PurposeAs cause‐related marketing (CRM) is usually subsumed under corporate social responsibility (CSR), in practice CSR and CRM can serve as different public relations tools. This study aims to compare the effect of CRS and CRM on customer attitude.Design/methodology/approachIn order to overcome various measurement problems, an experiment is conducted in a country characterized by a significant diversity of attitudes towards a cause.FindingsThe result indicates that both CSR and CRM have similar positive effects on customers' attitudes. However, while CRM might be more cost‐efficient, its positive effect is limited to customers with high cause affinity. In contrast, CRM has a negative effect on customers with low cause affinity, or who oppose the cause. A major finding is that CRM can compensate for negative CSR to a high degree in the cause affinity segment of the market. Therefore, a high degree of cause specificity of CSR might only be preferable if the market is characterized by broad cause affinity, or if a firm is facing negative public sentiment caused, for instance, by a product harm crisis.Originality/valueThe paper conceptualizes the difference between the cause‐unspecific and cause‐specific dimension of CSR and highlights the importance of cause affinity in cause‐specific CSR.

This study examines whether international visitors' pro-environment attitudes is enhanced by the experience of nature-based tourism, destination attachment and ownership of property at the destination. It also examines whether visitors are obstructed from exhibiting pro-environment attitudes and behaviors by situational barriers at the destination. A questionnaire survey was employed to test the hypotheses. The main sample of 300 respondents was collected in Thailand in two main tourism regions. Results from the survey indicate that destination attachment and nature-based tourism experience positively influence visitors' pro-environment attitudes, whereas ownership of property at the destination enhances their sense of attachment to the destination. "Vacation mindset" and different social norms have a negative impact on their pro-environment attitudes, while the lack of availability of "green" infrastructure, products and information negatively impact their attitudes as well as behaviors. Based on these findings, visitors' pro-environment attitudes may be enhanced by eliciting feelings of attachment to the destination and more frequent experience of nature-based tourism, while their pro-environment behaviors may be enhanced by greater provision of environmental friendly tourism products, infrastructure and information.

Purpose -The purpose of this paper is to propose a general model that examines the contextual factors underlying the decision-making process of international hospital outshopping. Design/methodology/approach -Patients who chose medical treatment abroad were selected to analyze the drivers of internationalization in medical services. A total number of 27 international patients who traveled from developed countries to receive medical treatment at the largest hospital in Thailand were interviewed and their responses assessed through narrative analysis. Findings -The narrative analysis reveals that while high costs and the deteriorating conditions of health care in developed countries are initially driving consumers to leave their local service area and choose foreign service providers, pull factors such as innovation, organizational efficiency, emotional service quality and patient-doctor relationships in service encounters are nurturing a real preference for choosing foreign health care providers. Research limitations/implications -This exploratory study is limited to the largest hospital in South East Asia. Future research could expand upon its findings and comparisons be made with other different foreign health care providers. Practical implications -In order to attract foreign customers a personal service, such as medical treatment, must be based on and sustained by continuous innovation in service quality. Originality/value -The paper is the first empirical in-depth study that examines the factors underlying the decision-making process of international hospital outshopping.

An emerging trend in medical tourism is the flow of patients from developed countries seeking treatment in developing nations. Medical tourism seemingly acts as a valve for capacity limitations and cost escalation at home. In contrast to the prevailing view that developing countries mainly offer a price advantage, we argue that the underlying success factor for the sustainable competitiveness of a healthcare destination is neither price nor medical quality, but patient-centred, highly personalised service quality. This conclusion is based on a comprehensive narrative analysis of the lived experiences of patients from developed countries who receive invasive medical procedures at one of the largest private hospitals in Thailand, which has been described as emblematic for the trend of internationalisation of healthcare and a model that many other hospitals in Asia follow. We find that, while a low price might initiate interest in medical treatment abroad, return visits are built on profound patient satisfaction, and even bonding, to doctors and nurses. Successful health destinations need to provide foreign patients unexpectedly pleasant experiences through organisational innovations and service quality based on superior patient-doctor-nurse relationship.

Purpose This study aims to conceptualize and test the effect of monetary and non-monetary incentives for word-of-mouth (WOM) campaigns on the brand attitude of those receiving an incentivized brand recommendation. It also studied whether or not the type of relationship between the recommender and the person who receives the recommendation and the expertise of the recommender moderate the impact of incentivization on brand attitude. The results should enable brand management to improve the design of WOM campaigns. Design/methodology/approach An experiment was conducted utilizing a sample of about 645 respondents in Thailand. In a 3 × 3 experimental design, three levels of incentivization and three types of social relationships were manipulated. All other variables were measured through a respondent-administered questionnaire. For incentivization of WOM, monetary reward and non-monetary reward are compared to a non-incentivized control state. The three types of social relationships are an authority relationship, a kinship relationship and a market pricing relationship between strangers as the control state. Findings The results of the experiment show that the introduction of rewards for recommendations harms the attitude of the receiver of a recommendation toward the brand. The attitude of potential buyers toward the brand can be tainted by the impression that a brand has enticed friends and relatives into profiting from their relationship. The negative effects increase further with the introduction of cash rewards. Contrary to expectations, however, the social relationship between the recommender and the new customer did not moderate the effect of incentivization. Source expertise has a direct as well as moderating effect on brand attitude. Practical implications The findings suggest that companies should use referral rewards with caution. Brand managers need to be aware that there is a trade-off between the advantages and the disadvantages of incentivized WOM campaigns. Recommendations have been derived about how to improve the design of incentivized WOM campaigns. Whether the advantages outweigh the disadvantages probably depend to some extent on brand-specific factors such as brand strength and market- or industry-specific factors, such as a credence good quality within the industry. It also emphasized that WOM campaigns need to be carefully monitored by measuring customer attitudes toward the brand. Originality/value Although past research provides valuable conceptual and empirical insights into consumer responses in incentivized WOM situations, most research has focused on the immediate effectiveness of WOM by measuring purchasing intentions. There is still a lack of information about how different kinds of incentivization affect customer attitudes toward a brand that incentivizes WOM, and how various relationship types moderate the effects; in particular, authority relationships have not yet been studied in this context.