Monday, May 19, 2014

Ensuring the Success of Our Youth: A Critique of Our Current Approaches- Divya Mehta

        Underage alcohol use is one of the most pervasive problems affecting our youth. The period of adolescence is one filled with discovery, the development of one’s identity and the launching pad for many of the decisions that will affect their future lives. The issue of alcohol use in this population is not a novel one, but rather a problem that has plagued many generations of vulnerable youth. In 2009, the CDC reported that 48% of the deaths in youths between 15-19 were due to accidental injuries(1). This figure also includes 5,000 deaths a year attributed to alcohol consumption such as motor vehicle accidents, alcohol poisoning, or homicide. These numbers have been increasing rapidly with each passing year and there have been numerous campaigns targeting these youth in an effort to decrease their alcohol consumption.  
      In a time during which various forms of media are a continual part of one’s day, there’s a multitude of different messages being sent to these youth and many are struggling to determine the best course of action for their health and lives. Whether it’s through advertisements for specific brands or the inclusion of teenage drinking in popular TV shows, the message often targeting the youth is that alcohol consumption is a natural part of growing up and represents the transition from being a naive kid to becoming an adult. There has been no shortage of public health campaigns trying to stem this movement such as “Say no to Drugs” or “D.A.R.E” (2,3). However, none of these programs has been effective in altering the level of alcohol consumption in adolescents in the long term due to their inability to make messages that appeal to their target audience.
          One of the most recent campaigns is “My Instead”, which uses videos to reach out to teens about the benefits of abstaining from alcohol consumption and choosing another activity to fill their time(5,). Their main promotional video focuses on a young group of teens, approximately middle-school age. The first scene outlines the group dynamics in which one of the teens is clearly the bully and is trying to convince one of the other boys in the group to steal a bottle of liquor from his parent’s party they are about to have that evening. He brags about being the only member of the group who has tried alcohol and puts pressure on the other boy to provide them alcohol so they can all try it like him. The boy who is pressured spends the remainder of the afternoon planning the best way to steal the bottle with another female member of the group who he is romantically interested in. After obtaining the bottle, the entire group meets up and prepares to open the bottle. The video then allows the viewer to watch three potential endings to this scenario. The first involves the pressured boy spilling the alcohol on the bully and refusing to drink it, which gains the approval of the female character. The second option involves a family member coming to look for the alcohol. He offers them different options for why drinking would be bad for them and the dangerous effects it could have.  The last scenario involves the boy giving into the pressure and ultimately throwing up on the girl which causes all of the friends to leave his house.
Ineffective Use of Social Learning Theory
     I believe that this video and campaign were attempting to employ the Social-Behavioral model of Social Learning theory to present its message. The main premise of this theory is that the primary form of learning occurs through interactions with peers and other members of a person’s life (4). These interactions are believed to be the basis for the development and continuation of new behaviors.  However, in order to encourage the individuals to adopt the behavior, the model should be similar and relatable to that person.  I believe that the use of a group of children as opposed to an individual in this scenario was effective because it did allow for the viewer to observe how group dynamics impacted the decisions made, which is a common part of social interactions. However, one of the reasons this video failed was the age group used is far younger than the target audience for these videos.  Studies have shown that adolescent drinking can commence during middle school, but media campaigns are far more ineffective than school or community-based campaigns(6,7). Studies have shown that targeting middle-school aged children is effective in the short term, but this behavior change isn’t maintained as they get older(6, 9,10).In addition to the effectiveness of alcohol interventions, the majority of adolescents have their first experience with alcohol in high school (8,11)  The target audience for alcohol campaigns is 15-19, which also corresponds with a period when their emotional and social skills are continually evolving(12). In addition, adolescents are eager to accentuate this emotional development by striving to appear as mature as possible. Showing them a video of younger children stealing alcohol would be completely unbelievable and would lead to them mocking it as opposed to using it as a learning tool.
     Another issue is that they only focus on the motives of the boys within the group for drinking, but don’t provide any motivation for the girl in the group except that she’s going along with what her crush is doing. Alcohol consumption is a problem for both genders, and this video primarily focuses on the males’ behavior. The focus on this type of behavior only reinforces the misconceptions that surround drinking in young females. The most recent reports from the Partnership for Drug Free America showed that teenage females who report drinking by the age of 18 has increased dramatically by 15% during the past 15 years and is now the same as teenage male drinking rates(12). One of the contributors to this increase is the availability of fruity and sugary drinks which encourage binge drinking among this population. However, the primary contributor is that females are increasingly turning to alcohol use to self-medicate in response to increasing stresses at school or home. Thus, by introducing a character whose primary motivation is mimicking her romantic interest, this campaign is failing to create a model that is similar and relatable to the target population.
Resistance to Authority Figures
     The use of scare tactics by authority figures has been a strategy used by public health officials to combat the rise in alcohol use in teenagers, but has demonstrated little success. Adolescents are generally very resistant to following the advice of their parents and often strive to behave in a way that defies them. This type of behavior is described by the Psychological Reactance theory, in which people react strongly when they perceive that their personal freedoms or ideals are being infringed upon(13). For teenagers, the ideal that they treasure the most is the freedom to make their own decisions and assert their independence. In this video, the only time that the detrimental effects of alcohol use is mentioned is by the boy’s uncle who is looking for the missing bottle of Tequila. While using the uncle to spread this knowledge slightly reduces the resistance the teens might have to his message, he still represents a source of authority which the teenagers are unlikely to follow. The act of stealing this bottle of alcohol is the first rebellious action and allows him to assert a position of power amongst his group of friends. For teenagers watching this video, it is likely that this feeling of power is something that they would relate to. However, the advice given by the uncle would likely be very ineffective in changing their behavior because it is in direct opposition to the actions that they are taking that make them feel more confident and powerful. In addition to inducing resistance in adolescents, scare tactics often induce more anxiety and stress. Many studies have suggested that this increased stress actually causes the teenagers to drink more to assuage these feelings as opposed to stopping.
Failure to Utilize Marketing Theory
     One of the primary reasons why many public health campaigns fail in reaching their target audiences is because they don’t employ some of the same techniques that the large alcohol companies do. The primary theory that the alcohol industry uses is Marketing Theory(14). It relies on appealing to the core values and desires of the consumers, and then structuring their product in such a way that it appears to fulfil these aspirations. As mentioned previously, the general goals that all teenagers generally have are to gain freedom from authority figures and to have control over their lives. However, the only theme of gaining freedom and control in this commercial is linked to how the boy feels when he steals the bottle of alcohol. Within his group, he is generally considered the odd one out and is bullied for not doing all the same activities as the cooler kids within his group. At the beginning of the video when they are first discussing drinking, the two popular kids within the group belittle the boy and his crush for being the only ones to not try alcohol. By providing the group with alcohol at the end of the video, he establishes himself within the group as the leader who has the power. Thus, instead of using their desire for power and control to promote abstaining from alcohol, this video is actually more effective in demonstrating that drinking will allow you to achieve your goals.  
     Another way in which this video fails to appeal to the desires of the target population is its length. Due to the rapid development and integration of social media into the lives of teenagers, they have become reliant on short bits of media to provide them information and entertainment. Between Facebook and Twitter, most of the messages they are able to broadcast are limited to less than 200 characters. The target audience for this message is not interested in long, drawn out videos, but rather something short that they can absorb quickly. The main body of the video lasts for 5 minutes and each of the alternate ending videos require clicking on a different link and last up to a minute. It is highly unrealistic that adolescents in the target audience would actively watch this video, given its’ content on alcohol use. This video is also only available on YouTube and has not been marketed onto any other form of social media that would be more readily accessible.
Proposed Modifications to Model
     While I commend this campaign for employing the use of group dynamics in this promotional video, I don’t believe they were successful in providing models that their target audience can relate to. One of the ways in which they could resolve this issue would be to produce informational material that is age-specific. There is a wide age range that is being targeted by these messages, which does make it an issue to create material that can effectively appeal to all of the different age levels. Since the premise of this campaign is to show the target audience what they could be doing instead of drinking, a potential idea would be to make promotional materials that contrast the activities that the teenagers could be engaging in at each different age rang to their lives while drinking. This structuring by age would allow the target audience to not only better identify with the models presented, but also observe the progression of their behavior and lives if they choose to drink at this young age. I believe that these modifications would better suit the target audience and make the campaign more successful in reducing alcohol consumption.
     In addition to adjusting the age demographics for the target audience, I believe a significant improvement would be tailoring their campaign to address the differences that gender has on the rates of adolescent drinking. As mentioned earlier, alcohol consumption in teenage girls is now equal to that of boys, but most of the campaigns only focus on the boy’s motivations for drinking. Females are primarily drinking as a way to deal with the intense pressures they are feeling emotionally and physically. One way to combat this might be show promotional videos in which the females are exposed to stress but are able to use other healthy alternatives for stress relief such as enrolling in yoga, outdoor activities, or joining the arts. In addition to encouraging teenage girls to find an activity that they enjoy, it would also be helpful to emphasize that using alcohol to combat emotional problems and stress is only a temporary solution, but that there are other options out there that will provide them more relief in a more positive way.  Another comparison of a life with and without these activities I believe would provide female teenagers with a model for how to deal with some of their issues in a healthy and productive way.
 Alternatives to Scare Tactics
          There have been numerous campaigns at the high school and college levels that have tried to employ different techniques other than scare tactics. A potential model for this program is the “truth” campaign, an anti-smoking campaign. One of the most effective aspects of that campaign was their way of presenting the facts which are still just as chilling, but in such a way that was accessible to the viewer. Whether it was laying out body bags or singing about how “5 million deaths must be a typo”, the creators of this campaign were able to present the audience with the same type of facts that are thought provoking(15). Many studies have shown that this campaign was extremely successful in providing more information to students while decreasing the smoking rates in adolescents who viewed the commercials (15). While deaths due to alcohol aren’t on the same scale as those due to smoking, the fact that 5,000 teenagers die each year from alcohol-related incidents would likely be a shocking fact to teenage drinkers. Inundating teenagers with facts isn’t necessarily effective, but providing them with more information about the consequences on a larger scale might resonate with them. A potential ad campaign for teenage drinking might involve a hundred teens standing in a crowd and being partitioned off to represent the different proportions of teens that die each year from various causes. As I mentioned earlier, 48% of teenage deaths are due to accidental injuries and a percentage of that population are those injuries due to alcohol use. By representing these statistics with actual people, it might be able to get the message across to the audience that accidents and life events happen to all of us, but those that involve alcohol use are avoidable and only you can make that choice to make yourself safer. This way of structuring this information I believe would provide information to these teenagers to reinforce the idea that they aren’t invincible and the choices they make do have consequences.
Altering Appeal of Target Message
One potential solution is to employ the use of labeling theory. The basic premise of this theory is that a person’s behavior is influenced by the way that they are perceived by outsiders and they will conform their actions to fit this “label” they are given(16). Cornell University developed the “Smart Woman” anti-drinking campaign on their campus using this theory. Their primary focus wasn’t necessarily on stopping drinking on their campus, but rather encouraging them to make smart decisions when drinking so that they maintained their safety. They appealed to the “label” that smart woman make good decisions and that every woman on their campus is a “smart woman”. Their intent is that the women on the campus would adopt this label and act in a safe way while drinking. Some of the posters for this campaign showed images of a “smart woman’s purse” before going to a party which included bringing along money for a cab fare at the end of the night and a condom just in case something happened. They also launched a separate campaign for men that included posters with the slogan, “Smart Men Pre-Game with Food”.  Follow-up surveys on their campus displayed a significant decrease in the number of alcohol related incidents on campus involving women after the conclusion of this campaign (17). I believe that the primary benefit of using labeling theory in alcohol prevention is that it appeals to the positive traits within people and builds them up instead of focusing on their flaws that lead to them making bad decisions. One way to apply a concept like this at the high school level could be to appeal to teenagers through the different activities that they are involved in. For example, if they wanted to focus on a teenager that is really involved in the music world, they could show the everyday items that they need to achieve their goals of becoming a professional performer. This could include the sheet music that they learn from, a guitar pick, and a bottle of water among other items. The advertisement could label the water as the key to their success because it hydrates their vocal chords and makes them better singers. The bottom of the advertisement could mention that a successful musician has these items in their toolkit and focus on how alcohol isn’t included. This advertisement would use labeling theory but presenting them with the label of successful musician that they would want to live up to. By presenting some of the items that they need to achieve this success, they are building up the image that if they combine their talents with these tools, that they have the ability to achieve their life dreams which don’t involve alcohol use.    
     While there have been numerous studies that have examined the use of television and radio in public health campaigns, there have been few papers that have examined the effectiveness of using social media to disseminate the knowledge. I believe that in order to reach teenagers in an effective way, we need to alter the way in which we are providing them information. One way to craft these messages would be to employ the use of advertising theory. When many advertising firms are developing advertisements, they do copious amounts of research to determine the primary characteristics of the demographic that they are targeting. I believe that we should use this same level of examination to determine the best way to target adolescents.  Twitter and Facebook are two of the primary forms of social media used by teenagers and if we could create content that could be used on these platforms, I believe that we would to provide the message in an applicable way. One of the most popular items that are shared on these sites are “memes” which are pictures or small movies with writing associated them that portray usually a humorous or thoughtful message. A particular meme that was circulating social media was one that focused on a particular activity or profession and provided the different ways in which people perceived that same activity. For example,  a meme that focused on teachers portrayed them thinking that their job saves the world whereas the children view them as slave masters that rule their life. I believe that making a meme like this about alcohol use would be one potential way of showing adolescents the different perceptions their peers and parents have of drinking. By putting this message in a form of media that they are comfortable with seeing, I think this would an effective way of reaching them and providing them with the information that they need to make decisions about drinking.
     The “My-Instead” Campaign is one that attempts to provide their target audience with the knowledge about the effect that alcohol use can have one an adolescent’s life. While they do employ certain techniques such as the use of groups to display the importance of group dynamics in these types of decisions, there are three main flaws in their delivery of their message. They most importantly fail to employ Social Learning Theory to create a model that other adolescents can relate to when actively choosing not to drink and fail to address the differences in motivations for drinking between genders. This campaign also tries to use scare tactics and don’t market this information in a way that appeals to their target audience. My first solution was to create advertisements or videos that focus on alcohol consumption at different ages and genders to provide better models that the entire target audience can relate to. I also believe that using labeling theory will enable students to feel empowered in making decisions that will lead them to their eventual life goal without using alcohol along the way. Lastly, using forms of social media would be a more effective way to provide this information in a context that is easily accessible to the target audience and mirrors the content they use in other parts of their lives. Adolescent drinking is a serious problem that needs to be addressed in order to ensure that the future generations of adolescents are able to achieve their full potential without being hindered by poor life decisions.

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17.   Cornell University. Smart Woman Campaign. 2006

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