Essay by an American alcohol campaign. The health problem has been described, followed by the communication strategies used and an explanation of why we; /are not effective and an example of gamification. Rated 8.5! Obtained during my master's degree in Health sciences
Bring the message across to Live better & Drink less
Name: Laura Joosse Date: 3 February 2023
Student number: 2741738 Course: Communication Campaigns and Research
In the United States, individuals over the age of 18 consume an average of 8 liters of pure
alcohol per year, which is higher than the global average of 6.4 liters (WHO, 2018). Alcohol
consumption is a significant risk factor for disease and death globally and is the ninth-largest contributor
to disability-adjusted life-years (GBD 2015 Risk Factors Collaborators, 2016). Additionally, excessive
alcohol use harms people's health and brings social and economic losses for individuals and society as a
whole (WHO, 2018). To address the health and social-cultural impact of alcohol consumption, the Pan-
American Health Organization (PAHO) has initiated an awareness campaign called ‘’Live Better, Drink
Less.’’ The campaign aims to raise awareness among American adults about the health and social
benefits of reducing alcohol consumption (PAHO TV, 2021a) and tries to intervene before any health
effects occur by changing health behaviors that fit the primary prevention aim (Brug & van Assema,
2017). The behavior the campaign targets explicitly is making American adults drink less alcohol to
reduce many alcohol-related conditions. The campaign includes various components, such as posters,
videos, and a website (PAHO TV, 2021a). The video ‘’Live Better, Drink Less’’ will be the main
campaign material to evaluate the most prominent used message factor and the expected effectiveness.
Followed by message factor recommendations, the use of gamification, and the potential unintended
effect. A brief description of the campaign video can be found in Appendix A.
Message factor, behavioral determinants and the Theory of Planned Behavior
The campaign uses different message factors in the video, such as framing, fear appeal, affect,
and evidence. Affect is defined as the experience of emotion and can be distinguished into different
forms, such as anticipated emotions (PAHO TV, 2021a; Loewenstein et al., 2001). The campaign video
uses this message factor, anticipated emotions, most prominent (Loewenstein et al., 2001; Koch, 2014).
Anticipated regret is a form of anticipated emotions that are not experienced in the immediate present but
are expected to be experienced in the future and evoke certain feelings of regret (Loewenstein et al.,
2001; Koch, 2014). This is shown in the video by a scene in which a man drinks too much while being in
a bar with friends. Followed by a scene where the same man arrives at his apartment and fails to enter his
front door. At the end of the video, the same man gets offered a second beer and, in a moment of
hesitation, declines it (PAHO TV, 2021a). By emphasizing the moment of hesitation of the man (e.g.
‘Shall I take a second beer, and end up like last time?’), the feeling of regret (e.g. ’I will regret after I
have consumed to much alcohol’) is focused on (Chapman & Coups, 2006; Koch, 2014). The campaign
uses anticipated emotions, such as anticipated regret, and might use this as a communication strategy to
change the attitude and, thereby, the intention of a person to drink less alcohol. To explain the
relationship between anticipated regret, attitude and intention the Theory of Planned Behavior (TPB) will
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be used. TPB is a social psychological model that aims to explain human behavior by predicting the
intention to perform a behavior and actual behavior (Azjen, 1991). According to the TPB, the primary
determinants of future behavior are a person’s intention to perform the behavior (e.g. ‘I intend to drink
less during this weekend’). In turn, intentions are predicted by the variables attitude, subjective norms
and perceived behavioral control. Attitudes are a person's positive or negative evaluation of the behavior
(e.g. ‘For me drinking less alcohol this weekend would be…’ unpleasant or pleasant). Subjective norms
are a person’s perception of other people's opinion regarding to the performed behavior (e.g. ‘Most
people who are important to me think that I should drink less this weekend’). Perceived behavioral
control refers to a person’s sense of control over performing the behavior (‘I am confident that I am able
to drink less this weekend’) (Azjen, 1991; Bhochhibhoya & Branscum, 2018). In my opinion, the
campaign video clearly focussed on changing a person’s attitude towards drinking less alcohol. This
appeals by showing many scenarios where people experience unpleasant feelings that might occur
through drinking too much alcohol and ending with evaluating this behavior. Referring back to the TPB,
attitude emerged as the strongest determinant of intention (Azjen, 1991; MCEachan et al., 2011). In
addition, Koch (2014) found that anticipated regret has a direct influence on a person’s intention toward
health and safety behavior. In sum, the video uses the message factor anticipated regret to influence a
person’s attitude and intention towards drinking less alcohol.
Effectiveness of the message factor anticipated regret
As previously mentioned, anticipated regret is used in the campaign to evoke certain feelings
of regret (PAHO TV, 2021a; Koch, 2014). The campaign video might use an effective approach to
reduce alcohol consumption among American adults by responding to the behavioral determinants
attitude and intention through the use of anticipated regret. To start, McNally and Palfai (2001) found
that negative emotional expectancies predicted willingness to reduce alcohol consumption. In addition,
Cooke et al. (2007) suggest that it may be wise to emphasize regret in health promotion campaign
material, such as leaflets, aimed at reducing alcohol consumption because of the finding that anticipated
regret mediated the relationship between past drinking behavior and intentions (Cooke et al., 2007). If a
person has had unpleasant experiences with drinking alcohol, these experiences are very likely to be
included in their feelings of anticipated regret (Cooke et al., 2007). The strength of this campaign is that
they clearly respond to anticipated emotions and past drinking experiences by showing several everyday
life situations in which a person can identify previous unpleasant experiences due to alcohol
consumption. A possible improvement to make this message factor even stronger is the use of anticipated
quotes. In the video, they show after each scene a transition frame with a glass of alcohol being filled.
This ‘transition frame’ after the scene of domestic violence can be replaced with an anticipated quote like
‘’I will never hit you again.’’ Another example could be after the scene in which the woman is cooking
alone because the man has consumed too much alcohol, an anticipated quote like ‘’I promise it will never
happen again.’’ These quotes, in which the feelings of regret are clearly reflected, would reinforce this
message factor and can be found in Appendix B.
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