Drink a Little Less, See a Better You: The NHS Health Check and Wind Down initiative is a social marketing campaign designed to reduce alcohol harm in the target group - men between the ages of 35-55 years - in the pub setting. In order to understand the impact of this initiative, the Cheshire and Merseyside Public Health Network commissioned the Centre for Public Health Research at the University of Chester to carry out an evaluation.Cheshire and Merseyside Public Health Networ

Alford, Simon

Hughes, Deanna

Thurston, Miranda

English

ChesterRep

       This work has been submitted to ChesterRep – the University of Chester’s online research repository  http://chesterrep.openrepository.com    Author(s): Miranda Thurston; Simon Alford; Deanna Hughes    Title: An evaluation of the Cheshire and Merseyside Public Health Network 'Drink a Little Less, See a Better You' social marketing campaign   Date: July 2010   Originally published in:    Example citation: Thurston, M., Alford, S., & Hughes, D. (2010).  An evaluation of the Cheshire and Merseyside Public Health Network 'Drink a Little Less, See a Better You' social marketing campaign. Chester: University of Chester    Version of item: Published version    Available at: http://hdl.handle.net/10034/118266 Centre for Public Health Research    An evaluation of the Cheshire and Merseyside Public Health Network Drink a Little Less, See a Better You social marketing campaign          Miranda Thurston Simon Alford Deanna Hughes         July 2010  Summary  Background  The Northwest of England has the highest level of harmful drinking (6.3%) and the second highest level of hazardous drinking (22.1%) in England. The Directors of Public Health in Cheshire and Merseyside identified tackling the harm caused by alcohol as one of the priority areas for action across the network area and provided the resources to implement a Cheshire and Merseyside social marketing programme to address the issue. The Cheshire and Merseyside Public Health Network Social Marketing Action Group decided to work with the pub industry to deliver a social marketing campaign called Drink a Little Less, See a Better You as a pilot project. It was designed to reduce alcohol harm in the target group – men between the ages of 35-55 years – in the pub setting. The key aim of the specific pub-based intervention – referred to as the NHS Health Check and Wind Down initiative – was to raise awareness of the potential harms of drinking and reduce the levels of hazardous drinking within the identified target group.   In order to understand the impact of this initiative, the Cheshire and Merseyside Public Health Network commissioned the Centre for Public Health Research at the University of Chester to carry out an evaluation.  Drink a Little Less, See a Better You: the NHS Health Check and Wind Down initiative  The Cheshire and Merseyside Public Health Network social marketing campaign was targeted at a sub-group of the Ties of Community cluster, namely men between the ages of 35-55 years, who tend to drink outside of the home – predominantly in pubs. It ran for eight weeks in each pub. Health checks were provided by an outside company or pharmacists and were offered through an appointments system. Appointments were offered between 4.00–7.30pm on one or, in some cases, two evenings during the eight week period. The Wind Down was scheduled to run between 10.00-11.00pm Monday to Thursday and was the time when customers were encouraged to drink an alternative soft drink or low alcohol drink, for which they would be entered into a prize draw. The initiative was supported through a range of creatives that were displayed in the pub.  Aim of the evaluation The key aim of the evaluation was to understand the impact of the intervention from different stakeholder perspectives: men in the target group; those outside the target group but who were drinking in the pub during the period of the intervention; and, key members of bar staff who were directly involved in supporting the intervention.  Methodology The overall study design comprised a series of case studies, each ‘case’ being the pub in which the intervention was delivered. Five pubs in the Cheshire and Merseyside sub-region consented to take part in the evaluation. At each case study site the following data collection activities took place:  baseline questionnaires (one to two weeks prior to the intervention) and follow-up telephone interviews (approximately 10 weeks later) with men from the target group;  site visits to conduct observation of the intervention, particularly the Wind Down element of the intervention;  semi-structured interviews with the bar manager.  In addition, data that were collected as part of the intervention were analysed in order to build up a picture of how people were engaging with the intervention:  summarised group-level data from the health checks;  data on numbers entering the prize draw;  data on numbers of text messages sent and opened.  Key findings Health checks  In the five pubs a total of 91 health checks appointments were offered; 55 (60%) people took up this offer.  The take up rate of the health checks varied from pub to pub, ranging from 86% to 7%.  The health checks identified a number of health risks: o 65% (36 people) were overweight/obese/very obese; o 48% (16 people) had a body composition that was categorised as ‘poor’, indicating a high proportion of body fat rather than lean muscle; o 45% (25 people) were smokers; o 80% (44 people) had a weekly alcohol consumption that exceeded the recommended units; o 20% (11 people) had a systolic blood pressure above 160 mm/mg or diastolic above 1000 mm/mg; o 53% (26 people) had a waist circumference that put them at increased risk of cardiovascular disease.  Overall, qualitative data revealed that people thought the idea of delivering health checks in a pub setting was a good one.  A number of reasons were given by research participants for why: o a way of accessing those who tend not to go to the doctors, particularly men; o a way of detecting health needs that were not being met; o a way of raising awareness about one’s own personal health; o a way of spreading awareness within the pub to a wider group of customers  The Wind Down  Overall, there were mixed feelings about the Wind Down: o good in theory but not in practice; o not appropriate for a pub; o a good idea – it helps you ‘wind down’.  The entries to the prize draw suggested that it had been a limited success in terms of those who had purchased a low alcohol or soft drink.  The creatives  Overall, feedback on the creatives was positive: o right tone; o humorous messages; o not ‘preachy’.  Impact of the initiative  There was evidence of behaviour change in terms of: o reducing alcohol consumption; o changing eating habits; o seeking out help from GPs to follow up on results received and advice given.  There was evidence of increasing awareness about possible health risks from certain activities and the importance of seeking advice from health professionals at an early stage.  What worked?  The pub was used as a ‘gateway’ to accessing men who had unmet health needs.  Access to the pub as a setting for the delivery of the initiative was negotiated successfully by the Cheshire and Merseyside Public Health Network Social Marketing team and was a key step in the process of implementation.  The NHS Health Check and Wind Down social marketing initiative was, overall, acceptable to bar managers and customers.  The fact that the pub is a valued social setting was used to an advantage in terms of: o accessing people who were at risk but who had the time to become involved in the initiative; o providing a forum for generating conversations amongst customers that maximised the impact beyond those who had directly participated in health checks.  The bar managers were critical to the success of the initiative and played an important role in facilitating implementation through their relationships with their customers.  The creatives provided a series of subliminal messages that supported the overall initiative.  The health checks worked for customers because of: o the duration of the appointment – approximately 30 minutes of one-to-one contact with a health professional; o the informal, relaxed  and supportive interaction between those delivering the health checks and customers; o the relative privacy; o the immediacy of the test results; o the personalised advice on the basis of individuals’ results.  Future developments  Prime the audience by promoting the initiative through the creatives in advance of the intervention.  Maximise the impact of the creatives by considering their placement and size within the pub setting.  Support sustainability of changes through an ongoing relationship with pubs, perhaps through the continued placing of creatives and other materials in the pub.  Consider the pub as a gateway to people with unmet needs.  Increase the volume of health checks, perhaps with a widening of the criteria to make them accessible to other target groups with unmet needs.  Re-consider the Wind Down in the light of the differentiated nature of customers’ patterns of pub usage.  Reconsider the use of the prize draw as an incentive to engage with the Wind Down.  Maximise the impact of the bar manager in the implementation of the intervention, perhaps by incentivising the role.  Conclusion The findings from this evaluation would suggest that the NHS Health Check and Wind Down initiative was successfully implemented in pub settings, was acceptable to customers and bar managers and led to improvements, amongst some people, in awareness and behaviours.   

An evaluation of the Cheshire and Merseyside Public Health Network 'Drink a Little Less, See a Better You' social marketing campaign

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An evaluation of the Cheshire and Merseyside Public Health Network 'Drink a Little Less, See a Better You' social marketing campaign

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