Health marketing communications: An integrated conceptual framework of key determinants of health behaviour across the stages of change

Despite the development of many health behaviour theories across various topics, the inconsistency in empirical support for their propositions and the on-going criticism about their limitations highlight the need for an adjusted and integrated approach. These theories have never been ‘abandoned’ or altered significantly to address their limitations, since their conceptualisations. The aim of this paper was to make a conceptual contribution by integrating distinct health behaviour theories (i.e. Health Belief Model, Extended Parallel Process Model, Transtheoretical Model), with a popular information-processing and attitude change theory from the marketing communications arena (namely, the Elaboration Likelihood Model). The specific objectives of this paper were: (1) to address limitations of prevailing health behaviour theories, by identifying key determinants of health behaviour across the most commonly used health behaviour theories; (2) to identify source, consumer, channel, and message characteristics, in addition to executional/situational factors and attitudinal variables, which may influence health behaviour; and lastly, (3) to explain under which conditions (i.e. stage of change) these determinants and factors are likely to impact health behaviour change and maintenance. In doing so, four assumptions and several propositions are developed. Future research directions and practical implications for creating health marketing communication messages are also discussed.     

Buying behaviour of rural and urban consumers in India: the impact of packaging

This study aims to establish whether the residential background of consumers has a varying influence on their buying decisions. A survey of 1090 urban and rural respondents was carried out of which 523 were rural and 567 were urban. The gathered data were analysed by applying counts, percentages, means, and analysis of variance. Rural residents found that packaging is more helpful in buying, that better packaging contains a better product and that they are more influenced by the ease of storing a package than their urban counterparts. Ease of carriage, package weight, simplicity, transparency and similarity of packaging have comparatively less impact on purchase decisions of rural consumers than urban ones. However, rural consumers are more critical about packaging as they strongly consider that it contributes to misleading buyers and is also an environmental hazard.     

Information search behaviour and its determinants: the case of ethical attributes of organic food

Daily decisions on food purchase are known to be undertaken using limited information search. However, when confronted with ‘ethical’ products, consumers often become more involved, and this results in a more extensive search for information. This research focuses on the information search behaviour of European consumers with regard to ethical attributes like animal welfare or environmental aspects of organic food by means of an Information Display Matrix. Row‐wise information search by product characteristics (attributes) was widely preferred over information search by product alternatives (column‐wise). Therefore, information (e.g. in the Internet) should increasingly be provided by attributes. The majority of consumers use simplifying and selective search strategies when looking for information on organic food with additional ethical attributes. Consumers tend to start information search in the top, left hand corner and move towards the bottom, right hand corner. Thus, principal attributes should be placed in the upper left corner and be followed by the next most important and so on when presenting information on an array of different products. Our results show that information search patterns of consumers depend on socio‐demographic characteristics like gender and age and, to a lesser extent, also on attitudes regarding environmental or social aspects of food production. Thus, marketers, particularly those using the Internet, should revise their systems of information provision and focus increasingly on consumers' needs.     

Effects of institutions on ecological attitudes and behaviour of consumers in a developing Asian country: the case of the Philippines

This study examines the effects of institutions emanating from the social environment on ecologically sustainable consumer behaviour in a developing country context. Drawing on the behavioural perspective model of consumer choice and institutional theory, this study argues that the regulative, normative and cognitive dimensions of the institutional environment play critical roles in shaping the pro‐environmental attitudes called eco‐attitudes of consumers. In turn, eco‐attitudes positively influence the eco‐behaviour of consumers. The structural equation modelling of data from a survey of 1045 consumers from the Philippines shows the significant and positive effects of the regulatory, normative and cognitive dimensions of the institutional environment on the eco‐attitudes of consumers, which in turn have strong positive influence on eco‐behaviour. The findings about the partial mediating role of eco‐attitudes offer a more nuanced explanation on how institutions explain the eco‐behaviour of consumers which is a topic that is less understood especially in a developing country context. The study highlights the theoretical, methodological, policy and future research implications of the findings.     

Impact of empathy with nature on pro-environmental behaviour

Existing studies show the role of empathy with nature in improving attitudes toward the environment. This article demonstrates that induced empathy with nature can improve environmental behaviours and commitments. We find that environmental commitment and behaviour are positively affected by empathy with nature and establish a causal model between empathy with nature and pro-environmental behaviour. We further investigate the relationship between self-construal (interdependent or independent), empathy with nature (existing or non-existing) and pro-environmental behaviour. The results indicate that participants who have empathy with nature display stronger pro-environmental behaviour, particularly in the private domain. Commitment to the environment plays a mediating role in this relationship and self-construal plays a moderating role. Specifically, for individuals with interdependent self-construal, empathy with nature promotes pro-environmental behaviour, whereas for individuals with independent self-construal, empathy with nature has no statistically significant effect on pro-environmental behaviour.     

Understanding the effect of stigmatization on food consumer knowledge,perception and behaviour in Northern Ireland

Stigmatization has only recently been linked with the perception of risk, and research into this area has mainly concentrated on measuring the differences between nationalities, gender and socio‐economic status. The concept of stigmatization helps us understand why the public views certain places, products, technology and environments as dangerous and in a negative manner. To date, little has been done to assess the relationships between the effects of stigmatization on situations and people's decision‐making capabilities with regard to food. The aim of this research is to examine food consumers’ knowledge of food‐related risk issues to provide insight into the process of stigmatization and its relationship to food risk management, thereby improving awareness of the information consumers require from food risk communication. To meet this aim, two phases of data collection were implemented. Phase 1 used a baseline survey to investigate consumer knowledge of food‐risk‐related issues, identify how much attention consumers pay to information and what they remember about the particular issues. Factors affecting participant's recollection included how recently the event associated with the issue occurred, the level of media coverage and the reported severity of risk outcome. Phase 2 involved a follow‐up survey to investigate consumer knowledge of food risk issues and determine any changes in consumer behaviour. Research results and conclusions of Phases 1 and 2 of the study will be presented to highlight the relationships between participant recollection of particular food issues and whether knowledge of such issues caused any change in behaviour.     

Consuming apart,together: the role of multiple identities in sustainable behaviour

Although consumers’ awareness of the environmental and ethical consequences of their behaviour has grown, research on the role of multiple consumer identities in sustainability behaviours is scarce. The aim of the current study was to explain sustainable behaviour from a social identity perspective. We conducted a longitudinal cross‐national within‐subjects design consumer study in six countries (T1, N=3083; T2, N=1440). The results indicate that environmental sustainability can comprise several distinct yet overlapping sustainable behaviours. Multiple social identities seem to play different roles in these different behaviours. Therefore, efforts to enhance different sustainability behaviours are challenging yet promising. Once consumers incorporate a sustainable behaviour, it becomes part of their own identity and could lead to spill over effects on other closely related sustainable behaviours.     

Traffic safety behaviour among young people in different residential settings: the use of seat belts,bicycle helmets,and reflectors by young people in Sweden

This study examines if, and how, the size of the community in which people live may contribute to explaining differences in traffic safety behaviour (self-reported behaviour regarding the use of seat belts, bicycle helmets and reflectors) among young people in Sweden. The study is based on a Swedish nationwide traffic safety survey with a net sample of 2854 respondents aged 16–25. Ordered logit regressions were performed, and place of residence is shown to have an impact on traffic safety behaviour. The results are presented and discussed in relation to risk exposure and traffic safety facilities in different settings. The implications of the study are considered, and the importance of investigating the way in which young people see traffic safety behaviour is emphasised.     

Consumer values,the theory of planned behaviour and online grocery shopping

Taking a hierarchical value‐attitude‐behaviour approach, this study empirically tests relations of consumer personal values, attitude, social norm, perceived behavioural control (PBC) and willingness to buy groceries online. The study distinguishes three groups of consumers: consumers who have not yet bought anything on the Internet; consumers who have bought something on the Internet – but not groceries; and consumers who have bought something on the Internet – including groceries. Data were collected from an online survey of Swedish consumers (n = 1058) using self‐administered questionnaires. The findings suggest that consumers may link personal values to attitude towards online grocery buying – but also that this relation may be moderated by whether the consumer previously has carried out an online purchase or an online grocery purchase.     

Food shopping behaviour in Scotland: the influence of relative rurality

Despite a number of studies investigating consumer food purchase behaviour, few studies actually address the nature of the rural consumer. This may have implications for the generalization of much research on food purchase behaviour, as official estimates of the UK rural population vary between 8.5% and 24%. This paper compares and contrasts the food shopping behaviour of customers in rural and urban areas in Scotland. Particular focus is given on respondent characteristics, attitudes towards rural and urban locations, distance travelled for food shopping purposes and store patronage. Results from the research emphasize the notion that rural and urban retailing should be conceptualized as a continuum rather than being regarded as dichotomous, and a conceptual framework is proposed.     

Gender differences in Egyptian consumers’ green purchase behaviour: the effects of environmental knowledge,concern and attitude

This study investigates the influence of three cognitive and attitudinal factors on gender differences in green purchase behaviour. Using a large sample size (n = 1093), a survey has been developed and administered across Egypt. The findings from the multivariate analysis of variance (MANOVA) confirm the influence of consumers’ ecological knowledge, concern and attitude on gender differences in green purchase behaviour. Consistent with previous studies, this study found that women appeared to be less aware of environmental issues compared with men. However, contrary to other studies conducted in the West, men showed more environmental concern and more positive outlook towards green purchase compared with women. The study discusses how the present findings may help policy makers and marketers alike to fine‐tune their environmental and marketing programmes.     

Assess the impact of subjective norms of consumers' behaviour in the Greek olive oil market

The objective of the research was to highlight the role that socio-economic and spatial attributes of consumers – households exert on their choices regarding not only the supply modes but also the price they are willing to pay for different categories of olive oil. Regarding WTP for different olive oil labels, consumers are willing to pay premiums only for olive oils being processed by either private companies or cooperatives, with the latter to gain 34% of them in case they would decide to change the olive oil they usually purchase. The most important consumer profile is the young educated consumer one.     

The impact of personal,market- and product-relevant factors on patronage behaviour in the automobile tyre replacement market

Using a qualitative and quantitative approaches, we investigate the choice behaviour of car owners regarding tyre replacement. In the first part of this study, focus groups are used to draw important insights about sources of tyre replacement and achieve an in-depth understanding of motivations and determinants of consumers’ auto workshop choice. Based on the outcome of the focus groups, we develop and test a conceptual model for car tyre replacement patronage. The behaviour observed with regards to tyre replacement indicates that consumers prefer a one-stop solution for their tyre replacement needs in terms of purchase and affixing of the tyre. Additionally, the mechanic plays a key role in providing information and influencing tyre brand choice of the consumer. Overall, the perceived importance of factors such as price, age, proximity (to tyre shop) and professionalism of service (i.e. service quality) had a direct effect on consumers’ willingness to travel to a tyre shop; while dealer reputation, personal contact (i.e. interpersonal service quality), quick service and gender were found to have mediated effects via dealer trust or brand involvement.     

Analysis on the determinants of currency invoicing in Korean trade

We investigate the determinants of currency invoicing in trade using import and export transactions data between Korea and its 30 major trading partners from 2000 to 2013. We find a noticeably different pattern of currency invoicing from advanced countries. For example, a large market share of Korean exporters in partner countries does not guarantee more use of the Korean won in currency invoicing. This might be attributed to a low degree of Korean won's internationalisation and the strong coalescing effect. We also observe that the higher the level of industry product differentiation, the weaker the coalescing motive. In addition, we verify that the share of invoicing in the currency of Korea's trading partner tends to be higher when the partner country has (i) a larger trade volume, (ii) higher level of financial development, (iii) lower inflation and lower price volatility and (iv) its own currency with lower transaction costs.     

The dietary and health behaviour of young people aged 18–25 years living independently or in the family home in Liverpool,UK

An individual's dietary habits are largely developed during childhood and adolescence, and are likely to be determined by both nature (the development of sensory perceptions) and nurture (parental influence, and later on the influence of peers). However, diet is likely to evolve throughout the life cycle as circumstances change and new influences are introduced to an individual's lifestyle. An example of this is the changes in diet that occur as a result of the transition young people make away from the family home into independent living. Leaving behind the meals provided and cooked by parents/guardians and learning how to shop on a budget and prepare and cook for themselves may result in the adoption of poor eating habits, which is likely to have a detrimental effect on health. Leaving behind the restrictions of parental control may also result in the adoption of unhealthy lifestyle practices such as smoking and excessive alcohol consumption. This study therefore seeks to investigate the effect of leaving home on a young person's diet and lifestyle. Health behaviour and food intake was assessed by questionnaire. Findings suggest that a young person's diet may change after leaving home, but these changes are not necessarily negative. More negative health behaviour was observed in young people living independently.     

A structural equation model of impulse buying behaviour in grocery retailing

PurposeEnvironmental changes, specifically the economic crisis and the growing penetration of digital technologies, have produced significant changes in shopping habits designed to create new paradigms for impulse buying behaviour. A new scenario seems to be opening up where customers enter the store much more prepared than in the past searching for products they had planned to buy. The purpose of this paper is to explore the determinants of impulse buying in a context of more planning and preparation for shopping.Design /methodology/approachThe data were obtained using a structured questionnaire from 316 respondents interviewed instore thanks to the cooperation of a leading Italian retail chain. We conducted a two-stage approach mall-intercept survey method to collect data. Firstly, we interviewed customers before entering the store, enquiring them about the pre-shopping preparation and shopping enjoyment tendency. Secondly, we interviewed the same customers at the end of their shopping trips, asking them to indicate which purchases were unplanned. Then, shoppers answered to questions regarding their general tendency to engage in impulse buying, the urges experienced to make impulse purchases, the level of positive and negative affect experienced during the shopping trip.FindingsIn the structural model tested with LISREL 8, we found that pre-shopping tendency influences directly impulse buying: confirming our hypotheses, a higher pre-shopping preparation lead to lower levels of impulse buying. Results also showed that the personality variables (shopping enjoyment tendency and impulse buying tendency) influenced impulse buying through positive affect and urge to purchase. Our research did not find support for the relationship between negative affect and urge. Finally, higher levels of urge to buy impulsively lead to higher levels of impulse buyingOriginality/valueFrom the review of past and recent literature, we have not found a model that considers the influence of pre-shopping tendency on impulse buying behaviour. This paper addresses this major gap in extant literature by including pre-shopping tendency among the individual characteristics (impulse buying tendency and shopping enjoyment tendency) taken into consideration by past contributions.     

Who buys newspapers in Spain? An analysis of the determinants of the probability to buy newspapers and of the amount spent

In this paper, we examine the determinants of household consumption of newspapers and the amount spent on their purchase by considering several explanatory variables related to household characteristics and the main household wage earner. Results show that the variables have quite similar effects on both the relative probability of buying newspapers and the amount spent. The key variables are the age and occupational status of the main wage earner, the number of household members, income and having to pay for the house, as well as a number of geographical variables. However, certain differences are also observed. The most important is the education of the main wage earner: while its effect on buying newspapers is very small (only those who did not complete primary education are less likely to buy), its effect on the amount spent increases with the level of education. As other studies of cultural goods and services consumption have suggested, education and occupational status are more relevant determinants than income.     

Veganism: Theory of planned behaviour,ethical concerns and the moderating role of catalytic experiences

The growing movement of veganism culture is drawing increasing scientific attention but falls short of an empirical investigation to examine antecedents and catalytic experiences for maintaining vegan diets. An integrated theoretical framework is proposed using the Theory of Planned Behaviour Model (TPB) and includes ethical concerns to investigate the interrelationships. Comparisons are also made by adopting the strength of high and low ethical catalytic experiences of each consumer group to identify moderating results. The proposed conceptual model was tested using Structural Equation Modelling from the responses of 478 vegan consumers. Results indicate that the TPB factors exert positive effects on the buying intention and ethical concerns mediate the relationship between attitudes and intention, as well as between PBC and intention, however, social norms did not impact ethical concerns.While consumers experiencing high catalytic experience had no significance, low catalytic experience consumers showed an inverse significant moderating relationship on PBC and maintaining vegan diets. Whereas the relationship for ethical concerns influencing the intention to buy vegan foods was significant and positive for the high catalytic experienced consumer, but not significant for the low catalytic experienced consumer. The moderating results for social norms were not significant on ethical concerns for the high catalytic experienced consumer but were negatively significant for the low catalytic experienced consumers indicating that the effect of peer pressure increase, results in a decline for ethical considerations.These findings offer strong theoretical and practical implications by contributing to the understanding of consumers’ behavioural intention to undertake vegan diets and extending our knowledge for formulating retail strategies to effectively tailor their offerings for this consumer segment.     

Effect of caregiver feeding behaviours on child nutritional status in rural Ghana

A six‐month observational study involving 100 mothers with infants between the ages of 6 and 12 months was conducted in the Manya Krobo district of Ghana. The objective was to assess the role of caregiver feeding behaviours on child nutritional status using a modified positive deviance approach. Each child was in the study for 6 months, during which they were observed at home once a month. On each visit, data were collected on the child anthropometry, child meal frequency, diet diversity, responsiveness of caregiver during feeding, child’s appetite and feeding atmosphere as well as caregiver hygienic practices related to feeding. Using weight‐for‐age (WAZ) and length‐for‐age (LAZ) scores, the children were classified as positive or negative deviant children. The study revealed significant differences between the two groups of children in terms of caregiver feeding behaviours. Positive deviant children had significantly higher meal frequencies (3.1 ± 0.4 vs. 2.4 ± 0.6, P = 0.001), diet diversity scores (6.3 ± 0.6 vs. 3.7 ± 1.1, P = 0.001), were fed under better hygienic conditions (7.2 ± 0.9 vs. 4.2 ± 1.1, P = 0.001) and were much more interested in food during feeding (85.8% vs. 59.3%). Caregiver responsiveness during feeding was also significantly higher among the positive deviant group (6.5 ± 0.8 vs. 4.5 ± 0.9, P = 0.001). This study has demonstrated the tremendous effect of caregiver feeding behaviours on child nutritional outcomes and provides a scientific basis for introducing care during feeding as a component of intervention to improve child nutritional status in Ghana.     

The influence of eco-label knowledge and trust on pro-environmental consumer behaviour in an emerging market

Consumers are increasingly concerned about the negative environmental implications of purchasing goods, which in turn shape their behaviour. Yet, there are indications that consumers do not always act on these concerns, causing an attitude–behaviour gap. For consumers to make ecologically responsible purchases, they need relevant product environmental information. Therefore, marketers and firms are increasingly integrating more detailed environmental information in their offerings, including eco-labels with externally validated information. This study integrates consumers’ knowledge and trust in eco-labels with their environmental knowledge to determine how these affect pro-environmental consumer behaviour (PECB). The findings suggest environmental and eco-label knowledge is positively associated with attitudes towards the environment, and that positive environmental attitudes and trust in eco-labels affect PECB. This implies that firms, policy-makers and accreditation organisations (i.e. labelling) can educate consumers about eco-labels and the environment to increase PECB. Such strategies will also build consumer knowledge and trust in eco-labels, necessary for facilitating PECB.