Multi-Modal Market Research to Develop a National Underage Drinking Prevention Campaign

Background:  Underage drinking continues to be a national public health issue in the United States.  According to the Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking, 50% of children have had an entire drink before the age of 15.  One-third have used alcohol before the age of 13.  Further, when young people drink, they tend to drink more than adults.  

Program background:  The Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Prevention (CSAP) has been directed by Congress to conduct a National Underage Drinking Prevention Media Campaign (the “Campaign”) that targets parents of children ages 9 to 15.  This Campaign supports SAMHSA’s Strategic Initiative No. 1, Prevention of Substance Abuse and Mental Illness, Goal 1.2, which is to prevent or reduce consequences of underage drinking and adult problem drinking.  The Campaign is firmly rooted in social marketing and behavior change principles.  In addition, Campaign planners have relied on current research on the developing brain, and the findings of the 2009 Institute of Medicine report Preventing Mental, Emotional, and Behavioral Disorders Among Young People, to guide the Campaign development process. Campaign goals include encouraging parents and other caregivers to engage in frequent, specific prevention behaviors.  Objectives include increasing parents’ awareness of the prevalence and the risks of underage drinking; knowledge, skills, and self-efficacy regarding prevention behaviors; and frequent prevention actions. 

Evaluation Methods and Results:  SAMHSA conducted formative research including a literature review, media content analysis, and environmental/competitive analysis.  Based on findings from this research, SAMHSA conducted a series of nationwide telephone focus groups to explore attitudes, concerns, social and cultural context, influences on parenting behavior, and language used to discuss underage drinking.  Using telephone focus groups allowed the inclusion of parents from a mix of rural, urban, and suburban locations.  Telephone groups also made it easier for busy parents to participate and fostered open, frank communication about underage drinking.  Focus groups revealed nuanced understanding of parents’ beliefs, including why parents are less concerned about underage drinking than other risky behaviors, why they do not take the recommended regular actions that are known to help prevent underage drinking, and why they are skeptical of prevalence data.  SAMHSA also conducted individual in-depth interviews with stakeholders from the advocacy and prevention arena, as well as from the alcohol industry.  These interviews identified promising practices, opportunities for collaboration, and pitfalls to avoid.

Conclusions:  Parents’ attitudes and behaviors regarding underage drinking are complex, and like their children’s attitudes and behaviors, are influenced by social norms, industry marketing, images conveyed in popular media, and conflicting messages they receive from various sources.  However, untapped opportunities exist to build upon parents’ concern for their children’s future and to work with and through existing trusted sources to reach them.

Implications for research and/or practice: The session will present the findings of each component of the research.  In addition, special attention will be devoted to the types of information gleaned from each method of formative research to inform research planning.