Social marketing and drug and alcohol prevention: evidence and examples Martine Stead Deputy...
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Social marketing and drug and alcohol prevention: evidence and examples Martine Stead Deputy Director Institute for Social Marketing University of Stirling
Social marketing and drug and alcohol prevention: evidence and
examples Martine Stead Deputy Director Institute for Social
Marketing University of Stirling and The Open University
Slide 2
1.Evidence for the effectiveness of social marketing as an
approach 2.How social marketing has been applied to substance use
prevention: some examples
Slide 3
1.Evidence for the effectiveness of social marketing as an
approach 2.How social marketing has been applied to substance use
prevention: some examples
Slide 4
How effective is social marketing as a strategy for drug and
alcohol prevention? The first place to look for evidence of
effectiveness is systematic reviews Some reviews do not include
social marketing as a category of intervention Some reviews equate
social marketing with media approaches A lack of understanding of
social marketing among reviewers
Slide 5
Review conducted by ISM into effectiveness of social marketing
interventions for diet, physical activity, alcohol, tobacco and
drugs Health Education Vol. 107 No. 2, 2007 pp. 126-191
Slide 6
How we defined social marketing Not by the label used in the
article or report about the study By the extent to which an
intervention met Andreasens 6 social marketing criteria: BEHAVIOUR
CHANGE CONSUMER INSIGHT SEGMENTATION & TARGETING EXCHANGE
COMPETITION MARKETING MIX
Slide 7
1.Searched for good quality systematic reviews (SR) of all
substance misuse interventions 2.Identified 310 individual studies
from these SRs which potentially met the social marketing criteria
3.Assessed these 310 studies against Andreasens 6 benchmarks 4.35
studies met all 6 criteria Search Strategy (drugs, alcohol and
tobacco): 35 SRs 310 individual studies 35 studies of social
marketing interventions
Slide 8
Results The interventions 15 measured impact on alcohol-related
behaviour, 13 on drug-related behaviour
Slide 9
Study Intervention Ary 1990Project PATH, school prevention
programme including peer leaders Biglan 2000Comparison of a school
programme with community advocacy to reduce under-age access to
tobacco (also measured impact on alcohol use) Botvin 1997Life
Skills Training for minority adolescents, theory-based school
programme Botvin 2001Life Skills Training for minority adolescents,
theory-based school programme Cuijpers 2002Netherlands school-based
drug prevention including parent/home elements Ellickson & Bell
1990Project ALERT, school social influences programme including
teen leaders Ellickson et al 2003Revised Project ALERT Hansen et al
1988Project SMART, school theory-based social influences programme
Hecht et al 1993School drama-based drug prevention programme
McBride et al 2000Project SHAHRP, Australian school programme for
alcohol harm minimisation Pentz et al 1989Project STAR,
multi-component school, community and media drug prevention Perry
et al 1996Project Northland, multi-component programme incl.
community taskforces & alcohol policy Spoth et al
2001Strengthening Families, theory-based drug and alcohol
intervention for families Sussman et al 1998Project TND (towards no
drug abuse), theory-based school programme Sussman et al
2002Project TND (towards no drug abuse), theory-based school
programme Wagenaar et al 2000Community and policy intervention to
reduce youth access to alcohol and drink-driving
Slide 10
Study 12 m: alcohol24+ m: alcohol12 m: drugs24+ m: drugs Ary
1990 No- - Biglan 2000 YYWeak Botvin 1997 Y-Y- Botvin 2001 YWeak
Cuijpers 2002 YYYNo Ellickson & Bell 1990 Mixed, weakNYNo
Ellickson et al 2003 Mixed, weak-Y- Hansen et al 1988 YYYNo Hecht
et al 1993 --Y- McBride et al 2000 Y--- Pentz et al 1989 YNYY Perry
et al 1996 -Y-N Spoth et al 2001 YY-- Sussman et al 1998 Mixed,
weak-Mixed 1998- Sussman et al 2002 Mixed, weakNoYY Wagenaar et al
2000 -Weak--
Slide 11
Alcohol prevention/harm minimisation (15 studies) 8 reported
positive effects on alcohol-related behaviour at 12 months, 5 at
longer-term follow-up 2 also reported changes in retail practices
and local laws Illicit drug use prevention (13 studies) 8 reported
positive effects at 12 months, 2 at longer-term follow-up
Slide 12
Overall, reasonable evidence that social marketing approaches
to alcohol and drug prevention can have positive effects on
behaviour in the short term, although effects wear off over time,
and not all programmes are effective Since the review, two major
studies (Slater et al 2006, Slater et al 2011) of social marketing
drug prevention interventions have reported significant reductions
in marijuana use associated with exposure to a mass media campaign
and participation in an in-school media campaign
Slide 13
1.Evidence for the effectiveness of social marketing as an
approach 2.How social marketing has been applied to substance use
prevention: some examples
Slide 14
Above the Influence and Be Under Your Own Influence, USA media
campaigns One national mass media campaign, one in-school media
campaign, 1999 to 2009 Target groups: Teenage youth (general
population, school) Behaviour change: Reduce marijuana use Consumer
insight: Research before each campaign showed that young people are
already familiar with the risks and are turned off by negative
messages. They take drugs partly because it makes them feel mature
and independent (competition) Exchange: Alternative and attractive
ways of feeling independent and mature.
Slide 15
Above the Influence and Be Under Your Own Influence, USA media
campaigns Marketing mix: Media campaign around core message: drug
use is inconsistent with your identity as an independent person.
Culturally appropriate materials for different segments (gender,
ethnicity, lifestyles) within the population. Materials included
posters, t-shirts, water bottles. Posters developed in conjunction
with schools and colleges, featuring photos of local children.
Interactive elements (Facebook etc). Evaluation: significant
reductions in marijuana use, suggesting that media campaigns based
on consumer-research can work independently of school-based
programmes (Slater et al 2006 HER, Slater et al 2011 Prev Sci)
Slide 16
Getting messed up is just another way of leaving yourself
behind.
Slide 17
Make your night last, media campaign, north west England
Target: 18-24 year old drinkers Behaviour change: to reduce
drunkenness by encouraging young drinkers to have water between
alcoholic drinks. Consumer insight: Young adult drinkers like
having a laugh and a good night out. They arent interested in
health messages, but dont like the hassle sometimes associated with
drinking to excess (fights, trouble, hospital). Exchange: you can
still have a good night out with less hassle Marketing mix: Tone of
the campaign reflected the drinking cultures and humour of the
target group. It made ironic references to some of the consequences
of drinking to excess.
Slide 18
Free water bottles printed with same messages distributed in
bars
Slide 19
truth Anti-tobacco industry campaign, Florida Target: Florida
teens, age12-17 Behaviour change: Reduce youth smoking prevalence,
access to tobacco products and exposure to secondhand smoke
Consumer insight: Young people didnt see tobacco as a big deal.
They didnt want to be told what to do. They knew tobacco killed,
but this didnt put them off it made smoking more attractive. They
smoked as a way of asserting that they were in control smoking was
a tool of rebellion (competition). Exchange: If we were to turn the
tables on tobacco, we surmised that we could not take away their
tool of rebellion without giving them an alternative. Attacking the
duplicity and manipulation of the tobacco industry became truths
rebellion (Hicks 2001 Tobacco Control)
Slide 20
truth Anti-tobacco industry campaign, Florida Marketing mix:
Youth-led mass media, online and advocacy campaign which harnessed
youth rebelliousness against the tobacco industry itself by
exposing its manipulative practices. Rather than targeting youth,
the campaign positions itself as on their side (including smokers)
against the exploitative adult world. Tone reflects the humour and
irreverence of young people. truth sought to become as compelling
and engaging a brand as other successful youth products Roadshows,
action groups and new media encourage interaction Evaluation: Young
people exposed to the campaign were significantly more likely to
remain non-smokers over 2 year period; dose-response effect (Sly et
al 2001, Am J Pub H; Sly et al 2002, Prev Med)
Slide 21
Florida's truth anti-smoking advertising campaign exposes the
duplicity and manipulation of the tobacco industry with edgy
humour. Hicks J J Tob Control 2001;10:3-5 2001 by BMJ Publishing
Group Ltd
Slide 22
the truth National campaign the truth built on Florida
model
Slide 23
Can the truth approach work without millions of dollars of
funding? We are currently working with a youth group in the west of
Scotland who want to use a similar approach, but locally and on a
much smaller budget
Slide 24
Road Crew programme, mid-west USA Target: 21-34 year old men
who drank heavily and caused a large proportion of drink-driving
crashes Behaviour change: Reduce alcohol-related car crashes
Consumer insight: Young men knew they shouldnt drink and drive, but
did so. Heavy drinking was a strong part of local culture. If men
drove to the pub in their cars, they were very tempted to drive
home when their judgement was impaired (competition). The idea of
going to the pub and not drinking was unrealistic. The best way to
stop them driving home drunk was to get them to the pub without
their cars.
Slide 25
Exchange: A fun and easy means of getting to and from the pub
without using their own car. Marketing mix: A limousine service to
collect groups of young men from their homes and to drive them
around all evening. The limousines were attractive (older luxury
vehicles). Men paid 10- 15$ each per evening. Each local community
adapts the programme to its own needs and context. Evaluation:
results to date suggest that drinking behaviour has not increased,
while drink-driving has reduced (estimated 17% reduction in crashes
in first year, Rothschild et al 2006). Road Crew programme,
mid-west USA
Slide 26
Slide 27
NE Choices, school-based drug education programme, North-East
England 1995-1999 Target: 13-16 year old school pupils in 10
schools Behaviour change: Reduce drug use prevalence AND to reduce
the harmfulness of drug taking among young people Consumer insight:
Young people wanted drug education, but it had to be credible and
interesting. They related to real life stories and people like
them. They didnt believe that drug takers were bad. Drug offers
were most likely to come from friends not strangers. Simply saying
no was unrealistic young people needed strategies for coping with
situations in which drugs were offered Parents needed constructive
advice on how to talk about drugs
Slide 28
NE Choices, school-based drug education programme, North-East
England 1995-1999 Competition: one of the main forms of competition
was the perception that drug education was boring and negative
Exchange: A highly engaging, enjoyable, locally-relevant drug
education experience which offers credible ways of dealing with
drug offer situations An attractive, high quality, well-resourced
drug education programme for schools Segmentation: Both universal
and selective approaches. For whole school year groups in the 1 st
and 2 nd years of the programme; self-selecting peer projects and
an outdoor esteem- building programme for high risk youth in the 3
rd year.
Slide 29
NE Choices, school-based drug education programme, North-East
England 1995-1999 Marketing mix: Interactive drama based approaches
(theatre workshop in 1 st year, out-of-school all-day drama
experience in 2 nd year) designed to explore attitudes towards
drugs and help young people rehearse how they would cope with drug
offer situations Peer-led projects Outdoor activity programme
Parent materials and activities; incentives for participation
Teacher training Tone and branding were crucial fun, engaging, non-
judgemental, personally relevant (NE), a real event
Slide 30
PaulMamKirsty Emma Rachels Room Secrets & Lies Computer
work-stations for small group work Stage Darren Character Rooms
Video screen In groups, young people investigated the disappearance
of a fictional 17- year old girl, Rachel (who appeared only on a
video clip) by visiting 7 different rooms. 5 rooms contained a
character who had some connection to Rachel and represented a
different view of drugs. The characters performed a piece of drama
then answered questions put by the groups of pupils. The Secrets
and Lies room contained multi-media materials designed to explore
facts and opinions regarding drugs. Groups also used interactive
software to find out more about the characters, and took part in
tasks (eg.producing a newspaper article about Rachels
disappearance.) Rooms were decorated to match character (eg. Mam
had a sitting room, Darren an old shed) NE Choices: drama
experience, 2 nd year
Slide 31
NE Choices: Evaluation High levels of engagement, ownership,
credibility, trust Effective in making young people relate to the
characters in the dramas and think about their own drug use and
attitudes No differences in drug prevalence or harm reduction
measures. Evidence of modest de-escalation of drug use (eg.
switching from harder to softer drugs) Why? Intervention possibly
not intensive enough, targeted at too old an age group, weaknesses
in evaluation and analysis. OR: perhaps the intervention WAS
effective in encouraging young people to make more informed choices
about drugs but they didnt make the choice the programme developers
wanted?
Slide 32
To sum up: Social marketing and drug and alcohol prevention
Because they are based on consumer insight and offer benefits which
consumers want, social marketing programmes score highly on
acceptability, feasibility, engagement, credibility, enjoyment and
personal relevance And there is evidence that they can produce
positive behavioural outcomes Effectiveness can be enhanced by
combining social marketing framework with evidence-based approaches
(eg. appropriate theory) Engagement etc may not be sufficient in
itself to change behaviour but it is an absolutely essential first
step