Email this article Purchase Intention of Made-in-China Medical Devices among Malaysians: Does COO Effect Work?
Abstract
Made-in-China products are getting popular around the world. Overcoming the ‘low quality’ perception or unfavorable country of origin (COO) effect is imperative not only for China marketers but also for any related business in other markets. Despite their huge popularity, understanding of market responses and perceptions towards China products remain unclear, especially in the technology-advanced healthcare sector. Based on the Theory of Reasoned Action (TRA) and COO effect, this study examined how subjective norms, self-image congruence and stereotype affected Malaysian consumers’ attitude and purchase intention of Made-in-China medical devices. 200 questionnaires in total were distributed among buyers in Malaysian public and private hospitals. A total of 178 valid responses were collected adopting purposive sampling technique. Findings indicated a significant impact of consumer attitude on purchase intention and attitude was found to be driven by subjective norms and stereotypes (warmth and competence), but not self-image congruency. The study also showed significant mediating effects of consumer attitude on the relationship between subjective norms and stereotype (competence) on purchase intention. The findings provide valuable insights to assist marketers in tapping into the Made-in-China medical device market as well as helping healthcare agencies plan and implement effective policy and marketing communication strategies.
References
Acmite Market Intelligence (2019). World Medical Devices Market (2019). Available on https://www.acmite.com/market-reports/medicals/world-medical-devices-market.html
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211. https://doi.org/10.1016/0749-5978(91)90020-T
Ajzen, I. and Fishbein, M. (1980). Understanding Attitudes and Predicting Social Behavior, Prentice Hall.
Baker, E.W., Al-Gahtani, S.S. and Hubona, G.S. (2007). The effects of gender and age on new technology implementation in a developing country: testing the theory of planned behavior (TPB). Information Technology and People, 20 (4), 352–375. https://doi.org/10.1108/0959384071083979
Balabanis, G. and Diamantopoulos, A. (2008). Brand origin identification by consumers: a classification perspective. Journal of International Marketing, 16(1), 39–71. https://doi.org/10.1509/jimk.16.1.39
Batra, R., Ramaswamy, V., Alden, D., Steenkamp, J. and Ramachander, S. (2000). Effects of brand local and nonlocal origin on consumer attitudes in developing countries. Journal of Consumer Psychology, 9(2), 83–95. https://doi.org/10.1207/S15327663JCP0902_3
Bilkey, W. J. and Nes, E. (1982). Country-of-origin effects on product evaluations. Journal of International Business Studies, 13(1), 89–99. https://doi.org/10.1057/palgrave.jibs.8490539
Bloemer, J., Brijs, K. and Kasper, H. (2009). The COO‐ELM model: A theoretical framework for the cognitive processes underlying country of origin‐effects. European Journal of Marketing, 43(1/2), 62-89. https://doi.org/10.1108/03090560910923247
Brodowsky, G., Stewart, K. and Anderson, B. (2018). Brand and country influences on purchase intentions: a theory-of-reasoned action approach. Journal of Promotion Management, 24(2), 251-269. https://doi.org/10.1080/10496491.2017.1360822
Brouthers, L. E. and Xu, K. (2002). Product stereotypes, strategy and performance satisfaction: The case of Chinese exporters. Journal of International Business Studies, 33(4), 657-677. https://doi.org/10.1057/palgrave.jibs.8491038
Brouthers, L. E., Story, J. W., Hadjimarcou, J. and Brouthers, K. (2005). Can developing country firms overcome negative country of origin stereotypes. In Annual Meeting of the Academy of International Business, Quebec City.
Chailan, C. and Ille, F. (2015). Branding from emerging countries: how to compete internationally? Critical Perspectives on International Business,11(1), 54–71. https://doi.org/10.1108/cpoib-11-2012-0055
Chattalas, M. and Takada, H. (2013). Warm versus competent countries: national stereotyping effects on expectations of hedonic versus utilitarian product properties. Place Branding and Public Diplomacy, 9(2), 88-97. https://doi.org/10.1057/pb.2013.5
Chinen, K., Sun, Y. and Ito, Y. (2014). The effects of country of origin on consumer willingness to purchase general motor automobiles in the United States. International Journal of Marketing Studies, 6(6), 1. http://dx.doi.org/10.5539/ijms.v6n6p1
Costa C, Carneiro J. and Goldszmidt R. (2016). A contingent approach to country-of-origin effects on foreign products evaluation: Interaction of facets of country image with product classes. International Business Review, 25(5), 1066-75. https://doi.org/10.1016/j.ibusrev.2016.01.003
Cuddy, A. J., Fiske, S. T. and Glick, P. (2008). Warmth and competence as universal dimensions of social perception: The stereotype content model and the BIAS map. Advances in Experimental Social Psychology, 40, 61-149. https://doi.org/10.1016/S0065- 2601(07)00002-0
Dobrenova, F. and Terlutter, R. (2015). The effect of familiarity on consumer ratings of the scientific support of health claims on food. Journal of Food Products Marketing, 21(6), 569- 587. https://doi.org/10.1080/10454446.2014.949967
Department of Statistic Malaysia (2016). Department of Statistics Malaysia Press Release Population Projection (Revised), Malaysia, 2010-2040. Department of Statistics Malaysia.
Euromonitor International (February, 2018). Top countries to drive medical device manufacturing.
Export.gov. (2018). Healthcare Resource Guide: Malaysia, 1-5.
Farhat, R. and Khan, B. M. (2012). Effect of brand image & self-image congruency on brand
preference & customer satisfaction. International Journals of Marketing and Technology,
(3), 92-102.
Fiske, S. T., Cuddy, A. J., Glick, P., & Xu, J. (2018). A model of (often mixed) stereotype content:Competence and warmth respectively follow from perceived status and competition (2002).In Social Cognition (pp. 171-222). Routledge
Fishbein, M., Ajzen, I. (1975). Belief, Attitude, Intention and Behavior: An Introduction toTheory and Research. Contemporary Sociology, 6, 244.
Fornell, C. and Larcker, D. F. (1981). Structural equation models with unobservable variables and measurement error: Algebra and statistics. Journal of Marketing Research, 18(3), 382-388. https://doi.org/10.1177/002224378101800313
Fuchs, C. and Diamantopoulos, A. (2010). Evaluating the effectiveness of brand-positioning strategies from a consumer perspective. European Journal of Marketing, 44(11/12), 1763– 1786. https://doi.org/10.1108/03090561011079873
García-Gallego, Manuel, J. and Mera, C. A. (2017). COO vs ROO: importance of the origin in customer preferences towards financial entities. International Marketing Review, 34(2), 206–223. https://doi.org/10.1108/IMR-03-2015-0069
Greenwald, A. G. and Banaji, M. R. (1995). Implicit social cognition: attitudes, self-esteem, and stereotypes. Psychological Review, 102(1), 4-27. https://doi.org/10.1037/0033-295x.102.1.4
Hair Jr, J. F., Sarstedt, M., Hopkins, L., Kuppelwieser, V. G. (2014). Partial least squares structural equation modeling (PLS-SEM). European Business Review, 26(2), 106-121.
https://doi.org/10.1108/EBR-10-2013-0128
Halkias, G., Davvetas, V. and Diamantopoulos, A. (2016). The interplay between country stereotypes and perceived brand globalness/localness as drivers of brand preference. Journal of Business Research, 69(9), 3621-3628. https://doi.org/10.1016/j.jbusres.2016.03.022
Hamzaoui-Essoussi, L., Merunka, D. and Bartikowski, B. (2011). Brand origin and country of manufacture influences on brand equity and the moderating role of brand typicality. Journal of Business Research, 64(9), 973-978. https://doi.org/10.1016/j.jbusres.2010.11.020
Herz, M. F. and Diamantopoulos, A. (2013). Country-specific associations made by consumers: A dual-coding theory perspective. Journal of International Marketing, 21(3), 95-121. https://doi.org/10.1509/jim.13.0004
Itoa, E., & Cheerb, J. M. Everyday Cycling Mobilities and Tourist Behaviour: The Emergence of Cycle Tourism as COVID-Secure Activity.
Jaffe, E. D. and Nebenzahl, I. D. (2006). National Image & Competitive Advantage: The Theory and Practice of Place Branding (2nd ed.). Frederiksberg: Copenhagen Business School Press.
Johnstone, M. L. and Hooper, S. (2016). Social influence and green consumption behaviour: A need for greater government involvement. Journal of Marketing Management, 32(9-10), 827-855. https://doi.org/10.1080/0267257X.2016.1189955
Kastanakis, M. N. and Balabanis, G. (2014). Explaining variation in conspicuous luxury consumption: An individual differences' perspective. Journal of Business Research. 67(10), 2147-2154. https://doi.org/10.1016/j.jbusres.2014.04.024
Khalid, N. R., Wel, C. A. C., Mokhtaruddin, S. A. and Alam, S. S. (2018). The influence of self- congruity on purchase intention for cosmetic merchandises. International Journal of Academic Research in Business and Social Sciences, 8(4), 933-945. http://dx.doi.org/10.6007/IJARBSS/v8-i4/4122
Khan, H., & Bamber, D. (2008). Country of origin effects, brand image, and social status in an emerging market. Human Factors and Ergonomics in Manufacturing & Service Industries, 18(5), 580-588. https://doi.org/10.1002/hfm.20126
Lee, J. and Nguyen, M. J. (2017). Product attributes and preference for foreign brands among Vietnamese consumers. Journal of Retailing and Consumer Services, 35, 76-83. https://doi.org/10.1016/j.jretconser.2016.12.001
Lim, K. and O’Cass, A. (2001). Consumer brand classifications: an assessment of culture-of- origin versus country-of-origin. Journal of Product & Brand Management, 10(2),120-136. https://doi.org/10.1108/10610420110388672
Liu, F., Li, J., Mizerski, D. and Soh, H. (2012). Self-congruity, brand attitude, and brand loyalty: A study on luxury brands. European Journal of Marketing. 467/8), 922–937. https://doi.org/10.1108/03090561211230098
Mady, T. (2018). What makes up intentions to purchase the pioneer? A theory of reasoned action approach in India and the USA. International Journal of Emerging Market,13(5), 734–757. https://doi.org/10.1108/IJoEM-01-2017-0007
Mafauzy (2000). Editorial the Problems and Challenges of the Aging Population. Malaysian Journal of Medical Sciences, 7, 7–9.
Magnusson, P., Westjohn, S. A. and Zdravkovic, S. (2011). “What? I thought Samsung was Japanese”: Accurate or not, perceived country of origin matters. International Marketing Review, 28(5), 454–472. https://doi.org/10.1108/02651331111167589
Maheswaran, D. (1994). Country of origin as a stereotype: Effects of consumer expertise and attribute strength on product evaluations. Journal of Consumer Research, 21(2), 354-365. https://doi.org/10.1086/209403
Maheswaran, D. and Chen, C. Y. (2009). Nation equity: Country-of-origin effects and globalization. Handbook of International Marketing, 91-113.
Malhotra, N. K. and McCort, J. D. (2001). A cross-cultural comparison of behavioral intention models: Theoretical consideration and an empirical investigation. International Marketing Review, 18(3), 235-269. https://doi.org/10.1108/02651330110396505
Mohan, M., Jiménez, F. R., Brown, B. P. and Cantrell, C. (2017). Brand skill: linking brand functionality with consumer- based brand equity. Journal of Product & Brand Management, 26(5), 477–491. https://doi.org/10.1108/JPBM-06-2016-1247
Moon, B.J., & Oh, H.M. (2017). Country of origin effects in international marketing channels. International Marketing Review, 34(2): 224–238. https://doi.org/10.1108/IMR-03-2015- 0073
Reardon, J., Vianelli, D., and Miller, C. (2017). The effect of COO on retail buyers’ propensity to trial new products. International Marketing Review, 34(2), 311-329. https://doi.org/10.1108/IMR-03-2015-0080
Rodrigo, P., Khan, H. and Ekinci, Y. (2019). The determinants of foreign product preference amongst elite consumers in an emerging market. Journal of Retailing and Consumer Services, 46, 139-148. https://doi.org/10.1016/j.jretconser.2018.04.012
Pandey, S., Srivastava, D. S. (2016). Antecedents of customer purchase intention. IOSR Journal of Business and Management, 18, 55–82.
Phang, I. G., Goh, Y. S. (2019). Offline brand outcomes of Instagram: Do cognitive network and self-congruity matter? Asian Journal of Business and Accounting, 12(2), 287-314. https://doi.org/10.22452/ajba.vol12no2.10
Podsakoff, N. P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of Applied Psychology, 885(879), 10-1037. https://doi.org/10.1037/0021-9010.88.5.879
Putrevu, S. and Lord, K. R. (1994). Comparative and noncomparative advertising: Attitudinal effects under cognitive and affective involvement conditions. Journal of Advertising, 23(2), 77-91. https://doi.org/10.1080/00913367.1994.10673443
Sarwar, A., Azam, S. F., Haque, A., Sleman, G. and Nikhashemi, S. R. (2013). Customer's perception towards buying Chinese products: An empirical investigation in Malaysia. World Applied Sciences Journal, 22(2), 152-160. https://doi.org/10.5829/idosi.wasj.2013.22.02.371
Sirgy, M. J. (1986). Self-congruity: Toward A Theory of Personality and Cybernetics, Praeger Publishers/Greenwood Publishing Group.
Sirgy, M. J., Grewal, D., Mangleburg, T. F., Park, J. O., Chon, K. S., Claiborne, C. B., Berkman, H. (1997). Assessing the predictive validity of two methods of measuring self-image congruence. Journal of the Academy of Marketing Science, 25(3), 229. https://doi.org/10.1177/0092070397253004
Steenkamp, J. B. E., Batra, R. and Alden, D. L. (2003). How perceived brand globalness creates brand value. Journal of International Business Studies. 34(1), 53-65. https://doi.org/10.1057/palgrave.jibs.8400002
Summer, T. A., Belleau, B. D. and Xu, Y. (2006). Predicting purchase intention of a controversial luxury apparel product. Journal of Fashion Marketing and Management, 10, 405–419. https://doi.org/10.1108/13612020610701947
Tehseen, S., Ramayah, T., Sajilan, S. (2017). Testing and controlling for common method variance: A review of available methods. Journal of Management Sciences, 4(2), 142-168. https://doi.org/10.20547/jms.2014.1704202
Ting, M. S., Goh, Y. N. and Isa, S. M. (2016). Determining consumer purchase intentions toward counterfeit luxury goods in Malaysia. Asia Pacific Management Review. 21(4), 219-230. https://doi.org/10.1016/j.apmrv.2016.07.003
United Nations (2017). World Population Ageing 2017. Department of Economic and Social Affairs, Population Division. (ST/ESA/SER.A/408).
WHO (2011). Global health and aging. Available https://www.who.int/ageing/publications/global_ health.pdf
Wilcox, D. (2015). Country-of-origin bias: A literature review and prescription for the global world. In Marketing, Technology and Customer Commitment in the New Economy (pp. 86- 96). Springer, Cham.
Wong, E. L. (August 17th, 2017). Malaysia’s medical inflation at double-digit pace. Available on https://www.theedgemarkets.com/article/malaysias-medical-inflation-doubledigit-pace
Xiao, G. and Kim, J. O. (2009). The investigation of Chinese consumer values, consumption values, life satisfaction, and consumption behaviors. Psychology Marketing, 26(7), 610- 624. https://doi.org/10.1002/mar.20291
Yang, S., Jiménez, F. R., Hadjimarcou, J. and Frankwick, G. L. (2019). Functional and Social Value of Chinese Brands. Journal of Global Marketing, 32(3), 200-215. https://doi.org/10.1080/08911762.2018.1545955
Zeng, X. (2016). Study on the Third Industrial Revolution and Paradigm Transformation of China’s Manufacturing Industry- Based on Theoretical Analysis of Scale Economy and Scope Economy. American Journal of Industrial and Business Management, 6(2), 73-82.
Zhang, X., Prybutok, V. R. and Strutton, D. (2007). Modeling influences on impulse purchasing behaviors during online marketing transactions. Journal of Marketing Theory and Practice, 15(1), 79-89. https://doi.org/10.2753/MTP1069-6679150106
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