MINI REVIEW article

A literature review of word of mouth and electronic word of mouth: implications for consumer behavior.

\r\nNuria Huete-Alcocer*

  • Economía Española e Internacional, Econometría e Historia e Instituciones Económicas, University of Castilla-La Mancha, Albacete, Spain

The rise and spread of the Internet has led to the emergence of a new form of word of mouth (WOM): electronic word of mouth (eWOM), considered one of the most influential informal media among consumers, businesses, and the population at large. Drawing on these ideas, this paper reviews the relevant literature, analyzing the impact of traditional WOM and eWOM in the field of consumer behavior and highlighting the main differences between the two types of recommendations, with a view to contributing to a better understanding of the potential of both.

Introduction

Consumers increasingly use online tools (e.g., social media, blogs, etc.) to share their opinions about the products and services they consume ( Gupta and Harris, 2010 ; Lee et al., 2011 ) and to research the companies that sell them. These tools are significantly changing everyday life and the relationship between customers and businesses ( Lee et al., 2011 ).

The rapid growth of online communication through social media, websites, blogs, etc., has increased academic interest in word of mouth (WOM) and electronic word of mouth (eWOM) (e.g., Hennig-Thurau et al., 2004 ; Brown et al., 2007 ; Cheung and Thadani, 2012 ; Hussain et al., 2017 ; Yang, 2017 ). Specifically, the present paper will review the literature on how these two media have evolved, the main differences between them, and the degree to which they influence both businesses and consumers, now that they have become some of the most influential information sources for decision-making.

Word of mouth is one of the oldest ways of conveying information ( Dellarocas, 2003 ), and it has been defined in many ways. One of the earliest definitions was that put forward by Katz and Lazarsfeld (1966) , who described it as the exchanging of marketing information between consumers in such a way that it plays a fundamental role in shaping their behavior and in changing attitudes toward products and services. Other authors (e.g., Arndt, 1967 ) have suggested that WOM is a person-to-person communication tool, between a communicator and a receiver, who perceives the information received about a brand, product, or service as non-commercial. Likewise, WOM has been defined as communication between consumers about a product, service, or company in which the sources are considered independent of commercial influence ( Litvin et al., 2008 ). These interpersonal exchanges provide access to information related to the consumption of that product or service over and above formal advertising, i.e., that goes beyond the messages provided by the companies and involuntarily influences the individual’s decision-making ( Brown et al., 2007 ). WOM is widely regarded as one of the most influential factors affecting consumer behavior ( Daugherty and Hoffman, 2014 ). This influence is especially important with intangible products that are difficult to evaluate prior to consumption, such as tourism or hospitality. Consequently, WOM is considered the most important information source in consumers’ buying decisions ( Litvin et al., 2008 ; Jalilvand and Samiei, 2012 ) and intended behavior. For example, tourist satisfaction is of utmost importance because of its influence on behavioral intentions, WOM and purchasing decisions. In other words, overall satisfaction leads to the possibility of revisiting and recommending the destination ( Sotiriadis and Van Zyl, 2013 ).

Similarly, previous research indicates that consumers regard WOM as a much more reliable medium than traditional media (e.g., television, radio, print advertisements, etc.) ( Cheung and Thadani, 2012 ). It is thus considered one of the most influential sources of information about products and services ( Lee and Youn, 2009 ). Users generally trust other consumers more than sellers ( Nieto et al., 2014 ). As a result, WOM can influence many receivers ( Lau and Ng, 2001 ) and is viewed as a consumer-dominated marketing channel in which the senders are independent of the market, which lends them credibility ( Brown et al., 2007 ). This independence makes WOM a more reliable and credible medium ( Arndt, 1967 ; Lee and Youn, 2009 ).

Today’s new form of online WOM communication is known as electronic word-of-mouth or eWOM ( Yang, 2017 ). This form of communication has taken on special importance with the emergence of online platforms, which have made it one of the most influential information sources on the Web ( Abubakar and Ilkan, 2016 ), for instance, in the tourism industry ( Sotiriadis and Van Zyl, 2013 ). As a result of technological advances, these new means of communication have led to changes in consumer behavior ( Cantallops and Salvi, 2014 ; Gómez-Suárez et al., 2017 ), because of the influence they enable consumers to exert on each other ( Jalilvand and Samiei, 2012 ) by allowing them to obtain or share information about companies, products, or brands ( Gómez-Suárez et al., 2017 ).

One of the most comprehensive conceptions of eWOM was proposed by Litvin et al. (2008) , who described it as all informal communication via the Internet addressed to consumers and related to the use or characteristics of goods or services or the sellers thereof. The advantage of this tool is that it is available to all consumers, who can use online platforms to share their opinions and reviews with other users. Where once consumers trusted WOM from friends and family, today they look to online comments (eWOM) for information about a product or service ( Nieto et al., 2014 ).

As a result of ICT, today consumers from all over the world can leave comments that other users can use to easily obtain information about goods and services. Both active and passive consumers use this information medium (eWOM). Individuals who share their opinions with others online are active consumers; those who simply search for information in the comments or opinions posted by other customers are passive consumers ( Wang and Fesenmaier, 2004 ).

Electronic word of mouth also provides companies with an advantage over traditional WOM insofar as it allows them both to try to understand what factors motivate consumers to post their opinions online and to gauge the impact of those comments on other people ( Cantallops and Salvi, 2014 ). However, consumers’ use of technology to share opinions about products or services (eWOM) can be a liability for companies, as it can become a factor they do not control ( Yang, 2017 ). To counteract this, businesses are seeking to gain greater control of customers’ online reviews by creating virtual spaces on their own websites, where consumers can leave comments and share their opinions about the business’s products and services ( Vallejo et al., 2015 ). By way of example, in the field of tourism, companies are starting to understand that ICT-enabled media influence tourists’ purchasing behavior ( Sotiriadis and Van Zyl, 2013 ).

Understandably, companies view both types of recommendations – WOM and eWOM – as a new opportunity to listen to customers’ needs and adjust how they promote their products or services to better meet them, thereby increasing their return. A negative or positive attitude toward the product or service will influence customers’ future purchase intentions by allowing them to compare the product or service’s actual performance with their expectations ( Yang, 2017 ).

In the field of consumer behavior, some previous studies (e.g., Park and Lee, 2009 ) have shown that consumers pay more attention to negative information than to positive information ( Cheung and Thadani, 2012 ). For example, the customers most satisfied with a product or service tend to become loyal representatives thereof via positive eWOM ( Royo-Vela and Casamassima, 2011 ), which can yield highly competitive advantages for establishments, businesses, or sellers, especially smaller ones, which tend to have fewer resources. Some studies have suggested that traditional WOM is the sales and marketing tactic most often used by small businesses.

Additionally, eWOM offers businesses a way to identify customers’ needs and perceptions and even a cost-effective way to communicate with them ( Nieto et al., 2014 ). Today, eWOM has become an important medium for companies’ social-media marketing ( Hussain et al., 2017 ).

WOM vs. eWOM

While many authors (e.g., Filieri and McLeay, 2014 ) consider eWOM reviews to be electronic versions of traditional WOM reviews, this paper aims to summarize and explain the main differences between the two concepts (Table 1 ). The first such difference is credibility as an information source ( Cheung and Thadani, 2012 ; Hussain et al., 2017 ), since it can influence consumers’ attitudes toward products or services ( Veasna et al., 2013 ), for example, with regard to the purchase of tourism services, which are considered to be high-risk ( Sotiriadis and Van Zyl, 2013 ). Luo et al. (2013) have suggested that the anonymity of online messages could have a negative effect on their credibility. In contrast, other studies (e.g., Hussain et al., 2017 ) have argued that consumers use eWOM more to reduce risk when decision-making. Likewise, eWOM tends to be more credible when the consumer using it has previous experience ( Sotiriadis and Van Zyl, 2013 ).

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TABLE 1. Differences between WOM and eWOM.

Message privacy is another feature that sets the two media apart, since with traditional WOM information is shared through private, real-time, face-to-face dialogs and conversations. In contrast, information shared through eWOM is not private and can sometimes be seen by anonymous people who do not know each other. Furthermore, reviews can be viewed at various points in time ( Cheung and Thadani, 2012 ). Indeed, because eWOM reviews are written, consumers and companies can check them at any time; this stands in contrast to traditional WOM, where once the message has reached the receiver, it tends to disappear.

Another salient difference between the two media is the speed of diffusion of the message; eWOM statements spread much faster than WOM statements because of where they are published, i.e., on the Internet ( Gupta and Harris, 2010 ). Online platforms for sharing information (social media, websites, blogs, etc.) are what set eWOM apart from traditional WOM ( Cheung and Thadani, 2012 ). First, they make the reviews accessible to more consumers ( Cheung and Thadani, 2012 ; Sotiriadis and Van Zyl, 2013 ). Second, because they are written, they persist over time ( Hennig-Thurau et al., 2004 ; Cheung and Thadani, 2012 ).

This paper has reviewed the literature with a view to providing a clearer understanding of WOM and eWOM in the context of consumer information searches.

To this end, the review found that, in keeping with numerous studies, WOM is both the oldest medium for sharing opinions about products or services and the one most likely to influence consumer behavior, due to the high reliability and credibility transmitted by family and friends. In contrast, few studies have examined the interaction between perceived risk and eWOM source credibility ( Hussain et al., 2017 ).

Notwithstanding the above, the review of the theoretical framework also revealed a gap in the literature on WOM credibility in situations involving multiple or many communicators and receivers and how this ultimately affects the end consumer. This would include, for instance, situations in which one person communicates a message to another, who acts as an intermediary, both receiving the original message and passing it along to a third party, i.e., the end consumer. In such cases, the original message can be altered or distorted, chipping away at the credibility of the WOM review as a source of information. This lends much more strength to written comments and reviews, such as eWOM, which can ultimately reduce risk and increase consumer confidence.

Another feature that distinguishes eWOM from traditional WOM is the speed with which it spreads and the ease of access to it. In this regard, when consumers need information about a product or service, they ultimately turn to online media (eWOM) for two reasons. First, they can get the information more quickly, as there is no need to wait for someone else – a friend or family member – to offer an opinion about what they wish to consume. Second, if they have already received WOM reviews, they can use eWOM to corroborate the information received. Therefore, credibility and speed are the two main features not only distinguishing the two media, but also influencing consumer behavior.

Finally, the analysis of the review showed that these two concepts – WOM and eWOM – while seemingly the same, are at the same time very different. The Internet has transformed traditional WOM into eWOM. The communication of opinions is no longer done interpersonally (i.e., person-to-person or face-to-face), but rather is mediated by ICT. However, the many studies conducted (e.g., Katz and Lazarsfeld, 1966 ; Brown et al., 2007 ; Daugherty and Hoffman, 2014 ; Yang, 2017 ) agree that they are the media most able to influence consumer behavior and the most often used to obtain information before, during, and after consuming a given product or service. For example, in the field of tourism, eWOM is considered the most influential pre-purchase source of travel information ( Sotiriadis and Van Zyl, 2013 ).

Author Contributions

This paper tries to offer a clearer understanding of the two concepts through a literature review and an exploration of how, as a result of advances in ICT, traditional WOM has given rise to eWOM. The author has made an important, direct, intellectual contribution to this paper and has approved it for publication.

This research was funded by the Spanish Ministry of Economy and Competitiveness under Research Project ECO2014-59688-R (“Planning and implementation of optimal management strategies for physical, online and mobile POSs based on ICT and innovation”).

Conflict of Interest Statement

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Keywords : businesses, consumers, WOM, eWOM, communication

Citation: Huete-Alcocer N (2017) A Literature Review of Word of Mouth and Electronic Word of Mouth: Implications for Consumer Behavior. Front. Psychol. 8:1256. doi: 10.3389/fpsyg.2017.01256

Received: 31 March 2017; Accepted: 10 July 2017; Published: 25 July 2017.

Reviewed by:

Copyright © 2017 Huete-Alcocer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Nuria Huete-Alcocer, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Word-of-mouth in business-to-business marketing: a systematic review and future research directions

Journal of Business & Industrial Marketing

ISSN : 0885-8624

Article publication date: 10 January 2023

Issue publication date: 18 December 2023

The purpose of this study is to review and analyze the status of word-of-mouth (WOM) research in the business-to-business (B2B) context and discuss and identify new possible future directions.

Design/methodology/approach

A systematic review was conducted and 36 articles on B2B WOM were collected to evaluate the current state of the literature and clarify possible future research directions.

This thematic analysis categorize these articles into three themes: WOM generation, WOM usage and reference marketing. Under each theme, the authors reveal research findings unique to B2B research and different from business-to-consumer (B2C) WOM research. This study identifies several research questions that should be addressed by future research.

Originality/value

Both academic researchers and business practitioners recognize that WOM plays an essential role in B2B marketing. However, no review paper focuses on WOM in the B2B context. Findings in the B2C WOM literature suggest that WOM substantially influences firms’ performance, but that managers cannot simply attempt to extrapolate B2C findings to the B2B arena. By synthesizing and assessing prior research on WOM in the B2B context, this study contributes to a better understanding of the B2B WOM phenomenon and facilitates future research on this topic.

  • Business-to-business marketing
  • Recommendation
  • Systematic review
  • Word-of-mouth

Ishii, R. and Kikumori, M. (2023), "Word-of-mouth in business-to-business marketing: a systematic review and future research directions", Journal of Business & Industrial Marketing , Vol. 38 No. 13, pp. 45-62. https://doi.org/10.1108/JBIM-02-2022-0099

Emerald Publishing Limited

Copyright © 2022, Ryuta Ishii and Mai Kikumori.

Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence maybe seen at http://creativecommons.org/licences/by/4.0/legalcode .

1. Introduction

In the field of business-to-consumer (B2C) marketing, it is widely accepted that word-of-mouth (WOM) has a meaningful influence on consumers’ buying decisions. Whether face-to-face or electronic, WOM has a more substantial impact on sales than other elements of the marketing mix, such as advertising and personal selling ( Kim and Hanssens, 2017 ; You et al. , 2015 ). The volume of consumer reviews on a particular product improves product awareness and drives consumers to purchase it ( Babić Rosario et al. , 2016 ; Chevalier and Mayzlin, 2006 ; Zhu and Zhang, 2010 ). Both positive and negative WOM can improve product evaluations and purchase intentions ( Allard et al. , 2020 ; Berger et al. , 2010 ). Furthermore, from a long-term perspective, consumers acquired through WOM bring about twice as much value to a company as other consumers ( Villanueva et al. , 2008 ).

WOM has a considerable influence on purchasing decisions, not only in B2C but in business-to-business (B2B) marketing as well ( Money, 2004 ). For example, purchasing managers in buying firms often obtain WOM information from their internal coworkers (e.g. salespersons and other purchasing managers) or external partners (e.g. exchange partners and business friends) when searching for a new supplier or evaluating a novel industrial product ( Money et al. , 1998 ; Tóth et al. , 2020 ). B2B buyers have begun forming online communities and use electronic WOM from other buyers in the community ( Steward et al. , 2018 ). Given that WOM plays a vital role in the purchasing decisions of buyer firms, seller firms proactively use it to promote their products and services. For example, they ask their existing customers to recommend their products to potential customers ( Hada et al. , 2013 ; Hada et al. , 2014 ) and post customer reviews of their products on their websites as case studies ( Jaakkola and Aarikka-Stenroos, 2019 ; Jalkala and Salminen, 2009 ). This practice, referred to as reference marketing or referral marketing, is widely used in business markets.

Therefore, the topic of WOM has attracted the attention of marketing managers and academic researchers because of its key influence on both B2C and B2B marketing. Indeed, to date, many reviews have been published on WOM ( Babić Rosario et al. , 2020 ; Berger, 2014 ; de Matos and Vargas Rossi, 2008 ; Donthu et al. , 2021 ; King et al. , 2014 ). However, all these reviews focus on WOM in the B2C context and not in the B2B context. Findings in the B2C WOM literature suggest that WOM substantially influences firms’ performance, but that managers cannot simply attempt to extrapolate B2C findings to the B2B arena. Thus, it is essential to synthesize research findings and identify future research directions on the role of WOM in B2B marketing.

Therefore, the purpose of our study is to review and analyze the status of WOM research in the B2B context, synthesize research findings to date and identify possible future directions using a systematic review method. This method differs from a traditional narrative review in that it removes the subjective bias of the researcher. It ensures exhaustive and comprehensive literature searches through a replicable, scientific and transparent process.

The rest of the paper is structured as follows. We first define and clarify the concept of WOM along with relevant concepts, such as referrals, recommendations and references in the Section 2. Next, we describe the systematic review method and the data collection procedure in the Section 3. Subsequently, we conduct descriptive and thematic analyses of the reviewed articles in the Sections 4 and 5. Finally, we present managerial implications, discuss our analysis, and show possible directions for future research in the Sections 6 and 7.

2. Word-of-mouth in the business-to-business context

WOM is defined as:

An oral or written communication process between a sender and an individual or group of receivers, regardless of whether they share the same social network, with the purpose of sharing and acquiring information on an informal basis ( Barreto, 2014 , p. 647).

Marketing scholars have used various terms to refer to the WOM phenomenon in the B2B context, such as WOM ( Faroughian et al. , 2012 ; Kim, 2014 ), referral ( Hartmann and de Grahl, 2011 ; Wallenburg, 2009 ) and recommendation ( Olaru et al. , 2008 ). Several authors have even used a combination of these terms, such as WOM referrals ( Money et al. , 1998 ; Roth et al. , 2004 ) and WOM recommendation ( Chenet et al. , 2010 ). However, these terms are often used interchangeably in the B2B WOM literature ( Aarikka-Stenroos and Sakari Makkonen, 2014 ; Tóth et al. , 2020 ). Thus, we only use the term “WOM” here. However, we need to draw a clear line between the terms WOM and reference. As discussed earlier, in B2B marketing, selling firms often use customers’ WOM as a marketing and sales tool. Such seller-initiated active utilization of customers’ WOM is referred to as reference marketing. Although reference marketing is included in the WOM phenomenon, B2B marketing scholars distinguish between “WOM,” which is informal communication among customers wherein the seller does not intervene, and “reference,” which is communication using WOM in which the seller intervenes.

Based on the above discussion, the WOM phenomenon in B2B marketing can be classified into two categories: “pure WOM” and “reference marketing.” As shown in Figure 1 , “pure WOM” is the process where a sender (e.g. an existing buyer or a salesperson) sends WOM to a receiver (e.g. a potential customer or an internal colleague). Suppliers do not directly intervene in this process, but they can be indirectly involved by incentivizing a sender to generate WOM about themselves or their offerings. “Reference marketing” is the process where a supplier uses WOM from a sender (i.e. reference customer) to provide information to a receiver (e.g. a potential customer). Suppliers can intervene in this process by choosing the sender as a reference customer.

WOM sender;

WOM receiver; and

A WOM sender (e.g. an existing buyer or reference customer) sends positive or negative WOM to internal colleagues or external buyers or provides experiential information related to suppliers. A WOM receiver (i.e. a potential customer) receives and processes WOM information from the senders and uses it for purchase-related decision-making. A supplier encourages existing customers to send WOM to prospective customers or to use WOM information from reference customers as a marketing tool. In the next section, we conduct a systematic review while considering these terminologies and classifications.

3. Methodology

We adopted the systematic review method to analyze the status quo of B2B WOM research. The advantages of this method are described in recent studies published in the Journal of Business & Industrial Marketing ( Chawla et al. , 2020 ; Minerbo and Brito, 2021 ; Yaghtin et al. , 2021 ) and others ( Hulland and Houston, 2020 ; Transfield et al. , 2003 ). We searched and reviewed articles based on the procedure established by Transfield et al. (2003) . First, we developed a review protocol, which included a review question, the focus of this research and the data collection strategy for relevant articles. We searched, collected and assessed the quality and relevance of the identified articles based on this protocol. We then conducted both descriptive and thematic analyses to reveal specific and detailed information on reviewed articles and summarized the key findings of the literature. Finally, we synthesized the findings into an integrated conceptual framework to investigate the WOM phenomenon in the B2B context and identified possible directions for future research. In this section, we describe the process of data collection and synthesis.

3.1 Review question

A systematic review is driven by a review question from which search strings for scientific database searches are defined, criteria for inclusion or exclusion are specified, and an overall process for collecting relevant literature is established. As stated earlier, we aim to synthesize research findings and identify future research directions on the role of WOM in B2B marketing. Therefore, we set two review questions: (1) “What do we know about WOM in B2B marketing?” and (2) “What do we not know about WOM in B2B marketing?”

3.2 Database and search terms

EBSCO Business Source Complete;

Science Direct; and

These databases have a worldwide reputation as reliable platforms; cover most of the published articles on business and marketing; and allow us to search for articles using the title, abstract and keywords.

Given that the review questions are about the findings and research gaps in B2B WOM, it is necessary to choose articles focusing on the context of business markets or B2B marketing. Therefore, we set two groups of keywords: the first group focused on WOM, including four keywords: “WOM,” “referral,” “customer reference” and “customer review”; and the second group was about B2B, also including four keywords: “business-to-business,” “industrial markets,” “industrial marketing” and “supplier.” We used the three databases to search for published articles containing WOM-related keywords in the first group and B2B-related keywords in the second group, either in the title, abstract or keywords. We conducted our initial search in January 2021 with no publication time limit. As shown in Figure 2 , 141 articles were obtained as the set of initial samples: 71 from EBSCO Business Source Complete, 32 from Science Direct and 38 from Emerald. After removing duplicate articles, 111 articles remained.

3.3 Inclusion and exclusion criteria

To ensure an unbiased selection of literature for our review, we established clear inclusion and exclusion criteria. We focused on peer-reviewed, full-text accessible, original research articles published in English. Therefore, non-peer-reviewed business articles and editorials were excluded. We included journals from two widely recognized international journal lists: the Academic Journal Guide (Chartered Association of Business Schools) and the Journal Quality List (Australian Business Deans Council). We included articles that address the WOM phenomenon as the explained object (e.g. studies that treat WOM as the dependent variable in quantitative studies) and articles that use WOM to explain a specific phenomenon (e.g. quantitative studies that have WOM as an independent variable in quantitative studies). We excluded articles that focused on the B2C context rather than B2B. We decided to include articles that considered WOM in both B2B and B2C contexts (e.g. comparing WOM effects in B2B and B2C contexts). We also decided to exclude articles that discussed WOM in general, since, at least in the academic field, WOM refers to B2C WOM, not B2B WOM. A key term associated with WOM is social media. Although communication among customers on social media can be viewed as a WOM phenomenon, the use of social media by firms is difficult to capture as a WOM phenomenon. Hence, studies focusing on WOM in social media were included in the review, whereas studies on social media usage were excluded.

3.4 Selection of relevant articles

Two researchers reviewed 111 literature summaries. Based on the inclusion and exclusion criteria, they screened the articles relevant to our review questions. However, for several references, it was difficult to determine whether to include them in our review based solely on reading the abstracts. In those cases, we manually read the full text to obtain the information needed to decide. Disagreements between the two researchers were resolved through consultation.

Most of the 111 references focused on WOM in a B2C context and the use of social media by B2B firms. Based on the inclusion/exclusion criteria, these references were excluded. Similarly, applying that criterion, editorial and economic articles were also excluded. Among the 111 articles, many focused on WOM in the B2C context and social media in the B2B context. Because the latter studies focused on the usage, design and management of social media by B2B companies, they were also removed, and 33 articles were extracted. Finally, by examining the citations of these 33 articles, 3 additional important articles were identified. Occasionally, review articles that focused on WOM in general were also cited; however, we did not add them as key references because the review articles implicitly focused on the B2C context (e.g. individual consumer reviews, informal communication among consumers). Consequently, there were 36 studies in total.

3.5 Extraction, analysis and synthesis

After determining the literature to be included in the review, the last step in the data collection process was to create a data extraction form. To extract the data, we used a Microsoft Excel spreadsheet. This sheet contained the following information for the collected literature: title, authors, publication journal, year of publication, article type, sample size, industry context, country, major research findings, type of WOM, etc. To reduce subjective bias as much as possible, each author reviewed all 36 references and completed the required fields in the spreadsheet. When disagreements arose among the authors regarding coding and classification, decisions were made through discussion. The final spreadsheet was helpful in conducting the descriptive and thematic analysis that followed.

4. Descriptive analysis

Literature on WOM in B2B marketing emerged in the 1970s, when academic scholars paid great attention to industrial buying behaviors and investigated the difference between B2B and B2C marketing strategies ( Sheth, 1973 ; Webster and Wind, 1972 ). The pioneering works of Martilla (1971) and Webster (1970) revealed that WOM is generated either by internal colleagues (i.e. intrafirm WOM) or external firms (i.e. interfirm WOM) and is an essential factor that influences business organizations’ decision-making processes. For almost three decades after these works, very little research focused on WOM in B2B marketing. Since the 2000s, however, more than 30 WOM-related articles have been published. Specifically, 2 articles (5.6%) were published between 2001 and 2005, 9 (25%) between 2006 and 2010, 11 (30.6%) between 2011 and 2015 and 11 (30.6%) between 2016 and 2020. There were at least three causes of the widespread recognition among researchers and the gradual increase in the number of WOM-related articles. First, online review websites have increased in B2B marketing, and WOM communication among buyers has influenced purchasing decisions. Second, in the context of B2B marketing, the use of social networking services has become commonplace, and communication about products and services has become active in buyer communities and professional networks. Third, the spread of the internet has increased the need for companies to establish their own websites and to post customer feedback as a form of testimonials on those websites.

As shown in Table 1 , the 36 articles included in this review were published in 15 separate journals. Of the 15 journals, 11 were rated three and above in the Academic Journal Guide (AJG; Chartered Association of Business School, 2021 ). According to the ABDC Journal Quality List (JQL), eight were A* journals, five were A and two were B ( Australian Business Deans Council, 2019 ). In the Scimago Journal Rank indicator, most journals (80%) belonged to the Q1 category. These results indicate that the articles included in this review are of good quality and that the editors and reviewers of top-level journals are paying attention to this topic. Regarding the number of articles, approximately half the articles (44%) were published in the two leading journals specializing in B2B marketing: Industrial Marketing Management (31%, n = 11) and Journal of Business & Industrial Marketing (14%, n = 5). This suggests that B2B marketing scholars have contributed considerably to our understanding of the WOM phenomenon in the B2B context. Other journals that feature in our study and are of international repute include Journal of Marketing (6%, n = 2), Journal of Marketing Research (6%, n = 2), European Journal of Marketing (8%, n = 3), Journal of Supply Chain Management (8%, n = 3) and Journal of Services Marketing (6%, n = 2). Other articles were also published in internationally recognized journals in the field of marketing and business, such as the Journal of the Academy of Marketing Science and Journal of Business Research . Most of these journals are general journals on marketing and business. The appearance of articles on B2B WOM in such journals suggests that various marketing researchers are interested in this topic.

Figure 3 shows the trend over time and current proportion of each methodology used by the selected articles. According to the present proportion of methodologies used, of the 36 articles, most were empirical studies (94%, n = 34), with the most common method being quantitative analyses with data collection by mail or an online survey (47%, n = 17). This trend is similar to that of other topics in B2B marketing. The qualitative interview method (25%, n = 9) was also often used by the selected articles. Compared to quantitative methods, qualitative methods are used in the early stages of a particular research field because they are better at examining new and complex phenomena in an exploratory manner ( Granot et al. , 2012 ; Woodside and Wilson, 2003 ). Indeed, several articles in our review stated that they use qualitative methods because there are few studies on B2B WOM, and there is an insufficient description of the phenomenon and elaboration of the concepts ( Jaakkola and Aarikka-Stenroos, 2019 ; Jalkala and Salminen, 2010 ). Therefore, a relatively large proportion of qualitative studies in the selected articles suggests that the study on B2B WOM is in its early stages.

No literature reviews (e.g. systematic reviews or meta-analyses) were found. Notably, the time-series trends indicate a gradual increase in the number of experimental methods in recent years. This is because B2B marketing is beginning to pay more attention to experimental methods: the use of experimental stimuli in a B2B context is difficult because the purchase of B2B products/services involves multiple persons, and the buying process is a long one. Hence, experimental methods tend to be shunned in B2B marketing research. However, the experimental method is a valuable gold standard for analyzing causal relationships ( Hada, 2021 ). In fact, experimentation is used extensively in B2C WOM research.

Figure 4 shows the loci of the empirical studies analyzed in this review. Of the 34 empirical studies, 25 explicitly indicated the country where data were collected. The two major regions were Europe (32%, n = 8, three studies in the UK, two in Germany, two in a particular European country, and one in Finland) and the USA (28%, n = 7). Four studies were conducted in China and one each in Australia, Canada and India. Moreover, three studies collected data from multiple countries (i.e. USA and Japan) to compare the organizational buying behaviors. Overall, most extant literature has focused on organizational behaviors of developed Western countries. Such overall trends indicate that researchers in the USA and Western Europe are the main contributors to research on B2B WOM. Additionally, we should be cautious about applying such research findings to WOM behaviors in other regions such as Asia and Africa.

Table 2 shows the industries that the empirical studies in this review considered as the research context. Overall, most studies focused on B2B services, which, unlike tangible industrial products, are characterized by their intangible and variable nature, making it difficult to assess their quality before buying or experiencing them. Therefore, WOM information plays a crucial role in the evaluation and purchase of B2B services. Previous studies ( Faroughian et al. , 2012 ; Hada et al. , 2014 ; Jalkala and Salminen, 2009 ; Money, 2004 ) have often focused on three services: “IT and software procurement,” “logistics and transportation” and “financial service.” In the information technology (IT) and logistics service industries, it has been found that sellers and buyers actively use WOM, the latter in making purchasing decisions. Several studies have focused on reference marketing in the context of IT procurement or logistics services. This suggests that in the IT and logistics industries, selling firms actively use WOM information as a marketing tool, whereas buying firms rely on it to make purchasing decisions. Further, start-up companies often face purchasing decisions regarding logistics and financial services ( Money et al. , 1998 ; Roth et al. , 2004 ). Other services that frequently appear in empirical studies are telephone and food services, which were investigated in two studies. Other services include printing, advertising and packaging. Some studies have focused on the transactions of tangible industrial goods rather than services. Specifically, they have examined the role of WOM in the purchasing decisions of pharmaceuticals, electronic machinery and processing equipment.

5. Thematic analysis

WOM generation;

WOM usage; and

reference marketing.

Table 3 presents an overview of research findings from the reviewed articles. This section offers the contributions and discusses the main research findings for each theme.

5.1 Theme I: word-of-mouth generation

The first theme is WOM generation and focuses on the sender or source of WOM; 16 (44%) of the 36 studies in this review come under this theme, where the research question is, “Why do customer firms send positive or negative WOM messages?” These studies investigate the antecedents of WOM communication. This theme has two characteristics: first, prior research on this theme has often treated positive WOM messages, such as recommendations and referrals, as positive outcome indicators, along with repurchase intention, satisfaction, loyalty and relationship continuity. By stating that “a widely studied outcome variable within the relationship marketing literature is word-of-mouth,” Brock and Yu Zhou (2012 , p. 372) emphasized the importance of WOM as a performance indicator in B2B research. Second, 13 (81%) of the 16 studies used a quantitative survey as the empirical method. Most of these survey studies focused on B2B services, such as logistics, IT, and finance. This suggests that B2B service marketers emphasize WOM generation.

Prior research on B2C marketing identifies satisfaction, loyalty, quality, perceived value and trust as essential antecedents of WOM generation ( de Matos and Vargas Rossi, 2008 ). WOM studies in B2B marketing extend these research findings of B2C WOM by identifying moderating variables specific to B2B marketing. Olaru et al. (2008) showed that the effect of service value on positive WOM generation is moderated by organization type (government versus private firm) and contract length (long versus short). Anaza and Rutherford (2014) considered both individual and organizational levels of the interorganizational relationship between seller and buyer. They found that positive WOM is created by loyalty to individual salespersons and satisfaction with seller firms.

Studies under this theme have identified the antecedents of WOM generation, such as firm strategy, organizational capabilities, strategic orientation and interfirm relationships, which have not been assessed in WOM research in the B2C context. Hartmann and de Grahl (2011) focused on the concept of organizational flexibility and indicated that logistics service providers can promote customer referrals by responding flexibly to customers’ needs and changes in the environment. Mo et al. (2020) found that an increase of out-of-the-channel-loop perception, which means a channel member’s perception of exclusion from a supplier’s distribution channel networks, decreases positive WOM generation.

Prior research has also investigated the generation of negative WOM messages when B2B service failure occurs. Wang and Huff (2007) identified the conditions under which buyers generate negative WOM when a seller violates the buyer’s trust by failing to meet the buyer’s confident expectations. Specifically, they showed that buyers in the early stages of trust development and/or those who perceive a high likelihood of repeated violation respond negatively and sensitively to a violation of trust.

Overall, prior studies have shown that firm characteristics and interfirm factors generate WOM or moderate the effects of WOM. However, there has been no attempt to examine who generates WOM within a firm or what happens to buyer firms and purchasing managers as a result of WOM generation. These are research questions to be addressed in the future, and we discuss them in detail in the next section.

5.2 Theme II: word-of-mouth usage

Research under the theme of WOM usage has addressed the following questions: What types of WOM messages do customer firms use? Why do customer firms use WOM messages as a source of information for purchase decision-making? What are the consequences of WOM usage? These questions are rarely addressed in B2C WOM research and are specific to the field of B2B marketing.

As shown in Table 4 , WOM information used by customer firms is classified into four types based on the sender–receiver relationship (within-firm versus between-firm) and communication mode (face-to-face versus internet). The first type is the intrafirm offline WOM . Martilla (1971) conducted exploratory interviews with 66 managers in the paper industry and found that there are opinion leaders in each company who have a considerable influence on the purchasing decisions for industrial products through WOM communication within the company. The second type is the intrafirm online WOM . Steward et al. (2018) showed that sellers’ scorecards (performance appraisal systems) available on company intranets can be regarded as WOM information within a company and that they influence purchasing decisions in B2B markets. The third is interfirm offline WOM , which has been the focus of many studies. Money et al. (1998) and Roth et al. (2004) found that start-up firms often refer to WOM information from relatives, friends, and business acquaintances when they make purchase decisions for B2B services such as logistics, advertising and finance. Hada et al. (2014) also focused on the face-to-face WOM prompted by suppliers (i.e. face-to-face reference) in B2B markets and showed that B2B marketers often use such reference information from other companies in the purchase process. Fourth is interfirm online WOM . According to Steward et al. (2018) , professional B2B buyers have formed online communities in recent years and refer to other buyers’ reviews of B2B products and services. Many studies in this review examine online reference marketing, where sellers post buyers’ WOM reviews on their own website and use it as a marketing tool ( Jalkala and Salminen, 2009 ; Terho and Jalkala, 2017 ). They show that online WOM from other companies (i.e. interfirm online WOM) is often used in B2B marketing.

Previous studies also address the research questions: Why do customer firms use WOM messages as sources of information for purchase decision-making? What are the consequences of WOM usage? These studies investigate the antecedents and consequences of WOM usage. The former focuses mainly on firm characteristics as a factor influencing WOM usage. For example, Money et al. (1998) conducted exploratory interviews with purchasing managers of 48 start-up firms in Japan and the USA and showed that organizational culture plays a vital role in selecting B2B service providers. Specifically, Japanese companies are more likely to use WOM information sources than US companies because Japanese companies have a strong culture of collectivism and uncertainty avoidance. In addition, Yang et al. (2017) found that firms performing above expectations tend to choose suppliers based on partners’ referrals because they are more inclined to maintain the status quo and are less willing to take risks.

Existing studies focusing on the consequences of WOM usage investigate the effects of WOM usage and WOM type on outcome variables such as satisfaction and relationship continuity. In thesecases, the supplier is selected through WOM information. For example, Money (2004) indicated that buyer firms’ switching behaviors are influenced by the use of WOM and tie strength between the sender and receiver (buyer firms). Specifically, firms that use WOM information to select B2B service providers are less likely to switch to existing suppliers than those that do not. In addition, Japanese firms in Japan do not tend to change service providers when they consult WOM sources with high likability and/or expertise. Furthermore, Kim (2014) found that the higher the expertise of the WOM source and the more similar the buyer and the WOM source, the more likely that the buyer will establish a strong relationship and continue business with a supplier.

In summary, prior research has shown that using WOM to select business partners allows firms to form strong relationships with them and reduce the likelihood of switching to other firms in the future. In addition, prior research has shown that firms use WOM to reduce uncertainty and maintain their current favorable performance. However, there is insufficient empirical evidence on the relationship between WOM usage and firm performance. Insights are needed on how firms should use different types of WOM and under what conditions WOM usage is effective.

5.3 Theme III: reference marketing

Studies on reference marketing have addressed the question of how a B2B firm implements reference marketing. What are the consequences of this? Compared to Themes I and II, this theme is more recent in B2B marketing research. Approximately 70% of the studies under this theme have been published within the past 10 years. Since almost half (44.4%) of these studies use qualitative interviews, this topic is characterized by being in its early stages and is oriented toward theory building.

the supplier (i.e. selling firm);

reference customer (i.e. WOM source, WOM sender); and

potential customer (i.e. WOM receiver).

Figure 5 shows how the three parties are involved, depending on whether the communication mode is online (internet) or offline (face-to-face). In offline reference marketing, the supplier first asks the reference customer to spread positive WOM about the products or the supplier. The reference customer then shares their experience with the supplier’s brand with potential customers ( Hada et al. , 2014 ; Jaakkola and Aarikka-Stenroos, 2019 ). In the case of online reference marketing, the supplier posts the reference customer’s reviews on their website as success stories or testimonials. The website is then used to encourage potential customers to initiate a business relationship with the supplier and buy the brand ( Jalkala and Salminen, 2010 ; Tóth et al. , 2020 ).

supplier-focused;

reference customer-focused; and

potential customer-focused research.

Supplier-focused research investigates how B2B firms implement reference marketing and whether such practices lead to high firm performance. Jalkala and Salminen (2010) conducted exploratory interviews with 38 companies in the information and communication industry and showed that B2B firms use WOM (online references) collected from reference customers in two ways: the external use of customer references to promote sales and enhance the firm’s reputation and the internal use of customer references for employee training and customer understanding. Terho and Jalkala (2017) , using quantitative survey data collected from 220 B2B firms, found that both external and internal uses of customer references lead to high sales performance (e.g. new customer acquisition and large market share). Reference customer-focused research is limited: Jaakkola and Aarikka-Stenroos (2019) conducted interviews with 76 B2B firms in the knowledge-intensive services industry and examined the value of reference marketing to the supplier, reference customer and potential customer. They showed that reference customers try to strengthen their business relationships with suppliers by sharing their experiences with potential customers, but they also experience the risk of leaking information that could potentially harm the reference. Potential customer-focused research has been conducted to understand B2B customer behaviors. Hada et al. (2014) examined how reference valence and source credibility affect potential customers’ evaluation of suppliers. Through multiple experiments, they found that the effect of a positive reference is more meaningful when prospective buyers and source firms (i.e. reference customers) have previous business experience. They also showed that source credibility plays an important role only when the reputation of reference customers is high.

In sum, prior research has investigated the effectiveness of reference marketing from the perspective of three parties: suppliers, reference customers and potential customers. Although these studies have advanced our understanding of reference marketing, further work is needed to examine its impact on firm performance. New insights are required on what references firms should use and how to encourage their own salespeople to use references.

6. Managerial implications

By identifying three themes and summarizing the findings in each theme, we offer some useful suggestions for business managers. Specifically, we provide practical insights to sales managers of firms who sell goods/services and purchasing managers who buy them, respectively.

Sales managers of suppliers or selling firms should refer to research findings on decision-making regarding how existing customers communicate WOM (Theme I), how WOM is evaluated (Theme 2), and how reference customers’ WOM is leveraged (Theme 3). For example, the following suggestions can be drawn from prior literature. According to previous research on WOM generation ( Anaza and Rutherford, 2014 ), the loyalty of the purchasing manager toward the sales manager triggers positive WOM. Hence, salespeople should treat loyal customers with care, not only in terms of their large direct contribution to sales, but also in terms of their indirect contribution to sales through sales promotions to other companies. Research findings on WOM usage ( Yang et al. , 2017 ) indicate that in a highly competitive environment, high-performing firms are more likely to select business partners based on WOM; therefore, firms in a highly commoditized and highly competitive environment should place importance on existing customers as WOM generators. Furthermore, according to the research findings of reference marketing in Theme 3 ( Terho and Jalkala, 2017 ), firms should use customers’ opinions and success stories not only as a promotional tool but also as a learning material for sales representatives.

Purchasing managers in buyer firms should refer to research findings on decision-making regarding what benefits firms can obtain from sending WOM to other firms (Themes 1 and 3) and when firms should use WOM as a source of information (Theme 2). Jaakkola and Aarikka-Stenroos (2019) show that the dissemination of WOM as a customer reference allow firms not only to build close business relationships with supplier firms, but also to form strong relationships with potential customers. Kim (2014) reveals that using the WOM of other firms that have high expertise and are similar to one’s own firm to select business partners reduces the likelihood of switching business partners; thus, WOM from such firms should be considered important in making purchasing decisions.

Throughout this review, we indicated that WOM has a considerable influence on purchasing decisions in the B2B context. Although some B2B marketing managers may underestimate the role of WOM, online review websites for B2B products/services are widespread and online communities among purchasing managers are formed. Considering these trends, it is anticipated that WOM is more and more likely to drive purchasing decisions in the B2B context, just as WOM is a powerful influence in B2C marketing. Therefore, B2B marketing managers are required to use WOM as a strategic tool for firm success.

7. Discussion and future research directions

We conducted a systematic literature review of 36 articles to determine the current state of research on WOM in the B2B context. The following section discusses the future research directions for WOM research within all the three themes; that is, WOM generation, WOM usage and reference marketing. For each theme, we identify several research questions that should be addressed in future works. In addition to the three themes above, we identify promising research directions in two emerging themes not addressed by previous studies: collecting and managing WOM information about the supplier’s brand.

7.1 Word-of-mouth generation

Although B2B WOM research has examined the antecedents of WOM generation, it has only considered WOM generation as a positive outcome, along with other outcome indicators such as satisfaction and loyalty. Therefore, future research needs to address why buyers talk about selling firms and seller brands. Buyer firms probably send WOM messages to others to maintain their reputation in the market and to develop trust with their suppliers. It would be useful to assess such relationship drivers.

It is also helpful to focus on the WOM generation behaviors of individual purchasing managers in buyer firms. Some purchasing managers frequently send WOM to other buyers, while others generate none. Based on the findings of WOM research in the B2C context ( Berger, 2014 ; Donthu et al. , 2021 ; King et al. , 2014 ), psychological propensities such as altruism, self-enhancement and product involvement motivate buyers to send WOM. Additionally, purchasing managers with a vast informal network of contacts outside their firms are likely to generate WOM messages to maintain their networks. Therefore, it is essential to conduct qualitative and quantitative studies to examine the WOM communication behaviors of buyer firms.

To our surprise, no study has focused on the consequences of WOM generation. To deepen our understanding of WOM generation behaviors, it is necessary to investigate not only its antecedents but also its consequences. Future research should address the following research question: What are the consequences of WOM generation? For example, considering individual buyers, those who often send WOM to other buyers may obtain useful WOM information from other buyers in return. Consequently, the buyer can have a high level of knowledge about the market and its competitors. Providing such empirical evidence on the behaviors of buyer organizations and purchasing managers would contribute to the advancement of WOM research in the B2B context.

It is necessary to conduct qualitative and quantitative studies on the role of a supplier in generating WOM about their products or services. What kind of behavior is adopted by the suppliers in the first place? Although academic scholars, mainly in northern Europe, have assessed the online reference marketing activities of suppliers, other WOM activities have not been investigated. For example, how do suppliers make efforts to generate WOM about their offerings? What kind of firms focus on activities to induce WOM communication about their products? How supplier–sender relationships drive WOM generation? Future research should address these questions.

7.2 Word-of-mouth usage

Many studies have focused on factors that influence WOM usage behaviors. These studies address the question of when and why buyer firms use WOM information. While existing research has shown that organizational culture and performance affect WOM usage behaviors, there are many unanswered questions. For example, what product characteristics drive B2B firms to use WOM information? It is possible that B2B firms are more likely to use WOM when purchasing complex or innovative products. Future research should provide further empirical evidence on this topic.

B2B firms use various types of information sources: online and offline WOM, customer references, advertisements, salespeople and catalogs. Prior research has begun to address the use of WOM combined with other information sources ( Steward et al. , 2018 ; Tóth et al. , 2020 ). However, there is room for further investigation. Examples include the following: Which has a more substantial influence: online or offline WOM? How do salespeople’s explanations and external WOM information influence buyers’ purchase decisions? How much and what kind of WOM is used by B2B firms in the purchase decision-making process? Although pioneering research on WOM in the B2B context has addressed the latter questions ( Martilla, 1971 ), little research has focused on WOM in organizational purchase behavior since then. How much importance do purchasing managers give to WOM information from inside and outside the organization (i.e. intrafirm and interfirm WOM)? How do opinion leaders in an organization influence the purchase decision-making process? What are the characteristics of opinion leaders in an organization? Further research is needed to address these research questions.

One of the main questions on this topic is, “Does WOM usage lead to positive outcomes?” According to previous studies, WOM usage reduces uncertainty about suppliers and B2B offerings and enables firms to search for suitable exchange partners. Consequently, a mismatch of exchange partners can be prevented, thereby improving satisfaction and relationship continuity with the supplier. However, there is no satisfactory evidence on this topic. Intuitively, WOM communication is expected to increase satisfaction in an uncertain environment. Thus, future research can consider environmental factors. Furthermore, Money et al. (1998) showed that the effect of WOM usage on the intention of relationship continuity varies across nations. They focused only on collectivism and uncertainty avoidance among Hofstede’s six cultural dimensions, but how do other cultural dimensions affect WOM usage behaviors? Further research is required to investigate the role of organizational culture.

The following questions about WOM usage can be considered: What types of WOM improve supplier evaluation? How does WOM valence, a concept often used in WOM research in the B2C context, affect B2B offerings? Can negative WOM enhance supplier evaluations? Further, the effects of online reviews remain unclear: What types of online reviews are helpful for B2B firms? Future research should address these questions and provide empirical evidence.

7.3 Reference marketing

The most important consequence is firm performance, such as in sales, profits and market share. Thus, B2B marketers are interested in the impact of reference marketing on firm performance. Terho and Jalkala (2017) found that reference marketing, which consists of both external and internal use of online references, leads to high performance (e.g. new customer acquisition and market share). However, the effectiveness of reference marketing depends on various conditions and situations. Under what conditions is reference marketing effective? Which firms should invest in reference marketing? What type of reference marketing will improve firm performance? The number and type of references, the content of the references and the profile of the reference customers should impact firm performance.

A further exciting topic is the use of references in sales strategy, which has long been used in B2B marketing to promote the sales of a firm’s offerings. In B2B marketing, customer references are not an alternative for a salesperson but rather a supplementary means. Thus, B2B firms need to combine customer and salesperson references to improve their performance. However, little is known about the relationship between sales management and customer references. How does a salesperson use customer references as a sales tool? Do salespeople who use references achieve higher sales than those who do not? How does a sales force respond to potential customers who receive WOM messages about the firm? These questions are of great academic and practical relevance. Therefore, future research should address these questions.

Examining the motivations of existing customers to serve as reference customers can yield rich managerial implications because it can provide selling firms with guidelines regarding the selection and recruitment of reference customers. Intuitively, one of the motivations for a customer to become a reference customer at a supplier’s request would be to strengthen their relationship with the supplier. However, little empirical evidence is provided on reference customer behaviors. Why does a reference customer send WOM for their suppliers? How does becoming a reference customer lead to a close relationship with suppliers? Future studies are encouraged to investigate these research questions.

7.4 Word-of-mouth collection

The theme of WOM collection addresses how firms collect WOM information about their own brands. Prior research in this review assumes that existing customers’ WOM about the supplier’s brand is valuable information for potential customers (e.g. potential customers can rely on WOM information to make accurate purchase decisions). However, it is also beneficial to the supplier itself. WOM information about a supplier’s brand represents the customer’s honest evaluation of the supplier’s products, which allows the supplier to understand the strengths and weaknesses of its own brand, the uniqueness of its own products, and points to be improved in its services. This is a valuable source of information for the supplier. Therefore, firms should actively collect such WOM information about their B2B products/services to develop product innovations and understand the appeal of their brands.

However, according to this systematic review, no studies focused on supplier WOM behavior regarding supplier branding and collection behavior by suppliers. Therefore, future research should address this topic. For example, how can firms collect WOM information about their products from existing customers? It would not be so easy to collect face-to-face WOM information from existing customers. Collecting negative WOM from existing customers is challenging because they do not want to communicate it directly to suppliers. However, suppliers need to collect such information because negative WOM contains information on what needs to be improved in their brands and what customers need. How can firms collect negative WOM? Perhaps, it might be more efficient to collect it indirectly from intermediaries rather than directly from customers ( Ishii, 2021 ).

Regardless of whether WOM is positive or negative, it is valuable information for a firm. It is also precious for an individual salesperson. This is because salespeople who understand the firm’s brand and capture customer needs through WOM can achieve better sales performance than other salespeople. Therefore, salespeople may hesitate to inform other salespeople or their supervisors about WOM about their brand and may keep the information confidential. If this is true, a key factor for WOM collection is establishing a system to gather WOM information from the in-house salespersons. The collection of WOM information, if regarded as the generation of market information, is included in market-oriented behavior ( Ishii, 2020 ; Mostafiz et al. , 2021 ; Powers et al. , 2020 ). It would be interesting to provide empirical evidence on whether the collection of WOM information enhances firm outcomes.

7.5 Word-of-mouth management

The second is the management of WOM about the firm’s brand. Prior studies generally focus on the role of positive WOM, such as sending out positive WOM and posting positive WOM on the company’s website. While previous studies ( Gruber et al. , 2010 ; Homburg and Fürst, 2005 ) have addressed how B2B firms respond to customer complaints (i.e. a type of negative WOM), to the authors’ knowledge, no research has addressed how they respond to negative electronic WOM. This is because, as mentioned above, negative WOM is not often received by suppliers. However, now that social networking services have become widespread, and B2B purchasing managers have formed connections through LinkedIn, Facebook, etc. and informal communication in closed networks has become more accessible, negative WOM can spread quickly among customers. Therefore, how a company responds to negative WOM may impact its survival.

For example, how should B2B firms respond to negative WOM on online review websites? Currently, online review websites for B2B brands are becoming popular. Owing to the source’s anonymity, negative WOM is more likely to be communicated online than in person. Therefore, it will become increasingly critical for B2B marketers to manage negative WOM. Another unanswered question is how B2B marketers should respond to negative WOM on social networking sites. Some B2B brand firms have their own social networking accounts and may receive complaints or requests for improvement on their timelines or through direct messages. How should companies respond to such customer feedback to maintain their high evaluation by their customers? Academic researchers in the field of B2B marketing are expected to make efforts to address these research questions.

8. Conclusion

Both academic researchers and business practitioners have recognized that WOM plays an essential role in B2B marketing. In fact, many B2B studies have examined WOM and reference marketing during the past 20 years. However, no reviews focus on WOM in the B2B context. Since various findings have been presented on this topic, it is imperative to assess the current state of WOM research and clarify unaddressed research questions. This study aims to synthesize the findings from existing studies on WOM in the B2B context, propose an integrated conceptual framework and identify potential research directions.

Through a systematic review, 36 articles on B2B WOM were selected. We then described the published journals, the countries used as the subject of the empirical analysis, and the methods used by these articles. Our thematic analysis categorized these articles into three themes:

Under each theme, we summarized research findings unique to B2B research different from B2C WOM research. We identified several research questions that should be addressed by future research. By synthesizing and assessing prior research on WOM in the B2B context, we hope to have contributed to a better understanding of the B2B WOM phenomenon and facilitated future research on this topic.

word of mouth marketing research paper

WOM phenomenon

word of mouth marketing research paper

Search strategy

word of mouth marketing research paper

Research methods used in selected articles

word of mouth marketing research paper

Researched contexts in selected articles

word of mouth marketing research paper

WOM flowchart in reference marketing

Journals included in the analysis

Overview of the findings from the reviewed articles

Four types of WOM

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Acknowledgements

The authors would like to thank the Editor-in-Chief, Dr. Wesley Johnston, and anonymous reviewers for providing valuable insights and constructive comments.

Funding : This work was financially supported by JSPS KAKENHI Grant Number JP18K12883.

Corresponding author

About the authors.

Ryuta Ishii is an Associate Professor of Marketing at the College of Business Administration, Ritsumeikan University, Japan. His research interests focus on business-to-business relationships, channel management and international marketing. His work has been published in Industrial Marketing Management , International Marketing Review , Marketing Intelligence & Planning and other journals.

Mai Kikumori is an Associate Professor of Marketing at the College of Business Administration, Ritsumeikan University, Japan. Her research interests focus on digital marketing and social interactions, particularly in word-of-mouth, online review and social media usage.

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  • 1 Miami Business School, University of Miami, 5250 University Drive, Coral Gables, FL 33124, United States. Electronic address: [email protected].
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  • PMID: 31377578
  • DOI: 10.1016/j.copsyc.2019.06.026

Given the importance of online word of mouth (WOM), there has been an increasing need to understand the psychological mechanisms that underlie WOM transmission (i.e. sharing of opinions) and reception (i.e. processing of received messages). The goal of the current paper is to review some of the most recent research in online WOM (focusing on the past two to four years) as well as make suggestions regarding future research. [For earlier syntheses on WOM senders and social media marketing, see King et al., 2014, Stephen, 2016, Whitler, 2014] [6-8].

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A Literature Review of Word of Mouth and Electronic Word of Mouth: Implications for Consumer Behavior

The rise and spread of the Internet has led to the emergence of a new form of word of mouth (WOM): electronic word of mouth (eWOM), considered one of the most influential informal media among consumers, businesses, and the population at large. Drawing on these ideas, this paper reviews the relevant literature, analyzing the impact of traditional WOM and eWOM in the field of consumer behavior and highlighting the main differences between the two types of recommendations, with a view to contributing to a better understanding of the potential of both.

Introduction

Consumers increasingly use online tools (e.g., social media, blogs, etc.) to share their opinions about the products and services they consume ( Gupta and Harris, 2010 ; Lee et al., 2011 ) and to research the companies that sell them. These tools are significantly changing everyday life and the relationship between customers and businesses ( Lee et al., 2011 ).

The rapid growth of online communication through social media, websites, blogs, etc., has increased academic interest in word of mouth (WOM) and electronic word of mouth (eWOM) (e.g., Hennig-Thurau et al., 2004 ; Brown et al., 2007 ; Cheung and Thadani, 2012 ; Hussain et al., 2017 ; Yang, 2017 ). Specifically, the present paper will review the literature on how these two media have evolved, the main differences between them, and the degree to which they influence both businesses and consumers, now that they have become some of the most influential information sources for decision-making.

Word of mouth is one of the oldest ways of conveying information ( Dellarocas, 2003 ), and it has been defined in many ways. One of the earliest definitions was that put forward by Katz and Lazarsfeld (1966) , who described it as the exchanging of marketing information between consumers in such a way that it plays a fundamental role in shaping their behavior and in changing attitudes toward products and services. Other authors (e.g., Arndt, 1967 ) have suggested that WOM is a person-to-person communication tool, between a communicator and a receiver, who perceives the information received about a brand, product, or service as non-commercial. Likewise, WOM has been defined as communication between consumers about a product, service, or company in which the sources are considered independent of commercial influence ( Litvin et al., 2008 ). These interpersonal exchanges provide access to information related to the consumption of that product or service over and above formal advertising, i.e., that goes beyond the messages provided by the companies and involuntarily influences the individual’s decision-making ( Brown et al., 2007 ). WOM is widely regarded as one of the most influential factors affecting consumer behavior ( Daugherty and Hoffman, 2014 ). This influence is especially important with intangible products that are difficult to evaluate prior to consumption, such as tourism or hospitality. Consequently, WOM is considered the most important information source in consumers’ buying decisions ( Litvin et al., 2008 ; Jalilvand and Samiei, 2012 ) and intended behavior. For example, tourist satisfaction is of utmost importance because of its influence on behavioral intentions, WOM and purchasing decisions. In other words, overall satisfaction leads to the possibility of revisiting and recommending the destination ( Sotiriadis and Van Zyl, 2013 ).

Similarly, previous research indicates that consumers regard WOM as a much more reliable medium than traditional media (e.g., television, radio, print advertisements, etc.) ( Cheung and Thadani, 2012 ). It is thus considered one of the most influential sources of information about products and services ( Lee and Youn, 2009 ). Users generally trust other consumers more than sellers ( Nieto et al., 2014 ). As a result, WOM can influence many receivers ( Lau and Ng, 2001 ) and is viewed as a consumer-dominated marketing channel in which the senders are independent of the market, which lends them credibility ( Brown et al., 2007 ). This independence makes WOM a more reliable and credible medium ( Arndt, 1967 ; Lee and Youn, 2009 ).

Today’s new form of online WOM communication is known as electronic word-of-mouth or eWOM ( Yang, 2017 ). This form of communication has taken on special importance with the emergence of online platforms, which have made it one of the most influential information sources on the Web ( Abubakar and Ilkan, 2016 ), for instance, in the tourism industry ( Sotiriadis and Van Zyl, 2013 ). As a result of technological advances, these new means of communication have led to changes in consumer behavior ( Cantallops and Salvi, 2014 ; Gómez-Suárez et al., 2017 ), because of the influence they enable consumers to exert on each other ( Jalilvand and Samiei, 2012 ) by allowing them to obtain or share information about companies, products, or brands ( Gómez-Suárez et al., 2017 ).

One of the most comprehensive conceptions of eWOM was proposed by Litvin et al. (2008) , who described it as all informal communication via the Internet addressed to consumers and related to the use or characteristics of goods or services or the sellers thereof. The advantage of this tool is that it is available to all consumers, who can use online platforms to share their opinions and reviews with other users. Where once consumers trusted WOM from friends and family, today they look to online comments (eWOM) for information about a product or service ( Nieto et al., 2014 ).

As a result of ICT, today consumers from all over the world can leave comments that other users can use to easily obtain information about goods and services. Both active and passive consumers use this information medium (eWOM). Individuals who share their opinions with others online are active consumers; those who simply search for information in the comments or opinions posted by other customers are passive consumers ( Wang and Fesenmaier, 2004 ).

Electronic word of mouth also provides companies with an advantage over traditional WOM insofar as it allows them both to try to understand what factors motivate consumers to post their opinions online and to gauge the impact of those comments on other people ( Cantallops and Salvi, 2014 ). However, consumers’ use of technology to share opinions about products or services (eWOM) can be a liability for companies, as it can become a factor they do not control ( Yang, 2017 ). To counteract this, businesses are seeking to gain greater control of customers’ online reviews by creating virtual spaces on their own websites, where consumers can leave comments and share their opinions about the business’s products and services ( Vallejo et al., 2015 ). By way of example, in the field of tourism, companies are starting to understand that ICT-enabled media influence tourists’ purchasing behavior ( Sotiriadis and Van Zyl, 2013 ).

Understandably, companies view both types of recommendations – WOM and eWOM – as a new opportunity to listen to customers’ needs and adjust how they promote their products or services to better meet them, thereby increasing their return. A negative or positive attitude toward the product or service will influence customers’ future purchase intentions by allowing them to compare the product or service’s actual performance with their expectations ( Yang, 2017 ).

In the field of consumer behavior, some previous studies (e.g., Park and Lee, 2009 ) have shown that consumers pay more attention to negative information than to positive information ( Cheung and Thadani, 2012 ). For example, the customers most satisfied with a product or service tend to become loyal representatives thereof via positive eWOM ( Royo-Vela and Casamassima, 2011 ), which can yield highly competitive advantages for establishments, businesses, or sellers, especially smaller ones, which tend to have fewer resources. Some studies have suggested that traditional WOM is the sales and marketing tactic most often used by small businesses.

Additionally, eWOM offers businesses a way to identify customers’ needs and perceptions and even a cost-effective way to communicate with them ( Nieto et al., 2014 ). Today, eWOM has become an important medium for companies’ social-media marketing ( Hussain et al., 2017 ).

WOM vs. eWOM

While many authors (e.g., Filieri and McLeay, 2014 ) consider eWOM reviews to be electronic versions of traditional WOM reviews, this paper aims to summarize and explain the main differences between the two concepts ( Table ​ Table1 1 ). The first such difference is credibility as an information source ( Cheung and Thadani, 2012 ; Hussain et al., 2017 ), since it can influence consumers’ attitudes toward products or services ( Veasna et al., 2013 ), for example, with regard to the purchase of tourism services, which are considered to be high-risk ( Sotiriadis and Van Zyl, 2013 ). Luo et al. (2013) have suggested that the anonymity of online messages could have a negative effect on their credibility. In contrast, other studies (e.g., Hussain et al., 2017 ) have argued that consumers use eWOM more to reduce risk when decision-making. Likewise, eWOM tends to be more credible when the consumer using it has previous experience ( Sotiriadis and Van Zyl, 2013 ).

Differences between WOM and eWOM.

Message privacy is another feature that sets the two media apart, since with traditional WOM information is shared through private, real-time, face-to-face dialogs and conversations. In contrast, information shared through eWOM is not private and can sometimes be seen by anonymous people who do not know each other. Furthermore, reviews can be viewed at various points in time ( Cheung and Thadani, 2012 ). Indeed, because eWOM reviews are written, consumers and companies can check them at any time; this stands in contrast to traditional WOM, where once the message has reached the receiver, it tends to disappear.

Another salient difference between the two media is the speed of diffusion of the message; eWOM statements spread much faster than WOM statements because of where they are published, i.e., on the Internet ( Gupta and Harris, 2010 ). Online platforms for sharing information (social media, websites, blogs, etc.) are what set eWOM apart from traditional WOM ( Cheung and Thadani, 2012 ). First, they make the reviews accessible to more consumers ( Cheung and Thadani, 2012 ; Sotiriadis and Van Zyl, 2013 ). Second, because they are written, they persist over time ( Hennig-Thurau et al., 2004 ; Cheung and Thadani, 2012 ).

This paper has reviewed the literature with a view to providing a clearer understanding of WOM and eWOM in the context of consumer information searches.

To this end, the review found that, in keeping with numerous studies, WOM is both the oldest medium for sharing opinions about products or services and the one most likely to influence consumer behavior, due to the high reliability and credibility transmitted by family and friends. In contrast, few studies have examined the interaction between perceived risk and eWOM source credibility ( Hussain et al., 2017 ).

Notwithstanding the above, the review of the theoretical framework also revealed a gap in the literature on WOM credibility in situations involving multiple or many communicators and receivers and how this ultimately affects the end consumer. This would include, for instance, situations in which one person communicates a message to another, who acts as an intermediary, both receiving the original message and passing it along to a third party, i.e., the end consumer. In such cases, the original message can be altered or distorted, chipping away at the credibility of the WOM review as a source of information. This lends much more strength to written comments and reviews, such as eWOM, which can ultimately reduce risk and increase consumer confidence.

Another feature that distinguishes eWOM from traditional WOM is the speed with which it spreads and the ease of access to it. In this regard, when consumers need information about a product or service, they ultimately turn to online media (eWOM) for two reasons. First, they can get the information more quickly, as there is no need to wait for someone else – a friend or family member – to offer an opinion about what they wish to consume. Second, if they have already received WOM reviews, they can use eWOM to corroborate the information received. Therefore, credibility and speed are the two main features not only distinguishing the two media, but also influencing consumer behavior.

Finally, the analysis of the review showed that these two concepts – WOM and eWOM – while seemingly the same, are at the same time very different. The Internet has transformed traditional WOM into eWOM. The communication of opinions is no longer done interpersonally (i.e., person-to-person or face-to-face), but rather is mediated by ICT. However, the many studies conducted (e.g., Katz and Lazarsfeld, 1966 ; Brown et al., 2007 ; Daugherty and Hoffman, 2014 ; Yang, 2017 ) agree that they are the media most able to influence consumer behavior and the most often used to obtain information before, during, and after consuming a given product or service. For example, in the field of tourism, eWOM is considered the most influential pre-purchase source of travel information ( Sotiriadis and Van Zyl, 2013 ).

Author Contributions

This paper tries to offer a clearer understanding of the two concepts through a literature review and an exploration of how, as a result of advances in ICT, traditional WOM has given rise to eWOM. The author has made an important, direct, intellectual contribution to this paper and has approved it for publication.

Conflict of Interest Statement

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding. This research was funded by the Spanish Ministry of Economy and Competitiveness under Research Project ECO2014-59688-R (“Planning and implementation of optimal management strategies for physical, online and mobile POSs based on ICT and innovation”).

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The current state of research of word-of-mouth in the health care sector

  • Original Article
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  • Published: 08 February 2022
  • Volume 20 , pages 125–148, ( 2023 )

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  • Gerlinde Pauli   ORCID: orcid.org/0000-0003-2894-193X 1 ,
  • Sebastian Martin 1 &
  • Dorothea Greiling 2  

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Health information plays a significant role in the health behavior of individuals. Word-of-mouth (WOM) is essential in this context. In recent years, new forms of online communication have greatly expanded the possibilities for seeking information and, in consequence, significantly changed communication behavior. Similarly, the doctor-patient relationship has gradually evolved and the traditional asymmetry of medical knowledge is increasingly being corrected as today’s health care consumers are becoming more well-informed. A key source of information is either in-person or online WOM. A research gap exists in terms of analyzing the current state of research of WOM in health care. Although various studies highlight the influence of WOM on health behavior, to the best of our knowledge there exists no systematic literature review that summarizes the current state of research on WOM in health care. Therefore, this paper presents a comprehensive systematic literature review on WOM in health care. The literature review investigates existing WOM studies in the health care sector based on a systematic search for articles in a twenty-year timeframe from January 2000 to December 2019. The resulting total of 34 articles constitutes the basis of this paper. These studies are analyzed using a model of WOM in health care and – based on the theory of cognitive dissonance, the theory of the strength of weak ties, and the theory of perceived risk – clustered into the creation, spread, and impact of WOM. The investigated studies emphasize the importance of the staff in the service process. Furthermore, negative reviews have a stronger impact than positive ones, with service quality representing the main reason for negative WOM. In addition, the importance of electronic word-of-mouth (eWOM) is underlined, as online reviews are gaining popularity for patient decision-making processes. Although some studies have addressed WOM in health care, research gaps remain. For example, there are few studies on eWOM and some medical disciplines in private practice are neglected in WOM research. By systematically presenting and analyzing the literature on WOM in health care, this paper represents an important starting point for future research and also provides insights into the role of WOM in health care practice.

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1 Introduction

Health information plays a significant role in the health behavior of individuals. Patients increasingly want to have an active say in the choice of their physician and the treatment methods they choose (Dobele & Lindgreen, 2011 ; Liang & Scammon, 2011 ). However, such co-determination is only possible on the basis of sufficient information. Because the actual medical service is difficult for patients to assess, there is a growing demand for simple medical information they can understand (Argan, 2012 , 2016 ; Martin, 2017b ). In addition, the doctor-patient relationship has gradually evolved. The traditional asymmetry of medical knowledge is increasingly being corrected as today’s health care consumers are becoming well-informed (Loane & D’Allesandro, 2014 ). New forms of online communication have greatly expanded information-seeking options in recent years, significantly changing communication behavior (Cao et al., 2017 ; Drevs & Hinz, 2014 ; Gheorghe & Liao, 2012 ; Hinz et al., 2012 ; Liang & Scammon, 2011 ; Lin & Lin, 2018 ).

A key source of information is either in-person or online word-of-mouth (WOM), which is the noncommercial recommendations of individuals who have already used the health care service (Argan, 2012 , 2016 ; Dobele & Lindgreen, 2011 ; Martin, 2017b ). Patients draw on information from family members, friends, relatives, neighbors, or coworkers as a basis for choosing a new physician (Argan, 2016 ). It is important to keep in mind that when information is disseminated through WOM, there is a risk of misinterpretation or reinterpretation (Liberatore et al., 2019 ). The dissemination of information through social networks multiplies the number of recipients exponentially.

Although various studies highlight the influence of WOM on health behavior (Argan, 2012 , 2016 ; Drevs & Hinz, 2014 ; Ferguson et al., 2008 ; Hinz et al., 2012 ; Liang & Scammon, 2011 ; Martin, 2017b ), to the best of our knowledge there exists no systematic literature review that summarizes the current state of research on WOM in health care. A literature analysis on WOM in health care was published in 2017 (Martin, 2017a ), based on a research timeframe from 2005 to 2015. Since the literature analysis by Martin was explorative and did not systematically use prestigious databases, and the most recent studies it included are from 2015, an up-to-date literature review seems necessary to investigate the current state of research. Therefore, this paper investigates existing WOM and eWOM studies in the health care sector within a systematic literature review. This study aims to:

systematically compile the literature on WOM in health care and provide a current overview of studies in this research field

identify factors that influence WOM

reveal potential gaps in WOM research.

A study by Martin ( 2017b ) proposes a model of word-of-mouth in the health care sector. Since the model categorizes the different dimensions of WOM as well as influencing factors in the context of the health care sector, it serves as an anchor in this research field and is used to systematize the literature under review.

To answer the research objectives, the article proceeds as follows: following the introduction (section 1), section 2 describes the conceptual framework of the literature review. In this context, the model of WOM in health care is discussed. Section 3 illustrates the methodological approach. Section 4 presents the empirical findings of the review, clustering the results with respect to creation, spread, and impact of WOM. Section 5 presents the discussion, and section 6 outlines the conclusion and further research.

2 Conceptual framework

In the current literature review, an article by Martin ( 2017b ) warrants special attention. He presents a model of WOM in health care founded on three scientifically based theories: the ‘theory of cognitive dissonance’, the ‘theory of the strength of weak ties’, and the ‘theory of the perceived risk’. These scientific theories can be applied to WOM-related aspects in general and are not specifically related to the health care sector. Nevertheless, all three theories include various aspects that explain the creation, spread, or impact of WOM.

2.1 Relevant theories

The theory of cognitive dissonance describes psychological aspects that can be used to explain the creation of WOM (Festinger, 1957 ). According to this theory, every person has specific cognitive elements, opinions, and past behavior. When one cognitive element follows logically from another, they are said to be consonant to each other. They are dissonant to each other, when one does not logically follow from the other (Oshikawa, 1969 ). Dissonance can be reduced by attitude change, selective exposure, and WOM. Recommending a particular product or service to others and gaining their purchase support helps to convince actual consumers of their decision (O’Neill & Palmer, 2004 ; Wangenheim, 2005 ). Referring to health care, this means that if the chosen product or service is ranked as the best alternative, individuals may recommend health care providers or services in order to reduce or avoid cognitive dissonances (De Matos & Rossi, 2008 ). Further, WOM senders may recommend a health care provider or treatment because of uncertainty, in order to convince themselves of their own decision (O’Neill & Palmer, 2004 ; Wangenheim, 2005 ).

The theory of the strength of weak ties focuses on the spread and impact of information, emphasizing the strength of ties in interpersonal networks (Granovetter, 1973 ). Weak ties have a higher reach of information and recommendations, whereas strong ties have a lower reach but trust in information is higher (Brown & Reingen, 1987 ). Strong ties often exist between family members, close friends, or even good colleagues, while weak ties describe the relationship between acquaintances (Buchanan, 2002 ). Individuals form network clusters which are connected by strong and weak ties. In particular, individuals connected by strong ties are likely to engage in the same clusters. Weak ties connect different clusters, enabling cross-group information exchange (Granovetter, 1973 ). Weak ties are critical to the flow of recommendations across clusters. WOM spread by strong ties, on the other hand, is more likely to influence behavior, such as the use of a particular health service (Brown & Reingen, 1987 ).

In addition to Granovetter’s theory of the strength of weak ties, the theory of perceived risk by Bauer ( 1967 ) and Cox ( 1967 ) adds important aspects that help to understand the information sought by WOM and its implications. Perceived risk theory states that the degree of uncertainty plays a role in most purchases of services or goods (Bauer, 1967 ; Cox, 1967 ). Perceived risk is a key aspect of consumer behavior that strongly influences decision making (Bauer, 1967 ; Bettman, 1973 ; Cox, 1967 ; Gemünden, 1985 ; Taylor, 1974 ; Zhang et al., 2012 ). When perceived risk exceeds the subjective tolerance level, an individual is motivated to develop a risk reduction strategy (Bauer, 1967 ; Cox, 1967 ; Gemünden, 1985 ; Sheth & Parvatiyar, 1995 ). Such strategies may focus on limiting potential negative consequences or reducing uncertainty about the likelihood of such consequences. Strategies for reducing uncertainty include searching for, processing, and storing information (Gemünden, 1985 ). Relevant information can be obtained, inter alia, through the advice of family and friends. Therefore, WOM communication provides a common strategy for reducing perceived risk (Cox, 1967 ; Nießing, 2007 ; Roselius, 1971 ; Sheth & Parvatiyar, 1995 ).

2.2 WOM model in health care

Martin ( 2017b ) defines three dimensions in his WOM model that can be clustered as the creation, spread, and impact of WOM. With respect to creation, WOM senders can either be patients or family, relatives, friends, and acquaintances. Influencing factors of WOM creation can be clustered into medical factors and atmospheric factors as well as provider, sender, and admission characteristics, whereas the health care provider can only influence medical and atmospheric factors directly. Motives for the spread of WOM can be altruistic or egoistic. Communication by WOM depends on content, channel, anonymity, and network structure. In the dimension of impact, WOM may affect the individual’s knowledge, emotion, and behavior. The degree of such influence might depend on receiver characteristics. The theory of cognitive dissonance relates to the dimension of creation, because it describes psychological aspects that can be used to explain the creation of WOM. The theory of the strength of weak ties relates to the dimension of spread, since the strength of ties impacts the spread of information. However, it also relates to the dimension of impact, since WOM spread by strong ties is more likely to influence the behavior of WOM receivers. Especially concerning one’s own health, risk reduction plays a significant role. Individuals might share information about health services to reduce uncertainty. Therefore, the theory of perceived risk mainly pertains to the dimension of impact. In addition, the theory also relates to the dimension of spread, as relevant information is sought through different communication channels.

Since the model outlines more or less the entire process of WOM communication in the health care sector, it serves as a basis for systematizing the articles covered in this literature review. The model proposed by Martin was published in 2017 and is based on a literature analysis from 2005 to 2015. To the best of our knowledge, there exist no further literature reviews regarding the state of research on this topic. Figure 1 shows the model of WOM in the health care sector in Martin ( 2017b ).

figure 1

Source: Martin, 2017b

A model of word-of-mouth in the health care sector.

3 Methodological approach

To gain a deeper understanding of WOM in health care, the following literature review investigates existing WOM studies in the health care sector based on a systematic search for articles in a twenty-year timeframe, from January 2000 to December 2019. WOM and eWOM articles are considered and analysed to get a more holistic view of word-of-mouth in a health care setting. In our model, various aspects concerning face-to-face and online WOM are added and compared, further differences identified. Therefore, the revised model of word-of-mouth in the health care sector provides a general overview of (electronic) WOM in the health care sector and indicates important aspects which need to be considered concerning the creation, spread and impact of both face-to-face as well as electronic WOM. We recognize that there are differences between WOM and eWOM, which need to be more closely considered in further research. We added this aspect to the limitations of this study. Nevertheless, we believe that WOM might frequently also appear in a combination of face-to-face and electronic recommendations. In this way, a holistic model for both face-to-face WOM as well as electronic WOM seems to be beneficial. With our study we suggest such a model that summarizes the state of art of WOM research and can be used as a scientific anker for future research. With respect to a broad field of marketing papers concerning WOM, only papers focusing on the health care sector were included in the literature review. The research databases EBSCOhost Business Source Premier and ScienceDirect were used to identify potentially relevant articles related to WOM and health care. The exact search string used was: (“word-of-mouth” OR “word of mouth” OR “WOM” OR “eWOM”) AND (“*health*” OR “clinic” OR “hospital” OR “emergency room” OR “*physician*” OR “*medical*”) in the fields “Title”, “Abstract” or “Author-specified keywords”. Only research articles in scholarly (peer-reviewed) journals were included in the literature search. The result of this advanced search was a total of 161 articles: 90 articles in the EBSCOhost database and 71 articles in the ScienceDirect database. All 161 articles were carefully read. Articles that did not address WOM and health care were excluded, as were non-academic articles with no scientific sources, like editorials. The remaining number of papers was 26 (first level). Furthermore, if the references of the selected articles contained the wording WOM and health care in the title, these articles were also included in the analysis. Eight additional articles were added (second level). A total number of 34 articles form the basis of the literature analysis. Figure 2 summarizes the review process.

figure 2

Source: Own compilation

The process of the systematic literature review.

4 Empirical findings

4.1 general findings.

On the first level of journals, 26 articles concerning WOM in health care were identified by the authors. On the second level, an additional eight articles were included. Therefore, this research paper is based on a literature review of a total of 34 studies focusing on WOM in the health care sector. Regarding the methodology applied, most studies carried out surveys (n=14), followed by interviews (n=6). Four studies completed both surveys and interviews (n=4), and one study carried out a mix of survey, interview, and content analysis (n=1). A literature review was done by two studies (n=2), of which one literature review focused on leading scientific journals regarding WOM in health care, and one literature analysis dealt with buzz marketing related to antibiotic medication. Further, online reviews (n=2), messages, e.g., on social networking sites, forums and blogs (n=2) and websites (n=1) were analyzed. Additionally, one study completed both an online review and a survey (n=1), and one study carried out a survey comparing two studies (n=1). Concerning the WOM content/area, ten studies paid attention to hospitals, seven to outpatient care, and four to both inpatient and outpatient areas. Regarding outpatient care, studies focused on health care professionals for children, osteopaths, pharmacies, blood donation facilities, members of an obesity group, gay health centers, pregnant women, and mothers who had given birth. Some studies did not focus on a specific institution, area or group. Instead, these research articles focused on health behaviors and specific health illnesses/conditions (n=5). With respect to the country focus, most of the studies were conducted in Asia (n=13); both North America and Europe were studies in eight studies, while one study investigated South America and one Australia. Three studies focused on several countries. Regarding the channels of communication, 20 studies dealt with WOM and 13 studies with eWOM. One study addressed both WOM and eWOM. In addition, inasmuch as whether WOM is positive or negative may have a different influence of the creation, spread, and impact of WOM, the WOM type was considered, too. Six studies dealt with positive WOM, three studies dealt with negative WOM, and another six studies with both positive and negative WOM. All other studies used no further specification concerning the WOM type. Since Martin ( 2017b ) already carefully developed and clustered the dimensions of WOM in health care in his model, this clustering is adopted in the present article. With respect to the WOM dimensions, 20 studies were identified as related to WOM creation, five studies addressed WOM spread, and eleven studies addressed the WOM impact; only the study by Martin ( 2017b ) pertained to all three dimensions, i.e., creation, spread, and impact. In the case of articles relating to several dimensions, the respective article was assigned to the more significant dimension. Based on current literature, the authors give the following overview of research on WOM in health care, shown in Table 1 .

4.2 Creation of WOM

The creation dimension of WOM is explored by 20 articles. Five of these focus especially on eWOM. Eight studies were carried out in Asia, five in Europe, five in North America, and one in South America. In the study by Martin, WOM articles in health care are considered worldwide. The results of the literature analysis regarding the dimension of creation are summarized in Table 2 .

A research study by Pentescu et al. ( 2014 ) investigated modelling patient satisfaction in healthcare, which is important for WOM. This study identifies the perceived quality of the provided healthcare services, services’ rates, and personal factors as determinants of patient satisfaction and highlights the influence of patient satisfaction on patient loyalty, compliance with treatment, and the influence on positive WOM. Cheng et al. ( 2003 ) emphasize that interpersonal skills are equally or even more influential on patient satisfaction than clinical competence, and that technical competence is important for recommendations of patients. Further, the findings imply that a high degree of patient satisfaction in a hospital does not necessarily mean a high rate of recommendation. With regard to patient loyalty and positive WOM, both patients’ overall satisfaction and hospital personnel satisfaction are important, indicating that “high levels of satisfaction are required to create true ambassadors of a service organization” (Ferguson et al., 2008 , p. 60). To underline the importance of the staff, Chaniotakis and Lymperopoulos ( 2009 , p. 238) conclude that “in order to exploit the opportunities for having satisfied customers and creating positive word of mouth communications, they [practitioners] have to understand the importance of the staff in the service process”. Patient loyalty is linked to employee satisfaction and also influences the recruiting of new patients and new employees. Henthorne et al. ( 2009 ) emphasize that recommendations lead to preliminary loyalty, but only until patients make their own experiences.

Based on the model of WOM in the health care sector, Martin ( 2017b ) defines medical factors, atmospheric factors, provider characteristics, sender characteristics and admission characteristics as influencing factors for the WOM sender. According to this classification, the following medical factors are confirmed by this literature analysis: qualification of physicians (Bishop et al., 2013 ), perceived quality (Kemp et al., 2014 ; Pentescu et al., 2014 ; Tu & Lauer, 2008 ), perceived competence, and perceived credibility (Mannan et al., 2019 ), service quality (Cao et al., 2017 ; Mannan et al., 2019 ; Sivakumar & Srinivasan, 2010 ), interpersonal skills (Cheng et al., 2003 ), and customer-oriented behavior (Kemp et al., 2014 ). Investigating hospitals, Sivakumar & Srinivasan ( 2010 ) point out that the reliability and assurance of the service quality mainly influence the behavioral outcomes of patients.

Focusing on positive WOM for maternities, Chaniotakis and Lymperopoulos ( 2009 ) found that, besides satisfaction, empathy is the only service quality dimension which directly affects WOM. “In addition, ‘empathy’ affects ‘responsiveness’, ‘assurance’ and ‘tangibles’ which in turn have only an indirect effect to WOM through ‘satisfaction’” (Chaniotakis and Lymperopoulos, 2009 , p. 229). In contrast, Kitapci et al. ( 2014 ) demonstrate that empathy and assurance are important antecedents of satisfaction, and satisfaction also interrelates with WOM communication and repurchase. Regarding provider characteristics, technical skills (Cheng et al., 2003 ), website quality (Mannan et al., 2019 ), price (Pentescu et al., 2014 ; Tu & Lauer, 2008 ), communication style and consultation time (Mehra, 2018 ), and provider referrals (Gombeski et al., 2015 ) are factors influencing WOM.

As admission characteristics, convenience factors including waiting time for appointments and location (Tu & Lauer, 2008 ) are identified. In addition, satisfaction with hospital admissions depends on whether the hospital was chosen by patients chose themselves or patients’ agents (Drevs & Hinz, 2014 ). A health care provider is able to directly influence the medical and atmospheric factors, whereas the provider, sender, and admission characteristics can be influenced only partially or not at all (Drevs & Hinz, 2014 ). Trust (Kemp et al., 2014 ), disease knowledge and disease risk for online physician selection (Cao et al., 2017 ), first impressions (Bishop et al., 2013 ; Gombeski et al., 2015 ), and the disconfirmation of expectations (Kucukarslan & Nadkarni, 2008 ) are characteristics that influence the provision of WOM.

Focusing on eWOM, Lin and Lin ( 2018 ) investigate the demand for online platforms for medical WOM and found that sender characteristics like gender, age, educational level, and occupation group impact the likelihood of recommendations of an online evaluation platform. For instance, women are more willing to recommend a platform, and satisfaction with platforms decreases with age. Price perception, eHealth literacy, quality of reviews on social media and websites as well as website quality (Mannan et al., 2019 ) are important factors influencing the willingness to make use of online health services. Da Silva Terres et al. ( 2014 ) investigated antecedents of clients’ trust in low- and high-consequence decisions. They found that in high-consequence decisions affective aspects - such as emotions, care, concern, and attention - have a greater impact on consumer trust, whereas cognitive aspects – such as competence, efficiency, and effectiveness - have a greater impact on consumer trust in low-consequence decisions. Further, the more acute the consequences are, the greater is the impact of trust on positive WOM.

Motives cannot be clearly assigned to the creation and spread of WOM. Based on the current literature, Liberatore et al. ( 2019 ) deduced self-enhancement/-affirmation, altruism, social comparison, the need to belong, and information-sharing as social drivers for WOM in the context of public health campaigns. Hinz et al. ( 2012 , p. 18) investigated reviews on an online platform for hospital reviews and highlight that “altruistic motives override egoistic motives”. Moreover, the study shows that the reviews are more often positive than negative, but negative reviews include more detailed information on medical processes and care. In this way, motives and characteristics influence not only the reason a review is written, but also the content of the review. Helping or warning other patients is more important to reviewers than expressing positive or negative feelings, for both positive and negative experiences (Hinz et al., 2012 ). In addition, there are immense differences between the WOM of patients and their relatives (Drevs & Hinz, 2014 ). The positive result of a review is influenced by whether patients have chosen a hospital themselves or not. Other-directed patients are more likely to write negative online reviews than those who chose a hospital themselves (Drevs & Hinz, 2014 ).

4.3 Spread of WOM

The spread dimension of WOM is explored by two European, one North American, one Asian, one cross-national study between USA, Canada, UK, New Zealand, and Australia, and one worldwide study. Two studies focus on eWOM. In comparison to the other WOM dimensions, only a few studies deal with the spread dimension. A special focus of these studies is on the spread of health information. The results are summarized in Table 3 .

Um and Lau ( 2018 ) focus on dissatisfied patients and identify outcome quality, administrative quality, interaction quality, and environmental quality as factors influencing patient dissatisfaction, noting that service quality attributes mainly lead to dissatisfied patients and negative behaviors. Dissatisfied patients tend to be more active in negative WOM, complaining or switching to another health care provider. Lockie et al. ( 2015 ) underline the importance of better understanding the role of online reviews in patient decision-making processes, because they are gaining popularity in health services. Focusing on online reviews for general practitioners, the overall content is more important to readers than only the valence or rating of a review, and reviews with a more narrative and experiential style are perceived as more useful than very short or more fact-based reviews. Identifying and cultivating opinion leaders can help to increase WOM about a new product or service (Holdford, 2004 ). WOM works best when patients perceive benefits of an innovation, e.g., a clear vision of consequences of an innovation. In contrast, sponsored eWOM communications are not as effective because they lead to bias of customers (Kareklas et al., 2015 ). For the spread of public health campaigns, citizen co-creation can be an important and cost-effective tool (Liberatore et al., 2019 ).

4.4 Impact of WOM

The impact dimension of WOM is explored by eleven articles. The majority of the articles, namely four studies, were carried out in Asia, two in North America, two in Europe, one in Australia, one cross-national study was done between Austria, Belgium, and the UK, and in the study by Martin WOM articles in health care were considered worldwide. Five of the studies focus especially on eWOM. The results regarding the impact dimension are summarized in Table 4 .

Gheorghe and Liao ( 2012 ) examined the content of messages in an online gynecological community forum and emphasize that negative eWOM postings have a stronger impact linguistically than positive postings. Reasons for posting negative messages are often negative emotions like frustration, anger, uncertainty, disappointment, and sadness (Gheorghe & Liao, 2012 ; Lee & Wu, 2015 ). Venting, searching for advice, helping the receiver, and seeking revenge are identified by Lee and Wu ( 2015 ) as negative eWOM measures. Argan ( 2012 ) point out that three WOM dimensions tie strength and relationship, health knowledge and experience, and similarity and preference awareness directly and indirectly influence the satisfaction, encouragement, and discouragement of patients when selecting a physician.

WOM referrals are used by consumers to choose physician services. Communication skill, expertise, reputation and success, and institutional facilities influence patient satisfaction and “the relationships between physicians and patients have an indirect effect on potential patients” (Argan, 2012 , p. 191). To encourage the willingness to donate blood, WOM can help promote recommendations from blood donors and establish direct contact with potential donors (Tscheulin & Lindemeier, 2005 ). Dobele and Lindgreen ( 2011 ) investigated the consumer value in health care in the context of new mothers and identified the discussed value (including the quality of the experience, the friendliness and expertise of the staff, and the source credibility) as influencing factors. In addition, referrals are seen as supporting or confirming information, understanding options and reducing the anxiety and time spent for searching for information.

Regarding eWOM, patients have opportunities to gain and provide information and experience anonymously, twenty-four-seven and tailored to personal needs. It is not only the message that influences patients’ responses, but the reactions by commenters play an even more important role, and comments from experts have a greater impact on attitude and behavioral intention (Kareklas et al., 2015 ). Online comments influence purchase intentions, too (Lee et al., 2014 ). Beside informational support, online websites, forums or blogs can also give emotional support to support seekers (Liang & Scammon, 2011 ). In addition, through online support groups especially for chronic diseases, patients become educated and empowered health consumers and are able to act on a partnership level with the doctor, which may change the patient-doctor-relationship (Loane & D’Allesandro, 2014 ).

5 Discussion

The present literature review analyzes 34 WOM studies that focus on health care in a twenty-year timeframe. Most of the studies were conducted in Asia. Eight studies focused on hospitals, seven studies on physicians, seven on other health care providers, and six studies on online communities. Six other studies do not clearly identify the focus group. In terms of the WOM dimensions distinguished by Martin ( 2017b ), the creation dimension is the most researched category, followed by the impact dimension. Only five studies deal with the spread of WOM. Another clustering criterion is the focus on positive or negative WOM. This is a new aspect, which is not included in Martin’s research. The present literature review therefore explores possible differences between positive and negative WOM communication. Only about a third of the studies specify whether the focus is on positive or negative WOM. All studies regarding positive WOM concern the creation dimension, and all studies concerning negative WOM address in the impact dimension, excepting one study that focused on negative WOM in the spread dimension. Therefore, a direct comparison between positive and negative WOM within the dimensions is not possible. Nevertheless, this aspect is included in the model.

The importance of the staff in the service process is not only relevant for satisfied patients, patient loyalty, and creating positive WOM, but also for recruiting new patients and new employees (Ferguson et al., 2008 ; Chaniotakis & Lymperopoulos, 2009 ). In order to more actively use WOM for a service organization, the goal should be to create ambassadors, whereas caution is advised for sponsored WOM, as this is less effective and can quickly bring negative effects (Ferguson et al., 2008 ; Kareklas et al., 2015 ). The theory of the strength of weak ties implies that individuals form network clusters connected by strong and weak ties, with weak ties enabling a cross-group information exchange across different clusters (Granovetter, 1973 ; Brown & Reingen, 1987 ). Health care workers or the patients could act as ambassadors that spread their positive impressions of the health care service among their clusters of family, friends and acquaintances, through such strong and weak ties.

The differences between paid and unpaid WOM are not illustrated in Martin’s model of WOM in health care, which could be considered in the spread dimension. Further, negative reviews have a stronger impact than positive ones and include more detailed information on medical processes and care (Gheorghe & Liao, 2012 ; Hinz et al., 2012 ). The main reason for dissatisfied patients and negative behaviors, such as negative WOM, complaining or switching to another health care provider, is service quality, while empathy, reliability, and assurance of service quality can positively influence the behavioral outcomes of the patients (Chaniotakis & Lymperopoulos, 2009 ; Sivakumar & Srinivasan, 2010 ; Um & Lau, 2018 ). Drawing on the theory of cognitive dissonance, Festinger ( 1957 ) argues that dissonance can be reduced through attitude change, selective exposure, and WOM. This includes WOM about health care services and provides.

Most eWOM studies were conducted in the last six years. Online reviews are gaining popularity for patient decision-making processes, and patients are becoming educated and empowered health consumes, which may lead to a challenge in the patient-doctor-relationship. Therefore, it is important to better understand the role of online reviews (Loane & D’Allesandro, 2014 ; Lockie et al., 2015 ). For readers, the content of a review is more important than an isolated rating, and reactions from commenters play an even more important role (Kareklas et al., 2015 ; Lockie et al., 2015 ). Beside informational support, internet-based communication can also provide emotional help to support seekers (Liang & Scammon, 2011 ). In terms of the theory of perceived risk, patients seek health information from family, friends, or online to reduce their perceived risk. In comparison to WOM, information and experiences in eWOM are anonymous and available twenty-four-seven. Furthermore, eWOM communication usually involves multiple participants. Thus, trust and credibility play an even more significant role. Martin’s literature review, used here as basis for the model of WOM in health care, includes only six eWOM studies. The WOM model in health care also applies well to eWOM, although the fact that multiple participants communicate with each other could be represented better. Furthermore, in addition to trust, credibility is equally important.

Because the studies on which Martin’s model of WOM in health care is based have a strong focus on hospital recommendations, attention is paid to whether there are differences in WOM between inpatient and outpatient areas. In this literature review, all eight studies focusing on hospitals are in the creation dimension. However, no significant differences between inpatient and outpatient areas were found.

By analyzing in-depth the results of the literature review in the context of Martin’s model, most of the aspects are already included in the WOM model. However, the current literature identified some additional factors that should be added; these are presented in a revised version of the model in Figure 3 . Concerning the WOM sender, Martin distinguishes directly and indirectly affected senders. The directly affected sender refers to the actual patient, whereas the indirect senders are family, relatives, friends, and acquaintances who witnessed the health service. In addition to Martin’s account, staff is also an indirectly affected WOM sender; especially in terms of eWOM, review writers and commenters are also indirectly involved in the decision-making process and should not be underestimated.

figure 3

A revised model of word-of-mouth in the health care sector (based on Martin 2017b )

In relation to the differentiation between sponsored and unpaid WOM, a distinction must be made, particularly with regard to eWOM. Sponsored WOM can quickly bring negative effects. The aspect ‘paid’ versus ‘earned’ content is outlined in the content attribute. The distinction between face-to-face and eWOM communication is included in the channel. Beside the anonymity and the network structure, the availability of information is also an important factor in the spread of WOM, and a distinction can be made here between short-term and long-term availability. Furthermore, no differentiation between positive and negative WOM could be made in the literature review, thus no results are included in the state-of-the-art model. Nevertheless, the distinction between positive and negative WOM is important and therefore taken into consideration in the revised model. In addition, credibility is just as important as trust for the WOM receiver, as shown in the revised model in Figure 3 .

Based on the literature review, the authors conclude that the simplified representation of WOM sender, WOM communication, and WOM receiver is the same for all forms of communication. However, especially with the increasing importance of eWOM, communication takes place more frequently online, usually involving more people in the communication process than in face-to-face conversations. Hence, the bar “bidirectional/multidirectional communication” illustrates the involvement of multiple discussion partners throughout the communication process. To further illustrate the differences in WOM and eWOM communication, the distinction between one-to-one, one-to-many and many-to-many communication is depicted separately in the figure. Figure 3 represents the revised version of the model of word-of-mouth in the health care sector.

6 Limitations

Based on the recent literature, the paper investigates the importance of WOM in health care and provides a revised model of word-of-mouth in the health care sector, including new aspects such as the clustering criterion on positive and negative WOM, the difference between paid and unpaid WOM and the clustering on short-term and long-term WOM effects, compared to the original model from Martin ( 2017b ). Nevertheless, the presented paper has some limitations. First of all, the applied theories do not have exclusive validity for the health care sector, but only describe WOM-related aspects in general. Furthermore, the results are based on a literature review of 34 articles on WOM with a specific focus on the health care sector. Therefore, this study may neglect WOM articles from other disciplines, such as retail. In addition, only the databases EBSCOhost Business Source Premier and ScienceDirect were used for the literature review. Databases such as PubMed or Medline were not part of the study and could provide further valuable input as they are specialized in collecting information in the health care field. Another limitation is that the paper presents WOM and eWOM in a combined model. To further validate both research streams and illustrate the differences even more, face-to-face and electronic word-of-mouth could additionally be considered separately in future studies.

7 Conclusion and further research

To the best of our knowledge, there exist no up-to-date literature reviews focusing on the state of WOM research in the health care sector. To provide an overview of the recent literature, the paper investigates the importance of WOM in the health care sector. Further, the importance of future research on this topic is outlined. Martin’s approach regarding the classification of the articles in terms of creation, spread, and impact dimensions is supported. With respect to the investigated articles and databases, this research is necessarily limited. The literature review identified 34 articles related to WOM and health care. Most of the studies concern the creation and impact of WOM, and only a few studies deal with the spread of WOM. Compared to the WOM content, the allocation between hospitals, physicians, health care providers, online communities, and others is rather balanced.

Nevertheless, several research gaps remain. For example, it is noteworthy that not a single study explicitly deals with prevention, despite the increasing importance of preventive health care. Because of this major research gap, WOM in preventive health care represents a future field of research. In addition, although a reasonable number of studies address WOM and eWOM, there are still fewer studies on eWOM, and no study has yet compared WOM and eWOM. The investigation of differences between WOM and eWOM communication is an important future research field and could be examined in future studies. Approximately half of the eWOM studies were conducted in Asia, while only few studies on this subject were carried out in North America and Europe, clearly indicating a need to catch up. Furthermore, only two studies involved a comparison between countries. Research into cultural differences could be more focused. Cultural components differ strongly, also in WOM. Therefore, additional WOM studies comparing countries would likely provide new scientific insights. Regarding medical disciplines, there exist few studies on general practitioners, gynecologists, and osteopaths, but no studies could be found on medical disciplines like dermatologists, ophthalmologists, otolaryngologists, and pediatricians, to mention only a few neglected fields.

Concerning the creation dimension, only one study by Drevs and Hinz ( 2014 ) investigated indirectly affected stakeholders, namely relatives, who may also play an important role in the creation of WOM. Future studies could examine additional stakeholders involved in the WOM creation process. For example, within eWOM, not only family members of patients are indirectly involved in the decision-making process, but also review writers and commenters of postings. In addition, most of the studies concerning the creation dimension were conducted on the inpatient area. Future studies could focus more on the outpatient area. With respect to the spread dimension, the circulation of WOM in personal networks could be examined in future studies. An interesting research field are, for example, the differences between the spread of positive and negative health-related WOM, the influence of the personal network structure, and the estimation of source credibility. Studies on the differences between paid and unpaid WOM also represent a future field of research. Regarding the impact dimension, due to the increasing prevalence of online communication, inaccurate and fake health care information are easily spread. Potential risks related to this development represent another future field of research.

For all future studies, the revised WOM model can be an important contribution inasmuch as it systematically presents existing studies on WOM in health care.

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Pauli, G., Martin, S. & Greiling, D. The current state of research of word-of-mouth in the health care sector. Int Rev Public Nonprofit Mark 20 , 125–148 (2023). https://doi.org/10.1007/s12208-022-00334-6

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Academic Journal of Business & Management , 2022, 4(8); doi: 10.25236/AJBM.2022.040819 .

Spanning 36 years, the evolution and trend of word-of-mouth marketing research – based on bibliometrix analysis

Zhencheng Huang, Chen Zhe

Zhanjiang University of Science and Technology, Zhanjiang 524094, China

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Word of mouth is an important influencing factor of customers' purchase decision-making behavior, and also a key basis for product promotion and improvement in business activities. Word of mouth marketing is a new tool of marketing, which has a special communication mechanism and characteristics, and is the main focus of business activity research. Based on the retrieval data of web of science, this study uses bibliometrix software to conduct network econometric analysis on 259 literatures on word-of-mouth marketing in the past 36 years. The research on word-of-mouth marketing is divided into three stages, focusing on the evolution of research topics and future development trends.

word of mouth, word of mouth marketing, network measurement, bibliometrix

Cite This Paper

Zhencheng Huang, Chen Zhe. Spanning 36 years, the evolution and trend of word-of-mouth marketing research – based on bibliometrix analysis. Academic Journal of Business & Management (2022) Vol. 4, Issue 8: 127-134. https://doi.org/10.25236/AJBM.2022.040819.

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COMMENTS

  1. A Literature Review of Word of Mouth and Electronic Word of Mouth

    The rapid growth of online communication through social media, websites, blogs, etc., has increased academic interest in word of mouth (WOM) and electronic word of mouth (eWOM) (e.g., Hennig-Thurau et al., 2004; Brown et al., 2007; Cheung and Thadani, 2012; Hussain et al., 2017; Yang, 2017). Specifically, the present paper will review the ...

  2. Word-of-mouth in business-to-business marketing: a systematic review

    By stating that "a widely studied outcome variable within the relationship marketing literature is word-of-mouth," Brock and Yu Zhou (2012, p. 372) emphasized the importance of WOM as a performance indicator in B2B research. Second, 13 (81%) of the 16 studies used a quantitative survey as the empirical method.

  3. (PDF) Word of Mouth: A Literature Review

    Abstract and Figures. Purpose: The purpose of this paper is to understand, summarize and highlight the current research work in the area of word-of-mouth (WOM) along with the existing gaps in the ...

  4. Past, Present, and Future of Electronic Word of Mouth (EWOM)

    Marketing, electronic word of mouth, websites, and information systems themes evolve during the last subperiod. A strategic map for each subperiod ... Research papers in cluster 3 revolve around the role of eWOM in experience-dominated sectors such as hospitality and tourism. Experience-dominant services are intangible and difficult to evaluate ...

  5. On Brands and Word of Mouth

    Abstract. Brands and word of mouth (WOM) are cornerstones of the marketing field, and yet their relationship has received relatively little attention. This study aims to enhance understanding of brand characteristics as antecedents of WOM by executing a comprehensive empirical analysis.

  6. The Impact of Word of Mouth on Intention to Purchase Currently Used and

    This paper measures how the impact of positive and negative word of mouth (PWOM, NWOM) is related to the receiver's intention to purchase brands, ... International Journal of Market Research, 53, 3, pp. 327-346. Crossref.

  7. Revisiting the antecedent of electronic word-of-mouth (eWOM) during

    De Bruyn A, Lilien GL (2004) A multi-stage model of word of mouth through electronic referrals. eBRC Research Paper Series, (ref. 2004-02). Chau M, Cao J, Knotts T, Xu J (2009) Word of mouth marketing through online social networks. Cheng X, Zhou M (2010) Study on effect of eWOM: a literature review and suggestions for future research. In: 2010 ...

  8. Networked Narratives: Understanding Word-of-Mouth Marketing in Online

    Word of mouth marketing — the intentional influencing of consumer-to-consumer communications — is an increasingly important technique. The authors overview and synthesize extant word of mouth theory and present a study of a marketing campaign in which mobile phones were seeded with prominent bloggers. ... HEC Paris Research Paper Series ...

  9. Psychology of word of mouth marketing

    The goal of the current paper is to review some of the most recent research in online WOM (focusing on the past two to four years) as well as make suggestions regarding future research. [For earlier syntheses on WOM senders and social media marketing, see King et al., 2014, Stephen, 2016, Whitler, 2014] [6-8].

  10. Word of Mouth and Its Impact on Marketing

    Business. As a result different aims were drawn; the initial aim of this research is to study the attention of the customers in word of mouth to power their online purchasing activities. The next aim is to analyze the people influenced by interest of word of mouth. The following aim is to examine the marketing behavior bearing in mind the ...

  11. (PDF) The Renaissance of Word-of-Mouth Marketing: A ...

    In this paper the importance of word of mouth for marketing management in the twenty-first century will be discussed. After a short introduction, there will be a focus on the demarcations and ...

  12. A Literature Review of Word of Mouth and Electronic Word of Mouth

    Background. Word of mouth is one of the oldest ways of conveying information (Dellarocas, 2003), and it has been defined in many ways.One of the earliest definitions was that put forward by Katz and Lazarsfeld (1966), who described it as the exchanging of marketing information between consumers in such a way that it plays a fundamental role in shaping their behavior and in changing attitudes ...

  13. Word-of-Mouth Research: Principles and Applications

    Complexity science modeling is introduced as an effective method for simulating the real-world operation of WOM in a given market category and identifying ways in which marketers can influence it to their advantage. ABSTRACT Word of mouth (WOM) is an important component of a complex and dynamic marketplace environment, and as such, WOM research is best undertaken as part of a holistic research ...

  14. The Effect of Electronic Word of Mouth on Sales: A Meta-Analytic Review

    The increasing amount of electronic word of mouth (eWOM) has significantly affected the way consumers make purchase decisions. Empirical studies have established an effect of eWOM on sales but disagree on which online platforms, products, and eWOM metrics moderate this effect.

  15. The current state of research of word-of-mouth in the health care

    Health information plays a significant role in the health behavior of individuals. Word-of-mouth (WOM) is essential in this context. In recent years, new forms of online communication have greatly expanded the possibilities for seeking information and, in consequence, significantly changed communication behavior. Similarly, the doctor-patient relationship has gradually evolved and the ...

  16. (PDF) Word of Mouth: A Literature Review

    Information from word of mouth is an important message about the company's products or services in the form of "consumer talk" conveyed to other consumers (Kundu & Rajan, 2017). The quality of ...

  17. PDF Redalyc.UNDERSTANDING THE POWER OF WORD-OF-MOUTH

    At the same time that positive word-of-mouth is a powerful tool for compa-nies to promote their business; negative word-of-mouth can have a disastrous impact on a companyÕs image. One of the things that it is shown in research about word-of-mouth is the fact that dissatisfied customers tend to spread their negative experiences to

  18. Word of mouth: Why is it so significant?

    Word of mouth (WOM) is a concept of ever increasing importance to both marketing academics and practitioners. Despite the interest in WOM, no research to date has summarised the factors that contribute towards WOM's significance. Based on a synthesis of the literature, this paper develops a conceptual framework of the factors that contribute towards the significance of WOM.

  19. Words Of Mouth (WOM) And Its Impacts On Consumer Behavior

    The aim of this study is to measure the model of brand equity to investigate the effect electronic word of mouth in context of social media, data was taken from past research papers.

  20. Word-of-Mouth as Self-Enhancement

    In this research we predict and demonstrate that consumers' propensities to generate word-of-mouth (WOM) is affected by their motivation to self-enhance, that is, to seek experiences that bolster the self-concept. Data from three experiments and an empirical analysis of real-world WOM indicate that self-described consumer experts demonstrate a ...

  21. Spanning 36 years, the evolution and trend of word-of-mouth marketing

    Word of mouth marketing is a new tool of marketing, which has a special communication mechanism and characteristics, and is the main focus of business activity research. Based on the retrieval data of web of science, this study uses bibliometrix software to conduct network econometric analysis on 259 literatures on word-of-mouth marketing in ...

  22. [PDF] Word of Mouth: A Literature Review

    Purpose: The purpose of this paper is to understand, summarize and highlight the current research work in the area of word-of-mouth (WOM) along with the existing gaps in the literature. Design/methodology/approach: This study is a qualitative analysis of 20 research articles from peer-reviewed sources covering a span of 14 years from 2002 till 2016 addressing WOM, its antecedents, the effects ...

  23. PDF Word of Mouth and Its Impact on Marketing

    Currently, Word-of-Mouth is also a great aspect in marketing and more above all in e-Marketing. The diverse tools used by marketers in order to pass on information to likely customers are present everywhere on the Web, from advertisements to opinion on blogs or forums. (Hung & Li, 2007).