Factors Influencing Customer Loyalty Among Optical Clinics in The City of Koronadal, South Cotabato, Philippines

ABSTRACT


Introduction
The optometry field holds a pivotal role in preserving eye health and preventing vision-related ailments.Optical clinics, as essential providers of eye care services, are instrumental in meeting the rising demand for eye-related issues.Unfortunately, the advent of the Covid-19 pandemic has presented formidable challenges to these clinics, leading to a decline in service revenue.This decline can be attributed to the public's hesitancy to visit healthcare facilities amidst the pandemic [1].
A service design model was developed by [2] for the ophthalmology and optometry industry to address post-epidemic challenges related to low consumer satisfaction and service entity-consumer service needs mismatch and the results indicated several important findings: professional and technical satisfaction positively impacts service experience satisfaction and service efficiency satisfaction; service efficiency satisfaction positively affects service experience satisfaction and serves as a mediating factor between professional and technical satisfaction and service experience satisfaction.The COVID-19 pandemic had a profound impact on the healthcare landscape, resulting in a substantial decrease in in-person visits to optometry clinics as individuals, concerned about virus transmission, hesitated to seek in-person healthcare services [3].
The study conducted by [4], yielded noteworthy results, highlighting crucial relationships in the context of Pakistan's telecommunications services sector.It was found that Corporate Social Responsibility (CSR) exhibited a positive and significant correlation with customer loyalty.Similarly, a strong and favorable connection was observed between customer satisfaction and customer loyalty.Additionally, the study unveiled a positive and meaningful link between customer trust and customer loyalty.These findings significantly enhance our understanding of CSR, customer satisfaction, trust, and loyalty dynamics, providing valuable guidance for policymakers, especially within Pakistan's Telecom sector.The research also acknowledged its limitations and recommended avenues for future studies in this domain.
In Philippines, amid the COVID-19 pandemic, customer satisfaction with service quality plays a vital role in maintaining customer loyalty, highlighting the importance of enhancing empathy and service effectiveness during such crises [5].Optical and optometry clinics have faced significant challenges in attracting and retaining customers during the COVID-19 pandemic.With concerns about health and safety, many individuals have been hesitant to visit healthcare facilities in person, leading to a reduction in foot traffic.This decline in in-person visits has posed a major obstacle for these clinics, as they rely heavily on regular customer interactions for revenue and customer loyalty.To adapt to these challenges, clinics have had to explore alternative service delivery methods, such as optometry and online sales of eyewear, to reach and retain their customer base.Additionally, ensuring a safe and comfortable environment for in-person visits has become a top priority to rebuild trust and maintain customer loyalty in these uncertain times.
Customer loyalty is a critical aspect of service industries in the Philippines, including healthcare, and has garnered attention due to the country's growing healthcare service sector.According to [6], Customer satisfaction has long been recognized as a precursor to customer loyalty.In healthcare services, including optometry, satisfied patients are more likely to exhibit loyalty by returning for followup appointments and recommending the services to others.
In South Cotabato, the optical industry is experiencing growth, with several clinics vying to become market leaders.The local government is also pushing for reforms in healthcare initiatives to enhance the delivery of basic optical health services to residents.The common customer management practices of local optical clinics include providing quality services at affordable rates, committing to service excellence, and ensuring customer satisfaction.
The research gap lies in the limited knowledge regarding customer loyalty in the healthcare sector, especially in the optical health domain.While existing literature points to the link between service quality, customer satisfaction, and customer loyalty, the specific connection between crucial factors and customer loyalty requires further exploration.This study aims to fill this gap by identifying and assessing the relationship of significant factors influencing customer loyalty in optical clinics in Koronadal City.
This research seeks to contribute to the growing body of knowledge on customer loyalty in the optical clinic industry, particularly within the unique context of Koronadal City, South Cotabato.While existing literature has extensively examined the interplay between service quality, customer satisfaction, and customer loyalty across various sectors, the optical clinic domain remains relatively unexplored.By investigating the specific determinants and dynamics affecting customer loyalty in this industry, this study offers a novel perspective that can potentially inform strategic decisions and practices for optical clinics.It addresses a critical research gap and aims to provide timely insights into optimizing customer loyalty, a vital asset for businesses, especially in the face of challenges posed by the ongoing pandemic and evolving consumer behaviors.

Research Design
In this research, a quantitative method was employed to conduct a descriptive correlational study aimed at determining the significant factors influencing customer loyalty to the services offered by optical clinics in the City of Koronadal.Primary data was exclusively utilized for the study, gathered through purposive-convenient sampling.The descriptive nature of this study focused on providing a comprehensive description of the characteristics of the specific population under investigation.The quantitative approach adopted in this research allowed for statistical analysis to explore the correlations between each variable and the dependent variable, shedding light on the crucial relationships affecting customer loyalty.

Respondents
The respondents in this study were consumers of Optical Clinic who had visited the clinic at least once.They were the intended respondents of this survey as they had previous encounters with the services provided.Since the total population of the respondents was unknown, the unknown population sample size calculation was used to determine the study's total sample size (with 90% confidence level).A total of 68 (based on the result of the sample size calculation) respondents participated in this study.
• Z is the Z-score associated with the desired level of confidence (1.645 for a 90% confidence level).
• α is the standard deviation at 0.5 • E is the desired margin of error (expressed as a decimal, 0.10 for 10%).

Research Tools and Instruments
The research employed a modified questionnaire developed by [7] , which underwent KMO reliability testing and content validity assessment conducted by two experts.There were three (3) components inside the survey questionnaire.The first component comprised questions about the respondents' demographic profile, including their gender, age, occupation, average monthly income, most recent education, and the number of monthly visits to ophthalmic service providers.The second section included questions about the framework's constructs.The second component of the questionnaire was further segmented into four (4) constructs, Service Quality, Customer Service, Customer Trust, and Brand Image, for the independent variable, with five (5) items for each construct, for a total of twenty (20) items.The objective of the third section was to collect data on the independent variable of Customer Loyalty.
Using Cronbach's alpha test, pilot testing was conducted to check the instrument's reliability.Cronbach's alpha is one of the tools to measure the reliability of instruments.

. Cronbach's Alpha
Cronbach's Alpha Internal Consistency α ≥ 0.9 Excellent 0.9 > α ≥ 0.8 Good 0.8 > α ≥ 0.7 Acceptable 0.7 > α ≥ 0.6 Questionable 0.6 > α ≥ 0.5 Poor 0.5 > α Unacceptable A total of 25 respondents was aggregated.As a result, the reliability of the questionnaire accumulated to more than 0.70, which means that the instrument is acceptable.3. illustrates the alpha (α) for each construct.It can be shown that Cronbach's Alpha of all constructs is greater than 60.Therefore, all the constructs are reliable.

Statistical Tool and Statistical Treatment
All the data gathered from the processed questionnaire was tabulated and processed using the SPSS V23 or the Statistical Package for Social Sciences.This software offers a variety of statistical analyses suited enough for qualitative research.The following Statistical tools/analysis will be used in the study; The researchers used different statistical tools in analyzing the data to answer the questions depicted in the study.The statistical tools used were the following: Frequency.It will summarize the data by showing the number of times a data value occurs.
The formula would be: f=1/T Where: f=Frequency T= Period Percentage.This is an expression of the proportion of the population corresponding to a particular variable or item.This was used to present the profile of the respondents and the possible problems that the respondents might have encountered.Researchers used it to transform proportion to a percent by multiplying by 100.
The formula would be: % = f/n x 100 Where: Weighted Mean.It aimed to get the quantity to be averaged in assigning weight, using the frequency distribution, and measuring the respondent's evaluation in the questionnaire.This is adopted to establish the weighted means of the values and attitudes of the respondents.Standard Deviation.The researcher used this because it is the most commonly used indicator of the degree of dispersion and the most reliable measure to estimate the variability in the total population from which the Multiple Regression Analysis.Multiple regression is a statistical method for analyzing the relationship between a single dependent variable and several independent variables.Multiple regression analysis aims to predict the value of a single dependent variable based on the known values of the independent variables.Each predictor value is assigned a weight, representing the predictor's relative contribution to the overall prediction Data Interpretation Data gathered was interpreted using the Likert Scale Rating (five-point scale).Likert Scale Rating is an ordered scale from which respondents will choose one option that best aligns with their views.It served as the basis for interpreting the results that were arbitrarily prepared.The weighted mean of the evaluation used to interpret was based on the five-point scale Five (5) point scales can be assigned to each response in a point value, from 1 to 5, based on the number of responses.Typical values for the options start with "strongly disagree" at 1 point and "strongly agree" at 5. The mode will be the most common response to each statement, while the mean will be the overall average response.

Result and Discussion
This section contains research results or experiments and analysis of research results or experimental results.According to Table 5, female respondents constituted 66% of the total population and dominated this survey, while male respondents constituted 34%.Sixty-five percent of the population comprised those aged 18 to 24, followed by 16 percent of those aged 35 to 44, 10 percent of those aged 45 to 55, 7 percent of those aged 56 and over, and 2 percent of those aged 25 to 34. 49% of respondents are currently employed, 34% are students, 7% are jobless, 6% are housewives/husbands, 3% are retired, and 1% belong to other occupation classifications.In terms of monthly income, 49% of the population has a monthly income of less than ₱10,957, 34% of the population has a monthly income between ₱10,958 and ₱21,194, and 18% has a monthly income between ₱21,194 and ₱43,828.43% of respondents held a bachelor's degree, 38% a high school diploma or its equivalent, 9% an associate's degree, 6% a master's degree, 3% had some college but no degree, and 1% an advanced degree.Regarding the number of visits, the majority of respondents, or 64%, indicated that they had visited an optical clinic only once, and followed by 22% who had visited 4-6 times and 16% who had visited 2-4 times.The majority of respondents, or 31%, were from Aplasca Optical, followed by Ideal Vision with 24% of the total population, RA Alajar with 15%, Vintage Vision with 9%, Cabañal Optical Clinic and Eyeland Vision Clinic with 3% each, and Farofo Eye Clinic and Dulay Clinic with 1% each (Table 6).To examine the constructs, a confirmatory factor analysis was used.Table 7 reveals that the Kaiser Meyer-Olkin (KMO) Measure of Sampling Adequacy is more significant than 0.60 and that the Sig.level is less than 0.05 for all constructs.The key performance indicators (KPIs) for service quality are 0.767 (76.7%), customer satisfaction is 0.827 (82.7%), customer trust is 0.813 (81.3%), brand image is 0.785 (78.5%), and customer loyalty is 0.828 (82.8%).Thus, all constructs are significant, including service quality, customer satisfaction, customer trust, brand image, and customer loyalty.

Agree
The results of the service quality survey are presented in Table 8.Based on the interpretation, respondents agreed that service quality influenced customer loyalty (M=4.02).Similarly, most respondents strongly agreed that the reliability aspect of service quality (M=4.32) and the proximity from their office or home to the optical clinic are significant (M=3.99).
According to the findings, the optical clinic's reliability significantly influenced the respondents' customer loyalty.They are also considering the site of the optical clinic.This is similar to [8] study titled " Exploring the Emerging Role of Healthscape in Determining Patient Satisfaction : An Empirical Study in the Indian Private Healthcare Industry."According to the study's findings, patients' satisfaction is influenced by the hospital's reliability and responsiveness.Patients' satisfaction is closely tied to their loyalty.9.The respondents agreed (M = 4.12) that Customer Satisfaction strongly influenced customer loyalty.Results also indicate that respondents are content with their present optical clinic (M = 4.24).Most certainly, they are happy with the service provided by their optical clinic (M=3.99).The results indicate that respondents are satisfied with their decision of the optical clinic for their eye care needs.Likewise, they are satisfied with the current optical clinic's services.

Agree
Table 10 reveals that respondents agreed that consumer trust influences customer loyalty (M = 4.18).Whenever they visit an optical clinic, they are assured that their belongings are secure (M=4.24).Likewise, they agreed that their current optical clinic is transparent and honest (M=24).
Results indicated that respondents are concerned about the security of their belongings every time they visit an optical clinic.Additionally, they are sensitive to issues of transparency and honesty.The findings (Table 11) show that brand image affects customer loyalty (M = 4.15).Respondents strongly agreed that having a reputable and well-established optical clinic improved their opinion of the brand image (M=4.32) and that they could readily recall the symbols or logo of the optical clinic they visited (M=3.85).
The results indicate that the optical clinic's credibility influences respondents.They are looking for a well-established and reputed optical clinic to assist them with their eye care needsThe results align with the study conducted by [9], which explored the connection between brand image and customer loyalty in the service industry.The study's findings also revealed a clear and positive relationship between brand image and customer loyalty.A favorable brand image significantly contributes to enhanced customer loyalty.

Results of Multiple Regression Analysis
This study was conducted to determine if various factors can influence customer loyalty in optical clinics in Koronadal City.The hypothesis is that Service Quality, Customer Satisfaction, Customer Trust, and Brand Image significantly influence Customer Loyalty.To test the hypothesis, multiple regression analysis was used.The results indicate that the four (4) predictors account for 46.7% of the variance in customer loyalty (F(4,63)=15.656),p=.000).This demonstrates that the model only partially explains the goodness of fit but that the data are significant.A Durbin-Watson (DW) statistic was also calculated to evaluate the independence assumption of the residuals.The acceptable DW range without autocorrelation is 1.45 to 2.44.As indicated by the DW Value of 1.774, the fitted regression line result demonstrated no evidence of autocorrelation.This indicates that for Customer Satisfaction (.329) as a predictor of customer loyalty, there was approximately a .329rise in customer loyalty for every 1-point increase in customer satisfaction.Similarly, Customer Trust (.097) as a predictor revealed an increase of approximately.097, and Brand Image (.493) indicated an increase of approximately .493 in customer loyalty for every 1-point increase.In other words, customer loyalty increases with customer satisfaction, trust, and brand image.Alternatively, for every 1-point increase in Service Quality (-.011), customer loyalty decreases by approximately .011.  15 shows the rejection or acceptance of hypothesis based on regression analysis.Based on the results, hypothesis 2 and hyphothesis 4 were accepted with a pvalue of more than 0.05.A p-value less than 0.05 is typically considered statistically significant, so the null hypothesis should be rejected.A p-value more significant than 0.05 means that deviation from the null hypothesis is not statistically significant.

Conclusion
This study on customer loyalty in optical clinics within the City of Koronadal revealed significant findings.Researchers observed that customer satisfaction and brand image played crucial roles in influencing customer loyalty in these clinics.Surprisingly, neither service quality nor customer trust exhibited a statistically significant impact on customer loyalty.
These results align with the study conducted by [10] , which also emphasized a positive relationship between customer satisfaction and customer loyalty.In contrast, [11] observed an indirect relationship between customer satisfaction and loyalty

Table 3 .
Reliability of Constructs

Table 5 .
Demographic Profile of the Respondents (N=68)

Table 6
Number of Visits and Visited Optical Clinics

Table 7 .
Confirmative Factor Analysis of Variables

Table 8 .
Service Quality

Table 9 .
Customer Satisfaction

Table 15 .
The Final Remarks and Results of the (Acceptance/rejection of Hypothesis)