Investigating consumer confusion from a cultural perspective : evidence from the Saudi Arabian smartphone market

This thesis was previously held under moratorium from 3rd December 2019 until 3rd December 2021.With the increase of digital media, there is an excess of information about products and services in the marketplace. In addition, products are becoming more complex. These factors are contributing to consumer confusion, which is an uncomfortable psychological experience caused by exposure to marketing information that could be similar, misleading, ambiguous, or unnatural. Such a problem could increase in the future, as rapid developments in technology are contributing to multiply sources of information. In recent years, many studies have concluded that consumer confusion proneness, as it has several influences on behavioural outcomes, is a topic in need of ongoing investigation. With this in mind, the present study seeks to shed light on the phenomenon of consumer confusion in the Saudi Arabian smartphone market by identifying and analysing the cultural factors contributing to consumer confusion. The overall aim of this thesis is to explore the impact of cultural dimensions on consumer confusion in the Saudi Arabian smartphone market. Furthermore, the research objectives of this study are fourfold: (1) to explore the aspects of consumer confusion influencing consumers in the Saudi Arabian smartphone market; (2) to investigate the effect of consumer confusion proneness on three behavioural outcomes: customer satisfaction, word-of-mouth behaviour, and brand loyalty among consumers in the Saudi Arabian smartphone market; (3) to examine the moderating role of cultural dimensions on the relationship between consumer confusion proneness and its consequences; and (4) to identify the main strategies for minimising consumer confusion based on cultural factors. A conceptual model based on consumer confusion and the culture literature was developed in order to form hypotheses to predict the causality between the selected variables. A quantitative research approach was adopted in this research, reflecting a postpositivist philosophical framework. A self-administrated questionnaire was generated to collect the data, and the analysis technique employed to test the research hypotheses was structural equation modelling (SEM). As one of this first studies in this area to examine a Middle East society, it was found that incertitude confusion (overload/ambiguity) is the most influential aspect on consumer confusion for consumers purchasing smartphones in Saudi Arabia. The findings also highlight that customers in Saudi Arabia do not perceive the similarity of smartphones as contributing towards confusion. In addition, customers prone to incertitude confusion are likely to be dissatisfied and engage less in word-of-mouth behaviour, but they are more likely to display brand loyalty. The findings outline a role for previously unexplored cultural variables, i.e. social interaction, language barriers, and risk aversion, and their probable moderating influences on consumer confusion proneness and its behavioural consequences. This study has responded to previous calls for research to explore the cultural elements impacting on the construct of consumer confusion (Shukla, Banerjee and Adidam, 2010; Walsh et al., 2016) and to establish the cultural variables influencing consumers proneness to confusion while purchasing smartphones. By exploring the role of cultural dimensions in consumer confusion and its consequences, this research provides key managerial implications as well as theoretical contributions by extending the understanding of consumer confusion in relation to the role of cultural variables, thus enriching the construct of consumer confusion. Consequently, a number of theoretical, marketing, and consumer implications have been identified from this study’s empirical results. This thesis also opens the door for fellow researchers to expand upon the concept of consumer confusion by calling for future consumer confusion-based research from the perspective of other cultural dimensions, B2B consumer confusion, or the impact of social media.With the increase of digital media, there is an excess of information about products and services in the marketplace. In addition, products are becoming more complex. These factors are contributing to consumer confusion, which is an uncomfortable psychological experience caused by exposure to marketing information that could be similar, misleading, ambiguous, or unnatural. Such a problem could increase in the future, as rapid developments in technology are contributing to multiply sources of information. In recent years, many studies have concluded that consumer confusion proneness, as it has several influences on behavioural outcomes, is a topic in need of ongoing investigation. With this in mind, the present study seeks to shed light on the phenomenon of consumer confusion in the Saudi Arabian smartphone market by identifying and analysing the cultural factors contributing to consumer confusion. The overall aim of this thesis is to explore the impact of cultural dimensions on consumer confusion in the Saudi Arabian smartphone market. Furthermore, the research objectives of this study are fourfold: (1) to explore the aspects of consumer confusion influencing consumers in the Saudi Arabian smartphone market; (2) to investigate the effect of consumer confusion proneness on three behavioural outcomes: customer satisfaction, word-of-mouth behaviour, and brand loyalty among consumers in the Saudi Arabian smartphone market; (3) to examine the moderating role of cultural dimensions on the relationship between consumer confusion proneness and its consequences; and (4) to identify the main strategies for minimising consumer confusion based on cultural factors. A conceptual model based on consumer confusion and the culture literature was developed in order to form hypotheses to predict the causality between the selected variables. A quantitative research approach was adopted in this research, reflecting a postpositivist philosophical framework. A self-administrated questionnaire was generated to collect the data, and the analysis technique employed to test the research hypotheses was structural equation modelling (SEM). As one of this first studies in this area to examine a Middle East society, it was found that incertitude confusion (overload/ambiguity) is the most influential aspect on consumer confusion for consumers purchasing smartphones in Saudi Arabia. The findings also highlight that customers in Saudi Arabia do not perceive the similarity of smartphones as contributing towards confusion. In addition, customers prone to incertitude confusion are likely to be dissatisfied and engage less in word-of-mouth behaviour, but they are more likely to display brand loyalty. The findings outline a role for previously unexplored cultural variables, i.e. social interaction, language barriers, and risk aversion, and their probable moderating influences on consumer confusion proneness and its behavioural consequences. This study has responded to previous calls for research to explore the cultural elements impacting on the construct of consumer confusion (Shukla, Banerjee and Adidam, 2010; Walsh et al., 2016) and to establish the cultural variables influencing consumers proneness to confusion while purchasing smartphones. By exploring the role of cultural dimensions in consumer confusion and its consequences, this research provides key managerial implications as well as theoretical contributions by extending the understanding of consumer confusion in relation to the role of cultural variables, thus enriching the construct of consumer confusion. Consequently, a number of theoretical, marketing, and consumer implications have been identified from this study’s empirical results. This thesis also opens the door for fellow researchers to expand upon the concept of consumer confusion by calling for future consumer confusion-based research from the perspective of other cultural dimensions, B2B consumer confusion, or the impact of social media

Exploring the link between sustainable development practices, institutional pressures, and green innovation

Academics, business leaders, and policymakers are paying more and more attention to sustainable development. The influence of external forces on sustainable development practices, which could predict green innovation, is, however, still unexplored. This paper seeks to explore the role of external pressures on sustainable development practices in the driving of green innovation in Saudi Arabia. We took a quantitative approach through an online survey to collect the required data from manufacturing companies in Saudi Arabia. Structural equation modelling was used to analyse the data. The results revealed that institutional pressures (i.e., governance pressure, customer pressures, and competitive pressure) are key drivers of sustainable development practices and green innovation. They also indicated that sustainable development practices (i.e., environmental sustainability, social sustainability, and economic environmental sustainability) have a significant influence on green innovation. Our findings lead us to propose that green innovation is influenced by external pressures and sustainable development practices

Examining tourism consumers' attitudes and the role of sensory information in virtual reality experiences of a tourist destination

The purpose of this research is twofold: firstly, we aim to understand the role of virtual reality (VR) in influencing tourism consumers’ attitudes toward a tourist destination and, secondly, understand the influence of different levels of sensory information presented through VR experiences on the development of mental imagery, attitudes toward the destination, and visit intention. We tackle this through a multistudy experimental approach. First, in study 1, we demonstrate that VR plays a positive role in enhancing previously held consumer attitudes toward a tourist destination. Second, we affirm that VR has a greater positive effect on attitudes toward a destination in comparison to a less immersive technology (i.e., website). Third, in study 2, we find that different levels of sensory information in VR experiences result in significant differences with regard to the developed mental imagery, sense of presence in the experience, attitudes toward the destination and visit intentions

The role of VR in influencing tourism consumers' attitudes towards a tourist destination : an abstract

Virtual reality (VR) has been outlined as one of the most important technological developments to influence the tourism industry due to its ability to engage consumers and to market tourism destinations. The purpose of this research is to understand the role of VR in influencing tourism consumers' attitudes towards a tourist destination. Through a lab-based experiment with 204 tourism consumers this research found that following a VR preview experience of a tourist destination consumers will have more positive attitudes towards the tourist destination than prior to the VR experience. Interestingly, in comparison, a website preview has no significant effect on influencing tourism consumers' previously held attitudes towards the destination. More so, the results indicate that tourism consumers have more positive attitudes towards a tourist destination in a VR preview in comparison to a less immersive website preview. Thus, the inherent interactive, immersive, and sensory rich attributes of VR have a positive effect on tourism consumers' attitudes towards a destination

Examining the influence of virtual reality tourism on consumers' subjective wellbeing

Tourism consumption has been outlined as having a positive effect on individuals’ subjective wellbeing, however, we had limited empirical or conceptual understanding on the propensity of VR tourism in fostering positive subjective wellbeing and the subsequent effects this has for tourism providers and policymakers. A vacation transports one’s self to an alternative world, physically. In parallel, VR transports one’s self to an alternative world, virtually. Accordingly, through a multiple quantitative study research-design and drawing on the theoretical lens of Presence-Theory and Effort-Recovery-Theory, this research uncovers the positive effect of VR tourism on individuals’ subjective wellbeing, the nuance of the sense of presence in VR tourism in enabling psychological-detachment and enhancing consumer wellbeing along with the subsequent attitude and behaviour intentions stimulated by consumer wellbeing. Our results pertain that not only can VR tourism provide important societal and health benefits in recovery and enhancing individuals’ wellbeing, but also benefits from an economic perspective

INVESTIGATION OF THE CLINICAL SIGNIFICANCE OF ESCITALOPRAM-INDUCED ELECTROCARDIOGRAPHIC CHANGES IN MEN: A PILOT OBSERVATIONAL STUDY

Objective: We sought to investigate the clinical significance of secondary electrocardiographic (ECG) changes in men after using escitalopram. Methods: This pilot observational cohort study recruited male patients taking escitalopram for at least 6 mo in Mental Hospital of Qassim. All patients underwent a 12-lead ECG examination. We also measured the heart rate (HR), QTc, and QRS interval. Data on all related medical conditions and medications were recorded. Results: Fifty-three men were recruited, with a mean age of 37.39±8.39 y: 34.4% and 31.1% of these patients were taking escitalopram for depression and anxiety, respectively. The mean dose of escitalopram was 14.35 mg. Observations showed that 20.9% of the patients taking escitalopram had a fast HR (>100 beats/min [bpm]), indicative of sinus tachycardia, whereas 11.4% of patients had a slow HR (<60 bpm). The mean QT and QTc in patients taking escitalopram were 366.62±28.69 and 398.92±16.15 ms, respectively. Conclusion: Low doses of escitalopram resulted in minimal clinically significant changes. Thus, patients should be monitored when doses are escalated further

Incidence of adverse drug events in public and private hospitals in Riyadh, Saudi Arabia: the (ADESA) prospective cohort study

Objectives: To determine the incidence of adverse drug events (ADEs) and assess their severity and preventability in four Saudi hospitals. Design: Prospective cohort study. Setting: The study included patients admitted to medical, surgical and intensive care units (ICUs) of four hospitals in Saudi Arabia. These hospitals include a 900-bed tertiary teaching hospital, a 400-bed private hospital, a 1400-bed large government hospital and a 350-bed small government hospital. Participants: All patients (≥12 years) admitted to the study units over 4 months. Primary and secondary outcome measures Incidents were collected by pharmacists and reviewed by independent clinicians. Reviewers classified the identified incidents as ADEs, potential ADEs (PADEs) or medication errors and then determined their severity and preventability. Results: We followed 4041 patients from admission to discharge. Of these, 3985 patients had complete data for analysis. The mean±SD age of patients in the analysed cohort was 43.4±19.0 years. A total of 1676 ADEs were identified by pharmacists during the medical chart review. Clinician reviewers accepted 1531 (91.4%) of the incidents identified by the pharmacists (245 ADEs, 677 PADEs and 609 medication errors with low risk of causing harm). The incidence of ADEs was 6.1 (95% CI 5.4 to 6.9) per 100 admissions and 7.9 (95% CI 6.9 to 8.9) per 1000 patient-days. The occurrence of ADEs was most common in ICUs (149 (60.8%)) followed by medical (67 (27.3%)) and surgical (29 (11.8%)) units. In terms of severity, 129 (52.7%) of the ADEs were significant, 91 (37.1%) were serious, 22 (9%) were life-threatening and three (1.2%) were fatal. Conclusions: We found that ADEs were common in Saudi hospitals, especially in ICUs, causing significant morbidity and mortality. Future studies should focus on investigating the root causes of ADEs at the prescribing stage, and development and testing of interventions to minimise harm from medications

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London