SCALE DEVELOPMENT ON CONSUMER BEHAVIOR TOWARD COUNTERFEIT DRUGS IN A DEVELOPING COUNTRY SETTING
Alfadl, Abubakr Abdelraouf (1); Ibrahim, Mohamed Izham (2); Hassali, Mohamed Azmi (1)
1: Universiti Sains Malaysia, Malaysia; 2: Qassim University, Saudi Arabia, Universiti Sains Malaysia, Malaysia
Abstract
Introduction: Counterfeiting of medicines in developing countries has been reported as a
distressing issue. Moreover, although desperate need and drug counterfeiting are linked, no
much study has been carried out to cover this area, and there is a lack of proper tool and
methodology.
Objective: The objective of this research is to develop a valid and reliable scale based on the
currently accepted scale development paradigm to operationalize the main construct.
Step 1: Domain
Specification
Step 2: Item Pool
Generation
Design, Study Settings and Population: This is a quantitative survey conducted in Sudan
through two rounds; pilot (n = 100), and final survey (n = 1003). Sampling approach was based
on the availability of participants.
Results: The raw data were analyzed using SPSS version 16. Internal consistency was
examined and improved. Cronbach’s alpha improved from 0.818 to 0.862. Finally, convergent
and discriminant validity was demonstrated.
Conclusion: To the authors’ knowledge, this is the first work attempt to conceptualize and
operationalize consumer behavior toward counterfeit drugs. High reliability and demonstration of
convergent and discriminant validity indicated that the “Consumer Behavior toward Counterfeit
Drugs Scale” is a valid, reliable scale existing within a solid theoretical base. Ultimately, the study
offer public health policy makers and marketing manager a valid measurement tool to build a
better understanding of the demand side of counterfeit drugs and hence aids in developing more
effective strategies to combat the problem.
Keywords: Counterfeit drug, Consumer, Behavior, Scale
Background
Perceived risk (PR)
Product attributes (PA)
Literature
Search
Literature Search
Experts
Item Relevance
Step 3: Expert
Item Judging
Item Clarity
item Conciseness
Reviewers Suggestions
Step 4: Data
Collection
Step 5: Measure
Purification
Coefficient Alphas
Attitude Toward
Counterfeit
Drugs Purchase
Subjective
Norm
Affordability (Af)
Scale and Reliability Statistics
Step 7:
Dimensionality
Assessment
Step 8:
Reliability &
Validity
Assessment
Mean
Intention to
Purchase
Counterfeit
Drugs
Step 9: Norms
Development
Motivation to
Purchase
Counterfeit
Drugs
Aim and Objectives
This research aims at establishing the necessary knowledge of the demand side of the
problem of counterfeit drugs. In other words, this research aims at providing a better
understanding of vulnerability to counterfeit drugs, which, in this context, are to be
understood as the major characteristics, derivers, and influencing factors of demand with
respect to counterfeit drugs.
Specific objective of this research is to propose a conceptual framework based on Theory
of Planned Behavior (TPB) (Ajzen, 1991) and Theory of Reasoned Action (TORA) (Ajzen
& Fishbein, 1980) to develop a valid and reliable scale based on the currently accepted
scale development paradigm to operationalize the main construct.
Std.
Cronbach's
Deviation
Alpha
AVE %
KMO
Bartlett
N of
Variance
Items
PA
20.12
25.137
5.014
.659
53.637
.000
.863
9
PR
8.84
15.982
3.998
.893
70.365
.000
.873
5
RA
6.58
5.600
2.366
.748
70.365
.000
.767
4
PQI
10.52
17.875
4.288
.798
63.679
.000
.747
4
ASC
6.11
5.765
2.401
.652
61.077
.000
.585
3
SN
7.08
4.119
2.030
.673
75.356
.000
.500
2
Aff
18.514
4.303
.871
72.224
.000
.829
Coefficient Alpha & Average Variance
Explained
12.69
4
Ava
6.74
5.153
2.270
.752
80.190
.000
.500
2
Convergent Validity
Acc
6.86
5.340
2.311
.811
.000
.500
2
BI
6.88
4.220
2.054
.653
.000
.500
2
Total Scale
92.43
205.062
14.320
.796
.000
.914
37
Exploratory Factor Analysis
Discriminant Validity
Average and Other Statistics
Summarizing Distribution of Scores
Accessibility (Ac)
Availability (Av)
The initial EFA on all 41 items disclosed a thirteen factor structure. Three items
failed to load significantly (≤ .5) on any factor. Other two items loaded on more
than one factor (i.e., cross-loaded). Consequently, an iterative process conducted
where by the authors removed scale items one at a time which stopped when the
analysis exhibited a clean factor structure (i.e., no non-loading items, no crossloading items).
Second sample
Convergent validity was tested through evaluating average variance explained
(AVE) and reliability estimates (Cronbach’s alpha). All AVE exceed .5, while all
reliability estimates are well above .60. Secondly, discriminant validity was
assessed through comparing individual bivariate correlation matrix and the
reliability estimates. No correlation is higher than the reliability estimate.
Exploratory Factor Analysis
Awareness of societal
consequences (ASC)
Normative Beliefs
and Motivation to
Comply
First sample
Cronbach’s alpha was determined for each of the dimensions suggested by the
conceptual framework to provide a preliminary assessment of reliability. An
examination of the item-to-total correlations within each dimension was conducted.
Based on item-to-total correlations two items from perceived product attribute
dimension and one item from perceived risks dimension were deleted. Cronbach’s
alpha for the complete 41 item scale improved from 0.818 to 0.862.
Scale items were then assessed by examining means, variances, squared multiple
correlations (SMCs), item-to-total correlations and result of an exploratory factor
analysis (EFA) using component factor analysis with varimax rotation.
Step 6: Data
Collection
Although desperate need and drug counterfeiting are linked in developing countries, no
much research has been carried out to address this area, and there is a lack of proper tool
and methodology. This study addresses the need for a scale to aid in understanding demand
side of drugs counterfeiting. As this research prime focus is developing a scale to measure
consumer behavior regarding counterfeit drugs purchase and factors influencing this
behavior, it seems that Theory of Planned Behavior (TPB) (Ajzen, 1991) with its roots in
Theory of Reasoned Action (TORA) (Ajzen & Fishbein, 1980) is a suitable conceptual
framework (Figure 1). It was also suggested that it is suitable to develop the scale following
the procedures advocated by Churchill (1979) and DeVellis (2003) (Figure 2).
.
Price quality inference (PQ)
Risk averseness (RA)
Results (Continue)
Scale Development Procedure
Results
Phase 1: Items generation and reduction
In this study, decision rule that focused on the overall evaluation of all the
judges was used Zaichkowsky’s (1985). The application of this judging
procedure reduced the number of items across the four aspects from sixty
nine items to forty four items.
Data Analysis of the First and Second Round of Data Collection
The two samples covered all age groups from 18 to 75 years. They
contained 52% and 47% males for the first and second samples
respectively. Respondents reported their annual income in five groups,
their education status in four groups, and their working status in ten
groups.
74.269
62.563
Conclusion
To the authors’ knowledge, this is the first work attempt to conceptualize and
operationalize consumer behavior toward counterfeit drugs. High reliability and
demonstration of convergent and discriminant validity indicated that the “Consumer
Behavior toward Counterfeit Drugs Scale” is a valid, reliable scale existing within a
solid theoretical base.
Ultimately, the study offer public health policy makers and marketing manager a valid
measurement tool to build a better understanding of the demand side of counterfeit
drugs and hence aids in developing more effective strategies to combat the problem.
References
Ajzen, I. & Fishbein, M. (1980). Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice Hall.
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211.
Churchill, G. (1979). A Paradigm for constructing better measures of marketing concept. Journal of Marketing Research, 16(1),
64-73.
De Vellis, R. F. (1991). Scale development: Theory and applications. Newbury Park, CA: Sage.
Zaichkowsky, J. L. (1985). Measuring the involvement construct. The Journal of Consumer Research, 12(3), 341-352.