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 of brand equity or an outcome of brand equity or

as a moderating factor 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 of 300 respondents was selected from Jammu city in India to gather data on brand loyalty

and brand equity from the users of Jammu healthcare services. Scale-item analysis, both EFA and

CFA analysis were applied for finalisation of scale and model testing respectively. The findings of

the study support all three hypotheses i.e. brand equity is the resultant factor of attitudinal loyalty

and results in behavioural loyalty (Model1), brand loyalty viz. both attitudinal loyalty and

behavioural loyalty can be considered as an indicator as well as an outcome of brand equity in

healthcare sector (Model2 and Model3). 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. --------------------------------------

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Key Words: Brand Equity, Brand Loyalty, Attitudinal Loyalty And Behavioural Loyalty

INTRODUCTION

Developing 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 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 of service brands which have created their place in the Indian vis-à-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 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.

Brand Equity, Brand Loyalty and Hypotheses Formulation

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 market the brand (Pitta and Katsanis, 1995). The literature on

brand equity focuses on financial 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 accompanied with positive attitude. Thus attitudinal loyalty 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 of brand equity or as an outcome of brand equity 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 of

brand 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 of brand 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 Model1, Model2 and Model3 that need to be addressed in the literature.

Model1 proposes that brand equity is the result of attitudinal loyalty which in turn 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:

Hypothesis 1: Brand equity is directly influenced by the attitude of the consumer and

results in behaviour of the 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).

Research Design and Methodology

Generation of Scale Items

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 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

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 of brand

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.

Scale Item Analysis

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 subsequent factors or 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 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).

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 of wards 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 (Is the word correct?- yes………) , 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 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 (α) 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 of three factors i.e. attitudinal loyalty (with 4 items), behavioural

loyalty (with 4 items) and brand equity (with 2 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 simultaneous 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 (α) 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.

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 1, 2 and

3) were examined for Model1, 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 attainment 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 co-related in model 1 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 (This is correct ----Is the word correct?) 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:

Model 1: 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 χ2 / 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 hypotheses1 i.e.

brand equity is directly influenced by the attitude of the consumer results in behaviour of the

consumer.

Model 2: Behavioural Loyalty and Attitudinal Loyalty as the indicators of Brand Equity

The effect of both attitudinal loyalty and behavioural loyalty on brand equity was tested on

Model 2 (Figure 5). Similar to model 1, after using modification indices fitness criteria the model 2

is found to be quite acceptable. Akin to the results of Model 1 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 model 1 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 loyalty as the indicator of brand 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 of attitudinal 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=0.896) 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 1 and model 2 are highly contributing to their respective constructs. These

results were accepted as brand equity reflects attitudinal loyalty and behavioural loyalty. Hence

hypothesis 3 is also accepted.

Discussion

Overall the comparative analysis of three 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 of Aaker (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 words of mouth process is significant in establishing

good image of the hospital in the later period.

Model1 reproduced behaviour as the consequence of brand equity and brand equity as the

outcome of attitude of the consumers which confirmed the views of the 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),

explains 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 of the 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 of certain 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.

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.

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Brand Valuation,” Journal of Product and Brand Management, 10.4, pp.243 - 256.

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.

FIGURES AND TABLES

Model 1:- Brand Equity as the Resultant Factor of Attitudinal Loyalty

and Results in Behavioural Loyalty

Figure1

Model 2:- Behavioural Loyalty and Attitudinal Loyalty as the

indicators of Brand Equity

Figure 2

Attitudinal

loyalty Brand Equity Behavioural

Loyalty

Brand Equity Behaviour and attitude

Brand Equity

Behaviour and attitude

Source of brand

equity

Outcome of

brand equity

Model 3:- Brand Equity as an Indicator of Behavioural Loyalty

and Attitudinal Loyalty

Figure 3

0,

Attitudinal

Loyalty

0

Brand Equity

0

Behavioural

Loyalty

PERF

0,

e6

1

1

FUNC

0,

e51

SART

0,

e41

EXP

0,

e31

SERV

0,

e101

1

RECO

0,

e91

RECOO

0,

e81

VISIT

0,

e71

IMPER

0,

e1

1

1

EXPER

0,

e2

1

0,

error1

1

0,

error2

1

Figure 4

Key Words EXP= Expertise skill of the staff

SART=Availability of state of art

FUNC= Functioning of the staff

PERF=Overall performance of

the hospital

SERVE= Usually availed services

RECO=Recommend to friends

and family

RECOO=Recommend to others

VISIT=Generally visited hospital

EXPER=Excellent performance

in comparison competitors

Model 1

Brand Equity as the Resultant Factor of Attitudinal Loyalty

and Results in Behavioural Loyalty

IMPER=Continuously improved performance

0,

Attitudinal

Loyalty

0

Brand Equity

0,

Behavioural

Loyalty

PERF

0,

e6

1

1

FUNC

0,

e51

SART

0,

e41

EXP

0,

e31

VISIT

0,

e10

1

1

RECOO

0,

e91

RECO

0,

e81

SERV

0,

e71

EXPER

0,

e111

IMPER

0,

e21

0,

error

1

Figure 5

Key Words

EXP= Expertise skill of the staff

SART=Availability of state of art

FUNC= Functioning of the staff

PERF=Overall performance of

the hospital

SERVE= Usually availed services

RECO=Recommend to friends

and family

RECOO=Recommend to others

VISIT=Generally visited hospital

EXPER=Excellent performance

in comparison competitors

IMPER=Continuously improved

performance

Model 2

Behavioural Loyalty and Attitudinal Loyalty as the indicators of Brand

Equity

22

0

Attitudinal

Loyalty

0,

Brand Equity

0

Behavioural

Loyalty

PERF

0,

e61

1

FUNC

0,

e51

SART

0,

e41

EXP

0,

e31

SERV

0,

e101

1

RECOO

0,

e91

RECO

0,

e81

SERV

0,

e71

IMPER

0,

e1

11

EXPER

0,

e21

0,

error2

1

0,

error3

1

Figure 6

Key Words

EXP= Expertise skill of the staff

SART=Availability of state of art

FUNC= Functioning of the staff

PERF=Overall performance of

the hospital

SERVE= Usually availed services

RECO=Recommend to friends

and family

RECOO=Recommend to others

VISIT=Generally visited hospital

EXPER=Excellent performance

in comparison competitors

IMPER=Continuously improved

performance

Model 3

Brand Equity as an Indicator of. Behavioural Loyalty and

Attitudinal Loyalty

23

Table1:- Demographic Profile of the Respondents

Particulars Frequency Percent (%) Particulars Frequency Percent (%)

Gender Education

Male 163 54.3 Illiterate 6 2.0

Female 137 45.7 Matriculate/+2 57 19.0

Age (in years) Graduate 140 46.7

20-35 128 42.5 Post Graduate+ 97 32.3

35-50 143 47.7 Occupation

above 50 29 9.7 Service class 135 45.0

Monthly Income (in Rs) Business 54 18.0

below 5000 47 15.7 Profession 94 31.3

5000-10000 107 35.7 Dependent 15 5.0

10000-15000 113 37.7 Type of Treatment Taken

above 15000 32 10.7 ENT 41 13.7

Health Insurance Taken Skin 31 10.3

Yes 104 34.7 Surgery 71 23.7

No 191 63.7 Any other 299 52.0

Table2:-KMO Values, Number of Items Deleted, Total Number of Items after Deletion

and Cumulative % at Each Stage of Factor Analysis

Key Note: * Cross loading values

S.No KMO Values

after Deletion

of Items

Corrected

Item - Total

Correlation

Cronbach

value if

item

deleted

Cronbach

alpaha value

( Overall

Scale)

Number

of Items

Deleted

Total Number

of Items after

Deletion

Cumulative

%

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 * * 0.840 1 12 60.25

3 0.753 * * 0.814 2 10 63.40

24

Table3:-Factor Wise Mean Score Values, Factor Loading Values and Percentage

Variance

Dimensions of Brand Loyalty and Brand Equity Mean Score

Values

Std.

Deviation

Factor

Loading

% of

Variance

F1:- Attitudinal loyalty

Expertise skill of the staff 4.03 0.93 0.867

26.69

Availability of state of art 4.01 1.11 0.811

Functioning of the hospital 4.15 0.98 0.714

Overall performance 4.03 0.99 0.675

F2:-Behavioural loyalty

Usually availed services 3.97 0.92 0.800

21.21

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

F3:-Brand Equity

Continuously improved performance 3.87 1.12 0.851

15.50 Excellent performance 3.97 1.07 0.736

Cumulative % of Variance 63.401

Kaiser-Meyer-Olkin (KMO) Measure of Sampling Adequacy 0.753

Rotation converged in 5 iterations.

25

Table4:-Model wise SRW and CR Values

Model 1 Model 2 Model 3

Relationships SRW CR Relationships SRW CR Relationships SRW CR

Brand Equity <--Attitudinal Loyalty 0.695 4.68 Brand Equity <-- Attitudinal Loyalty 0.133 1.18 Attitudinal Loyalty <--Brand Equity 0.691 5.11

Behavioural Loyalty <--Brand Equity 0.906 4.46 Brand Equity <--Behavioural Loyalty 0.502 3.91 Behavioural Loyalty <-- Brand Equity 0.896 4.41

PERF< ---- Attitudinal Loyalty 0.494 - PERF< ---- Attitudinal Loyalty 0.494 - PERF< ---- Attitudinal Loyalty 0.492 -

FUNC< ---- Attitudinal Loyalty 0.628 8.30 FUNC< ---- Attitudinal Loyalty 0.628 8.30 FUNC< ---- Attitudinal Loyalty 0.628 8.30

SART< ---- Attitudinal Loyalty 0.844 7.82 SART< ---- Attitudinal Loyalty 0.844 7.82 SART< ---- Attitudinal Loyalty 0.847 7.82

EXP< ---- Attitudinal Loyalty 0.727 7.62 EXP< ---- Attitudinal Loyalty 0.727 7.62 EXP< ---- Attitudinal Loyalty 0.727 7.61

VISIT< ---- Behavioural Loyalty 0.452 - VISIT< ---- Behavioural Loyalty 0.452 - VISIT< ---- Behavioural Loyalty 0.446 -

RECOO< ---- Behavioural Loyalty 0.890 6.81 RECOO< ---- Behavioural Loyalty 0.890 6.81 RECOO< ---- Behavioural Loyalty 0.901 6.67

RECO< ---- Behavioural Loyalty 0.565 6.39 RECO< ---- Behavioural Loyalty 0.565 6.39 RECO< ---- Behavioural Loyalty 0.550 6.29

SERV< ---- Behavioural Loyalty 0.386 6.26 SERV< ---- Behavioural Loyalty 0.386 6.26 SERV< ---- Behavioural Loyalty 0.382 6.26

EXPER < ---- Brand Equity 0.466 - EXPER < ---- Brand Equity 0.720 - EXPER < ---- Brand Equity 0.466 -

IMPER < ---- Brand Equity 0.368 5.51 IMPER < ---- Brand Equity 0.569 5.51 IMPER < ---- Brand Equity 0.370 5.51

Chi-square 86.052 Chi-square 86.052 Chi-square 75.416

df 29 df 29 df 28

CMIN/DF 2.967 CMIN/DF 2.967 CMIN/DF 2.693

RMSEA 0.081 RMSEA 0.081 RMSEA 0.075

CFI 0.933 CFI 0.933 CFI 0.944

Key Note: CR= Critical ratio and SRW= Standardised Regression Weight

26