Research and analysis

Drink Free Days campaign 2018: executive summary

Published 19 July 2019

Background

Building on the momentum of Drinkaware’s 2016 to 2017 ‘Have a little less, feel a lot better’ (HALL) campaign, Public Health England (PHE) and Drinkaware collaborated on a new campaign in 2018.

The campaign was run in partnership between Drinkaware and PHE, with Drinkaware responsible for funding all campaign development and marketing activity. PHE provided strategic advice and input into campaign development and was responsible for funding and commissioning a fully independent, peer-reviewed evaluation of the campaign.

The new campaign, known as ‘Drink Free Days’, aimed to deliver:

• more precise health harms messages: alcohol can be more harmful to your health than you think illustrated via 3 harms (weight gain, blood pressure and breast cancer), the more you drink the greater the risk
• a clear and simple specified behavioural action of taking ‘Drink Free Days’ to support action to moderate drinking
• digital behavioural support in the form of an alcohol consumption comparison tool and the Drink Free Days app specifically to support taking drink free days
• the entire narrative and desired behavioural action in the radio advert itself to try to maximise overall impact, whether or not the digital customer journey (see full report) is taken

The target audience was broadened versus HALL to women aged 40 to 64 in addition to men, with a focus on increasing and higher risk (IHR) drinkers.

The campaign ran from 10 September to 18 November 2018 across radio and digital channels and had a total media budget of £1.1 million ^{[footnote 1]}.

The evaluation set out to answer the main questions which serve to help understand the extent to which the campaign has reached and influenced its target audience.

The main findings for each question are listed below.

Methodology

There were 6 main elements to the Drink Free Days campaign evaluation:

Drink Free Days campaign evaluation tracking survey

A pre- and post-campaign survey conducted online via 10 to 15 minute interviews with 1,000 adults per wave in England, aged 40 to 64 whoever reported drinking alcohol. Data were weighted to be representative of adults in this group by age, gender, region, and socioeconomic grade.

Drink Free Days app user survey

A survey of 319 respondents who downloaded the app within the campaign period. It consisted of a 7-minute online survey entered via push notifications in the Drink Free Days app.

Drink Free Days app data analysis

Data collected from usage of the Drink Free Days app, from users who downloaded within the campaign period, was supplied from PHE’s database and analysed using SQL queries.

Stakeholder review

Annual stakeholder research was commissioned by PHE and conducted by Ipsos MORI. This tracked stakeholder views on working relationships, ambitions and impact, expectations and areas for improvement.

Analysis of how actors have used the campaign

A piece of research that will seek to understand how health organisations and non-aligned bodies have promoted the campaign, and whether the campaign was used by commercial operators to promote commercial or other interests.

PHE have commissioned an external academic expert to undertake this research, which will commence in the summer and continue through to March 2020.

Social listening analysis

Social listening analysis was conducted by Wavemaker to understand the overall themes and sentiment of discourse around the campaign on social media channels, and in particular, gauge the reaction to the partnership between PHE and Drinkaware.

Analysis of how actors have used the campaign

A piece of research that will seek to understand how health organisations and non-aligned bodies have promoted the campaign, and whether the campaign was used by commercial operators to promote commercial or other interests. PHE has commissioned an external academic expert to undertake this research, which will commence in the summer and continue through to March 2020.

This summary and the full report focus on the first 5 elements of the evaluation.

Campaign reach and resonance

Did the campaign reach and resonate with its intended audience?

The Drink Free Days media strategy performed well, exceeding targets in terms of radio reach, paid digital media clicks and tool completes, despite the short campaign period. Adding women into the target group for this campaign has helped drive media efficiency by increasing engagement, as women are more responsive than men to health advertising, both generally and in terms of digital actions.

Campaign awareness was good in the context of the £1.1 million budget. Almost a quarter (24%) of 40 to 64-year-olds reported recognising the Drink Free Days campaign, driven by the radio ads (22%) as anticipated which accounted for 60% of overall media spend. Campaign recognition was significantly higher among the key IHR audience (32%), and this was the case for each of the creatives, suggesting successful media targeting.

The Drink Free Days creative resonated strongly with 40 to 64-year-olds and even more so with IHR drinkers; this audience took out both the key health risk and behaviour change messages and reported good levels of relevance and believability. This was also reflected in the profile of web tool users and app downloaders during the campaign period, the majority of whom were in the target age group.

Both the Health Harms and Weight radio ads were well-received, in terms of the metrics above (including relevance and believability). The breast cancer radio creative resonated particularly well with its intended female target and was no less credible among the female IHR drinkers, with good levels of believability (76%), perceived relevance (64%) and ‘new news’ (56%). The breast cancer creatives were also the most cost-effective on Facebook in driving engagement with the online tool (£0.44-£0.91 cost per tool complete versus £1.33-£1.68 for other creatives).

All ad channels prompted good levels of consideration of taking more drink free days, particularly among IHR drinkers (44% of male and 59% of female IHR drinkers in response to the Health Harms radio ad and 43% and 52% respectively in response to the Weight radio ad).

Effect of campaign on target audience attitudes

Did the campaign change the target audience’s attitudes towards drinking, in particular that regular drinking increases the health risks?

IHR drinkers were just as likely as 40 to 64-year-old drinkers overall to understand the health risks of drinking too much: 84% agreed that ‘the more alcohol you drink, the higher your health risk’ and most showed a good level of understanding of what health conditions alcohol consumption can be linked to.

However, IHR drinkers are slightly less likely to acknowledge the more personal risks of high alcohol consumption and are relatively less convinced that low level daily drinking (such as ‘as long as you’re not getting very drunk, regular drinking won’t affect your health’) or binge drinking (such as ‘as long as you stick to the recommended weekly allowance, it doesn’t matter if you drink it all in one night’) are problematic behaviours in comparison to 40 to 64 drinkers overall.

Although the creatives performed well in prompting reported reappraisal around helping IHR drinkers realise that more drink free days can help reduce health risks and are an easy way to drink less, there is little evidence to suggest they have reappraised their drinking habits at a broader level, with no consistent shifts in knowledge or attitudes post-campaign. This lack of change at a population level reflects, in part, the proportion of the population that are aware of the campaign (around a third of IHR drinkers).

The campaign’s online drinking comparison tool, which shows users how much alcohol they drink compared to others their age, saw impressive levels of engagement from the target audience during the campaign (90% of those who started to use the tool went on to complete it, versus 77% of those in the previous HALL campaign).

There was not scope to evaluate the tool beyond engagement. However, in future it would be important to assess what role it plays in encouraging people to reappraise their drinking behaviours and any opportunities to strengthen it to address this.

Assessment of strategy

Is the strategy of encouraging drink free days an appropriate approach for reducing alcohol consumption among 40 to 64 year old IHR drinkers?

Behaviour change posed a challenge among IHR drinkers (38% of whom think they do not need to cut down) but taking drink-free days appears to be a good strategy for this group, as it is a message that is already understood and favoured by this audience in comparison to other methods of moderation, and so can be leveraged as a prompt to change.

IHR drinkers are more likely than 40 to 64s to understand the value of drink free days, seeing them as a good way to cut down (85%) and to reduce the health risks (77%), although they are less likely to be very confident they can do it themselves (24%).

Drink free days were found to already be a familiar strategy for IHR drinkers: 58% have tried taking them, 45% reporting having maintained this behaviour. Just 11% of IHR drinkers would not consider trying drink free days as a strategy to moderate their drinking, with far more saying they would not consider stopping drinking at home (36%), for a month (38%), or going out less to places that serve alcohol (37%).

Action the campaign generated and assessment of online tools

What action has the campaign driven and do the online tools help?

As a direct result of the campaign, 14% of drinkers aged 40 to 64 and 20% of IHR drinkers reported taking some action (22% among those with increasing risk). Reported actions mostly relate to reducing alcohol intake rather than ‘softer’ actions, such as talking to people, with 10% of IHR drinkers reporting taking or trying to take more drink free days.

The campaign successfully stimulated use of the online tools, with the majority of those engaged within the target 40 to 64 age group. Over 430,000 people visited the Drink Free Days site during the campaign period and over 330,000 people completed the comparison tool on the site.

There were over 31,000 app downloads during the campaign period (higher than download volumes seen in an equivalent period before any campaign activity), with two-thirds of downloads by those in the target age group, 94% of whom were IHR drinkers.

The online journey in 2018 was, however, complicated by 2 issues, without which an even better performance could have been expected:

• the Drinkaware site appeared at the top of search results for ‘drink free days’ for most of the campaign period meaning significant levels of traffic landed on the Drinkaware website rather than the intended Drink Free Days microsite
• GDPR and UK country questions on entering the Drink Free Days microsite led to some dropout

There was no significant decrease in self-reported drinking at a population level between the pre and post-waves, which is expected, given the scale of the task as shifting overall consumption at a population level ultimately requires a longer-term effort.

However, those who used the Drink Free Days app felt they drank less after using the app than before. Users were almost universally positive about the app, with the majority reporting taking action as a direct result of downloading it, most reducing alcohol intake and increasing drink free days. A sizeable minority of users reported broader actions, including changes to diet and physical activity.

Stakeholder impact and branding

From PHE’s 2018 stakeholder survey the Drinkaware partnership was spontaneously raised by a minority of respondents, 7 out of 33 qualitative participants, and by 14 of the 313 stakeholders in the quantitative survey.

Opinion within these minority of responses was mixed and where concern was raised, it was mainly related to the impact on PHE’s reputation from the partnership and the lack of messaging around the volume of alcohol consumed when drinking.

Social listening showed very limited public discourse around the campaign. Negative commentary was concentrated within the public health community and did not spill over to other online communities. There was no evidence that public perceptions of PHE had been negatively influenced by the partnership.

From a public perspective there was a high level of misattribution of campaign branding. It is likely brand attribution responses are a response to tone and take out of campaign messaging hence general attribution of government and health. Given high levels of misattribution among the target audience, it suggests that the campaign proposition worked effectively irrespective of the branding.

Conclusions

The Drink Free Days campaign has had some notable successes – it was well received by its intended audience (IHR male and female drinkers aged 40 to 64) and delivered an improvement in levels of engagement versus the previous HALL campaign.

Perhaps most importantly, Drink Free Days was successful in driving action with 1 in 5 (20%) IHRs reporting they took an action as a result of the campaign and 10% reporting they had taken or tried to take more drink free days.

Whilst there was no significant decrease in self-reported drinking at a population level between the pre and post-waves, this is to be expected given the scale of the task versus the resources available. We would reasonably expect that shifting overall consumption at a population level ultimately requires an increased longer-term effort.

The evaluation showed that Drink Free Days is a good strategy for this group, as it is a message that is already understood and favoured by this audience in comparison to other methods of moderation, and so can be leveraged as a prompt to change. Data suggests the proposition is strong enough to repeat, using the evaluation findings to adjust and test improvements.

The health harms messages were deemed relevant, attention-grabbing and seen to deliver new news. This was particularly the case among women in response to the breast cancer message, suggesting that there is further scope to use this message in future.

A significant finding to emerge from the evaluation is that IHR drinkers did not reappraise their drinking habits, so a principal consideration in future would be to what extent we need to change attitudes to alcohol consumption and encourage reappraisal to drive behaviour change or if prioritising the promotion of alcohol moderation actions is more effective.

If attitudinal shift were to be a priority, then we would need to give further consideration of how messages, channels, and tools can support this objective.

1. Based on the three-question AUDIT-C (Alcohol Use Disorders Identification Test developed by the WHO in 1989). ↩