The Role of Mass Media Campaigns in Reducing High-Risk Drinking among College
Students*
WILLIAM DeJONG, Ph.D.† Department of Social and Behavioral Sciences, Boston University School of
Public Health, 715 Albany Street, Boston, Massachusetts 02118
ABSTRACT.Objective: This article categorizes and describes current
media campaigns to reduce college student drinking, reviews key principles of
campaign design and outlines recommendations for future campaigns. Method:
The article describes three types of media campaigns on student drinking: information,
social norms marketing, and advocacy. Key principles of campaign design are
derived from work in commercial marketing, advertising, and public relations
and from evaluations of past public health campaigns. Results: Information
campaigns on the dangers of high-risk drinking are common, but none has been
rigorously evaluated. Quasi-experimental studies suggest that social norms marketing
campaigns, which correct misperceptions of campus drinking norms, may be effective,
but more rigorous research is needed. As of this writing, only one major media
campaign has focused on policy advocacy to reduce college student drinking,
but it is still being evaluated. Lessons for campaign design are organized as
a series of steps for campaign development, implementation and assessment: launch
a strategic planning process, select a strategic objective, select the target
audience, develop a staged approach, define the key promise, avoid fear appeals,
select the right message source, select a mix of media channels, maximize media
exposure, conduct formative research, and conduct process and outcome evaluations.
Conclusions: Future campaigns should integrate information, social norms
marketing, and advocacy approaches to create a climate of support for institutional,
community and policy changes that will alter the environment in which students
make decisions about their alcohol consumption. (J. Stud. Alcohol, Supplement
No. 14: 182-192, 2002)
AMERICANS HAVE long been intrigued by the potential power of the mass media
to help solve social problems. Television, radio and print advertising can entice
people to buy a wide range of products and services, and television entertainment
programs and movies exert enormous influence over our ideas, values and behavior.
Therefore, according to conventional wisdom, it should be possible to use mass
communications to get people to act on behalf of their own health and well-being
or to "do right" by important social causes. Based on this assumption,
since World War II, federal, state and local governments, private foundations
and other nongovernmental organizations have sponsored hundreds of public service
campaigns to promote social rather than commercial "goods" (DeJong
and Winsten, 1998).
It is not surprising, then, that prevention advocates would
look to the mass media as an important aid in addressing
the problem of high-risk drinking among college students.
Some advocates have pushed for reform or other restrictions
on alcohol advertising (DeJong and Russell, 1995).
Others have sought to influence entertainment producers to
end the glorification of high-risk drinking on television and
in the movies (Montgomery, 1989). More recently, prevention
advocates have produced a small number of media
campaigns designed to change student knowledge, attitudes
and behavior.
How can the power of the mass media be used effectively
to reduce high-risk drinking among college students?
To explore that question, this article begins by reviewing
three types of mass media campaigns focused on student
drinking: information, social norms marketing, and advocacy.
This is followed by a review of key lessons for campaign
design derived from work in commercial marketing,
advertising and public relations and from past public health
campaigns. The article concludes by suggesting how future
campaigns on student drinking might be constructed so that
they work in sync with environmentally focused prevention
efforts now being implemented on college campuses.
A Review of Current Campaigns
Most media campaigns focused on college student drinking have been campus based,
using a mix of posters, flyers, electronic mail messages and college newspaper
advertisements. More recently, a few regional, state and national media campaigns
have begun to address this issue as well. The following review describes three
types of campaigns. First, information campaigns try to raise awareness
of the problem, usually with the intent of motivating students to avoid high-risk
alcohol use. Second, social norms marketing campaigns try to correct
misperceptions of current drinking norms, based on the idea that if students
no longer have an exaggerated view of how much alcohol their peers are consuming,
fewer of them will be led to engage in high-risk drinking. Third, advocacy
campaigns attempt to stimulate support for institutional, community or public
policy change. Unfortunately, evaluation data for all three types of campaigns
are still very limited.
Information campaigns
"Party Smart" is a media awareness campaign launched
by Boston Mayor Thomas M. Menino as a response to the
1997 death of Scott Krueger, a freshman at the Massachusetts
Institute of Technology who died from alcohol poisoning
after a fraternity hazing. Each of the advertisements
for this poster and billboard campaign uses a photograph
taken from the point of view of a drinker, with the rhetorical
tagline, "Remind you of last night?" One shows the
blurry image of a toilet, the apparent target of an intoxicated
drinker who needs to vomit. Another shows the
splayed feet of a drinker lying in bed, the room spinning
rapidly around him. A third shows a covey of young women
pointing and laughing at a drinker (presumably a male)
who has passed out or fallen on the floor.
The "Dirk" campaign, sponsored by the Ohio Department
of Transportation, is a similar awareness campaign.
Print advertisements are built around a fictional character,
Dirk, who sets out to learn about the negative consequences
of excessive alcohol consumption among Ohio college students.
Television advertisements also focus on negative consequences.
In one, the camera pans across a set of ringing
alarm clocks and empty alcohol containers, then to a snoring
student who is sleeping through a final exam. In the
other advertisement, a young woman is sitting on a bed in
a dorm room. A young man beside her wakes up, having
no memory of who she is.
Mothers Against Drunk Driving has launched a print
campaign, "Face the Brutal Truth About Underage Drinking,"
to remind the public, especially young people, of the
repercussions of underage drinking. Each advertisement
shows a close-up of a distraught young man or woman
with a caption that describes a possible negative consequence
of drinking (e.g., "Alcohol consumption contributes
to unwanted pregnancies"; "Alcohol kills more people
under 21 than cocaine, marijuana, and heroin combined";
"Alcohol is involved in half of all sexual assaults on
campus").
Information campaigns focusing on negative consequences
are unlikely to have much impact on college students'
alcohol consumption. Students involved in high-risk
drinking already know that alcohol misuse can lead to serious
injury and death. They also know from their own experience,
however, that dire consequences, while common
enough to be noteworthy, are still relatively rare events,
given that 81% of college students consume alcohol
(Wechsler et al., 1998). As a result, serious injuries or death
related to drinking are likely to be attributed to an error in
the individual's specific actions, rather than to predictable
consequences of excessive alcohol consumption, as predicted
by "just world" theory (Lerner, 1980).
It is also unlikely that the depiction of highly familiar
but less serious negative drinking consequences, such as
those in the Party Smart campaign, will penetrate the fog
of denial that lets students continue to engage in high-risk
drinking. Most young people take good health for granted,
and many view long-term problems from their current drinking
as too distant and unlikely to be of concern. Moreover,
many young people do not understand the probabilistic nature
of risk, and the inherent uncertainty facilitates denial.
Finally, many young people overestimate their own capacity
to change their behavior before long-term consequences
become an issue (DeJong and Winsten, 1998).
The National Association of State Universities and Land
Grant Colleges launched a different kind of information
campaign in September 1999, with the endorsement of 113
university presidents. A one-page parody "advertisement"
for "Binge Beer" was run in national and major regional
newspapers to encourage parents to talk with their children
about "binge drinking." It should be noted that the advertisement
generated extensive news coverage, which helped
to extend the campaign's message to a wider audience.
Although the advertisement was eye catching, the heart
of the prevention message was buried, and it was not clear
that it was directed to parents until the last line of copy.
The "Binge Beer" ad may have succeeded in reminding a
few parents that they should talk to their college-age son or
daughter about the dangers of high-risk drinking, but no
advice was provided on how to have that discussion. Several
important messages have been identified that parents
can convey to their college-age children (Devine and
DeJong, 1998), but these were not indicated in the ad or a
related website. An alternative strategy would have been to
encourage parents to take an active role in helping their
college-bound children choose a college that has implemented
key programs and policies for creating a safe campus
(DeJong and Zweig, 1998).
Social norms marketing campaigns
College students tend to overestimate how many of their
peers engage in dangerous alcohol consumption. The disparity
between actual and perceived drinking norms can be
very large. If students believe that most other students drink
heavily and seek to conform to that perceived norm, then
collective rates of high-risk drinking will be sustained or
even increase. Incoming first-year students, independent
from parental control for the first time and seeking guidance
on how to fit into their new social environment, are
especially vulnerable to exaggerated representations of
drinking norms (Perkins, 1997).
Prevention experts have speculated that this dynamic might be turned around
through a campus-based media campaign that corrects students' misperceptions
about their peers' alcohol consumption. Quite simply, if students more accurately
perceive how much drinking is really going on, then this should change their
perception of the norm, which in turn should lead to reductions in high-risk
drinking. The effort to get this message out—using publicity events, student
newspapers, posters, email messages, and other campus-based media—is called
a social norms marketing campaign (Perkins, Social norms, this supplement).
This approach has been tested on several different campuses.
Northern Illinois University implemented a 5-year
program to change perceptions of student norms regarding
high-risk drinking (Haines and Spear, 1996). A subsequent
student survey found an 18% reduction in perceived heavy
episodic drinking (69.3% versus 57.0%) and a 16% reduction
in actual heavy episodic drinking (43.0% versus 37.6%).
Northern Illinois University has continued to implement the
media campaign for several years, producing steady declines
in the rate of self-reported high-risk drinking (Haines,
submitted for publication).
Additional preliminary studies have been conducted at
Hobart and William Smith Colleges, the University of Arizona,
and Western Washington University. Although all of
the evaluation designs are subject to criticism, the consistent
pattern of findings reported by these campuses is impressive,
especially in light of survey data showing relatively
little change at the national level (Perkins, Social norms,
this supplement). Additional research is needed to explore
campus-based social norms campaigns.
In Montana, the social norms approach is being tried in
a state-funded media campaign called "Most of Us." This
campaign is directed to all young people in Montana under
age 25, including college students, and its objective is similar
to that of college-based campaigns. A baseline survey confirmed
that misperceptions about how much alcohol young
people actually drink are widespread among all subgroups
of 18- to 25-year olds in the state (Linkenbach and Perkins,
submitted for publication). A quasi-experimental evaluation
of the campaign is currently underway.
Advocacy campaigns
As of this writing, there is only one major media campaign
focused on college student drinking that has sought
to create a climate of support for environmental change.
Launched in late 1997 by the Center for Science in the
Public Interest, "Had Enough!" is being piloted at Cornell
University, the University of Arkansas at Little Rock, and
the University of North Carolina at Chapel Hill. The campaign
targets the many students who are tired of having the
quality of their education and their safety compromised by
the high-risk drinking of others, with the hope that they
will channel their anger into advocacy.
"Had Enough!" uses newspaper advertisements, posters
and flyers to draw students to a website (HadEnough.org),
which then urges them to "get involved" in fighting "binge
drinking" on their campus. Each advertisement presents a
multiple-choice drinking quiz, such as the following:
You're driving your trashed friend back from a party when
she declares she's going to hurl. To assist, you: a) Tell her to
stick her head out the window and let it rip. b) Quickly swerve
over and open the door so she doesn't get any in your car. c)
With one hand on the wheel, hold her hair back while she
barfs in her purse. d) NONE OF THE ABOVE.
The last alternative is marked with an asterisk, which draws
attention to the key line of copy. In this example, it reads:
"You didn't come to college to baby-sit a binge drinker.
To really be helpful, advocate for change. Visit http://www.HadEnough.org."
The website is designed to reinforce the visitor's negative
opinion about high-risk drinking and provide a resource
for students who want to "do something about it." Under
the banner "Binge Drinking Blows," the home page begins,
"Had enough on your campus? Haven't we all about
had enough of the effects binge drinking has on the quality
of campus life? Well, join the club. There are plenty of us
that are sick and tired of drunken nuisances. And with good
reason." It offers general advice to students on how to address
the problem, such as organizing alcohol-free activities
during orientation or joining a local coalition on alcohol
issues, and provides a basic primer on the importance of
institutional and government policy for addressing the problem.
At the three pilot sites students are linked to activities,
programs, and advocacy efforts specific to their campuses.
Evaluation of the campaign is still underway.
The University of Delaware recently launched an eclectic
poster campaign under the slogan, "University of Delaware.
Party School?" One series of posters includes elements
similar to "Had Enough!" but without providing sources
for additional information. For example, one poster shows
a disarrayed dormitory room. Under the headline "Wasted,"
the copy reads: "Your room. Someone threw up in the
wastebasket; cans and bottles are everywhere. And, who's
that guy passed out on your bed?" "Haven't we had
enough?" At the bottom appears the standard line, "University
of Delaware. Party School?" Unfortunately, judging
from the photograph of the dorm room, the answer appears
to be "Yes."
Another series of posters seeks to communicate a positive
image in contrast to the university's "party school"
reputation. For example, under the headline "Trashed," one
poster shows a group of student workers for the university's
recycling program and another shows Greek organization
volunteers participating in a roadside cleanup program. A
third, headlined "Party Animal," shows the university mascot
and students participating in a fundraiser for the March
of Dimes. The references to high-risk drinking are unfortunate,
as they may subtly reinforce the university's drinking
school image and undermine the central message. Also,
showing that certain students are not part of the high-risk
drinking scene fails to communicate clearly what the real
norms on campus are.
A more traditional series of posters highlights the negative
consequences of high-risk drinking: (1) "Wasted. All
that time spent partying instead of hitting the books. Failed
classes equal wasted time, wasted money, wasted effort."
(2) "Mug Night. It was a great party, wasn't it? Maybe he
didn't know a police record will prevent him from entering
law school." (3) "Attitude Adjustment. He seemed like such
a nice guy…until he had a few drinks. Then, his attitude
changed: He got abusive and you got scared." Each poster
concludes with the line, "Haven't we had enough?" Unfortunately,
the posters do not refer students to an additional
source of information.
Lessons from Past Public Health Campaigns
Given these modest efforts, it is helpful to explore how
the mass media might be used more effectively to address
the issue of college student drinking. Decades of work on
public service campaigns have taught public health advocates
a great deal about how to harness the power of the
mass media. An overview of key lessons is presented here,
organized as a set of guidelines that can be used to stimulate
ideas, manage the process of campaign development
and implementation, and evaluate campaign results. These
guidelines have their origins in two major traditions: (1)
commercial marketing, advertising and public relations and
(2) public health practice.
Launch a strategic planning process
Public service campaign planning often begins with the
wish to "do something" about a problem using the mass
media. What often ensues is a review of how other campaigns
have used the media, with the assumption that their
methods can be imitated or adapted for the new campaign.
For example, the value of television public service announcements
seems to be regarded as self-evident, leading
even small organizations with limited means to spend valuable
time and resources in developing them and then pushing
them in front of media gatekeepers, who have an
ever-shrinking store of free advertising slots to dispense
(Hammond et al., 1987).
The problem is that campaign planners are thinking about
which media technique to use without first having a clear
strategic objective in mind. Ideally, the objective should be
one that applies to the sponsoring organization's entire programmatic
effort, not just the media campaign alone. Furthermore,
the nature and scope of the media campaign
should be outlined in tandem with the organization's other
activities. This is the only way to guarantee that the media
campaign will be consistent with and support the larger
goals and objectives of the organization.
Select a strategic objective
The first step in designing a public health campaign is
to select a strategic objective for the entire program, of
which the media campaign is one part. Campaign planners
can then consider how the mass media might best be used
to advance that objective. Thinking about media options in
the absence of an overall strategy is shortsighted and very
likely to lead to disappointing campaign results.
A consideration of strategic options is well informed by
a social ecological framework, which recognizes that health
behavior change is affected by multiple levels of influence:
individual factors, interpersonal and social processes, institutional
factors, community factors and public policy
(Stokols, 1996). Accordingly, broad objectives for the overall
program could include: (1) individual behavior change,
(2) changes in interpersonal and social processes, (3) support
for institutional or community-based interventions or
(4) promotion of public action for environmental change
(DeJong et al., 1998). The most profound decision to be
made by campaign planners is which of these areas should
be the focus of their strategy.
Selection of a strategic objective should be informed by
a thorough analysis of the problem at issue, its causes and
the full range of possible solutions. The ultimate decision
should be based on a determination of which option will
provide the greatest leverage for generating change. In some
cases, it will be clear that an issue is not yet on the public
agenda, and a basic informational campaign will be needed,
directed either to the public at large or to policy-makers
and principal opinion leaders. Or there may be a lack of
knowledge, erroneous beliefs or skill deficits that must be
addressed before further progress is possible. There may be
social or interpersonal factors at work in the community
that can provide a strategic opportunity. In some cases, it
will be clear that the key to producing behavior change is
to alter institutional or community factors that are driving
the problem. Or it may be that broad changes in laws or
regulations are most needed.
There is no easy formula. In the end, the decision must rest on informed judgment,
grounded in a systematic analysis and consideration of the problem. Campaign
planners often assume that their campaign message should be designed to educate
people about their individual behavior. That may sometimes be appropriate, but
often it will be more important to use the media to stimulate action in support
of institutional, community or policy change. This can be done through advertising
messages or by influencing how news reporters cover the story (Wallack and DeJong,
1995).
Select the target audience
In general, campaign messages should be directed to a
well-defined target audience specified in terms of its geographic,
demographic, psychological and problem-relevant
characteristics (Lefebvre and Flora, 1998). With a focus on
stimulating action in support of institutional, community or
policy change, the audience should be defined as critical
decision makers, who can be reached either directly or
through mobilized public opinion. Determining the type of
audience that should be targeted for a public service campaign
or how narrowly or broadly that audience should be
defined depends heavily on the nature of the problem, lessons
learned from past work to address it and the availability
of resources. Ideally, members of a target audience
should share similar knowledge, concerns and motivations
that affect their behavior, and they should be reachable
through similar media, organizational or interpersonal
channels.
Develop a staged approach
Very few mass communication campaigns can be expected to stimulate an immediate
change in people's health-related behavior. Hence, rather than focusing on immediate
behavior change, it is often more realistic to concentrate on achieving intermediate
objectives that will contribute to behavior change in the long term using a
staged approach. Campaigns to promote change in interpersonal and social processes
or build support for policy change can also benefit from this type of structure.
According to models of the behavior change process,
change results when people are led through the following
steps (Roberts and Maccoby, 1985):
Awareness. A media campaign needs to raise consciousness
of the problem, prompt reevaluation of personal risk and encourage consideration
of individual or collective action (Dearing and Rogers, 1996).
Knowledge and beliefs. The campaign must bring
about a change in beliefs and attitudes about the behavior being promoted.
It is critical to anticipate and address the audience's points of resistance.
Behavioral skills. Behavior change often requires
the development of new skills (e.g., self-monitoring, refusal behaviors),
which can be taught using media by modeling or step-by-step instruction (Bandura,
1986).
Self-efficacy. The conviction that one can execute
a particular behavior (called self-efficacy) is predictive of subsequent behavior
change (Bandura, 1986). Observing others' experience is an important way of
developing efficacy expectations.
Supports for sustaining change. Learning and maintaining
a new pattern of behavior requires that people know how to monitor their behavior;
apply self-reinforcement strategies; and anticipate, eliminate or cope with
stimuli that trigger unwanted or competing behaviors (DeJong, 1994). Mass
communications can be used to teach these self-management techniques.
To apply the behavior change model, campaign planners
should establish where in the behavior change process
the target audience can presently be found. The campaign
should try to move the audience sequentially through the
remaining steps, noting that it is possible for a set of messages
to move an audience through several stages at once,
depending on the difficulty of the behavioral objective.
Define the key promise
In general, campaign messages are more likely to be
effective if they call on the target audience to take some
kind of specific action. The selected action should be one
that serves to work in tandem with other program elements
and advance the broader strategic objective. For instance,
community residents might be encouraged to call a telephone
hotline to receive information about a public health
problem. At the policy level, targeted government officials
might be urged to pass a budget that will allow for stricter
law enforcement. Once the desired action is identified, ways
to motivate the target audience must be identified.
Commercial advertisers think in terms of a key promise—that is, the single
most important benefit that the audience will receive if they do what the campaign
message is asking of them. Personal concerns or barriers that might deter the
audience from taking action must also be considered. To "sell" the
key promise, the campaign message must provide support statements that explain
why the promised benefit serves the target audience's interests and why the
advantages of taking this action outweigh any disadvantages. The key promise
and support statements are brought together to create a net impression, which
can be thought of as a summary of what members of the target audience should
say to themselves after seeing or hearing the message.
Identifying the key promise is a critical step. Commercial
advertisers understand that people are more likely to
attend to and remember messages that meet their needs or
support their values. Hence, commercial advertising often
plays on people's insecurities, desires and aspirations and
then "positions" the advertised product or service as a means
of meeting those needs immediately. In contrast, public
health advocates tend to think more narrowly in terms of
promised health benefits. In fact, those benefits may not be
primary motivators for the target audience, which may have
other, more immediate concerns. When crafting a campaign
message, consideration should be given to a broader range
of benefits that might appeal to the target audience (DeJong
and Winsten, 1998).
Avoid fear appeals
There is continuing controversy about the use of fear
appeals or scare tactics. Their use is based on a firmly held
belief that people can be motivated to stop life-threatening
or otherwise dysfunctional behaviors through an emotionally
charged portrayal of that behavior's negative consequences.
Most experts have concluded that fear campaigns
are extremely difficult to execute, rarely succeed and should
be used only under limited circumstances (Job, 1988). Indeed,
they argue that there is a real risk that fear appeals
will backfire, making the problem behavior even more resistant
to change (DeJong and Winsten, 1998).
Despite these considerations, fear appeals continue to
have strong intuitive appeal and are frequently used by advertising
professionals in public service campaigns. One
reason is that focus group participants usually rate emotional
or arousing fear appeals as highly motivating and
effective, but this is true even when subsequent experimental
studies show those appeals to be ineffective (Job, 1988).
The reason for the continuing allure of fear-based messages
is clear: In general, the threat of punishment is relied
on to control behavior when its causes are insufficiently
understood or those causes are difficult to change (Bandura,
1986).
Lack of clarity about what constitutes a fear appeal compounds the confusion.
In their zeal to promote alternative approaches, some experts extend their concerns
about fear appeals to any message that focuses on negative consequences of certain
behaviors. In fact, however, people need to be made aware of threats to their
health if this is new information for them, and they need occasional reminders
of those facts, especially when the audience has low anxiety about a problem
(DeJong and Winsten, 1998). Also, it is legitimate to use public policy to create
new threats, such as stricter law enforcement, about which the public then needs
to be informed (DeJong and Atkin, 1995). The threat of punishment, primarily
through legal sanctions, is a basic instrument of social policy—one frequently
used to achieve public health objectives.
On the other hand, once people are already aware of a
problem or have been notified about changes in policy,
other means of influencing their behavior must be found,
such as modeling appropriate skills, demonstrating the benefits
of alternative behaviors, promoting participation in
community-based programs or encouraging active support
for further policy changes. Unfortunately, most public service
campaigns never get past the stage of reinforcing
people's awareness of the problem and stay stuck in a negative
approach.
Select the right message source
The choice of the named campaign sponsor is fundamental.
The persuasiveness of the message will depend on
the trustworthiness and credibility of its source, as perceived
by the target audience. In some cases, this can create a
dilemma for the agency supporting the campaign. Its leadership
may want the public (or its funders) to know of their
sponsorship, but at the same time being prominently named
might serve to undermine the target audience's receptivity
to the message.
The use of celebrities should be approached cautiously
for several reasons (DeJong and Winsten, 1998). First, the
message may be overwhelmed by the celebrity's presence
and ultimately forgotten. Second, celebrities can lose their
luster; among adolescent fans in particular, perceptions of
entertainment and sports stars change very quickly and unpredictably.
Third, celebrities can suddenly become newsworthy
in ways that directly undermine the campaign or
are otherwise inappropriate. In the case of alcohol and other
drug prevention messages, there is a fourth consideration:
Adolescents often view celebrity messages skeptically because
they suspect the celebrity was paid to deliver the
message or they believe that many stars are substance users
(Harvard Business School, 1987).
A celebrity should be selected whose public image fits
the underlying strategy of the campaign, not just because
he or she is available. Data on the celebrity's popularity
among different demographic groups should be examined,
and formative research should be undertaken to test the
target audience's perceptions of the celebrity's credibility,
trustworthiness and attractiveness. Most important, people
who know the celebrity, and whose judgment can be trusted,
should be consulted for their advice whenever possible.
Select a mix of media channels
A tenet of commercial marketing and advertising is to
use a variety of media channels to provide a clear and consistent
message (DeJong and Winsten, 1998). They should
be selected according to the target audience's media preferences,
the objectives of the campaign and cost. Audience
rating systems and formative research can be used to help
identify which specific stations, programs, print venues,
websites or other media are the best vehicles for reaching
the target audience at the lowest cost per contact.
It is sometimes assumed that a campaign must use television to be effective,
but that is mistaken. In general, television is excellent for providing short,
uncomplicated messages, evoking emotional reactions, establishing evidence of
new social norms, and modeling behaviors that can be easily taught. Radio shares
many of television's advantages and is much less expensive, both in terms of
production costs and advertising rates; this allows greater repetition of the
messages. Moreover, the variety of radio stations on the air facilitates the
targeting of messages to very narrowly defined groups.
The print media are less able to command attention than
the broadcast media, but they can be used to reach narrowly
defined target groups, especially policy-makers and
community opinion leaders. In addition, because print advertisements,
brochures and feature articles can be reread
and invite reflection, they are better suited for presenting
rational arguments or detailed information. For college students,
campus newspapers can be an ideal medium for campaign
materials.
The Internet and the web are becoming another consequential
medium for public service campaigns, especially
for college students. While the private sector, including alcohol
and tobacco companies, have aggressively developed
home pages on the web (Williams et al., 1997), public service
groups have only recently begun to explore the
medium's possibilities. Those organizations that have made
the greatest progress in developing this resource have had
extensive government or foundation support (e.g., the National
Clearinghouse for Alcohol and Other Drug Information).
Recently, it has become feasible to use websites to
make video and audio materials widely available to the
public, which opens up a whole new world of possibilities
for public health advocates.
Maximize media exposure
What constitutes adequate exposure has not been extensively
studied in public service campaigns because, historically,
those campaigns have relied on public service time
or have had small budgets. Two broad generalizations can
be provided for guidance (DeJong and Winsten, 1998). First,
repetition helps draw attention to the message, facilitates
learning and increases liking for the message. However,
repetition can be counterproductive if it is excessive. Second,
airing spots in high-frequency bursts (or "flights") is
superior to having the same number of messages drawn out
over a longer period. Precise recommendations cannot be
made, however, because the right amount of exposure depends
on multiple variables, including the nature of the
target group, the precise objective, the complexity and entertainment
value of the message, the nature and extent of
competing messages and the context in which the campaign
is conducted.
Conduct formative research
Formative research with the target audience is essential
at each step of the campaign development process: defining
the campaign's goals and objectives, selecting the most
promising audience segment, identifying appropriate media
channels for delivering messages, designing educational
materials, tracking audience exposure and reaction, and refining
the campaign (DeJong and Winsten, 1998). In essence,
creating an effective campaign requires entering into
a dialogue with the audience (Garcia, 1990).
It is surprising how often campaigns are developed without
careful formative research. Funding is usually not the
issue, as pretesting expenses can be kept relatively modest.
More often, not enough time has been allowed to do the
research. At a minimum, focus groups should be conducted
to test preliminary executions, such as scripts, storyboards,
and mock-ups of print advertisements. Tests of finished
products are generally less critical, although in some isolated
cases, this type of testing is absolutely essential
(Wallack and Barrows, 1982-1983).
Representatives of the target audience are an excellent
source of information at this stage, but not everything they
say should be accepted at face value. For example, focus
groups almost always endorse fear messages; but, as discussed
above, research suggests that fear-based messages
work under only extremely limited circumstances (Job,
1988). Therefore, it is essential that formative research include
consultation with experts who can provide an experience-based and analytical perspective.
Conduct process and outcome evaluations
Few public service campaigns have been rigorously
evaluated. Campaigns involving academic researchers tend
to be low-budget, short-term and localized efforts. Fullscale
national campaigns are rarely evaluated due to both
expense and the difficulty of setting up a research design
that permits meaningful inferences about a campaign's impact.
The common failure to evaluate these campaigns prevents
planners from assessing the need for making
midcourse corrections and impedes progress in learning what
types of campaign strategies work best. Hence, whenever
possible, early program planning should incorporate both
process and outcome evaluation activities to monitor
progress and demonstrate project impact.
There are three types of evaluation strategies that have
been used to assess the impact of mass media campaigns:
(1) community studies, which assess the impact of local or
regional campaigns by comparing "treatment" and "control"
(no campaign) communities; (2) exposure studies,
which compare the knowledge, attitudes and behaviors of
people who have been exposed to the campaign versus those
who have not; and (3) time-series studies, which involve
the examination of data for an extended period of time,
both before and after the introduction of the media campaign.
Most campaign evaluations have failed to capture the diversity and complexity
of mass media effects. Measurement systems should be designed to capture the
full range of expected effects. For example, if a campaign's objective is to
move an issue to the top of the public agenda, the project's success can be
established by tracking the number of news stories before and during the campaign,
the number of legislative proposals submitted and passed, the growth of grassroots
advocacy groups and so forth (Roberts and Maccoby, 1985).
Conclusion
Learning from both the successes and failures of past
mass communication campaigns, public service groups are
working now with a renewed enthusiasm for using the mass
media to promote their causes. Studies have demonstrated
that when long-term mass communication campaigns are
designed and executed according to sound principles, they
can play a meaningful role in changing behavior, either
directly or by helping bring about environmental change at
the institutional, community or policy level. Many failed
campaigns are understood to have been seriously flawed in
design and execution due to poor planning and inadequate
formative research.
An Outline for Future Mass Media Campaigns
To date, most mass media campaigns focused on college
drinking have used a basic information approach. These
campaigns have been driven by the widely shared conviction
that the techniques of commercial advertising can be
successfully applied to this problem. These campaigns are
developed with the implicit conviction that people will naturally
take steps to protect themselves if planners can find
just the right messages to inform them about the problem
and to motivate them (Wallack and DeJong, 1995). Like
commercial advertising, this approach seeks to change individual
behavior directly by providing information.
This approach is not congruent with the general thrust
of work in public health, which has focused on identifying
and controlling environmental factors that contribute to disease
and other health-related problems. This environmental
work (e.g., draining the swamps, providing clean water,
building sanitation facilities) has been credited for the great
gains in life expectancy seen in developed countries. Over
time, attention shifted to public health problems that seem
rooted in poor behavioral choices. To address these, public
health specialists turned away from the tradition of environmental
management and instead turned to health education,
with its focus on altering individual behavior through
changes in knowledge and attitude.
The health education approach is valuable, of course, if
not essential. However, it is also limited in what it can
accomplish. In recent years, public health experts have argued
that a paradigm that addresses the physical, social,
legal and economic environment that encourages and sustains
high-risk behavior is the most effective way to reduce
behavioral health problems. Accordingly, public health media
campaigns can make their greatest contribution by creating
a climate of support for changing this environment
(Wallack and DeJong, 1995).
The environmental management framework outlined by the Higher Education Center
for Alcohol and Other Drug Prevention brings attention to the vital role of
policy change at the institutional, community, state and federal level in preventing
alcohol-related problems on campus (DeJong et al., 1998). Research has already
shown that community-based coalitions can affect policy change to reduce alcohol
consumption (Holder et al., 1997; Perry et al., 1996), and it is recommended
that this general strategy be adapted to reduce alcohol-related problems in
higher education (DeJong and Langford, this supplement). The following discussion
addresses how the mass media can be used to create a climate of support for
environmental change.
Policy change as a participatory process
A participatory process that includes all major sectors of
the campus and community is key to developing and implementing
new policies (DeJong et al., 1998). College presidents
and other top administrators on many campuses have
grappled with the problem of how to involve students as
real partners in this process. Which student leaders should
be involved? How should they be selected? What is a meaningful
role for them to play? These are difficult questions.
What is evident, however, is that the participation of any
group of student leaders in this process will not be accepted
by the student body at large in the absence of broad
student support for policy change. The paramount question,
then, is how such support can be generated through a
mass media campaign.
It is important to remember that policy reforms cannot
go too far beyond perceived social norms without provoking
resistance or even open defiance. It follows that support
for policy change will be less forthcoming if people
have an exaggerated view of student norms regarding alcohol
consumption. A critical step in building support for
policy change, then, is to conduct a social norms marketing
campaign that will correct that misperception. Once people
realize that the majority of students are already practicing
safe, moderate behaviors, college administrators can more
easily enlist the support they need to advance a policy
agenda that reinforces those positive trends. In short, another
way to think about social norms marketing campaigns
is that they put the college community in touch with the
positive social norms that exist on campus.
Another type of information that can be used to build the case for policy change
concerns the secondary effects of high-risk drinking—that is, the negative
consequences that students experience due to other students' misuse of alcohol.
Various college alcohol surveys have found that a majority of students experience
these consequences, which include interrupted study and sleep; having to take
care of a drunken student; being insulted or humiliated; having a serious argument
or quarrel; having property damaged; experiencing unwanted sexual advances;
being pushed, hit or assaulted; and being a victim of sexual assault or date
rape (Wechsler et al., 1996). The realization that secondhand smoke puts nonsmokers
at risk gave new momentum to the antitobacco movement. Similarly, an increased
awareness that high-risk drinking hurts students who are not at high risk themselves
can increase support for campus alcohol control policies. Media can play a pivotal
role in developing this new awareness.
Mass media campaigns can also be used to provide evidence
of substantial support for new policies that are consonant
with the actual values and norms shared on campus.
The 1997 Harvard survey revealed that there is widespread
support nationally for various measures to reduce high-risk
drinking, including strict enforcement of the rules (65%),
prohibiting kegs on campus (60%), "cracking down" on
Greek organizations (60%) and banning on-campus advertisements
from local outlets (52%) (Wechsler et al., 2000).
Support for policies is also subject to misperception. Evidence
from a study conducted on one Northeast campus
showed that, just as students overestimate how much alcohol
is being consumed on campus, they underestimate how
much student support exists for reasonable policy reform
(DeJong and Langford, this supplement). For example,
54.3% of students supported using stricter disciplinary sanctions
for repeated violations of campus alcohol policies,
but only 25.7% thought that other students supported this
policy. Clearly, not all policy proposals will receive majority
support, and the level of actual support for any particular
policy will vary from campus to campus.
Campaign planners using this approach should determine
where student support exists, correct misperceptions about
this support and then move forward with a policy agenda
that most students will endorse. This does not mean that
presidents and other top administrators should never implement
policies that are opposed by a majority of students,
but that, whenever they can, they should find and build on
student support. Over time, changes in policy, if enforced,
hold the promise of further reducing high-risk drinking,
which in turn can further alter the community's perceptions
of its values and behavioral norms and thus set the
stage for additional changes in policy.
Key steps in building support for policy change
This broad campaign outline suggests a sequence of specific
steps that campus-based task forces can take to build
student support for environmentally focused policy changes
using the mass media.
First, the task force should define the problem in a way
that motivates behavior change. This means focusing on
the secondary effects of high-risk drinking rather than the
incidence of negative consequences experienced by the
drinkers themselves. When describing the problem in this
way, the task force should take care to avoid inadvertently
reinforcing misperceptions of student drinking norms
(DeJong and Linkenbach, 1999).
Second, the task force should collect and report survey
data that will correct misperceptions of student drinking
norms. This can have a positive effect on behavior, both
directly and by helping build support for policy changes
that reflect the health-protective values and behavioral norms
of the majority.
Third, the task force should publicize positive trends to
help reinforce further changes in behavioral norms. There
are positive changes underway on many campuses, but a
narrow focus on the severity of student alcohol-related problems
can obscure them. Letting students know about "good
news" can help strengthen the resolve of abstainers and
moderate drinkers to stay that course, while also motivating
other students to moderate their alcohol consumption.
Fourth, the task force should collect information on student
opinions about various policy options. This information
will be especially useful in efforts to give students a
meaningful role in reviewing, developing and implementing
campus policies. If a majority of students favor certain
alcohol control measures, that fact should be publicized,
providing an opportunity to correct misperceptions about
the level of community support.
Fifth, when feasible, the task force should consider implementing
a program of environmental change by starting
with those policies that enjoy majority support and then
moving on from there. When students know that new policies
are consonant with the values and behavioral norms of
the community, protests from opponents will be fewer and
more easily contained.
At some schools, however, basing policies solely on the
preferences of students would result in slow, evolutionary
changes in student behavior and would not satisfy key constituencies,
including administrators, faculty, parents, private
donors and legislators. To build pressure for change,
college presidents and other task force members must continue
to voice their concerns about student alcohol consumption
and its threat to their institution's capacity to
achieve its educational mission (Presidents Leadership
Group, 1997). At the same time, the task force should foster
a campus environment where the large numbers of students
who want reasonable policy reform and stricter
enforcement of the rules are emboldened to speak out and
can be heard.
Sixth, once new policies or programs are in place, students,
faculty and others on campus must be informed. The
mass media provide a superb vehicle for publicizing these
changes, not just through news coverage, but also through
special advertising and promotions. Research in drunk-driving
prevention has shown, for example, that widespread
publicity of "sobriety checkpoints" and other law enforcement
measures is essential to their general effectiveness. In
the absence of publicity, such policy changes have little or
no discernible impact (Ross, 1992).
Conclusion
The strategy recommended here represents a structured
integration of the three kinds of mass media campaigns
that have been attempted to reduce student drinking: information,
social norms marketing, and advocacy. The result
is a sequenced and participatory campaign that would build
the case for and otherwise support the type of environmentally
focused prevention efforts now being implemented on
many college and university campuses (DeJong and
Langford, this supplement). Ultimately, this and other campaign
ideas need to be tested experimentally to learn what
will work best to reduce alcohol-related problems on
campus.
Acknowledgments
The author gratefully acknowledges comments provided on earlier drafts
by David Anderson, Ph.D., George Mason University; Marilyn Aguirre-Molina, Ed.D., Columbia University School of Public Health; Gayle M.
Boyd, Ph.D., National Institute on Alcohol Abuse and Alcoholism; and
Don S. Kenkel, Ph.D., Cornell University.
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*This article was prepared for the Panel on Prevention
and Treatment of College Alcohol Problems, Advisory Council Subcommittee on
College Drinking, National Institute on Alcohol Abuse and Alcoholism. Work on
the article was supported by U.S. Department of Education contract ED-99-CO-0094
to Education Development Center, Inc., Newton, MA for operation of the Higher
Education Center for Alcohol and Other Drug Prevention, for which the author
serves as director. The views expressed here are those of the author and do
not necessarily reflect the official position of the Department of Education.
†William DeJong may be reached at the above address
or via email at: wdejong@bu.edu.
