It's been a while since we last reported on activities undertaken by Drinkaware, the industry-funded alcohol awareness charity which aims to 'help people make better choices about their drinking'.
Drinkaware recently held a national conference which highlighted its ten year anniversary, and its reach and resources have undoubtedly become significant over that time. It's website is by far the most widely-accessed source of alcohol-related health information and it has run numerous campaigns and disseminated millions of resources.
The last ten years have not been without challenges, though: in 2013 it faced significant questions following a critical independent review and one past campaign was found to have undesirable effects. It has subsequently made considerable efforts to improve its credibility and impact and revised its governance structure. Recently it announced Professor Fiona Sim, ex-Chair of the Royal Society for Public Health, is taking over as Chief Medical Advisor.
However because Drinkaware is industry funded and was reportedly devised by the Portman Group, some public health advocates continue to oppose its existence, arguing that its activity - however valuable by their own measures - 'disguise fundamental conflicts of interest and serves only to legitimize corporate efforts' in order to avert evidence based policy. Certainly it’s activities are constrained to educational and consumer-focused approaches and do not extend into the ‘upstream’ policy levers viewed by many public health academics as the most effective in reduce harms: i.e the pricing, availability and marketing of alcohol.
However it may be that over time an increasing proportion of those in the alcohol field have come to the view that Drinkaware’s significant reach and resources cannot be ignored, especially whilst Government led alcohol information campaigns have all but dried up. Furthermore political resistance to adopting supply-side policies or mandatory controls – for instance an absence of statutory requirements on labelling - may also contribute to the appeal of its activity.
A new 5 year strategy
Drinkaware's 2017 conference showcased recent projects and also launched a new 5 year strategy [pdf]. Previous priorities had focused on under-age drinking, 'drunken nights out', and work on 'equipping people to moderate their drinking'. The new strategy says it will now focus on three key areas:
On expanding the provision of information and advice, Drinkaware aims to achieve 15 million 'individual engagements by 2022' through its website, social media and other resources. In 2015 it reported just under 9.4 million unique visitors to the website, though what proportion of these are UK-based is not clear. Drinkaware’s moderation support app has been downloaded over 300,000 times since 2013 and the Strategy states that it aims 'to be a leading provider of digital support and tools', albeit an increasingly busy marketplace.
Activities on reducing the number of risky career drinkers stem from Drinkaware’s previous segmentation of drinkers drawn from the Monitor survey. Last year the charity launched a campaign targeting middle aged men who drink at home, aiming to encourage change via a message that drinking a little less each day can benefit their health. The campaign will use advertising, video content and an online tool as well as new products and initiatives, and an evaluation will be published in 2019.
On reducing the number of risky social and coping drinkers, Drinkaware says it is building on the learning from its ‘Wouldn't Shouldn’t’ campaign which aimed to reduce sexual harassment on nights out. The evaluation will be published in 2018 whilst the Drinkaware Crew project, which sees staff working in bars and clubs to reduce drunken anti-social behaviour, will be expanded.
Is Drinkaware’s credibility improving?
The new five year strategy sets out further objectives on partnership working, research and impact, income generation and performance measurement. It states that by 2020 Drinkaware aims to have developed its reputation 'with the public and experts alike as the leading UK source of accessible, up-to-date alcohol-harm facts and evidence-based support tools'. Further, it intends to monitor and assess its outcomes more effectively, to better identify specific target groups via research and to develop interventions based on a theory of change.
From Drinkaware’s position, seeking credibility and engagement with such a diverse range of stakeholders is undoubtedly challenging. The issue of ‘partnership working’ for instance, may be seen as controversial in itself, albeit Drinkaware’s approach may be different to industry-led voices heavily advocating partnership approaches as central to alcohol policy responses. The effectiveness of approaches focusing on partnerships remains poorly supported by the evidence, with some academic reviews reporting the high-profile Alcohol Responsibility Deal was unlikely to have made an impact, although the official Department of Health evaluation was more positive. Similarly, recent evaluations have called into question the effectiveness of local schemes such as Community Alcohol Partnerships (CAPs). Nonetheless, partnership approaches have found favour in recent Government policy and appear to be popular amongst many local stakeholders, with the number of local schemes appearing to be increasing.
Another challenging factor for Drinkaware has been how and whether to take a position on the supply side issues central to wider policy debates. Notably, Drinkaware have now identified the role of external factors including price and advertising in its theory of change framework, bringing its analysis closer into line with the public health perspective – albeit that it remains focussed on the delivery of demand-side in its approach to interventions.
Inevitably, political and ethical debates over the role of the various organisations involved in the alcohol harm reduction field will continue. While Drinkaware seeks to increase its impact and research profile, there will be some who will remain of the view its funding creates an unavoidable conflict of interest, despite the revised governance structure. However, with no national campaigns and a continued squeeze on public health resources, Drinkaware’s consumer-focused resources are likely to remain widely used by a variety of individuals and organisations, even while health advocates continue to call for evidence-based interventions to further regulate alcohol supply side activities.
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