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Measuring the Impact of Cultural Variances on Product DesignMeasuring the Impact of Cultural Variances on Product Design

Medical Device & Diagnostic Industry MagazineMDDI Article IndexOriginally Published October 2000Market Research For manufacturers attempting to market a new product internationally, the failure to perform in-depth cross-cultural research can be a costly mistake.Bryce G. Rutter and Tammy Humm Donelson

October 1, 2000

16 Min Read
Measuring the Impact of Cultural Variances on Product Design

Medical Device & Diagnostic Industry Magazine
MDDI Article Index

Originally Published October 2000

Market Research

For manufacturers attempting to market a new product internationally, the failure to perform in-depth cross-cultural research can be a costly mistake.

Bryce G. Rutter and Tammy Humm Donelson

0010d112a.jpg A common axiom holds that 80% of a product's cost is determined during the first 20% of development. In other words, if manufacturers make a few wrong turns at this early stage, it won't take long for product development costs to skyrocket. Conducting design research early in the development process helps eliminate unnecessary costs. When the product is intended to enter the global market, the manufacturer must further consider the variances of each country in which the product is to be sold.

In today's global economy, cross-cultural research is fast becoming a valuable tool for manufacturers trying to determine product viability. At the very simplest level, cross-cultural research involves studying respondents from more than one culture. The dilemma is that culture has a broad range of definitions; as a result, interpreting cultural differences is extremely vulnerable to subjectivity.

Medical products are particularly sensitive to cultural influence due to differences in medical practices throughout the world. In some countries, consumers might have a choice between private practice and socialized medicine or between holistic and clinical approaches to medical treatment. Patients also receive treatment in different environments, from doctors' offices to urban hospitals to rural clinics. A company's failure to acknowledge cultural differences in medical practices often limits its product's marketability. Cross-cultural research provides the key to unlocking these potential marketing barriers.

Like all research, cross-cultural studies provide qualitative and quantitative data that can be translated into a broad-based analysis of user needs. Quality cross-cultural research assesses and analyzes differences in perception, context, and in the use of medical products in selected countries or geographic regions. Just as successful product developers wouldn't attempt to design and manufacture a new product without first performing comprehensive research, a global enterprise shouldn't enter the world market without proper cross-cultural research. Information on how products are perceived in different geographic locations greatly increases the likelihood of global success.


It is much easier for a manufacturer to penetrate the global market when it is armed with the right information. Unfortunately, in the rush to get to market, some manufacturers take the global plunge and then find out that their lack of cultural information creates a flurry of potential marketing disasters. Following are some of the most common mistakes made by manufacturers in their rush to international markets.

Boardroom Design. Product design often revolves around profits, marketing, engineering, or product aesthetics without involving end-users in the process. The problem with creating the widget and then looking for a market should be obvious. Research should test every assumption so that product viability is based on quantitative results. Design driven by consumer needs— as opposed to design in the corporate boardroom—ensures greater product acceptance and longevity.

Copycat Mentality. Another tendency of boardroom product design is the copycat product that mimics the competitors. This stifles creativity and ultimately limits company growth. In this paradigm, products are relegated to a commodity market where real differences are hard to find and price becomes the deciding factor. Obviously this is not where manufacturers want to be, since it means constantly reducing profit margins to stay competitive. A better option is to differentiate a product through usability and functionality. A comprehensive matrix that includes cross-cultural, design, ergonomics, marketing, end-user perception, and usability research provides a basis for creative thinking that's grounded in reliable data.

Feature Creep. Features are not synonymous with functionality. In fact, unnecessary features can be a liability instead of a benefit. "Feature creep" is the result of trying to make one product fit every need. For example, one client may ask for a particular feature, while another client wants a different feature; eventually, all the features overwhelm the product's usability. This happens in every product category, but medical products are particularly susceptible because they need to work in a host of different medical environments and cultures. Features necessary in one country may not be important in another. Instead of adding different features for each country, cross-cultural research discovers which features can be whittled down to one solution, which can be eliminated, and which are necessary country-specific variances. The goal is to obtain this information early in the product development process, when all possibilities are open.

Oversimplification. When consumer and product studies are conducted among respondents in different cultures, they are often done superficially, arriving at overly simplistic cultural attributions. Catastrophic marketing mistakes occur when design, manufacturing, or marketing decisions are based on generalized conclusions about ethnic and national groups. It is not enough to report the differences; there needs to be an understanding of why the differences exist. Differences in economies, governments, education, occupations, ethnicity, gender, social class, and family systems should be analyzed for their effect on research results.


To achieve maximum benefit for the design process, the cross-cultural research team should be included in development discussions as soon as there is the desire to pursue a new global product, and should continue to be included at every step of the way. Using cross-cultural as well as ergonomic and design research early in the development process allows the research team to find enhancements that may add little or nothing to the cost, but contribute significantly to the perceived value and profit margin.

Cross-cultural research should uncover the process of interaction between the medical practitioner and the patient. Levels of technology vary, but the proposed product must be geared to maximize the process of this interaction.


Attending to the following points from the initial product planning stage through the final interpretation of results provides manufacturers with measurable cross-cultural data. The data establish a firm foundation for universal product design and global marketing decisions. Product acceptance and marketing success ultimately depend on understanding the social factors and cultural variances of today's global economy.

Step 1. Define systematic procedures for designing the study, gathering data, and analyzing the findings. Address the concerns unique to each country to minimize their impact on results.

Step 2. Incorporate high levels of systematic control into the end-user or consumer study.

Step 3. Do not overlook similarities across cultures; do not assume there will be overwhelming differences.

Step 4. When differences are found, decipher the extraneous variables or, at a minimum, consider them during interpretation. Thoroughly analyze and interpret cross-cultural results. Anticipate the differences and probe the reasons behind them.

Define the Procedures. All scientific study requires a precise research methodology consisting of systematic procedures for designing the study, gathering the data, and analyzing the findings. Like other market research, cross-cultural research uses traditional market slicing by age and gender, but it goes further to include data on cultural effects, socioeconomic conditions, and distribution channels in order to address the concerns unique to each country. In defining the procedures, manufacturers should take the following steps:

  • Begin research planning with project managers by clearly identifying the overall research objective. Confirm the consistency of the objective in each of the international markets.

  • Define all aspects of the procedural operations to ensure reliability in the data collection process. The same instructions should be followed during each interview, questionnaire, and observation. Follow a standard questionnaire to collect data on consumer response.

Incorporate Study Control. An objective in all scientific study is to minimize the variables so as to obtain clean, reliable data. The analysis and interpretation of cross-cultural results require a thorough investigation of extraneous factors to minimize their impact on results. Study control is difficult to obtain when crossing national borders, however. With the numerous variables that exist, cross-cultural studies require diligent control of all aspects within the sphere of influence. Control of the methodology and neutralization of the language differences are critical to obtaining reliable data.

To help facilitate the data-gathering process, training of the researchers and data collection methods should be standardized. Researchers should be trained on the project background, the product being studied, the research objectives, and the specific procedures to be carried out during interviews and observations.

Typical procedural controls should include:

  • Providing identical training for staff design researchers.

  • Using standardized questionnaires and research tools.

  • Using specific formats for interviews and observations.

  • Using native language speakers as translators. Only individuals whose first language is the required one should conduct all translations so as to minimize inaccurate translations or other confounding factors. Research materials and questionnaires should also be translated by native language speakers.

  • Having each researcher interview respondents with assistance from a native language speaker and citizen when appropriate. Most often these assistants serve as interpreters or translators, who are briefed on the cogent project details. As with most research, cost concerns often require a trade-off with research control. Ideal control would involve using the same interviewer in all countries, or having each researcher do a portion of interviews in all countries to eliminate the effects of individual bias.

  • Having interpreters repeatedly review original translations for accuracy. Ideal conditions include a research budget for back-translating the translated version into the original language by a second individual for comparison. The objective is to locate translation discrepancies before data collection begins.


Total time for project: 3–6 months.

Program Launch (1–2 weeks). Any existing research is reviewed. Research design strategies are developed. Goals are outlined.

Design and Ergonomics (4–12 weeks). Research methods and instruments such as questionnaires are finalized. Consumer research including one-on-one interviews and in-office or in situ discussions take place. Ergonomic specifications are determined based on cognitive, emotion, and perception studies.

Ergonomic Concept and Design Specifications (3–6 weeks). The research matrix is used to evaluate all subsequent design development. As the culmination of all research, design concepts may be presented on CD-ROM, in a multimedia presentation, or in written format. Ergonomic concept modeling presents different manifestations of the research data representing the best blend of needs for consumers, manufacturing, and brand leveraging.

Customer Validation Testing Techniques (3–4 weeks). Using simulation, user groups, point-of-purchase testing, and in-office or in-use testing, cross-cultural researchers look for any deficiencies and opportunities to enhance the final product.

Design Development and Documentation (2–4 weeks). Designs are finalized in functional prototypes and detailed CAD documentation is completed and then frozen. No more changes are made after this point; the design is simply implemented. This critical step is the strategic difference in getting products to market faster. Too many companies drag out the design phase in the belief that they can create something even better. In reality the indecisiveness and fear of commitment means lost business opportunities: while a firm chases a utopian ideal, other companies beat it to the marketplace.

Testing and Evaluation (3–4 weeks). This sign-off phase is the last check to make sure everything is working according to plan before product tooling and vendor commitments. Only minor refinements occur during this step.

Design Finalization (1–2 weeks). CAD documents are updated with any revisions from testing and evaluation. Production begins.


At the same time they are researching for cultural differences, manufacturers must be careful not to overlook similarities across cultures; they shouldn't assume there will be major differences. Differentiating a product for a certain group may create more problems than it solves. Adaptations of a current design means more money spent on retooling, manufacturing, and marketing. Research may uncover a universal solution that meets the needs of all cultures.

In recent research for an in-office medical equipment manufacturer conducted by Metaphase Design Group (St. Louis), similarities were revealed among respondents in all five countries studied. The most appealing product was consistent across countries, and many product features had the same appeal or lack of appeal across countries. The findings met the research objectives of the client and solidified the direction for future development.

The study also revealed major differences between national attitudes. Findings from the United States overwhelmingly showed a concern that a certain device be waived under the Clinical Laboratory Improvement Amendments of 1988, and that the doctor's office or laboratory be reimbursed for each test performed on the device. By contrast, in France, Germany, and the United Kingdom, quality control and accessory prices drove concerns. The differences stemmed from having managed care in the United States and socialized medicine in European countries. Although different cultures preferred the same product, the research indicated that the product needs to be marketed differently depending on the medical system of the country.

Often, as in this case, the main objective for the medical device or equipment manufacturer is to come to a global decision on a new product design. Countries are sampled for cultural variances with the purpose of achieving a sample broad enough to generalize the manufacturer's particular global market. This type of research is not intended to develop country-specific products.


If the objective of the preceding in-office equipment study had been to understand national markets, the broad research parameters would have made a perfect setting for the frequent mistakes made by global marketing decision makers. When the objective is country specific, the international differences need to be investigated for a deeper understanding of cultural and national influences by including data on cultural effects, socioeconomic conditions, and distribution channels. These studies must also address the similarities in findings across cultures and consider them in global marketing decisions.

Healthcare product success is particularly dependent on an understanding of protocol, procedural differences, and purchasing habits. For instance, across cultures there are different perceptions as to what constitutes a disposable or what represents a capitalized expense. Some countries can capitalize an expensive piece of medical equipment but not afford disposables, or vice versa. For manufacturers, the solution to the sale lies in the bundling. The disposable product can be bundled with the equipment and made part of the capitalized expense. In another purchasing paradigm, the equipment can be "earned" through the purchase of a specified quantity of disposable items. In the United States and other capitalist countries, the competition of the open market elevates the importance of profitability. Conversely, profitability is not an issue for socialist and communist countries.

When a company understands the reasons behind international differences, it has the information necessary to properly position its product in the market. For example, a study found that users and purchasers in the United States were less concerned about the price of a medical device than were respondents in England. Instead of mistakenly generalizing about more frivolous purchasing habits of U.S. consumers, one would have to further investigate the healthcare and insurance industries in the United States and England to understand the underlying financial concerns. The researchers would not only need to understand how the industries vary by country, but also how purchasing procedures vary in the private and public sectors.

Cultural rules and social norms must be understood in order to make an accurate analysis of results. Users and purchasers in Japan, for example, may report finding a product more appealing than consumers in Germany. But before jumping to conclusions and rolling out a large marketing campaign in Japan and a small campaign in Germany, further analysis is necessary. An understanding of Japanese culture would need to be considered when comparing Japanese responses to those in cultures where respondents are less inclined to emphasize the same social standards.

Respondents in all countries except the United States may consistently respond negatively to the largest size model of a medical instrument. Instead of looking only at such surface findings and jumping to country-specific conclusions, however, development teams must analyze why this country difference exists. For example, medical offices of Germany, France, Japan, and England are smaller on average than typical U.S. offices. Space limitations might be less of a concern in U.S. medical offices, but that does not necessarily mean that U.S. respondents prefer larger instruments. Again, the trick is to discern the meaning behind the cultural variable.


The cost of cross-cultural research depends on the number of subjects and venues included, as well as the degree of complexity and rigor required. The depth and breadth of the ergonomic performance research, the competitive analysis, and the market analysis determine the costs. In assessing the value of cross-cultural research, it is important to remember that the earlier research is integrated into the process, the more cost-effective it is.

One way to hold down the cost of cross-cultural research is to use internal resources to the fullest extent. First, manufacturers should assess the resources within their own organization. Do they have the time and capabilities to undertake some or all of the research process? In-house researchers and marketing, engineering, and design team members can help articulate goals and design strategies.


Cross-cultural research is a new breed of research, and its researchers draw from a plurality of education and experience. The cross-cultural researcher has a unique skill set that includes anthropology, psychology, design research, ergonomics, and industrial design. Training in several disciplines facilitates smooth passage from research to finished product.

The qualified cross-cultural researcher serves as the bridge between the pragmatic and the emotional. While the demand for cross-cultural research continues to grow, the limited availability of qualified researchers means some companies are developing their existing staff by providing the necessary training.


For help in developing a cross-cultural research program, manufacturers can contact the following professional organizations. These professionals can direct manufacturers to organizations specializing in cross-cultural research.

Industrial Designers Society of America: 703/759-0100

Design Management Institute: 617/338-6380

Human Factors and Ergonomics Society: 310/394-1811

Simply stated, cross-cultural research identifies the similarities and differences of various cultures. This understanding allows companies to capitalize on commonalities or respond to differences appropriately. A well-designed product should answer most consumer needs. The needs of different cultures, populations, and countries may not be able to be homogenized into one product, however. A country-specific variation of a product may be required. The question manufacturers need to ask themselves is if it is better to discover the need for country-specific variations before the design phase or after the prototypes have been created. The more thoroughly a product is researched in the early stages, the fewer mistakes occur in the more expensive development phase. The user-centric approach of cross-cultural research eliminates ill-fated proposals early in the game. The streamlined development process ensures that better products get to market faster and more economically.

Bryce G. Rutter is president and Tammy Humm Donelson is the director of marketing and public relations at Metaphase Design Group (St. Louis).

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