Creating persuasive messages to promote abstinence from alcohol during pregnancy

While the rates of Fetal Alcohol Spectrum Disorder within Australia are unknown, the rates of alcohol use during pregnancy and at-risk alcohol use by women of childbearing age highlight the need for universal prevention strategies addressing prenatal alcohol exposure. Though many awareness-raising campaigns for alcohol use during pregnancy have been conducted, predominantly in North America, they have rarely been developed using formative research nor have they been comprehensively evaluated (Saskatchewan Prevention Institute, 2009; Elliott et al., 2008). This lack of published information on the development and evaluation of campaigns makes it difficult to determine what communication elements are most credible and persuasive for the target audience. This study conducted theory-based formative research to develop and test messages suitable for a mass media campaign targeting women who may consume low to moderate levels of alcohol during pregnancy. In alignment with the Australian national guidelines for alcohol use by pregnant women (National Health and Medical Research Council, 2009), the aim was to create messages that increased women‟s intentions to abstain from alcohol during pregnancy. An exploratory phase comprising four focus groups with pregnant women and women of childbearing age living in Perth, Western Australia identified motivators for behaviour change and provided insight into the theoretical constructs that could be used to guide the creation of persuasive messages. Positive motivations for abstinence, such as a desire to feel in control and gain social approval were identified, as were several negative motivations, such as wanting to be free of fear and worry, and to avoid possible poor pregnancy outcomes. Along with constructs from social cognition models such as Protection Motivation Theory (Maddux & Rogers, 1983; Rogers, 1983, 1975), these data underpinned the development of a series of communication objectives and communication materials, such as television concept executions, and copy and graphics for print media. The communication materials were then tested through five focus groups with pregnant women, women of childbearing age and male partners to identify those that were most motivating, and to identify specific copy and execution elements that appeared to enhance the persuasiveness and credibility of messages. Two television concept executions, one a threat appeal based on fear and worry, and the other a positive appeal based on self-efficacy, had particularly good potential to motivate behaviour change. These became the basis for five final concept executions that were tested against a control with 685 women (520 women of childbearing age and 165 pregnant women). Results showed the concept executions containing a threat appeal were significantly more effective at increasing women‟s intentions to abstain from alcohol during pregnancy, compared with the control and positive appeal. This study provides evidence of messages effectively increasing women‟s intentions to abstain from alcohol during pregnancy. It demonstrates the value of using theory-based formative research with the target audience to inform the creation of messages that promote abstinence from alcohol during pregnancy. The results and recommendations have direct implications for the potential use of threat appeals and self-efficacy messages in mass media campaigns aimed at preventing prenatal alcohol exposure.

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