European Journal of Commerce and Management Research (EJCMR) Vol-I, Issue 1

www.ejcmr.org December 2012

Developing a Theoretical Framework for a Study

on the Impact of Advertising Credibility of
Consumer Healthcare Products.
R. Indu V. P. Jagathy Raj
Research Student, Professor
Bharatiyar University School of Management Studies
Coimbatore, India Cochin University of Science and Technology
India Kochi, India
([email protected]) [email protected]
factors that influence the consumer’s attitude towards
Abstract- The tough competition in the global and national
markets and new trends in consumerism resulted in an increase advertising such as target characteristics, source
in the volume of advertisements. Sometimes advertisers are characteristics, message characteristics, cultural aspects,
successful in achieving their intended objectives with a particular economical aspects, media characteristics, creativity and
advertisement and sometimes they are not .These factors cognitive routes; still the concept of credibility in
contributed a lot towards the decision making problems of advertisement continues to be an interesting topic to scholars
advertising agencies with regard to the selection of appropriate and practitioners in marketing and advertising (Goldsmith et
advertising strategies and tactics. The tough competition and al., 2000; Lafferty, Barbara A. 2000; Ferle et al., 2005; Abdul
large volume of advertising make the consumers confused and Majid, 2009).
this even created doubts in the minds of consumers about the
genuineness and reliability of manufacturers and products . Credibility refers to a person's perception of the truth of a
These factors caused a query regarding the active role piece of information. It is a multi-dimensional concept that
of credibility element in advertising. The proposed study serves as a means for the receiver of the information to rate
examines the effects of advertising credibility in consumer health the source or transmitter of the communication in relation to
care non durable product advertising on communication effect, the information. This rating correlates with the willingness of
purchase behavior and ad skepticism. This paper examines the the receiver to attribute truth and substance to the information
need for the study of advertising credibility and reviews the (Hovland et al. 1953). Advertisements that lack credibility are
advertising- consumer behaviour- credibility – healthcare
often ignored or avoided by consumers (Rodgers, 2005). Thus,
theories which form a basis for the study. It identifies the
different components and dimensions of advertising credibility credibility of advertising messages plays an important role in
and the importance of communication effect, purchase behavior the formation of attitudes and, ultimately, purchase behavior,
and ad skepticism. It also studies the relevance of credibility in as dictated by the hierarchy of effects models (Thorson 1996,
the consumer healthcare products advertising and suggests a Rodgers 2005; Wang et al. 2002).
Theoretical Framework for the proposed study.
Keywords: Advertising credibility, Communication effect, Components and Dimensions of Credibility
Purchase behavior, Ad skepticism, Healthcare Credibility of an advertisement is affected by various
INTRODUCTION factors, particularly by the company’s credibility and the
person who brings a message (Goldsmith, Lafferty and
Advertisements play a major role in changing the perception Newell, 2000) and the credibility of the information content
and consumption pattern of the society in general. Many (Pedro Gardete 2012). Advertising credibility can be classified
previous studies have already proved the link between the as advertiser credibility (corporate credibility) and
perception of an advertisement and the attitude and behaviour advertisement credibility (ad credibility). In some Attitude-
towards a product. Society needs advertisement for a variety toward-the-Ad research, advertiser credibility is defined as
of reasons like information sharing, consumer persuasion, "the perceived truthfulness or honesty of the sponsor of the
decision making etc. A growing body of research has ad" and Ad credibility refers to the extent to which consumers
indicated that credibility is one of the most important perceive the message in the ad to be believable. (MacKenzie
components of a persuasive message and can often influence and Lutz 1989). Ad credibility includes endorser credibility
the outcome of persuasive messages. In fact all ads need some and message content credibility. Both advertiser credibility
amount of credibility. But this study focuses on the intensity (Lafferty and Goldsmith 2004) and ad credibility have been
or level of credibility efforts in ads and its effects. In the identified as the important factors determining advertising
advertising and consumer behavior literature, advertising effectiveness.
credibility has been defined as the ‘‘extent to which the
consumer perceives claims made about the brand in the ad to In another classification corporate credibility and endorser
be truthful and believable’’ (MacKenzie and Lutz, 1989,; credibility are in one group – Source credibility. Advertiser
Cotte, Coultor and Moore,2005). There are a number of and the endorser are considered as sources of the ad message.

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An effective communication should possess certain Attractiveness - the attraction aspects of the communicator
characteristics including source credibility and message that he or she generates which are consistently liked more and
content credibility (Kotler 1972). Message content credibility have a positive impact on products with which they are
involves acceptance of the statements and is related in part to associated (Ohanian 1990, Goldsmith, Lafferty and Newell
the similarity between the communicators and the audience’s 2000, Forbes 2003, AbdulMajid 2009).
positions. It has been assumed that the more credible the
Freiden (1984) examined four types of endorsers, known
source and message content, the more likely the audience will
as celebrity, CEO, expert and typical consumer, and found that
accept the communication (McDougall and Fry 1975).
celebrity endorsers receive a higher score on several
Researchers have divided credibility into multiple dimensions than the other three types.
dimensions. For example, Thorson and Moore (1996) note the
Message Content Credibility (MC/C): Message or argument
importance of analyzing credibility in terms of the source as
quality is another aspect of ad credibility. Austin and Dong
well as the channel or medium. Kiousis (2001) noted that one
(1994) studied the sender along with the message to determine
could separate credibility into medium, source and message
if either would have an effect on the overall credibility of the
paradigms, each of which affect attitude change as it relates to
information. They found that the respectability of the source
credibility. (Forbes 2003). Lafferty and Goldsmith's (1999)
had little impact on the perceived credibility of the
have studied the effects of endorser and corporate credibility
information, and that the “innocuous” message was more
on attitudes. Sometimes Media credibility has been examined
believable than the sensational message. These findings led
separate from source or content, relying instead on perceptions
them to conclude that the perceived credibility of the
of the believability or trustworthiness of the medium (Kiousis
information had more to do with the message itself than the
2001). Lafferty and Goldsmith (1999) argue that regardless of
sender. (Forbes 2003).
media type, advertising credibility is a key influence for
attitude formation and resulting behaviors. (Rodgers 2005). A study conducted by Slater and Rouner (1996) examined
According to Abdul Majid(2009), Source credibility (e.g. source credibility by valuating the quality of the message and
endorser and corporate credibility) that is portrayed within an the impact on belief change. The results suggested when
advertisement is considered as one of the most important of all message quality was high the source appeared more credible.
stimuli that marketers use to build and enhance consumer’s This finding was strong for expert sources, but not for biased
attitude toward advertisement, and is assumed to have an sources, and message quality did not appear to influence the
effect on the other behavioural outcomes such as attitude credibility of the biased source. The results also suggested that
toward brand, and purchase intention. source credentials and attributes might not be as influential in
persuasion as a high-quality message. (Forbes 2003).
Advertiser Credibility/ Corporate Credibility (C/C): Recently,
advertiser or corporate credibility has received close attention Believability, Presentation of truth, Level of information,
which is influential in developing consumer’s attitudes toward Authenticity and Creative presentation are the factors that
products and the advertisement (Goldberg and Hartwick 1990; determine Ad Message Content Credibility.
Goldsmith, Lafferty and Newell 2000; Lafferty and Goldsmith
Third-party Endorsements: Dean (1999) examined pre-
1999). Corporate credibility is defined as "the extent to which
purchase attitudes through third-party endorsements, brand
consumers believe that a firm can design and deliver products
popularity and event sponsorship, and found third-party
and services that satisfy customer needs and wants" (Keller
1998, p. 426), and has been found to have direct, positive endorsement positively affected consumer variables. In a
related study, Dean and Biswas (2001) compared third-party
effects on attitude toward the ad, attitude toward the brand,
organization endorsement and celebrity endorsement of
and purchase intent (Goldsmith, Lafferty, and Newell 2000,
products and the impact on attitudes toward product quality.
Choi & Rifon 2002, Abdul Majid 2009).
The third-party organization that endorsed the two products
Endorser Credibility (EN/C): An endorser is any individual was the Consumer Digest magazine. The results indicated that
who enjoys public recognition and who uses this recognition a third-party organization endorsement significantly increased
on behalf of a consumer good by appearing with it in an perceived product quality when compared to a celebrity
advertisement (Byrne et al., 2003). En/C in this study refers to endorsement. Wang (2005) examined whether customer
a term used to imply a communicator’s positive characteristics testimonials and online news clips influenced purchase
and believability that affect the receiver’s acceptance of a intentions. The results indicated third-party endorsements,
message (Ohanian 1990, Goldsmith, Lafferty and Newell both consumer testimonials and online news clips, increased
2000) En/C can further be defined along the three dimensions trust and influenced purchase intentions.
of credibility, which are as follows:
In the present study, the researcher observes the combined
Expertise - the extent to which a communicator is perceived to effect of the different dimensions of advertising credibility
be a source of valid assertions, Trustworthiness - the degree of such as corporate credibility, endorser credibility (which
confidence in the communicator’s intent to communicate the includes third- party endorsement also) and message content
assertions he considers most valid (Ohanian 1990) and credibility on communication-effect, purchase behavior and ad

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skepticism with special reference to consumer health care According to experts the essential way of fixing target
product advertising. audience or market segmentation is by current behaviour and
current communication effects. So the researcher here selected
Importance of Communication Effect, Purchase Behavior and
the short run purchase behavior pattern of consumers
Ad Skepticism in Effective Advertising
consequent on advertising exposure, in a narrow sense.
The competent ad people should understand the consumer
Ad Skepticism
psychology well. They should always try to update their
knowledge about certain effects that lead to certain reactions. The concept of skepticism has been developed in
This will help both the ad agencies and the corporates to avoid consumer research as an individual predisposition to doubt
mistakes and increase results. persuasive messages (Obermiller and Spangenberg 1998).
Skepticism often forms when individuals create cognitive
As per the views of Rossiter and Percy (1987), Behaviour
"categories" of incoming information and treat all information
and Communication-effects are the primary basis for
according to a set of stereotypes or beliefs regarding what they
advertising segmentation and target audience definition, even
feel a particular message is trying to accomplish (Friestad and
for new products or new brands (Paul 2002). Consumer
Wright 1999). This set of beliefs can be general (i.e. all
skepticism, defined as the tendency toward disbelief of
advertising) or context specific (i.e. Internet advertising)
advertising claims, seems to negatively influence the ad
( Rodgers 2005).
effectiveness and the sales objectives. Therefore, the
researcher selected Communication-Effect, Consumer Obermiller and Spangenberg conducted three studies to
Purchase Behaviour and ad skepticism to study the impact of investigate the effects of ‘consumer skepticism toward
Credibility in Advertising. advertising’ on ‘responses to ads’. More skeptical consumers
like advertising less, rely on it less, attend to it less, and
Communication Effect
respond more positively to emotional appeals than to
According to Johnston and Wesley (1994), there is no informational appeals (Carl Obermiller, Eric Spangenberg and
single measure of advertising effectiveness. Generally two Douglas L. MacLachlan 2005).
approaches used to measure ad effectiveness-
In addition, it is observed that there is a negative
Communication-effect research and sales-effect research.
correlation between skepticism displayed by individuals and
From the practical research point of view, Communication-
level of ad credibility. Specifically, that if skepticism is high,
Effect is preferable to sales effect. Because the effects of
credibility will be low (Rodgers 2005). So it is assumed that
advertising in increasing brand awareness and favourable
when credibility is high, skepticism is low.
attitudes for the brand are easily documented, but the effects
on sales are difficult to find. Advertising is only one of many RELATED THEORIES
factors causing sales.
This section reviews the related theories and models
Communication effect is a measure of ad effectiveness. At which forms the basis for developing a conceptual framework
the same time it measures the level of fulfillment of for the study. Several theories are there to explain the impact
communication objectives also (Paul 2002). Advertising cause of credibility in advertising.
action through the process of communication, by establishing
Theories of Advertising
relatively enduring mental associations connected to the brand
in the prospective buyers' minds. This phenomenon is called According to Weilbacher (1984) generally the theories of
Communication-Effect (Rossister and Percy, 1987). advertising can be grouped into four, viz., pressure response
Communication Objectives are framed based on the theories, active learning theories, low involvement theories,
Communication-Effects. and dissonance reduction theories. Pressure response theories
of advertising assume that advertising effects are a function of
Consumer Purchase Behavior
the advertising dollars spent or messages received and stable
Consumer Behaviour, by definition, is the decision relations exist between advertising pressure and advertising
process and physical activity of making a purchase. To effect. Active Learning Theories of advertising suggests that
succeed in marketing, the advertisers need to understand what attitude or behavioural change is a result of the learning of the
makes people behave the way they do. Advertising effectively information conveyed by the advertising. According to Low
uses the information and knowledge gained from the Involvement Theories of advertising, at least in some
behavioural sciences to motivate, modify or reinforce advertising situations the information content of advertising is
consumer perceptions, beliefs, attitudes and behaviour. To not of importance to the consumer. Here advertising effects
accomplish this, advertising people are to be conscious of and cumulatively increased brand relevance or salience, result in
monitor peoples' attitude, values, likes and dislikes habits, changed purchase behavior and lead to revised attitudes only
fears, wants and desires. Advertising techniques are to be after the brand has been purchased or used. Dissonance
changed according to the behavioural characteristics of large Reduction Theories advocates that behaviour may lead to
groups of people (Weilbacher, 1984; Paul, 2002).

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attitude change and that newly formed attitudes are reinforced involvement products’ (e.g. soft drinks, cereals, and washing
and stabilised by information from advertising. powders) (Wells, Burnett, &Moriarty, 1995). According to the
above argument medical care is a high involvement situation
All the theories except pressure response theory have three
and consumer products decision making is a low involvement
common elements – learning, attitude change, behavioural
situation. Then naturally the consumer healthcare products
change. The difference is only with regard to the sequence of
which come in between these two groups will fall in the
these elements.
middle of the ELM elaboration continuum. So it is assumed
Learning -> Attitude Change -> Behaviour Change (Active that both the routes- central and peripheral are involved in the
Learning Theory/ High Involvement Hierarchy) processing. The main feature of product involvement is the
personal relevance of the product to the need and values of the
Learning -> Behaviour Change -> Attitude Change (Low consumers. If consumers perceive that the product is relevant,
Involvement Theory) their involvement is higher (Zaichkowsky, 1985).
Behaviour Change -> Attitude Change -> Learning According to Petty and Cacioppo’s ELM Model the
(Dissonance ReductionTheory) (Paul 2002, Rajeev Batra et viewer of an ad gives importance to corporate credibility and
al., 2008). message content when they pass through the central route to
Regarding the theories of advertising it is assumed that there is persuasion (high involvement attitude). They give value to
no single theory which is applicable in all the situations. The endorser credibility when they engage in peripheral route to
applicability of the theories also varies according to the persuasion (low involvement attitude). Experts say that it is
situation. One theory may be relevant in one situation whereas not necessary that the customer should engage in any one of
another may be better in another situation. The important the processing routes at a time. He/she can engage in both
advertising theories relevant for developing the conceptual central and peripheral processing simultaneously.
framework are reviewed here: However, “central” and “peripheral” are not really two
The Elaboration Likelihood Model (ELM) choices but the end points of a continuum. A listener can think
more thoughts (and be closer to the “central” end of the
Model that considers the role of involvement in continuum) or fewer thoughts (and be closer to the
determining which aspect of the ad has the biggest effect on “peripheral” end). It isn’t an either/or choice, as the metaphor
consumer preference for the brand is the elaboration two “routes” suggests. In fact, even peripheral processing
likelihood model or ELM. According to the ELM, developed requires some thoughts. (William L. Benoit, EEC).
by psychologists Richard E. Petty and John T. Cacioppo, a
basic dimension of information processing and attitude change The Cognitive Response model
is the depth or amount of information processing. At one In Cognitive response Model what appeared to be really
extreme, the consumer can consciously and diligently consider
important in determining attitudes was the nature of the
the information provided in the ad in forming attitudes thoughts that went through the consumer’s head as the ad was
towards the advertised brand. ie, the consumer is highly shown, as the consumer evaluated the incoming information in
involved in processing the advertisement. This type of the context of past knowledge and attitudes. These thoughts
persuasion process is termed the central route to attitude that the consumer has when viewing an ad are called cognitive
change. responses. A counter argument (CA) occurs when the
In contrast to such central processing, there also exists audience member argues against the message argument
peripheral route to attitude change. In the peripheral route, presented by the ad. A support argument (SA) is a cognitive
attitudes are formed and changed without active thinking response that affirms the argument made by an ad. The impact
about the brand’s attributes and its pros and cons. Rather the on attitude of cognitive responses will depend on the nature of
persuasive impact occurs by using cognitive “shortcuts” and the cognitive responses evoked by the ad. The basic predictive
accept the conclusion that the brand is superior because of model is that the number of SAs will be positively associated
endorser credibility, the context or music etc. with changes in beliefs, attitudes, and behavioural intensions
and that the number of CAs will be negatively correlated.
The ELM elaboration continuum contains different
degrees of effortful processing concerning motivation and Here the assumption is that careful efforts to increase the
ability. On the high end of the spectrum are high elaboration credibility perceptions of the ad will surely increase the
and the central route, and on the other are low elaboration and number of SAs and reduce the number of CAs which
the peripheral route. (Petty, Cacioppo and Schumann, 1983; ultimately results in changes in the attitudes and behavioural
Petty and Cacioppo, 1984). In the consumer decision making intensions.
process, consumers spend a lot of time, effort and energy for The Information Integration Theory
more expensive and personal products which are called ‘high
involvement products’ (e.g. computers, automobiles and Norman Anderson’s Information Integration theory
medical care);’ they spend less time, effort, and energy for explores how attitudes are formed and changed through the
inexpensive and less exciting products which are called ‘low integration (mixing, combining) of new information with

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existing cognitions or thoughts. Information integration theory equilibrium, especially if the dissonance affects their self-
considers the ideas in a persuasive message to be pieces of esteem. The theory suggests that 1) dissonance is
information, and each relevant piece of information has two psychologically uncomfortable enough to motivate people to
qualities: value and weight. The value of a bit of information achieve consonance, and 2) in a state of dissonance, people
is its evaluation (favorable or unfavorable) and the weight is will avoid information and situations that might increase the
the information’s perceived importance. dissonance.
This, Information Integration Theory states that when we For example, when the consumer seek a reassuring ad of
obtain new information (often from persuasive messages), the purchased brand, the new ads of the brand with more
those new pieces of information will affect our attitudes. They claims of credibility can help him to reduce the dissonance
won’t replace our existing attitudes: However, when we learn and loyalty can be improved.
new positive information, negative attitudes tend to become
ADVERTISING COMMUNICATION MODELS
less negative and attitudes that are positive are likely to
The Starch Model of Advertising Communication
become somewhat more positive.
Daniel Starch, in the early part of this century, put forward
Credibility in communication is positive in nature. So any
the idea that in order to be effective, an advertisement must be
positive information in advertisement, if credible, makes the
seen, read, believed, remembered and acted upon. In other
attitude more positive.
words people must climb the ladder step by step and the
Congruity Theory objective of advertising is to encourage them to do so. It
should sound credible in terms of promise of satisfaction of a
Congruity Theory is one of the Consistency Theories of
need or desire. In other words, effective advertising is
attitude change. It was developed by Charles Osgood and
persuasive (Jethwaney and Jain, 2006).
Percy Tannenbaum to improve on the first consistency theory,
Fritz Heider’s Balance Theory. AIDA Model of Advertising Communication
All consistency theories are about the relation ship of the The first model, devised by Strong, is known as AIDA
thoughts or ideas (cognitions) in a person’s mind. The basic model, the term being derived from the first letter of the four
idea is that people prefer harmony or consistency in their words in the process represented - Attention, Interest, Desire
thoughts. Further more, consistency theories hold that when and Action. Strong postulated that before becoming a user of
we have inconsistent thoughts, this inconsistency (also called the product the recipient of a message moves from an
imbalance or incongruity) motivates us to change our Awareness of the product to an Interest in it. From this he
persuasive messages, in general, try to persuade us to change develops a Desire for the product and this then results in
our minds or our attitudes (at times they also may try to Action in which he goes and purchases the product. This
strengthen or reinforce our existing attitudes). model, developed in 1920s in U.S.A.
One nice feature of Osgood and Tannenbaum’s(1955) Hierarchy of Effects Model of Advertising Communication
Congruity theory is that it is explicitly oriented to
The third model, conceived by Robert Lavidge and Gary
communication and persuation. Osgood and
Steiner is the Hierarchy of Effects Model that recognises two
Tannenbaum(1955) quantified two of the three relation ships
additional steps before the recipient becomes a purchaser and
in Heiders Theory: the degree of liking of the audience for the
gives importance to cognitive stages. (Rajeev Bhatra et.al,
source and the audience’s attitude towards the concept. The
2008). The individual is seen to move from an Awareness of
main point here is that congruity theory helps to predict the
the product's existence to a Knowledge of the product's
amount and direction of attitude change based on the
attributes. From there, he progresses to a Liking for the
audience’s attitude towards the Source and the audience’s
product, which results in a Preference for that product above
attitude towards the concept. The assumption is that when a
the others available. Then he gets a Conviction as to the value
message in an ad disagrees with us, there is discrepancy or an
of that product to him, which leads to the eventual stage of
inconsistency, between the message’s position and our
Purchasing the product.
attitudes. But if we find something that we like in the message
such as credible source, testimonials etc., that can be The New Adopter Hierarchy Model conceived by rural
translated into pressure or motivation to change our attitude, to sociologists, postulated five stages: awareness, interest,
bring it in line with the message. evaluation, trial and adoption (Rajeev Bhatra et.al, 2008).
Cognitive Dissonance Theory Innovation-Adoption Model of Advertising Communication
The theory replaces previous conditioning or Diffusion of an innovation occurs through a five–step
reinforcement theories by viewing individuals as more process. Rogers categorizes the five stages (steps) as:
purposeful decision makers; they strive for balance in their awareness, interest, evaluation, trial, and adoption. In fact,
beliefs. If presented with decisions or information that creates this model builds in the experience of usage and gives
dissonance, they use dissonance-reduction strategies tot regain importance to word-of-mouth communication. In later editions

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of the Diffusion of Innovations Rogers changes the the formation of an attitude towards the product, which then
terminology of the five stages to: knowledge, persuasion, serves as the input for field two. Field two represents a search
decision, implementation, and confirmation. However the and an evaluation of the advertised product and competitive
descriptions of the categories have remained similar alternatives. The output may or may not be a motivation to
throughout the editions. buy the advertised brand. If the motivation emerges, it serves
as the input for field three, the transformation of motivation
The DAGMAR Approach
into purchasing action. Finally, field four is the storage
In 1961, Russel H. Colley introduced the DAGMAR memory or use of the purchased item, and the output is
approach to advertisement planning and included a precise feedback of sales results to the business firm and retention of
method for selecting and quantifying goals and for using those the consequences of the purchase in the buyer’s memory.
goals to measure performance. An advertising goal is a
Paul (2002) in his study says that Lucas & Brit (1950) deals
specific communication task, to be accomplished among a
with four theories of Consumer Behaviour in connection with
defined audience, in a given period of time.
Advertising. They are discussed in 4.3.3, 4.3.4 and 4.3.5.
In the DAGMAR approach, the communication task is
Anatomy of Purchase Decision. : When making even the
based on a specific model of communication process. The
simplest purchase, a consumer goes through this complicated
model suggests that there is a series of mental steps through
mental process. Anatomy of Purchase Decision model shows
which a brand or objects must climb to gain acceptance. These
how external stimuli such as the company's marketing efforts
steps are Unawareness, Awareness, Comprehension and
and various noncommercial sources of information (Family,
Image, Attitude, Action (Rajeev Bhatra et.al, 2008).
Friend, Teachers etc.) join to activate the decision making
The second important concept of the DAGMAR approach process. At the same time, this process is also filtered by many
is that the advertising goal be specific. It should be a written personal influences on Consumer Behaviour such as
measurable task involving a starting point, a defined audience, Motivation, Personality, learned Attitudes and Perception. At
and a fixed time period. The concept, theory and models of anytime the decision process may be terminated if the
Communication clearly indicate that the task of advertising consumer loses interest or, after evaluating the product,
should be to achieve a Communication Objective or goal. The decides not to buy. Therefore, in order to fully understand the
advocates of DAGMAR approach suggest that the task of complexity of the consumers' buying decision, one has to be
advertising is best stated in terms of Communication-Effects. aware of variety of these personal influences and
environmental influences on Consumer Behaviour.
CONSUMER BEHAVIOUR THEORIES
Cognitive-Response Theory of Learning: This model views the
Jethwaney and Jain mentions two models of consumer learning as mental process of memory, thinking, and the
behavior (4.3.1 and 4.3.2) in their book Advertising rational application of knowledge to practical problem
Management. solving.
Basic Model for Understanding Human Behavior: According Stimulus-Response Theory of Learning: This theory treats
to this model, antecedents are the inputs or stimuli that trigger learning as a trial and error process. Some cue or stimulus
action, and behaviour is the output or result. The individual’s triggers the consumer's need or want, which in turn, creates
mental process stands between inputs and outputs that are the drive to respond. If the response reduces the drive, then
always inconspicuous. These are described as located within
satisfaction occurs, and the response is rewarded or reinforced.
the impenetrable black box. An exploration of what transpired This produces repeat behaviour next time when drive is
within the black box as a result of the input can only be an aroused and learning will have taken place. An ad is a
inference made by an analyst. There are a number of variables stimulus, or cue, and a purchase is a positive response. If the
that intervened between the stimulus and the response. As product gives the consumer satisfaction, then there is
these variables cannot be observed directly, their meanings are reinforcement. Additional reinforcement may be given
provided by explicit definitions and by their functional through superior product performance, good service or
relations within the context of general theories of behavior credible reminder advertising. Through repetition of the cues
(Brown, 1961). (ads), the learning process, including memory, may be
The Nicosia Model : Francisco Nicosia(1966) published a reinforced and repeat behaviour encouraged.
comprehensive model called The Nicosia Model which used THEORIES OF CREDIBILITY
the technique of a flow chart to designate elements and
relationships. It is assumed that field one includes the output Source Credibility Theory
of an advertising message from a business firm. As the
The Source Credibility theory states that people are more
message (sub-field one) reaches the consumer, it serves as an
likely to be persuaded when the source presents itself as
input into sub-field two, referred to as the consumer’s pace,
credible. The theory is broken into three models for the apt
which is composed of her/his psychological attributes. As this
application of the theory. Those models are: the factor model,
message is received and acted upon, the output expectedly is
the functional model, and the constructivist model. Hovland,

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Janis, and Kelley are the people who proposed the theory and improved lifestyles, richer diet, fast food, and less
in1953. The factor model (a covering laws approach) helps to exercise lead people to obesity. When people live longer, there
determine to what extent the receiver judges the source as is a risk of suffering from chronic diseases such as
credible. The functional model (a covering laws approach) osteoporosis, diabetes, cancer, vascularitis and dementia. The
views credibility as the degree to which a source satisfies a rate at which people are suffering from chronic diseases is
receiver's individual needs. The constructivist model (a rising at an alarming pace. The health risk factors due to
human action approach) analyzes what the receiver does with obesity, smoking, longevity and alcohol consumption are
the source’s proposal (Spring 2001 Theory work book). expected to accelerate in the coming years. As populations
with risk factors grow ( again, by 2020 it’s likely to be about
THEORIES OF HEALTHCARE COMMUNICATION
60 percent of the population of a country like the United
Activation Theory of Information Exposure The Activation Kingdom and about 40 percent of India), healthcare products
Theory of Information Exposure states that an individual will will move to the heart of the mass market (Hembert et. al,
seek to satisfy their need for stimulation and information when 2011).
attending to a message, before they seek to fulfill their need
As the healthcare environment is highly sensitive, litigious
for information alone. The theory was proposed by Lewis
and unique, companies who operate here have to substantiate
Donohew, Phillip Palmgreen, & J. Duncan in 1980. Activation
their health claims. The U.K.'s Advertising Standards
Theory of Information Exposure explains how individuals
Authority, for example, has banned some Actimel TV spots,
seek messages that fulfill their cognitive need for information
calling them misleading. Danone settled a U.S. lawsuit about
as well as their need to be entertained. An individual may
similar claims for $35 million, and the European Food Safety
choose to attend to message that are both stimulating and
Authority forced Danone to withdraw all health claims about
informative rather than those that are just informative (Spring
Actimel (Hembert et. al, 2011). FTC charged Nestle
2001 Theory work book).
(Carnation Coffee-Mate Liquid) and Kraft company (Kraft
Health Belief Model "The Health Belief Model is a value Singles Cheese) for the false representation of facts and
expectancy theory, which states that an individual’s behavior exaggerated health claims (Rajeev Batra et al., 2008).
can be predicted based upon certain issues that an individual Similarly in late 1990s P&G complained against HLL to the
may consider (i.e. perceived susceptibility, perceived severity) MRTPC against the advertisement of HLL’s ‘Ceramides
when making a decision about a particular behavior Sunsilk’ brand for exaggerated and misleading advertisement
concerning their health" (Glanz, Lewis, & Rimer, 1990). communication (Jethwaney and Jain, 2006). Governments and
Hochbaum proposed the theory in 1958. The model suggests consumers, both increasingly seek evidence and proof for the
that the likelihood that an individual will take action health claims. Government restrictions and responses may
concerning a health condition is determined by the person’s vary based on each country’s legal structure and political
desire to take action and by the perceived benefits of the stand. Even in developing countries, where governments are
action weighed against the perceived costs of barriers (Spring often less vocal, consumers seek reassurance through brand
2001 Theory work book). credibility and through recommendations of doctors,
pharmacists and experts.
CREDIBILITY AND CONSUMER HEALTHCARE
PRODUCT SEGMENT The major challenge is the development and
implementation of a right marketing mix – product
Global economic and demographic changes are creating a development, packaging, pricing, promotion, and distribution.
new market for consumer-focused products with significant To excel in all these areas the firms have to conduct scientific
health benefits. This new segment is called "consumer research and formulate effective strategies to operate. They
healthcare products" segment and is emerging midway should convince the consumers and regulators about the health
between mass retail-based consumer goods and pharmacy- claims and produce the evidence to prove credibility. If
based pharmaceuticals. The big players of both these consumers and regulators do not believe them nothing else
industries are competing each other to exploit the matters.
opportunities in the new potential market segment. Big
changes are expected in consumer markets. Most of the Importance and Foundations of Credibility
personal-care, food and Ayurvedic firms are emphasizing that
Over the last five years there has been a sharp increase in
their products have proven health benefits and have scientific
brands claiming health benefits. A presentation of clinical data
basis. A number of health foods and nutritional supplements
and scientific messages exists, it can be difficult for
for children and adults are flooding in to the market.
consumers to decide what is real and what is ‘marketing
Medicated tooth pastes, soaps, health drinks, Ayurveda
speak’ making credibility an elusive goal (Hunt 2010).
healthcare products etc., are trying to prove their credibility
Communicating credibility through advertising can
through mass advertising.
simultaneously foster trust in the provider and loyalty from the
Though longevity, reduced risk of death from infectious consumer. A careful consideration and presentation of facts
diseases etc., are the benefits caused by the increased wealth that enhance credibility of a brand is needed. Skillful

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presentation and communication of capabilities such as truly understand the needs and emotional motivations of their
corporate image, scientific data, credible endorsers etc., target market.
through advertisement will help the companies to survive in
the highly aggressive healthcare market. There are a number
of key considerations for advertising agencies and corporate: CONCEPTUAL FRAMEWORK
 Collect data about health related issues and consumer As per Fig.1, the Credibility in Advertising is determined
behavior through well organized studies mainly by three factors: Corporate Credibility, Message
 Plan suitable advertising strategies Content Credibility and Endorser Credibility. Corporate
 Careful selection of endorsers Credibility includes three sub concepts viz, Expertise,
 Translation of data/claims into understandable Trustworthiness and Dynamism. Endorser Credibility includes
statements expertise, Trustworthiness, attractiveness and relevant
 Very keen and careful monitoring of the market. knowledge. Believability, Presentation of truth, Level of
information, Authenticity and Creative presentation are the
Companies who recognize and act upon these factors will factors that determine Ad Message Content Credibility.
be best placed to add credibility for their ads and brands. The
markets in which we operate demand their health information Expertise
sources be credible. Building credibility in healthcare Trust worthiness
communication is crucial for the future success of the
consumer health businesses (to drive sales) especially as the Dynamism Corporate
number of companies involved in this sector increases and Credibility
interest in health continues to grow.
Communication Effect, Consumer Purchase Behaviour and Ad
Skepticism in Consumer Health Care Market Believability
Message
The consumer decision making process for purchasing Presentation of Truth content Advertising
Credibility
Consumer healthcare products is more complex than that of Level of Information credibility
FMCG products since health is a very sensitive issue. People
are more concerned about health and fitness nowadays. Authenticity
Consumer’s attitudes towards healthcare products are mainly Creative presentation
influenced by media and TV commercials. Consumer
Skepticism, pre-purchase information search and evaluation Endorser
etc., are more in the case of consumer healthcare products. Expertise credibility
Misleading advertisements and exaggerated health claims
increases Ad Skepticism and reduces consumer confidence in Trust worthiness
ads as well as in brands. Credible information and authentic
Attractiveness
source increases the Communication Effect of healthcare
advertising. Another important attribute of any product-market Knowledge
is Consumer Purchase Behavior. This is important as it is a
Determinants of Credibility
strong determinant of product usage, satisfaction, word-of-
mouth and repeat purchase behavior. This becomes an even Fig. 1
more important issue in the health care industry now. So the
As shown in Fig. 2 the degree or level of Advertising
effectiveness of the healthcare advertising communication can
credibility is definitely related to the Advertising
be studied by measuring the levels of Advertising
Effectiveness. Advertising Effectiveness models that describe
Communication effect, Ad skepticism and Consumer Purchase
the process of communication indicate that the task of
Behaviour.
advertising should be to achieve a Communication Objective
in terms of Communication Effects (Paul 2002). Different
Health enjoys about 9.4% share of the wallet of Indian
types and steps in Communication Effect are Category Need,
consumer and is on the rise for the last three years. This spent
Brand Awareness, Brand Attitude, Brand Purchase Intention
includes health supplements, health drinks, doctors and
and Purchase Facilitation (Murthy and Bhojanna 2007).
consultant fees, medicines, medical insurance, regular check-
Communication Effect is a measure of ad effectiveness also.
ups etc. About 91% of this was out-of pocket expense and
The measures are Recall of the ad , Recognition of ad,
only 9% came from employers and insurance (Mittal 2010).
Interest, Information value, Irritation level and Attitude
Today’s consumers are more educated on healthcare options
towards the ad.
and they demand improved quality, safety, and clarity of
information. Hence the Consumer healthcare companies must It is clear from the theories of advertising that consumer
response is a process that starts from Learning to Attitude

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Change and then to Behavioural Change. Therefore, the not necessary that the customer should engage in any one of
credibility element in Advertising is related to the subsequent the processing routes at a time. He/she can engage in both
Consumer Purchase Behaviour also. Different purchase related central and peripheral processing simultaneously. As
behaviours are Brand Trial, Brand Usage and Repeat discussed in the ELM model in the beginning the consumer
Purchasing or Brand Switching. The overall effect of purchase healthcare products fall in the middle of the ELM elaboration
related behaviour is Brand Loyalty. continuum and it is assumed that both the routes- central and
peripheral are involved in the processing.
Low Skepticism
Likability of ad According to the Cognitive response Model, the thoughts
Reliance on ad that the consumer has when viewing an ad are called cognitive
Like to attend
responses. A counter argument (CA) occurs when the
By pass the ad
Intention to audience member argues against the message argument
purchase presented by the ad. A support argument (SA) is a cognitive
Belief in the
CPB
response that affirms the argument made by an ad. The
claim
Brand trail viewer’s attitude is influenced by the nature of cognitive
Effective Advertising
(Cognitive Response Model:
Brand - responses evoked by the ad. The basic predictive model is that
Image
Increased SAs Reduced CAs)
Brand-
the number of SAs will be positively associated with changes
Advertising usage in beliefs, attitudes, and behavioural intensions and that the
Credibility
Repeat- number of CAs will be negatively correlated. Here it is
Communication effect purchase
Brand -
assumed that Credibility increases the number of SAs and
Ad Effectiveness Communication switching reduces the number of CAs. This increases the Effectiveness
Brand- of advertising. Fig. 4 shows how the ELM Model and
Objectives;
Loyalty
Recall of ad Category need Cognitive Response Model justifies the relationship between
Recognition of Ad Briand awareness
Interest Brand attitude the variables.
Information value Brand Purchase-
Irritation level intension ELM
Attitude towards -
Corporate
the ad Purchase
facilitation Credibility Centr
-al
route
Message
Relationship of Ad Credibility with CE, CPB and Ad content Advertising
Skepticism credibility Credibility
ELM
Fig. 2
Peri-
As per Hierarchy of Effects model of communication Endorser phera
Effective Advertising
credibility -l
different steps towards Purchase - Awareness, Knowledge, (Cognitive Response
route Model: Increased SAs
Liking, Preference, Conviction and Purchase-are the processes
Reduced CAs)
which start in the Learning stage; then passes through Attitude
Change stage and finally end in Behaviour Change stage (Fig.
3). Application of ELM and CR Model
Fig. 4
Awareness
An integrated model of all the relationships mentioned above is
Knowledge Liking Preference shown below as Fig. 5.

Conviction

Purchase

Hierarchy of Effects Model

Fig. 3
According to Petty and Cacioppo’s ELM Model the
viewer of an ad gives importance to corporate credibility and
message content when they pass through the central route to
persuasion (high involvement attitude). They give value to
endorser credibility when they engage in peripheral route to
persuasion (low involvement attitude). Experts say that it is

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216X Vol.48 No.2 (2010), pp.217-226; © EuroJournals
Publishing, Inc. 2010.
CONCLUSION [17] Holland, Carl, I. L. Jannis and H. H. Kelley (1953),
Communication and Persuasion, New Haven, CT: Yale
Though many studies support the role of credible
University Press.
communication in influencing consumer behavior, some [18] Huai-Liang Liang, Dong-Jenn Yang; A theoretical model of
studies disagree with it. There are differences in consumer endorser credibility and purchase intention: rumor as a
behavior dimensions and specifications in different parts of moderator.
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living standards, education level, social factors etc., influence Credibility, Engagement, Interactivity, and Brand Metrics of
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[21] Jing Zhao, 2004 ; An Experimental Comparison of Celebrity
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consumer trust and loyalty in the highly sensitive, competitive Identification on Attitudes toward the Ads and Future Interest.
consumer healthcare market segment. [22] June Cottea, Robin A. Coulterb, Melissa Moore; Enhancing or
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