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Cruwys T, Selwyn J, Rathbone JA, Frings D. Discrimination and social identity processes predict impairment and dysfunction among heavy drinkers. Soc Sci Med 2024; 343:116549. [PMID: 38219413 DOI: 10.1016/j.socscimed.2023.116549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/04/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Previous research has linked discrimination to poorer health. Yet health risk behaviours such as heavy alcohol consumption are often targeted with stigmatising public health campaigns. The current study sought to establish the link between experiencing discrimination and health outcomes among heavy drinkers, with a focus on exploring the multiple social identity processes that might underpin this relationship. METHODS A survey was conducted with 282 people who self-reported consuming alcohol above recommended guidelines. We measured discrimination experienced as a drinker, components of social identification as a drinker (centrality, satisfaction, solidarity, homogeneity, and self-stereotyping), and two health outcomes: psychological distress and severity of alcohol use disorder symptomatology. RESULTS Discrimination was a moderate-large predictor of psychological distress and alcohol use disorder symptoms. Three social identity constructs were implicated in the link between discrimination and ill-health: identity centrality and homogeneity positively mediated this relationship while identity satisfaction was a negative mediator. The model explained a large proportion of the variance (39-47%) in health outcomes. DISCUSSION Results are interpreted with an emphasis on the need to avoid stigmatising messaging and to prioritise social identity processes to prevent and treat substance use disorders. We further highlight the need for social identity researchers to consider the multidimensional nature of social identities, especially in the context of stigmatised groups.
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Affiliation(s)
- Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Australia.
| | - Joseph Selwyn
- School of Medicine and Psychology, The Australian National University, Australia
| | - Joanne A Rathbone
- School of Medicine and Psychology, The Australian National University, Australia
| | - Daniel Frings
- School of Applied Sciences, London South Bank University, United Kingdom
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Mills T, Grimes J, Caddick E, Jenkins CL, Evans J, Moss A, Wills J, Sykes S. 'Odds Are: They Win': a disruptive messaging innovation for challenging harmful products and practices of the gambling industry. Public Health 2023; 224:41-44. [PMID: 37714065 PMCID: PMC10627150 DOI: 10.1016/j.puhe.2023.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE This paper presents an evidence informed rationale for focussing on harmful gambling products and industry practices in public health messaging through the example of a recent innovation called 'Odds Are: They Win'. METHODS 'Odds Are: They Win' was initially developed through coproduction involving public health professionals and people with lived experience of gambling harms and implemented across a city-region area. A review of relevant evidence was undertaken, upon which the research team reflected to draw out the implications of 'Odds Are: They Win' for gambling harms messaging. RESULTS Evidence is mounting that safer gambling campaigns framed in terms of individual responsibility are ineffective and can generate stigma. 'Odds Are: They Win' presents an alternative focus that is not anti-gambling but raises awareness of industry manipulation of the situational and structural context of gambling. This is in-keeping with historical lessons from the stop smoking field and emerging research in critical health literacy. The latter highlights the potential of education on the social and commercial determinants of health to stimulate behaviour change and collective action. CONCLUSION 'Odds Are: They Win' is a potentially disruptive innovation for the gambling harms field. Research is required to robustly evaluate this intervention across diverse criteria, target audiences, and delivery settings.
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Affiliation(s)
- T Mills
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK.
| | - J Grimes
- Gambling with Lives - The Circle, 33 Rockingham Lane, Sheffield S1 4FW, UK
| | - E Caddick
- Greater Manchester Combined Authority - Tootal, 56 Oxford St, Manchester M1 6EU, UK
| | - C L Jenkins
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
| | - J Evans
- Greater Manchester Combined Authority - Tootal, 56 Oxford St, Manchester M1 6EU, UK
| | - A Moss
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
| | - J Wills
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
| | - S Sykes
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
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Gosselin S, Thaivalappil A, Papadopoulos A, McWHIRTER JE. Public Health Messaging to Address Indoor Tanning: A Scoping Review. JOURNAL OF HEALTH COMMUNICATION 2023; 28:241-253. [PMID: 36992625 DOI: 10.1080/10810730.2023.2196519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Indoor tanning (IT) is an avoidable skin cancer risk. Although numerous communication interventions have been assessed for IT deterrence, less attention has been paid to the persuasive messages within these interventions. This scoping review summarizes the current peer-reviewed literature on persuasive messages for IT. Overall, 20 articles (21 studies) were included. Most were experimental or quasi-experimental and conducted in the US. Participants were mostly young women who had tanned indoors before. Few studies evaluated persuasive theme; in those that did, health and appearance themes were effective. Narrative and statistical evidence formats were also effective. The included studies also supported normative messages, loss-framed messages, and images. Improved reporting on message design and evaluation would be beneficial for future evidence synthesis. Our understanding of persuasive messages for IT has expanded in recent years, but more research is needed to optimize them.
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Affiliation(s)
- Sydney Gosselin
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Abhinand Thaivalappil
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jennifer E McWHIRTER
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Hogenelst K, Snippe A, Martinic M. Harmful Drinking Phenotype in a Large Dutch Community Sample. Alcohol Alcohol 2022; 57:696-705. [PMID: 36007232 DOI: 10.1093/alcalc/agac041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/15/2022] Open
Abstract
AIMS Harmful drinking patterns are shaped by a broad complex interaction of factors, societal and individual, psychological and behavioral. Although previous studies have focused on a few variables at a time, the current study simultaneously examines a large number of variables in order to create a comprehensive view (i.e. phenotype) of harmful drinking, and to rank the main predictors of harmful and non-harmful drinking by order of importance. METHODS We surveyed a large sample of Dutch adults about their habitual drinking characteristics and attitudes, perceptions and motives for drinking. We fed 45 variables into a random forest machine learning model to identify predictors for (1) drinking within and in excess of Dutch guideline recommendations and (2) harmful and non-harmful drinking. RESULTS In both models, respondents' subjective perceptions of 'responsible drinking', both per occasion and per week, showed the strongest predictive potential for different drinking phenotypes. The next strongest factors were respondents' reason for drinking, motives for drinking and age. Other variables, such as drinking location, knowledge about alcohol-related health risks and consumption of different beverage types, were not strong predictors of drinking phenotypes. CONCLUSIONS Although the direction of the relationship is unclear from the findings, they suggest that interventions and policy measures aimed at individuals and social norms around drinking may offer promise for reducing harmful drinking. Messaging and promotion of drinking guidelines should be tailored with this in mind.
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Affiliation(s)
- Koen Hogenelst
- Department of Human Performance, The Netherlands Organisation for Applied Scientific Research (TNO), Soesterberg 3769 DE, The Netherlands
| | - Almar Snippe
- Department of Weapon Systems, The Netherlands Organisation for Applied Scientific Research (TNO), The Hague 2597 AK, The Netherlands
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Making sense of ‘‘drink responsibly’’ messages: Explorations of the understanding and interpretations of young Nigerians who use alcohol. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 103:103646. [DOI: 10.1016/j.drugpo.2022.103646] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022]
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Gray HM, Wiley RC, Williams PM, Shaffer HJ. A Scoping Review of "Responsible Drinking" Interventions. HEALTH COMMUNICATION 2021; 36:236-256. [PMID: 32153213 DOI: 10.1080/10410236.2020.1733226] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Public health groups, researchers, the beverage alcohol industry, and other stakeholders have promoted and applied the concept of "responsible drinking" for the past 50 years. However, little is known about the state of the existing responsible drinking evaluation research and its application to policy and practice. This project provides a scoping review of studies evaluating responsible drinking interventions. Two primary research questions guided this investigation: (1) To what extent have authors attempted to define the concept of responsible drinking while evaluating responsible drinking interventions? and (2) What is the state of the responsible drinking intervention evaluation literature? We retrieved 49 peer-reviewed articles that evaluated interventions designed to promote "responsible drinking." Four articles provided, or attempted to provide, an explicit definition of responsible drinking; these four definitions lacked consensus. The existing responsible drinking interventions varied considerably in terms of the messages they attempted to convey (e.g., avoid binge drinking, use protective behavioral strategies, stick to relatively safe drinking limits), again suggesting lack of consensus. We observed greater consensus concerning the approach to evaluating responsible drinking interventions: studies typically recruited college students to complete brief, well-controlled experiments and measured potential predictors of drinking behavior (e.g., attitudes, expectancies, intentions) rather than actual drinking behavior. We discuss limitations of this methodological approach and the need for greater consensus regarding the concept of responsible drinking.
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Affiliation(s)
- Heather M Gray
- Division on Addiction, Cambridge Health Alliance
- Department of Psychiatry, Harvard Medical School
| | | | | | - Howard J Shaffer
- Division on Addiction, Cambridge Health Alliance
- Department of Psychiatry, Harvard Medical School
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Lockwood N, de Visser R, Larsen J. "Have a little less, feel a lot better": Mixed-method evaluation of an alcohol intervention. Addict Behav Rep 2020; 12:100306. [PMID: 33364315 PMCID: PMC7752714 DOI: 10.1016/j.abrep.2020.100306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/21/2020] [Accepted: 09/25/2020] [Indexed: 12/27/2022] Open
Abstract
A multimedia campaign encouraging men to drink less produced changes in alcohol use. Men appreciated the straightforward message and friendly tone of the campaign. There is also a need to develop the necessary behavioural skills for behaviour change.
The aim of the mixed-methods study reported here was to evaluate the impact of a “gain-framed”, multimedia campaign to encourage heavier drinking men aged 45–64 years to drink less. Quantitative analyses were based on pre-intervention panel surveys of 3057 men in intervention regions and 500 in the control region, and post-intervention panel surveys of 1508 men in intervention regions and 219 in the control region. Qualitative analyses entailed thematic analysis of interviews with 14 men: five who had reduced their drinking after seeing the campaign, four who had considered reducing but did not, and five who did not consider changing. Interviews focused on men’s responses to the campaign, and their ideas for how to improve it. In quantitative analyses, the campaign was associated with significant changes in alcohol consumption, and significant increases in readiness to change and likelihood of using moderate drinking strategies. In qualitative analyses, men appreciated the friendly, non-threatening tone and that the message was straightforward, meaningful, achievable, and was gain-framed - i.e., emphasised the benefits of drinking less rather than the harms of drinking too much. However, the men who did not change their behaviour also identified several barriers to responding in ways encouraged by the message. It would be important to address their views of their drinking as not problematic, as pleasurable, and as socially expected, and also their sense of not feeling empowered to initiate or maintain behaviour change.
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Brennan E, Schoenaker DAJM, Durkin SJ, Dunstone K, Dixon HG, Slater MD, Pettigrew S, Wakefield MA. Comparing responses to public health and industry-funded alcohol harm reduction advertisements: an experimental study. BMJ Open 2020; 10:e035569. [PMID: 32988938 PMCID: PMC7523211 DOI: 10.1136/bmjopen-2019-035569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Conduct a head-to-head experimental test of responses to alcohol harm reduction advertisements developed by alcohol industry Social Aspects/Public Relations Organisations (SAPROs) versus those developed by public health (PH) agencies. We hypothesised that, on average, SAPRO advertisements would be less effective at generating motivation (H1) and intentions to reduce alcohol consumption (H2) but more effective at generating positive perceptions of people who drink (H3). DESIGN Online experiment with random assignment to condition. PARTICIPANTS 2923 Australian adult weekly drinkers (49% high-risk drinkers) recruited from an opt-in online panel. INTERVENTIONS Participants viewed 3 of 83 advertisements developed by PH agencies (n=2174) or 3 of 28 advertisements developed by SAPROs (n=749). PRIMARY OUTCOME MEASURES Participants reported their motivation to reduce the amount of alcohol consumed; behave responsibly and/or not get drunk; and limit their drinking around/never supply to minors, as well as intentions to avoid drinking alcohol completely; reduce the number of drinking occasions; and reduce the amount of alcohol consumed per occasion. Participants also reported their perceptions of people who drink alcohol on six success-related items and four fun-related items. RESULTS Compared with drinkers exposed to PH advertisements, those exposed to SAPRO advertisements reported lower motivation to reduce the amount of alcohol consumed (β=-0.091, 95% CI -0.171 to -0.010), and lower odds of intending to avoid alcohol completely (OR=0.77, 0.63 to 0.94) and to reduce the amount of alcohol consumed per occasion (OR=0.82, 0.69 to 0.97). SAPRO advertisements generated more favourable fun-related perceptions of drinkers (β=0.095, 0.013 to 0.177). CONCLUSIONS The alcohol harm reduction advertisements produced by alcohol industry SAPROs that were tested in this study were not as effective at generating motivation and intentions to reduce alcohol consumption as those developed by PH organisations. These findings raise questions as to whether SAPROs should play a role in alcohol harm reduction efforts.
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Affiliation(s)
- Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Danielle A J M Schoenaker
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kimberley Dunstone
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen G Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Michael D Slater
- School of Communication, Ohio State University, Columbus, Ohio, United States
| | - Simone Pettigrew
- George Institute for Global Health, Sydney, New South Wales, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Rice P. Plus ça change, plus c'est la même chose: a Review of Recent Alcohol Policy Developments in Europe. Alcohol Alcohol 2019; 54:123-127. [PMID: 30801630 DOI: 10.1093/alcalc/agz013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 02/15/2019] [Indexed: 11/14/2022] Open
Abstract
AIM This paper briefly reviews the history of alcohol policy development in Europe leading to the current consensus in the health field on strategic priorities. There is a review of recent policy developments in selected European countries, both EU and non-EU members. METHODS Narrative review of published journal articles, publications from WHO, and other health organisations and government publications. RESULTS The implementation of the WHO policy priorities has been variable across Europe. At EU level, there has been a recent pattern of trade considerations taking priority over health and a disinvestment in alcohol research and advocacy. Among EU member states new implementation of WHO strategies have been limited to a few smaller countries and regions. In Russia, there have been considerable falls in mortality following the introduction of controls on price, availability and marketing. CONCLUSION The implementation of WHO strategy at national level in Europe is highly dependent on the local political circumstances. Where there is concern about alcohol harm and political will, the WHO strategic priorities have been highly influential.In order to build public and political support for prevention, alcohol policy advocates should ensure that there is good data on trends within age, gender, and income groups and develops policies to respond to these trends. The concept of proportionate universalism, where interventions are understood to have a broad population effect but the effect is greater on the groups most in need, may be more useful than the traditional alcohol policy field conceptualisations of whole population and targeted measures.
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Affiliation(s)
- Peter Rice
- Steering Group Chair, Scottish Health Action on Alcohol Problems, Royal College of Physicians of Edinburgh, 12 Queen Street, Edinburgh, UK
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Frings D, Moss AC, Albery IP, Eskisan G, Wilcockson TDW, Marchant AP. Environmental Context Influences Visual Attention to Responsible Drinking Messages. Alcohol Alcohol 2018; 53:46-51. [PMID: 29040357 DOI: 10.1093/alcalc/agx076] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/30/2017] [Indexed: 11/14/2022] Open
Abstract
Aims Responsible drinking messages (RDMs) are used as a key tool to reduce alcohol-related harms. A common form of RDM is in a poster format displayed in places such as bars, bus stops and toilet cubicles. However, evidence for the effectiveness of RDMs remains limited. Moreover, it is not known how environmental contexts (e.g. the number of alcohol-related cues in the environment) impact how such RDMs are interacted with, nor how this in turn affects their efficacy. Methods One hundred participants completed a pseudo taste preference task in either in a bar laboratory (alcohol cue rich environmental context) or a traditional laboratory. The walls of the laboratory displayed either RDM or control posters during this task and eye tracking was used to assess participant attention to the posters. Results Participants looked at the RDM posters less in the bar laboratory where the environmental context is rich in alcohol cues compared to a traditional laboratory where alcohol cues are sparse. Neither poster type or environmental context affected the amount of 'alcohol' consumed and the amount of visual attention given to RDMs was unrelated to the amount of 'alcohol' consumed. Conclusions These findings provide experimental evidence that RDMs do not influence drinking behaviour in the direction intended (reduced consumption in situ). In addition, locating RDMs in alcohol-cue rich environments may result in sub-optimal behavioural responses to the RDM materials (e.g. visual attention to content). To maximize the potential impact of RDMs, the optimal location for RDMs is in environments where pre-existing alcohol cues are sparse to non-existent. Short Summary Responsible drinking messages (RDMs) aim to reduce alcohol consumption, however, the findings of this study show that they may not influence in situ consumption. These findings also suggest that the optimal location for RDMs is in environments with few or no other alcohol-related cues.
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Affiliation(s)
- Daniel Frings
- School of Applied Sciences, Division of Psychology, London South Bank University, 103 Borough Road, London SE1 0AA, UK
| | - Antony C Moss
- School of Applied Sciences, Division of Psychology, London South Bank University, 103 Borough Road, London SE1 0AA, UK
| | - Ian P Albery
- School of Applied Sciences, Division of Psychology, London South Bank University, 103 Borough Road, London SE1 0AA, UK
| | - Guleser Eskisan
- School of Applied Sciences, Division of Psychology, London South Bank University, 103 Borough Road, London SE1 0AA, UK
| | - Thomas D W Wilcockson
- School of Applied Sciences, Division of Psychology, London South Bank University, 103 Borough Road, London SE1 0AA, UK.,Psychology Department, Lancaster University, Lancaster LA1 4YW, UK
| | - Alexander P Marchant
- School of Applied Sciences, Division of Psychology, London South Bank University, 103 Borough Road, London SE1 0AA, UK
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Perman-Howe PR, Davies EL, Foxcroft DR. The Classification and Organisation of Alcohol Misuse Prevention with a Focus on Environmental Prevention. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0190-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hassan L, Shiu E. Communicating Messages About Drinking. Alcohol Alcohol 2017; 53:1-2. [DOI: 10.1093/alcalc/agx112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Indexed: 11/13/2022] Open
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Effect of Health Messages on Alcohol Attitudes and Intentions in a Sample of 16-17-Year-Old Underage Drinkers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101183. [PMID: 28981477 PMCID: PMC5664684 DOI: 10.3390/ijerph14101183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 12/31/2022]
Abstract
Background: Responsible drinking messages (RDMs) are a key component of many education-based interventions for reducing alcohol harms. The evidence base for the effectiveness of RDMs is extremely limited, with some recent research suggesting iatrogenic effects of such messages. Objective: To examine the effects of exposure to health messages on attitudes towards drinking and drunkenness, and intentions to drink and get drunk, amongst underage drinkers. Methods: Ninety-four underage drinkers were recruited from colleges in the UK. Participants were either actively or passively exposed to one of two health messages (RDM or general wellbeing). Measures of attitudes and intentions towards drinking and drunkenness were obtained one week before and immediately after participation in the study. A unit estimation task was also included. Results: Active exposure to RDMs led to more positive attitude towards drunkenness, while passive exposure led to more negative attitudes. Passive RDM exposure led to increased intentions to get drunk in future. Wellbeing posters produced the opposite effect in some but not all of these measures. Conclusions: Exposure to RDMs may have some beneficial effects in terms of creating more negative attitudes towards alcohol consumption, but we also identified potential iatrogenic effects regarding attitudes and intentions towards drunkenness amongst an underage sample of drinkers. Further research is required to better understand optimal ways of framing RDMs to produce positive changes in attitudes, intentions, and prospective drinking behaviour.
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