"Drink a little less. See a better you!" Social marketing campaign delivered by ChaMPs Public Health Network

Most areas in Cheshire and Merseyside are well above the average in England for alcohol harm and hospitals in Cheshire & Merseyside admit over 8,000 men per year with alcohol linked conditions.

In 2008, The Directors of Public Health in Cheshire and Merseyside identified tackling alcohol harm as one of the priority areas for action across the area and pooled resources to deliver a social marketing campaign managed by the social marketing team at ChaMPs Public Health Network.

Research and insight work conducted through the North West Public Health Observatory and Corporate Culture identified the target audience as regular pub drinkers who are male aged 35 to 55, who were drinking to hazardous and harmful levels. Further research with the target audience and pub industry identified key motivators and helped to develop the intervention and creative approach. The research also noted that males were less likely to visit their GP and get a health check.

The key aim was to raise awareness of the potential harms of drinking. Consequently, the behaviour goal was to reduce levels of hazardous drinking within the target audience, by encouraging them to set behavioural goals to help move away from their current drinking habits. It was also important to develop interventions that directed those in need to NHS Alcohol services across Cheshire & Merseyside.

The National Social Marketing Centre ‘social marketing planning process’ model was followed throughout, therefore a key stage of this social marketing campaign was scoping. The first part of this was the commissioning of a segmentation report using geo-demographic information from the Experian system, combined with other consumer and regional public health data. The North West Public Health Observatory was commissioned to do this work and produce a report. The report described nine “Mosaic” groups of harmful and hazardous drinkers across the area to help inform the social marketing campaign. Mosaic is a way of dividing the UK population into 11 groups based on socio-demographic characteristics, lifestyles, cultures and behaviours. The report also included area maps to show where each Mosaic group was located in each PCT across Cheshire & Merseyside.

A steering group of partner organizations was set up to work alongside the core delivery team at ChaMPs for the development phase. Their role was to help commission external agencies and help develop the intervention. They had an ‘ambassador’ role in their local PCT area and assisted with delivery of the campaign and also helped select the Mosaic group to focus upon for the campaign. The ChaMPs social marketing team held the budget, commissioned providers (including the evaluation) and developed, project managed and delivered the intervention. Other partners involved included trading standards, local councils and the pubs themselves.

Further insight work was commissioned by the Steering Group for their chosen Mosaic group (or segment) and Corporate Culture conducted qualitative interviews with this group and pub managers to help develop an intervention that would be accepted.

From the results, the chosen intervention was to work with targeted pubs and offer physical health checks (along with advice on alcohol consumption) and raise awareness of alcohol harm in the pub.

The campaign ran for 8 weeks in pubs from January 2010 across Cheshire and Merseyside and comprised three different components. The first was that health checks were provided in the pub by an outside company or pharmacist which included height, weight, blood pressure, cholesterol etc. The second was that a 'Wind Down' was scheduled to run between 10pm and 11pm Monday to Thursday in which customers were encouraged to drink a soft or low alcohol drink to help reduce their alcohol intake. The third was that the initiative was supported through a range of creative materials (mirrored posters, banner stands, beer mats and promotional mugs) which were displayed within each pub.

The creative approach and materials were developed using insight gained and were pre-tested with the target audience to check the messages resonated. The creative focused on the downsides of drinking too much and how it affects how people feel, look and their personal relationships

These messages sought to inform people of the damage alcohol can do to relationships, overall health and aimed to evoke a reaction in order to cause behaviour change.

The use of the beer mats with the ‘Drink a Little Less, See a Better you’ slogan, and the ‘Wind Down’ competition postcards (which offered a prize draw for £200 in high street vouchers when participants had a soft or low alcoholic drink and included their contact details on the postcard) ensured that people could also be followed up with text messages and e-mails with health tips and information on a regular basis. Mugs with the campaign slogan were also given out, following attendance at a health check.

Target Audience
The target audience was males aged 35-55 who drank on a regular basis. The Mosaic profiles showed the largest of the segments in the Cheshire & Merseyside region was called “Ties of Community”. The largest estimated number of harmful and hazardous drinkers were found to be in this group. These people live in close-knit, old fashioned communities and tend to have married young and have manual jobs. Other characteristics of this group were as follows:

• Belonged to social grades C2/D (skilled working class – according to the National Readership Survey social grades classification).
• Average income £20,000 per annum.
• Mostly drinking beer in pubs and social clubs.
• Reasonable levels of motivation to change their lives.
• Majority at pre-contemplation stage.

It is also important to note that this group perceive the pub as a regular social setting, where they meet friends who are also regular drinkers. Because this group were not at a stage of contemplation to reduce their drinking, it was important to raise awareness of alcohol harm and the consequences of hazardous drinking.

Behavioural theory model
The “stages of change” model was used (Prochaska & Diclemente, 1983) which conceptualises behaviour change as a linear process comprising six stages: Pre-contemplation, contemplation, preparation, action, maintenance, termination. The majority of the target audience for this project were at pre-contemplation with a reasonable level of motivation to change their lives. The aim was to move the target audience to a stage of contemplation and reconsider their behaviour and attitude towards alcohol.

Working with pubs
Working with pubs as a setting for an intervention to raise awareness of alcohol harm and provide health checks did prove to be difficult in some cases.

Bar managers and landlords had differing views about helping to reduce alcohol consumption on their premises. Some were not interested in taking part but others felt the health of their customers was important and were willing to take part. The ChaMPs team had many meetings and conversations with pubs to explain that the campaign was not about driving people away from pubs (indeed the pub was an important social setting for the chosen target group) but about encouraging people not to drink to excess and look after their health/visit their GP.

Links were made with Robinson’s Brewery, a Stockport based brewery with pubs across Cheshire & Merseyside and they allowed the campaign to run in some of their pubs. A pilot pub was chosen in Macclesfield with a high proportion of the target group and the media launch was held there. Significant coverage was gained in national, region and local media.