Alcohol self-help pilot project: Evaluation research
Summary of findings
An overview of typologies, drinker mindsets and response rates
Whilst not recruited for, there was a wide range of drinker typologies (based on the recent 2CV qualitative segmentation) identified within the sample. Responders tended to be from those typologies previously identified as being more likely to be predisposed towards changing their drinking behaviour. Although the non-responders included a broad mix of different typologies, it was evident that they were not yet open to changing their behaviour and consequently the campaign materials were unable to trigger a willingness to change. The research identified that the key factor driving response (or non-response) across both responders and non-responders, was their predisposition towards changing their drinking behaviour.
The steps towards a positive response to the materials
A key finding from the research was that four ‘mindset’ factors needed to be in place before a harmful drinking audience would be open to harmful drinking messages. These were ‘Consciousness’, ‘Curiosity’, ‘Concern’, and ‘Change’.
The first step towards behaviour change was identified as ‘consciousness’. Drinkers needed to become aware of the new issue of harmful drinking (through media and drinking communications campaigns), before they would be motivated to appraise their drinking behaviour. Once they had become more conscious of the issues, they tended to become more ‘curious’ and were keen to find out more about their own drinking and the health impact that their drinking levels may have on them. This often led these drinkers to becoming ‘concerned’ about the amount of alcohol they were drinking on a regular basis, which in turn led to a willingness to ‘change’ their behaviour.
Overall, the non-responder mindset was one of ‘pre-consciousness’ with respect to these issues, whilst the responders had already reached a level of concern and/or openness to change which made them more predisposed towards the acquisition materials and messages.
An evaluation of the acquisition materials: an overview
Overall, there was little recall of the acquisition materials in any detail. The responders recalled seeing or receiving something informing them of a booklet about drinking, which given their raised levels of consciousness and concern, had triggered their curiosity and interest, but they could recall little else about the materials. Their decision to respond to the materials tended to have been made spontaneously and instantaneously and beyond requesting the self-help booklet, no deeper engagement with the acquisition materials themselves took place.
Ultimately, the research found that the visual cues, rather than the provision of information or the messages themselves, were driving responders to request the booklet. Indeed, the visual cues so enabled this audience to quickly get to the information about the self-help booklet and response channels, that they consequently dismissed or overlooked the detailed information provided by the body copy of the acquisition materials.
Those non-responders who recalled having seen the acquisition materials tended to have dismissed the communication as not being relevant to them. They felt that they were drinking to ‘normal’ and reasonable levels and tended to believe that the communications were targeted at someone other than themselves.
Evaluation of the acquisition materials in detail
Of all the channels explored in the research (press insert, door drop and direct mail), the press insert was felt to be the most effective channel and format; conducive to a more open mode of consumption and supported with a more digestible 2-sided format. Whilst the door drop represented an easy and accessible channel, its 4-sided format was felt to be more challenging than the press insert. The direct mail channel was the least effective channel and format overall; it was frequently ignored or overlooked and its format was felt to be overly demanding.
In terms of the risk messages, these were not acting as the key hooks into the materials (this was more down to the visuals). The ‘general health’ message - ‘What are the health risks of drinking?’ was deemed the most effective in being the most open, curiosity-inspiring and relevant of the risk message questions posed. The more hard-hitting messages around cancer and cirrhosis of the liver were less effective, particularly as a leading message, as they were consumed as rhetorical questions and could prompt dismissal, especially amongst non-responders who could dismiss them as being too extreme to apply to them. Essentially, these messages were considered to have a more powerful role to play as supporting messages in the body of the materials, rather than as core hooks.
A key criticism of the acquisition materials, in terms of their content, was the complexity of the information provided. Many of the materials tended to be criticised for trying to collapse too much complex information into a small area, providing inadequate explanation of the information and creating a visual ‘busyness’ that was found to be too overwhelming. The units/ risk level guide in particular, was felt to be especially complex to decode. In some cases, there was a feeling that the acquisition materials themselves were ‘the information’ rather than pieces of communication leading to a call to action.
In terms of the flow of the information, this was not felt to be working hard enough to take people on a journey towards requesting the booklet. This was particularly the case with the direct mail and door drop formats. The most effective flow was deemed to lie with the press insert format, as it provided a reason to read with the visuals, provided the additional information in a succinct way, and then went straight to the call to action.
With respect to the call to action information, it was felt there was too much emphasis given to getting advice to help cut down. The majority were not ready to cut down until after they had read the booklet and felt that greater priority should be given to ‘receiving advice and information’ within the call to action.
Finally, although the overall language and tone of the materials had reasonable appeal, a specific focus on after-work drinks or wine with dinner was alienating to lower SEGs for whom this situation was not relevant, and some felt that some of the copy could be patronising.
The response channels
There was a very positive response to all the response channels amongst the responder sample. The coupon proved to be an important element in the overall channel mix, especially in reaching a more disadvantaged, lower SEG target audience who may not have access to the Internet or a landline.
The website was favoured by those with regular Internet access and they appreciated this channel for its ease, convenience and anonymity. There was, however, a polarised response to some of the more extreme questions in the compulsory questionnaire, and the hyperlink for ordering the booklet was felt to be too recessive.
Feedback for the telephone helpline was very positive. However, the level of questioning via this response channel did seem to vary quite dramatically. Overall, the majority felt that too many questions over the phone in relation to their drinking could be too obtrusive.
Attitudes towards and usage of the self-help booklet
Overall, responders’ expectations of the booklet were met and they felt that it served to both reinforce their existing knowledge and beliefs, as well as providing a more comprehensive understanding of drinking and its effects. It was felt to speak to them on their level, enable them to identify their drinking behaviour as risk behaviour and provide a credible and realistic approach for reaching behaviour change goals. Consequently, the majority were very happy and satisfied with the booklet and on reading the booklet most claimed to have experienced the motivational push needed to encourage them to try and reduce their drinking.
Non-responders were also shown the booklet and found it to be a lot more relevant than they had anticipated from having looked at the acquisition materials. This was a function of the fact that the booklet and its structure, began to take them on the requisite journey towards considering behaviour change. Overall, their responses to the booklet reflected the most positive responses of responders.
Despite the overall positive response to the booklet, there were a few criticisms. People had expected to see more information about the health risks in terms of the details of the damage being done, and how alcohol caused this. Within the Units information some felt that the absence of a specific drink from the drinks given, removed their ability to accurately make their drinking calculations, which they felt could lead to inaccurate assumptions. There was also confusion around the size of measurements especially if drinking off-trade.
Conclusions and recommendations
In order for people to respond to the acquisition materials, they needed to have already embarked on a journey towards wanting to change their drinking behaviour. It was apparent that in such early stages of raising awareness around the issue, the acquisition materials would need to work incredibly hard not only to motivate people to request the booklet, but also raise awareness as to why they might need it. Whilst the acquisition materials can be developed to more strongly meet this requirement, they may be unlikely to be as effective as hoped until the wider campaign has had more time to filter through.
There were, nevertheless, some clear recommendations on how the acquisition materials could be developed moving forward:
- In terms of media targeting, lead with the two-sided press insert and door drop formats, and de-prioritise direct mail.
- In terms of the materials, visual cues provide a strong short cut to the call to action and should prioritised within the materials.
- The lead risk message should be a general health message to raise consciousness and curiosity, however, this should be supported by more hard-hitting specific health risk messages within the body of the materials and in the booklet.
- Simplify the quantity of written information (bullet points could help) to make it less overwhelming and easier to digest.
- Re-consider the way in which the units/ risk level guide is presented to aid comprehension and relevance (consider reducing the amount of different but corresponding numbers and communication points).
- Carefully consider the flow of information to capture people’s attention and then take them quickly, easily and obviously to the call to action.
- Position the booklet not only as a tool for cutting down, but also as a source for more information and advice about the effects of regular drinking to maximise the effectiveness of the call to action.
- Ensure the language and tonality does not exclude or alienate some audiences – it needs to reflect the broadest target audience.
- In terms of response channels, we would recommend that the associated drinking questionnaire is provided as optional to avoid deterring some people
- The call to action hyperlink on the website could benefit from being more obvious.
There were also some suggestions for development of the booklet creative:
- Drinkers wanted to know more detail around the health risks to further motivate them towards changing their drinking behaviour i.e. images and explanations of diseases.
- There were also requests for more emphasis on the ‘softer’ side effects of regular drinking i.e. depression, tiredness, weight gain.
- Consider including an exhaustive list of drinks and their units to avoid potential de-selection or inaccurate calculation.
- Consider signposting the Units Tracker within the 6 steps and make it more visible.
There were two sets of research objectives as follows:
- To evaluate the journey from receiving acquisition communications, through to website/ helpline contact, to receiving the self-help materials.
- To understand perceptions of, and gauge reactions to, the information, advice and support given at the relevant stages of the process (acquisition materials, website/ helpline and self-help booklet) in order to identify areas for improvement.
- To explore the usage and value of the self-help materials in terms of raising awareness and supporting behaviour change (at least in the shorter term).
- To explore reactions to the acquisition materials and messages and understand barriers to response
- To understand how to overcome barriers in terms of messaging, language, tone and delivery channel
Qualitative research was conducted to evaluate a pilot acquisition campaign targeting increasing and higher risk drinkers, as part of the harmful drinkers’ strand of activity within the Alcohol Harm Reduction Strategy. The pilot launched in September 2008 in the North West region of England, and was aimed at encouraging the target audience to send off for a drinking self-help booklet.
The overall aims of the research were to explore the journey and experiences of those who had responded to the acquisition materials, as well as to understand the barriers to response amongst a sample of non-responders, in order to inform the further development of the acquisition campaign prior to national roll out.
In order for the target market to respond to this local pilot direct marketing campaign, people needed to have already embarked on a journey towards wanting to change their drinking behaviour. Direct marketing type material alone needs to work incredibly hard not only to motivate people to request the booklet, but also raise awareness as to why they might need it. A wider initiative is needed to raise motivation.
Across the board but included South Asian.
A cross section but with a focus on those with children at home.
6 group discussions and 34 depth interviews.
Data collection methodology
c. 82: 48 in focus groups and 34 in interviews