Alcohol media literacy interventions aim to develop capacity for critical analysis of alcohol-related media content in children and young people, in order to facilitate ability to resist pre-alcohol portrayals. This study reviewed evaluations of such interventions to understand factors supporting effectiveness including intervention content; theories of change; key mechanisms of delivery; strengths and weaknesses in current evidence and issues pertaining to potential adaptation for delivery in a UK context.
The review methods drew on Realist principles to better assess what works for whom in what circumstances and in what respects, and how? (Pawson and Tilley, 1997). An inclusion criteria was developed to identity relevant studies published in English between 2007 and 2017, with comprehensive searches resulting in a total of nine relevant studies identified for review.
Due to lack of evidence from UK studies and limitations in understanding youth exposure to channels of alcohol messaging, key questions were also explored through qualitative fieldwork. The overall aim of this was to consider the relevance of review findings for UK pupils, to better understand any necessary adaptations of existing media literacy interventions and/or testing issues for intervention development. Year 6 pupils (age 10-11 years) were recruited from three primary schools in South Wales, with a total of 28 children taking part.
Media literacy interventions as a means to enhance critical appraisal of media messages are somewhat supported in this review. Evidence suggests that interventions delivering core skills of media literacy within the school day consistently deliver positive outcomes for general population groups. Although there is some evidence of potential applications to higher risk groups and delivery in other settings, this is presently too limited for conclusion. Further research is recommended, both into delivery for at-risk populations and to understand whether media literacy is more effective than other interventions that theorise consumption in at-risk populations differently. Adaptation of intervention content to incorporate local advertising by country/region is supported however content here was focussed primarily on traditional forms of alcohol advertising, with limited inclusion of newer media.
Methodological variations were identified in use of control groups and baseline measures. Evidence suggests that, although core media literacy skills are commonly assessed at pre and post-test, exposure to alcohol advertising is not routinely captured at baseline, reflecting an underlying assumption of media exposure as relatively homogenous across youth populations. Further limitations include a lack of longitudinal follow up data to assess impact of future drinking behaviour. Intervention theorisation is based on the association between alcohol advertising, the development of alcohol norms, and subsequent alcohol behaviour, and it is therefore arguable that variations in baseline measures of exposure, as well as subsequent measures of consumption for older participants, are important for better understanding of whether this theorisation is supported. At present, evidence of alcohol media literacy interventions as reducing future drinking behaviour is weakly supported, necessitating further longitudinal research with young people.
In light of identified limitations, particularly lack of UK evidence, exploratory focus groups were convened with Year 6 pupils to consider: circumstances surrounding exposure to mainstream media alcohol advertising in children; children’s exposure to alcohol advertising through new (social) media; and degree of homogeneity in youth exposure to alcohol advertising, including by gender. Within groups, recall of alcohol-specific adverts was low and, where remembered, was relatively equal between traditional and online media. Media literacy intervention theory defines youth as active viewers, who engage with media messages rather than passively receiving them, and this was supported here by data suggesting that youth actively choose to disengage from alcohol media where it holds no interest. Newer options for TV viewing e.g. catch up, streaming services, online viewing etc. mean that adverts are often skipped over, suggesting greater choice is now possible over exposure as long as digital literacy is present. Participant capacity to be an active viewer was associated with own levels of awareness and use of media technology, suggesting that intervention development would benefit from adaptation for modern viewing practices to potentially incorporate content on active avoidance.
While ads for alcohol brands were not widely cited, supermarket advertising had greater penetration, with strong recall of use of multi-buy offers, special occasion promotions etc., both online and in mainstream media. The advertising style employed by supermarket promotions tends to avoid the more typical presentations seen for branded products, for example through presentation of young, social groups engaged in desirable activities. As supermarket use of media reinforces known high levels of youth exposure to alcohol promotion in store (Chambers et al. 2017), it should be considered whether analytical activities employed in alcohol media literacy interventions would be effective for supermarket marketing, in light of the frequency of exposure identified here.
Family acted as a significant influence in relation to exposure to alcohol advertising, with multiple pathways identified. Alcohol advertising and marketing were more frequently viewed within family viewing time in relation to TV and through family social activity, such as attending sports events or eating out. Exposure through media was limited by parental application of control settings and levels of monitoring of youth media use, illustrating the importance of parental technical literacy, for example in settings controls on household accounts. This suggests that the presence / absence of parental media literacy and application of parental controls should be considered in devising interventions. Family involvement has been observed here as complex and multi-layered, suggesting that intervention theory development should consider family behaviour more broadly, as well as potential changes to family influence as youth transition through different school contexts.
Alcohol media literacy interventions aid development of key critical analysis skills in young people and have potential applications in a UK context. Evidence suggests that the concept of advertising exposure underpinning alcohol media literacy interventions may benefit from expansion to incorporate broader types of exposure to alcohol marketing and promotion cited by participants. Testing inclusion of different forms of media as intervention components is recommended and will arguably still be amenable to the critical appraisal skills taught in media literacy (Jolls and Wilson, 2014).
Although evidence suggests that media literacy may be effective in delivering core skills across the range from early to late adolescence, the incorporation of newer viewing behaviours has implications for most effective age for delivery, with focus group data highlighting the need to reach younger audiences with the required generic technical skills for early media engagement. Exploratory research to better understand patterning and context of youth viewing of alcohol media is necessary to facilitate development of intervention content. This includes the potential role of the family in moderating intervention effects. Further research into changes to youth exposure to alcohol media by age is recommended, followed by intervention adaptation and testing to determine most effective use of this approach.
Contact details for corresponding author:
Dr Rachel Brown, DECIPHer, 1-3 Museum Place, Cardiff, CF10 3NB
Chambers, T., Pearson, A.L., Stanley, J., Smith, M., Barr, M., Ni Mhurchu, C., & Signal, L. 2017. Children’s exposure to alcohol marketing within supermarkets: An objective analysis using GPS technology and wearable cameras. Health and Place, 46, pp. 274-280.
Jolls, T. & Wilson, C. 2014. The Core Concepts: Fundamental to Media Literacy Yesterday, Today and Tomorrow. Journal of Media Literacy Education. 6 (2), pp. 68-78
Pawson, R. & Tilley, N. 1997. Realistic Evaluation. London: Sage.
