Two evaluations have been released assessing the 'Drink Free Days' (DFD) campaign launched last year as a partnership between Drinkaware and Public Health England (PHE), prompting controversy.
Drinkaware, the alcohol industry funded education charity, jointly launched the DFD campaign in partnership with Government body PHE, with the aim of encouraging at-risk and harmful middle-aged drinkers to take more days off from drinking.
The £1.1 million campaign covered a range of media and social media platforms to encourage DFDs as a moderation strategy to deliver health gains, building on Drinkaware's previous Have a little less, feel a lot better campaign.
The launch however triggered a series of objections over the partnership; Prof Ian Gilmore to quit his role as a PHE advisor and hundreds of academics signed an open letter [pdf], whilst PHE offered several arguments for the decision, including in a blog by PHE Chief Exec Duncan Selbie.
Whilst the campaign was funded by Drinkaware and PHE's role was only strategic input, critics argued it raised issues relevant to conflicts of interest. For example, it was argued the partnership represented endorsement of the alcohol industry's contested role in harm reduction, as well issues such as a focus on campaigns in the absence of more effective policies, as ranked in PHE's own evidence review.
DFD evaluations
As well as Drinkaware's own evaluation, PHE committed to an independent evaluation which was undertaken by Kantar Public (full report here). The report defines the background and scope of the project, its rationale and intended behaviour change purpose, as well as possible impact measures and stakeholder views.
Based on a survey of 1,700, it found 32% of the target group of 40-64 year old increasing or higher risk drinkers (IHRs) recalled the campaign. However, it states 'there is little evidence that IHR drinkers have reappraised their drinking habits at a broader level' and 'there were few consistent attitudinal shifts post campaign in knowledge of the risks or confidence in making changes.'
On the campaign strategy, it notes that whilst DFDs are the most popular strategy for those seeking to cut down, 40 to 64 year old IHR drinkers are less confident than lower risk drinkers of the same age that they would be able to have more DFDs if they tried. However, the report states that one in five of the target audience 'took action' (such as visiting the website), whilst 12% took drink-free days related action.
Concerning pre and post DFD survey actions, the report states 'there was no significant decrease in self-reported drinking at a population level between the pre and post waves, reflecting the scale of task and the long term nature of shifting overall consumption'.
In conclusion, the evaluation states that whilst the campaign strategy was considered well designed, it's limited impact - particularly concerning no changes seen in numbers taking DFDs - reflects the challenge of shifting behaviours amongst the target group. As such, it recommends further exploration 'to understand whether prompting and supporting alcohol moderation actions is more effective than seeking to change attitudes to alcohol consumption first.'
Conclusions from Drinkaware's evaluation may be deemed broadly consistent. Whilst Drinkaware suggest there 'was some increase in health harm awareness associated with the campaign' and 'some evidence of the campaign making a positive impact in terms of more people trying to cut down and take drink-free days', there appears no robust evidence for any significant behaviour change concerning DFDs specifically.
Notably, there was no change in pre to post campaign efforts to cut down in the last six months, and whilst there was a pre to post campaign increase from 91% to 93% in those reporting taking DFDs in England, there was no difference between those who recalled the campaign and those that didn't, and no change in Scotland or the South West.
Are the critics 'right'?
Amongst those who opposed PHE's decision to partner with Drinkaware, many might argue that the lack of impact on behaviour change adds weight to arguments that campaigns are being prioritised at the expense of more effective policies - a charge previously levelled at Drinkaware. Defenders of the partnership, including PHE, might maintain previous arguments, including stating Drinkaware as independently governed and a case of pragmatism given available resources.
Others may also point out that whilst campaigns rarely appear to directly effect behaviour change, targeting knowledge and attitudes may still be considered important components of alcohol harm reduction strategies. Indeed, health group's calls for better labelling have been based on arguments about the 'right to know' rather than any expected direct effects on drinking, whilst raising awareness of cancer risks may be seen as a valuable opportunity to increase support for alcohol policy control measures.
In more recent years there has been little policy indication as to what the future may hold concerning such matters, with no further indication in the recent prevention green paper. As such, discussions about communication campaigns and the role of Drinkaware and PHE will be likely to continue to feature within wider alcohol policy debates.
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