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Binge-Free 603: What's Your Reason? Preventing Binge Drinking in Young Adults By Accessing Values in a Peer Group

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This poster was presented by Christin D'Ovidio at the National Conference on Health Communication, Marketing & Media.

Through a contract with the NH Department of Health and Human Services, JSI conducted peer-crowd/peer-group validation and formative research to inform a public health prevention campaign targeting young adults (YA), aged 21-25, identified as most likely to engage in the misuse of alcohol.

The campaign (Binge-Free 603: What’s Your Reason?) addresses binge drinking behaviors and utilizes harm reduction messaging to create an effective marketing mix. JSI used a social norming, a social marketing approach, as the strategic planning framework for developing a campaign to decrease the prevalence of binge drinking in NH YA.

The resulting, highly-targeted campaign includes video production, illustration, social media assets (Facebook, Instagram, Youtube, Snapchat), A/B testing and geo-targeting to further hone effective messaging and reach, and a website.

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Binge-Free 603: What's Your Reason? Preventing Binge Drinking in Young Adults By Accessing Values in a Peer Group

  1. 1. Binge-Free 603: What’s Your Reason? Preventing Binge Drinking in Young Adults By Accessing Values in a Peer Group Christin H. D’Ovidio, MFA, CCPH, Karyn D. Madore, MEd, CCPH, Martha Bradley, MEd, Emma Kane, BS, & Faith Buchard, BFA - JSI Research and Training Institute, Inc. for the New Hampshire Department of Health and Human Services Implications for research and/or practice: Binge-Free 603: What’s Your Reason? was a successful campaign. It raised awareness, as seen by the views and impressions, and increased engagement, as seen by the shares, comments, likes, video completion rates and filter use. A longer campaign could be evaluated for campaign ad recall and for harm- reduction techniques remembered or implemented.  Through our research CHI learned that the final communication plan needed to adopt a branding and marketing approach that embraced the core values of the intended audience (Young Adults, Country-Local, Ages 21-25).  Having a brand ambassador would have been helpful, and lent authenticity to the campaign. For a future campaign iteration, we could engage multiple brand ambassadors and pay them for social content and potentially event engagement. (With a higher level of funding)  Some initial campaign engagement was negative. Usually, it was apparent that the person commenting was practicing excessive binge drinking by the comment that was made. These people may not be reached by the campaign message – it may not resonate with them. Testing the final creative that ran, again, with the priority population – especially those who are actively binge drinking – may bring out details of how the campaign could be tailored to appeal to this population more.  Due to a start and stop campaign beginning, some momentum was lost. Initial responses to posts went away when the campaign was re- started, and some of the connectivity of the campaign elements became disconnected for analytics purposes.  The contest was either too difficult, not promoted enough, or not something this priority audience would do. Further research needs to be done to understand how to encourage user-created content for the purpose of campaign promotion. Background: Young adult (ages 18 to 25 years) alcohol consumption rates in New Hampshire are higher than the national average and are the highest in New England. Binge drinking is defined by the Centers for Disease Control and Prevention as having five or more drinks within a few hours for men and four or more in a few hours for women. Young adulthood is a time of rapid social and cognitive development in which young adults gain greater control over their lives, it also marks a time when brain development is not fully formed. During young adulthood, the formation of problem-drinking and excessive drinking can begin.i Images and use of media, as well as peer influence, can play a significant role in the perceptions and behavior of young adults as they navigate this transition2 . Based on the data, the State of New Hampshire hired JSI Research and Training Institute, Inc. (JSI) to research and create a young adult binge drinking, prevention campaign. Prelliminary research indicated that drinking is influenced by youth (mis)perceptions of how their peers drink. If misperceptions can be corrected, young adults may drink less.3 Images and use of media, as well as peer influence, can play a significant role in the perceptions and behavior of young adults as they navigate the transition from adolescent to young adulthood.4 In addition to social norming, peer crowds/groups are known to influence young adult styles and music preference, as well as values and beliefs.5 Studies have found peer crowds/groups identification relates to behaviors such as substance use and risk-taking.6 Research: To start, JSI conducted a three-part assessment in August 2017 to understand the scope of the problem including: 1) a comprehensive literature review of over 80 peer-reviewed journal articles; 2) an environmental scan of current prevention or harm-reduction campaigns, both in the US and abroad; and, 3) a review of the data from national and statewide validated assessments. JSI’s research explored: what peer crowds/groups existed in NH, which young adult peer crowds/groups were engaging in binge drinking and if peer crowds/groups could be engaged with value-based, achievable, harm reduction messaging.  Preliminary data annalysis from JSI's state-wide survey, indicated that young adults (21-25), working and college enrolled, were binge drinking at the highest rates and that males were binge drinking more frequently and at higher rates than females.  The findings from the literature review underscored that the key messages in a health campaign should emphasize the immediate and realistic consequences of drinking versus the dramatic, extreme or unlikely, long- term impact.  Young adults prefer a health message that focuses on harm reduction, responsibility and moderate drinking. Two phases of focus groups were conducted to understand the factors influencing young adults’ excessive drinking behavior and how a social marketing campaign, or behavior-change campaign, might influence them to voluntarily reduce their risks. The exploratory first phase involved validating six nationally identified peer groups7 , defining their knowledge, attitudes and practices regarding excessive drinking and identifying the peer group in NH with the highest risk of binge drinking. The second phase involved market testing of potential creative material among the peer group at highest risk. Based on information gathered from the exploratory focus groups, the country-local peer group was identified as a priority audience. They represented the group of young adults mostly likely to engage in risky consumption of alcohol. Concept testing: The focus gruop participants unanimously preferred campaign concepts that depict healthy lifestyles, healthy activities and the personal reasons for avoiding excessive drinking. 2018JSI Research and Training Institute, Inc. Program background: JSI’s research pointed to defining social norms and utilizing a recognized eper crowd/peer group for a social marketing intervention, including: brand ambassadors or innovators/early adopters and using the Social Learning Theory as the guiding theoretical framework.8 The campaign, “Binge-Free 603: What’s Your Reason?”, utilizes positive messages espousing values consistent with this group and using images of activities that young adults in NH spend time doing such as: hiking, ATV use, mountain biking, fishing, kayaking, skiing, or snowboarding instead of showing people partying. The campaign emphasizes the immediate and realistic consequences of drinking versus the dramatic, extreme or unlikely, long-term impacts and depicts healthy lifestyles, healthy activities and utilizes positive messages with values consistent with the NH county-local peer group. The campaign is solely digital, it uses images of positive activities that reflect the values of its audience; it includes real stories of young adults with their reasons for drinking in moderation. Communication Strategies:  Create a brand that encompasses the values of the peer crowd/group identified to be most at-risk for binge drinking behavior, Country-Locals;  Meet our audience where they are by implementing a digital campaign on social media platforms;  Engage our audience by creating sharable content on social media with messaging that relayed their values; and  Create content that resonated with the audience and that provided health- risk-reduction information relative to binge drinking. To determine which advertising channels would be most effective for the campaign focus group participants were asked to list their most used social media platforms. Facebook and Instagram were the most used channels, and Snapchat and YouTube were subsequently ranked. Communication Channels:  Facebook: Facebook was rated as the most used social media channel by focus group participants. The advertisement targeting capabilities of Facebook are unparalleled.  Instagram: Instagram was rated as the second most used social media channel by ocus group participants. The picture-sharing platform is owned by Facebook, thus allowing for the same precision when targeting advertisements as Facebook does.  Snapchat: Snapchat was rated as the third most used social media channel. Snapchat advertising is a relatively new feature of the platform which means that the market is not as oversaturated with advertisers as Facebook and Instagram are.  YouTube: YouTube was rated as the fourth most used social media channe. YouTube advertisements are the most cost-efficient way to run public health public service announcements (PSA’s), costing only a few cents per advertisement view.  Google Search and Display Advertisements: Digital advertisements were run on Google Search and on Google’s Display network with a specific focus on certain keywords for search, and an interest in websites topics relevant to the Country Local peer group for Google Display. It is digital best practice to pair a social media advertising campaign with a digital media buy as this ensures that the campaign reaches a broader audience as not everyone in the intended audience uses Facebook. For those that do use Facebook, seeing similar campaign creative on their favorite mobile apps and websites creates additional brand awareness and can increase brand legitimacy. A/B testing was conducted on every social media channel except for YouTube and Snapchat. A/B testing is when you run two advertisements targeting the same audience at the same time in order to test which advertisement performs better. Evaluation Methods and Results: Key Performance Indicators:  Engagement - Reactions, comments, and shares on social media advertisements  Impressions and click through rates from digital and social advertisements  Campaign landing page site traffic The first week of the campaign saw 64 Facebook fans, 280 Facebook post engagements and over 27K YouTube views. The campaign was taken off-line for almost a month, upon its return, in just over two weeks, it increased Facebook fans by 50%, and had 61K YouTube video views, while the website had 1.7K monthly active users. Given the duration and funding, evaluation efforts were focused on short-term outcomes and key performance indicators, such as engagement and user-generated content. Campaign Outcomes:  The estimated total reach of the Campaign across all digital and social media channels was over 3,932,163 impressions served to NH young adults.  The number of visits to the campaign website was 7,133.  75.67% of website visitors were between the ages of 18 and 34.  NH doesn’t have a massive population that uses snapchat. 5,500 shares of the filter on the snapchat platform.  YouTube video ads were viewed to completion 136,308 times. (View Rate 34% - Industry average 29.6%)9 Campaign Elements: Four videos featuring NH young adults Facebook page: www.Facebook.com/BingeFree603 Instagram page: www.Instagram.com/BingeFree603 Campaign website: www.BingeFree603.org YouTube account, www.youtube.com/channel/UC1OG9gs6aWfWm1DQlEtt_VQ Snapchat Filter Video Contest Conclusions: Binge-Free 603 highlights the benefits of and normalizes performing a desired behavior and increases the cost of engaging in competing behaviors and is effective for engaging young adults. Choosing a risk reduction message over an abstinence message for an alcohol campaign for this audience is effective to garner engagement. Digital media can be an effective and targeted approach with a social marketing campaign. Campaign materials should refer to a trusted source that will help to increase the understanding of what to do to reduce excessive drinking for all viewers, in addition to promoting positive behaviors. 1 Muthén, B.O., and Muthén, L.K. The development of heavy drinking and alcohol-related problems from ages 18 to 37 in a U.S. national sample. Journal of Studies on Alcohol 61:290–300, 2000. PMID: 2 Moreno MA, Whitehill JM. Influence of Social Media on Alcohol Use in Adolescents and Young Adults. Alcohol Research : Current Reviews. 2014;36(1):91- 3 Sessa FM. Peer crowds in a commuter college sample: The relation between self-reported alcohol use and perceived peer crowd norms. 2007, Journal of Psychology, 141(3):293-305. 4 Moreno MA, Whitehill JM. Influence of Social Media on Alcohol Use in Adolescents and Young Adults. Alcohol Research : Current Reviews. 2014;36(1):91- 5 Falllin A, Neilands TB, Jordan JW, Hong JS, Ling PM. Wreaking “Havoc” on smoking social branding to reach young adult “partiers” in Oklahoma. Am J Prev Med 2015;48(1S1):S78-S85. 6 Sussman S, Pokhrel P, Ashmore RD, Brown BB, Addictive Behaviors 32 (2007) 1602–1627 7 Moran MB, Walker MW, Alexander TN, Jordan JW, Wagner DE. Why Peer Crowds Matter: Incorporating Youth Subcultures and Values into Health Education Campaigns. AJPH, 2017. 107(3): 389-395. 8 Bandura, Albert. Social Learning Theory. Englewood Cliffs, N.J.: Prentice Hall, 1977. Print. Bandura, A. (1989). Social cognitive theory. In R. Vasta (Ed.), Annals of child development. Vol.6. Six theories of child development (pp. 1-60). Greenwich, CT: JAI Press. 9 Industry averages cited from: The Big Picture 2017 Benchmark Report, Strike Social healthcommunication.jsi.com

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