurement might share some common data collection bias. Thus all the effort resulted in the overall fitness of the model. The results of each model are explained as under: Modell: Brand Equity as the Resultant Factor of Attitudinal Loyalty and Results Behavioural Loyalty Although initial application of confirmatory factor analysis relationship indicated somewhat poor fit of the model but using modification indices criteria greater than three (Diamantopoulos and Sigsaw, 2000) fitness was found to be quite acceptable (Figure 3). As per the threshold values, the various model fit indices such as ?2 / df =2.967, CFI= 0.933 and RMSEA=0.081 indicate moderate fitness of the model. Further all the four indicators of attitudinal loyalty viz. selection of the hospital based on expertise skill of the staff, availability of state of art technology, functioning of the hospital and overall performance of the hospital are quite significant with standardised regression weights (SRW) ranging between 0.494 and 0.844. The predictive ability of availability of the state of art technology is highest followed by expertise skill of the staff and functioning of the hospital. The effect of attitudinal loyalty on brand equity is found to be quite good with SRW as 0.695. Further the consequent effect of brand equity on behavioural loyalty is found even more high (SRW=0.906). Among the four indicators of behavioural loyalty, recommending the hospital to friends, family and others is affected maximally in comparison to usually availed services and generally visited hospital on account of brand equity. The overall result support the hypot~esesl i.e. brand equity is directly influenced by the attItude of the consumer results in behaviour of the consumer. Model2: Behavioural Loyalty and Attitudinal Loyalty . as the Indicators of Brand Equity The effect of both attitudinal loyalty and behavioural lo.ya.lty on brand equity was tested on Model 2 (Figure 5). Sundar to modell, after using modification indices fitness criteria the model 2 is found to be quite acceptable. Akin to the results ofModel I all the indicators were significantly contributing to their respective constructs of attitudinal loyalty and behavioural loyalty. Availability of technical facilities and recommending the hospital to other variables has highest impact on the attitudinal and behavioural loyalty respectively. However the model portray that attitudinal loyalty has little influence on brand equity (SRW=0.133) in comparison to behavioural loyalty (SRW=0.502). This seems to be quite acceptable as behaviour is always followed by attitude. Further unlike ~odel I excellent performance (SRW=0.720) is impacting highly towards brand equity in comparison to continued improved performance (SRW=0.569). Overall the hypothesis relating to attitudinal loyalty and behavioural loyaltyas the indicator ofbrand equity also stands accepted. Model 3: Brand Equity as an Indicator of Behavioural Loyalty and Attitudinal Loyalty The third model considers both attitudinal loyalty and behavioural loyalty as the reflective indicators of brand equity. The measurement indicators ofattitudinal loyalty and behavioural loyalty are again found to be significant in the modified model, after correlating variables using modification indices. The results indicate that brand equity impacts behavioural loyalty (SRW=O.896) more in comparison to attitudinal loyalty (SRW=0.691). It is also interesting to find that same indicators i.e. availability of state of art and recommend the hospital to others as examined in model I and model 2 are highly contributing to their respective constructs. These results VISION-The Journal of Business Perspective· Vol. 14· Nos. 1 & 2· January-June 2010 6 • Chahal and Bala were accepted as brand equity reflects attitudinal loyalty and behavioural loyalty. Hence hypothesis 3 is also accepted. DISCUSSION Overall the comparative analysis ofthree models indicates significant relationship between brand equity and attitudinal loyalty and behavioural loyalty, whether as an antecedent or as a mediator or as a consequential indicator. Similar to the findings ofAaker (1991) the study results indicate that brand loyalty (i.e. attitudinal loyalty and behavioural loyalty) serves as an indicator as well as an outcome of the brand equity (Models 2 and 3). As such all the four indicators of attitudinal loyalty advocate that patient's select the hospital on the basis of significant criterion namely expertise skill of the staff, availability of state of art technology, functioning of the hospital and overall performance of the hospital. Subsequently, the so developed positive attitude of consumer brings him again to the same hospital to get services from it and thereby recommending it to others including friends and relatives. This positive word ,of mouth process is significant in establishing good image of the hospital in the later period. Modell reproduced behaviour as the consequence of brand equity and brand equity as the outcome of attitude of the consumers which confirmed the views of Pappu, Quaster and Cooksey (2005) and Lassar, Mittal and Sharma (1995). For instance the steady and longitudinal positive perception of patients towards .hospital services build as a result of qualitative services recognised in terms competence, prescription quality of doctors and nurses along with other facilities and atmosphere factors will always indicate their satisfaction towards hospital performance. This consequently will result in not only in visiting the same hospital for same or different treatments but also recommending it to known persons, which reflects the behavioural loyalty of the patient. In other words it is the confidence or feeling of the patient's that generates brand equity of the hospital. This confidence gets translated into loyalty and their willingness to visit the same hospital again and recommend to others. The model2 result indicates that attitudinal loyalty and behavioural loyalty impact each other and affects brand equity. This indicate that attitudinal loyalty with some unique associations like expertise skill of the staff availability of state of art, functioning and overall performance of the hospital creates and build positive perception and ultimately impact his behaviour and visa versa. Thus, both attitudinal as well as behavioural loyalty is significant for enhancing the equity of the hospital in the form of its performance. In Model3 where brand equity directly affect brand loyalty (both attitudinal loyalty and behavioural loyalty), exp lains the rationale behind this fact that consumers prefer to trust famous brand names (Lau, Chang, Moon and Liu, 2006) especially in healthcare. As such high service brand hospitals will always be associated by the consumers with high attitudinal loyalty and behavioural loyalty. In conclusion we can say that increasing brand loyalty means ensuring brand equity which further develops the behaviour of the consumer. Implications of the Study The study has number of implications. Firstly from theoretical and research perspective the study provides an understanding that brand loyalty can be considered as an indicator as well as a consequence of brand equity in healthcare sector. Secondly from consumer's perspective behavioural loyalty is important indicator in comparison to attitudinal loyalty in judging brand equity specifically as patients consider usually availed services from the same hospital, recommending it to others and generally visited hospitals as important for assessing behavioural loyalty. The attitudinal loyalty on the other hand, is found to be the function of indicators such as expertise skill of the staff, availability of state of art, functioning of the hospital and overall performance ofthe hospital. Due to more awareness and more refined services available to the consumers, they can be more choosier of the services and as such select those services which they consider perfect, especially in case of healthcare where the question of their quality of life arises. This means consumers would select hospital on the basis ofcertain significant characteristics such as trust, positive perception, preference, availability of doctors and quality (attitudinal loyalty) and generally visit such hospitals and also recommend the same to others (behavioural loyalty). The managerial implication of the study reflect that healthcare service providers can consider the aforesaid factors such as good expertise skill of the staff technical facilities available, image of the hospital in delivering qualitative customised services as these factors build trust and positive feeling towards the hospital. This all subsequently enhance attitudinal loyalty as well as behavioural loyalty. To sustain competition in the healthcare market it is very important for the hospitals, both public as well as private to increase patient satisfaction to build attitudinal and behavioural loyalty. VISION-The Journal of Business Perspective· Vol. 14· Nos. 1 & 2· January-June 2010 Confirmatory Study on Brand Equity and Brand Loyalty • 7 Limitations and Future research The study is not free from limitations. Firstly, data was collected conveniently i.e. only those persons were contacted who were willing to provide information relating to healthcare. Secondly, there is a need to explore the relationship between brand loyalty and brand equity specifically in terms attitudinal loyalty and behavioural loyalty as the results of the study were moderate as per the goodness of fit indexes and as such these findings are required to be tested in similar settings with large randomly selected respondents. The study can be further extended to know the dependency of the brand loyalty on brand equity or visa versa not only in healthcare sector but also in other service sectors. The other important antecedents and mediating variables of loyalty and brand equity relationship such as tangibility, training, funds etc. should be considered in future research to contextualise brand equity in healthcare and other sectors. REFERENCES Aaker, DavidA., (1991), Managing BrandEquity Capitalising on the Value ofa Brand Name, (First Edition), pp.15-55, The Free Press, Illinois. Amine, Abdelmajid (1998), "Consumers' True Brand Loyalty: The Central Role of Commitment," Journal ofStrategic Marketing, 6 (May) , pp.305 - 319. Atilgan, Eda, Safak Aksoy and Serkan Akinci, (2005), "Determinants of the Brand Equity: A Verification Approach in the Beverage Industry in Turkey," Marketing Intelligence and Planning, 23.3, pp.237 - 248. Bagozzi, R.P., (1983), "Issues in the Application of Covariance Structure Analysis: A Further Comment," Journal of Consumer Research, 9.4, pp.449 - 450. Berry, L.L., (2000), "Cultivating Service Brand Equity," Journal of the Academy of Marketing Science, 28.1, pp.128 - 137. Calderon, Haydee, Amporo Cervera and Alejandro Molla (1997), "Brand Assessment: A Key Element of Marketing Strategy," Journal of Product and Brand Management, 6.5, pp.293 - 304. Chaudhuri, Arjun (1995), "Brand Equity or Double Jeopardy," Journal ofProduct and Brand Management, 4.1, pp. 26 32. Delgado, Elena and Jose Luis Munuera (2005), "Does Brand Trust Matter to Brand Equity?" Journal ofProduct and Brand Management, 14.3, pp.187 - 196. Diamantopoulous, Adamantios and Judy, A., Sigsaw (2000), Introducing Lisrel-A Guide for the Uninitiated, Sage Publications, London, pp.l02 - 128. Hair, Joesph Jr., Rolph E., Anderson, Ronald L., Tatham and William C., Block (2003), Multivariate Data Analysis with Readings, Prentice Hall, New Jersey. Interbrand (2007), Best Global Brands 2007, http:// www.interbrand.com/best_brands_2007.asp Keller, Kevin Lane (1993), "Conceptualising, Measuring, and Managing Customer-Based Brand Equity," Journal of Marketing, 57. 1, pp.l - 22. Keller, Kevin Lane (1998), Strategic Brand Management Building, Measuring and Managing Brand Equity, (First Edition), Prentice Hall, Upper Saddle River, New Jersey, pp.42 - 53. Keller, K.L., (2001), "Building Customer-based Brand Equity; Creating Brand Resonance Requires Carefully Sequenced Brand-building Efforts," Marketing Management, 10.2, pp.15 - 19. Keller, K.L., and Lehmann, D.R., (2003), "How do Brands Create Value?" Marketing Management, 12.3, pp.26 - 31. Kim, Hong-Bumm, Woo Gon Kim and Jeong A., An (2003), "The Effect of Consumer-Based Brand Equity on Firms Financial Performance," Journal ofConsumer Marketing, 20.4, pp.335 - 351. Krishnan, Balaji C., and Michael D., Hartline (2001), "Brand Equity: Is it More Important in Services?" Journal of Services Marketing, 15.5, pp.328 - 442. Lassar, Wulfried, Banwari Mittal and Arun Sharma (1995), "Measuring Customer-Based Brand Equity," Journal of Consumer Marketing, 12.4, pp.ll - 19. Lau, Mei-mei, Man-tsun Chang, Ka-leung Moon, Wing-sun Liu (2006), "The Brand Loyalty ofSportswear in Hong Kong," Journal of Textile and Apparel, Technology and Management, 5.1, pp.l - 13. Mackay, Marisa Maio (2001), "Application of Brand Equity Measures in Service Markets," Journal of Services Marketing," 15.3, pp.210 - 221. McDonald, Susan Schwartz (1990), "Brand Equity: Working toward a Disciplined Methodology for Measurement," http://www.nationalanalysts.com/pdfs/brand-equity.pdf. Mellens, M., Dekimpe, M.G., and Steenkamp, J.B., E.M., (1996), "A Review of Brand-Loyalty Measures in Marketing," Tijdschrift voor Economie en Management, XLI.4, pp.507 - 533. VISION-The Journal of Business Perspective· Vol. 14· Nos. 1 & 2· January-June 2010 8 • Chahal and Bala Motameni, Reza and Manuchehr Shahrokhi (1998), "Brand Equity Valuation: A Global Perspective," Journal of Product and Brand Management, 7.4, pp.275 - 290. Moderates Loyalty Formation: The Increasing Effect of Relational Equity on Customer Loyalty," Journal of Service Research, 11.2, pp.142 - 160. . Pappu, Ravi, Pascale G.., Quester and Ray,W., Cooksey (2005), "Consume Based Brand Equity: Improving the Measurement - Empirical Evidence," Journal ofProduct and Brand Management, 14.3, pp.143 - 154. Setharaman, A., Zainal Azlan Bin Mohd Nadzir and S., Gunalan (2001), "A Conceptual Study on Brand Valuation,"Journal ofProduct and Brand Management, 10.4, pp.243 - 256. Pitta, Dennis A., and Lea Prevel, Katsanis (1995), "Understanding Brand Equity for Successful Brand Extension," Journal ofConsumer Markeing, 12.4, pp.51 - 64. Shanthi, N.M., (2006), Branding Services Indian Perspective (First Edition), The ICFAI University Press, pp.90 - 191. Sheth, Jagdish N., (1970), "Measurement of Multidimensional Brand Loyalty of a Consumer," Journal of Marketing Research, 7.3, pp.348 - 354. Raimondo, Maria Antonietta, Gaetano "Nino" Miceli and Michele, Costabile (2008), "How Relationship Age FIGURES AND TABLES Outcome ofbrand equity Source of brand equity Attitudinal Loyalty .... Brand Equity ... .... .... Behavioural Loyalty Model l:- Brand Equity as the Resultant Factor of Attitudinal Loyalty and Results in Behavioural Loyalty Figurel Behaviour and Attitude Brand Equity Model 2:- Behavioural Loyalty and Attitudinal Loyalty as the indicators of Brand Equity Figure 2 [ Brand Equity Behaviour and Attitude J Model 3:- Brand Equity as an Indicator of Behavioural Loyalty and Attitudinal Loyalty Figure 3 VISION-The Journal of Business Perspective· Vol. 14· Nos. 1 & 2· January-June 2010 Confirmatory Study on Brand Equity and Brand Loyalty • 9 0, 0, ~ 0, ° ~SART ~FUNC 04 ° ~-c!J 0, 0, 0 8 PERF ~G e7 ~-- error2 Modell Brand Equity as the Resultant Factor of Attitudinal Loyalty and Results in Behavioural Loyalty Figure 4 KeyWords EXP= Expertise skill ofthe staff SART=Availability ofstate ofart FUNC= Functioning ofthe staff PERF=Overallperformance of the hospital EXPER=Excellent performance in comparison competitors IMPER=Continuously improved performance SERVE= Usually availed services RECO=Recommend tofriends andfamily RECOO=Recommend to others VISIT=Generally visited hospital 0, &_1_~L--_-----' 0, &--~L--_-----' 0:_1_~L--_-----' error 0-~L.-----.-J 0, 8·_1_~,-- 8_1_~,--_-----, 0, ° __ 8·_1_~,--_-----, 0, Attitudinal Loyalty Brand Equity 0, Behavioural Loyalty 8-~~ Model 2 Behavioural Loyalty and Attitudinal Loyalty as the indicators of Brand Equity KeyWords EXP= Expertise skill ofthe staff SART=Availability ofstate ofart FUNC= Functioning ofthe staff PERF=Overall performance of the hospital Figure 5 SERVE= Usually availed services RECO=Recommend tofriends andfamily RECOO=Recommend to others VISIT=Generally visited hospital EXPER=Excellent performance in comparison competitors IMPER=Continuously improved performance VISION-The Journal of Business Perspective· Vol. 14· Nos. 1 & 2· January-June 2010 10 • Chahal and Bala 0, error3 0, o Attitudinal Loyalty 0, 0, Brand Equity o 1 0, error2 Model 3 Brand Equity as an Indicator of Behavioural Loyalty and Attitudinal Loyalty Figure 6 KeyWords EXP= Expertise skill ofthe staff SART=Availability ofstate ofart FUNC= Functioning ofthe staff PERF=Overall performance of the hospital SERVE= Usually availed services RECO=Recommend to friends andfamily RECOO=Recommend to others VISIT=Generally visited hospital EXPER=Excellent performance in comparison competitors IMPER=Continuously improved performance Table 1:- Demographic Profile of the Respondents Particulars Gender Male Female Age (in years) 20-35 35-50 Above 50 Monthly Income (in Rs) Below 5000 5000-10000 10000-15000 Above 15000 Health Insurance Taken Yes No Frequency Percent (%) 163 137 54.3 45.7 128 143 29 42.5 47.7 9.7 47 107 113 15.7 35.7 37.7 10.7 32 104 191 34.7 63.7 Particulars Education Illiterate Matriculatel+2 Graduate Post Graduate+ Frequency Percent (%) 6 57 140 97 2.0 19.0 46.7 32.3 135 54 94 15 45.0 18.0 31.3 5.0 41 13.7 31 71 299 10.3 23.7 52.0 Occupation Service Class Business Profession Dependent Type of Treatment Taken ENT Skin Surgery Any Other VISION-The Journal of Business Perspective • Vol. 14 • Nos. 1 & 2 • January-June 2010 Confirmatory Study on Brand Equity and Brand Loyalty • 11 Table2:- KMO Values, Number of Items Deleted, Total Number of Items after Deletion and Cumulative of Factor Analysis S.No KMO Values after Deletion of Items Corrected Item - Total Correlation % at Each Stage Cronbach Value if Item Deleted Cronbach alpaha Value (Overall Scale) Number of Items Deleted Total Number of Items after Deletion Cumulative 0/0 Behavioural Loyalty 1 0.671 - - 0.704 - 8 66.66 2 0.685 0.162 0.731 0.735 1 7 60.34 3 0.726 0.367 0.723 0.724 1 6 61.83 4 0.716 0.229 0.760 0.760 1 5 51.27 Attitudinal Loyalty 1 0.819 - - 0.847 - 9 58.57 2 0.816 0.450 0.845 0.845 1 8 61.93 3 0.796 0.445 0.843 0.843 1 7 67.14 4 0.818 0.476 0.837 0.841 1 6 56.25 Overall Scale Analysis 1 0.816 - - 0.849 - 13 66.95 2 0.796 1 12 60.25 0.753 * * 0.840 3 * * 0.814 2 10 63.40 Key Note: *Cross loading values Table 3:- Factor Wise Mean Score Values, Factor Loading Values and Percentage Variance Mean Score Values Std. Deviation Factor Loading Expertise skill of the staff 4.03 0.93 0.867 Availability of state of art 4.01 1.11 0.811 Functioning of the hospital 4.15 4.03 0.98 0.99 0.714 0.675 Usually availed services 3.97 0.92 0.800 Recommend to friend and family 4.11 0.92 0.736 Recommend to others 4.14 0.89 0.636 Generally visited hospital 4.12 0.88 0.591 Continuously improved performance 3.87 1.12 0.851 Excellent performance 3.97 1.07 0.736 Dimensions of Brand Loyalty and Brand Equity of Variance 0/0 Fl:- Attitudinal loyalty Overall performance 26.69 F2:-Behaviouralloyalty 21.21 F3:-Brand Equity Cumulative % of Variance Kaiser-Meyer-Olkin (KMO) Measure of Sampling Adequacy Rotation converged in 5 iterations. 15.50 63.401 0.753 VISION-The Journal of Business Perspective· Vol. 14· Nos. 1&2· January-June 2010 12 • Chahal and Bala Table 4:- Model wise SRW and CR Values Modell SRW CR Relationships 0.695 4.68 Brand Equity <-Attitudinal Loyalty 0.906 4.46 Behavioural Loyalty <--Brand Equity 0.494 PERF< ---Attitudinal Loyalty FUNC< ---0.628 8.30 Attitudinal Loyalty SART< ---0.844 7.82 Attitudinal Loyalty 0.727 7.62 EXP< ---Attitudinal Loyalty 0.452 VISIT< ---Behavioural Loyalty 0.890 6.81 RECOO< ---Behavioural Loyalty RECO< ---0.565 6.39 Behavioural Loyalty 0.386 6.26 SERV< ---Behavioural Loyalty EXPER < ---0.466 Brand Equity IMPER < ---0.368 5.51 Brand Equity Chi-square 86.052 df 29 CMIN/DF 2.967 RMSEA 0.081 CFI 0.933 Model 2 SRW CR Relationships 0.133 1.18 Brand Equity <-Attitudinal Loyalty Brand Equity <-0.502 3.91 Behavioural Loyalty 0.494 PERF< ---Attitudinal Loyalty 0.628 8.30 FUNC< ---Attitudinal Loyalty 0.844 7.82 SART< ---Attitudinal Loyalty 0.727 7.62 EXP< ---Attitudinal Loyalty 0.452 VISIT< ---Behavioural Loyalty RECOO< ---0.890 6.81 Behavioural Loyalty RECO< ---0.565 6.39 Behavioural Loyalty SERV< ---0.386 6.26 Behavioural Loyalty EXPER < ---0.720 Brand Equity IMPER < ---0.569 5.51 Brand Equity Chi-square 86.052 df 29 CMIN/DF 2.967 RMSEA 0.081 0.933 CFI Model 3 Relationships Attitudinal Loyalty <--Brand Equity Behavioural Loyalty <-- Brand Equity PERF< ---Attitudinal Loyalty FUNC< ---Attitudinal Loyalty SART< ---Attitudinal Loyalty EXP< ---Attitudinal Loyalty VISIT< ---Behavioural Loyalty RECOO< ---Behavioural Loyalty RECO< ---Behavioural Loyalty SERV< ---Behavioural Loyalty EXPER < ---Brand Equity IMPER < ---- Brand Equity Chi-square df CMIN/DF RMSEA CFI SRW 0.691 CR 5.11 0.896 4.41 0.492 - 0.628 8.30 0.847 7.82 0.727 7.61 0.446 - 0.901 6.67 0.550 6.29 0.382 6.26 0.466 - 0.370 5.51 75.416 28 2.693 0.075 0.944 Key Note: CR= Critical ratio and SRW= Standardised Regression Weight Hardeep Chahal ([email protected]) is an Associate Professor in the Department of Commerce, Jammu University. Her research interest focuses on Services Marketing with emphasis on consumer satisfaction and loyalty, Service Quality, Brand Equity and Market Orientation. She has published articles in International Journal of Business and Globalisation, International Journal of Indian Culture, Business and Management, Journal of Health Management, Total Quality Management and Excellence, Vikalpa, Metamorphosis, Decision, Journal of Social Work, Vision -The Journal of Business Perspective, Journal of Services Research and Journal of Rural Development. She has also co-edited books on Research Methodology in Commerce and Management and Strategic Service Marketing. She currently serves on the editorial board of the International Journal of Health Quality and Assurance (Emerald), Journal of Services Research (India), and the Journal of Social Sciences (University of Jammu). Madhu Bala ([email protected]) is Lecturer, Government Higher Secondary School, Sarthal, Kistwar, Jammu and Kashmir. Her area of research is Service Brand Equity in healthcare sector. She has participated and presented papers in various national seminars and conferences and workshops across the country. VISION-The Journal of Business Perspective· Vol. 14· Nos. 1 & 2· January-June 2010 Reproduced with permission of copyright owner. Further reproduction prohibited without permission.
