Stigma and Opioid Harm Reduction Creatives and Message Focus Testing

Final Report

Prepared for Health Canada

Prepared by Narrative Research
PSPC Contract Number: HT372-224172
Contracted Value: $43,363.75
Contract Date: 2022-05-30
Delivery Date: 2022-08-25
POR number: 008-22

For more information, please contact: cpab_por-rop_dgcap@hc-sc.gc.ca

Ce rapport est aussi disponible en français

Stigma and Opioid Harm Reduction Creatives and Message Focus Testing

Final Report

Prepared for Health Canada

Supplier Name: Narrative Research
August 2022

This public opinion research report presents the results of focus groups conducted by Narrative Research on behalf of Health Canada. The research entailed a total of six online focus groups with males in physically demanding professions in targeted communities located in each of six regions: British Columbia (BC), Alberta/Prairies, Ontario, Quebec, Atlantic, and Northern territories/regions. Participants had current or past employment in designated physically demanding occupations (primarily construction trades) and were between the ages of 20 and 59. All sessions included a mix of cultural backgrounds, including Indigenous representation, and only those living in market for at least two years were invited to take part. The Quebec session was conducted in French while all other discussions were held in English. The research was conducted between July 28 and August 3, 2022.

Cette publication est aussi disponible en français sous le titre :
Mise à l’essai de messages et de documents créatifs sur la réduction de la stigmatisation et des méfaits liés aux opioïdes
This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from Health Canada. For more information on this report, please contact Health Canada at: cpab_por-rop_dgcap@hc-sc.gc.ca

Catalogue Number:
H14-413/2022E-PDF
International Standard Book Number (ISBN):
978-0-660-45290-6
Related publications (registration number: POR-008-22):
Catalogue Number H14-413/2022F-PDF (Final Report, French)
ISBN 978-0-660-45291-3

© His Majesty the King in Right of Canada, as represented by the Minister of Health, 2022

Table of Contents

• Executive Summary
• Introduction
• Research Methodology
• Research Findings
• Video
• Call-to-Action
• Audio Assets
• Digital Display Ads
• Social Media Posts
• Conclusions
• Direction

Appendices:

Appendix A – Recruitment Screener
Appendix B – Moderator’s Guide
Appendix C – Materials Tested

Executive Summary

Narrative Research Inc.
Contract Number: HT372-224172
POR Registration Number: 008-22
Contract Award Date: 2022-05-30
Contracted Cost: $43,363.75

Background and Research Methodology

With the significant increase in apparent opioid toxicity deaths since the beginning of the COVID-19 pandemic, Health Canada is in the process of developing a new creative concept and visual identity as part of the Department’s multi-year marketing campaign to address the growing opioid overdose crisis. As part of the campaign development, a new creative concept with a new visual identity is being considered as part of targeting a particular audience (rather than the broader audience of young- to middle-aged men in Canada that were targeted in previous campaigns). The campaign aims to:

• Provide men in physically demanding professions with tools and resources to learn more and access supports for substance use and addiction.
• Inform men in physically demanding professions of risks associated with substance use and promote help-seeking and resources for mental health, substance use and pain management.
• Provide resources for those who want to support men in physically demanding professions who may be struggling with substance use and addiction.
• Reduce the stigma associated with addiction and help-seeking/accessing treatment.
• Shift Canadians’ (especially men aged 20-59) attitudes and perceptions that contribute to stigma of those struggling with problematic substance use (de-stigmatization).

In this context, Health Canada was interested in testing the creative concepts developed as part of this marketing campaign, to determine which concept resonates most with the targeted audiences. More specific research objectives included:

• Determine if the content of the concepts tested was clearly understood, credible, relevant and of value to the audiences, appealing and appropriate, memorable, and able to motivate the audience(s) to take intended actions.
• Compare content options to select the best language and presentation of key messages to the target audiences.
• Capture suggestions for potential changes to ensure the messages and products resonate with the target audiences.

To achieve these objectives, a qualitative research approach was undertaken. This entailed a total of six online focus groups conducted between July 28 and August 3, 2022 in specific communities located across six regions: British Columbia (Vancouver, Thompson-Caribou, Fraser), Prairies (Medicine Hat, Edmonton, Calgary, various communities in Saskatchewan and Manitoba), Ontario (Thunder Bay, Sudbury, Toronto, Guelph, Ottawa), Quebec (Montreal and Québec City), Atlantic Canada (Fredericton, Moncton, Halifax), and various communities in Northern Territories or northern regions of provinces. In each region, one focus group was conducted with males aged 20 to 59 who work currently or formerly in physically demanding professions (predominantly in the construction sector). Sessions included a mix of cultural backgrounds, including Indigenous representation.

Each session lasted between 90 minutes and two hours and all group discussions were held in English except for one in Quebec which was conducted in French. Participants were provided an incentive of $125. Across all groups, a total of 59 individuals were recruited and 45 participated.

All participants were recruited per the recruitment specifications for the Government of Canada. Recruitment was conducted through qualitative panels stored on Canadian servers, with follow-up calls to confirm the details provided and to ensure quotas were met.

This report presents the findings from the study. Caution must be exercised when interpreting the results from this study, as qualitative research is intended to be directional only. Results cannot be attributed to the overall population under study, with any degree of confidence.

Political Neutrality Certification

I hereby certify as a Representative of Narrative Research that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Directive on the Management of Communications. Specifically, the deliverables do not include information on electoral voting intentions, political party preferences, standings with the electorate or ratings of the performance of a political party or its leaders.

Signed

Margaret Brigley, CEO & Partner | Narrative Research
Date: August 25, 2022

Key Findings and Conclusions

The following summarizes the key findings and conclusions from the Stigma and Opioid Harm Reduction Creatives and Message Focus Testing research study. Key findings and conclusions are presented below for each creative concept discussed during the focus groups. There is appreciation for an awareness campaign to address substance use and addiction among men, especially given the perceived prevalence of the situation in the construction and trades sectors.

Video Concepts

Three video concepts were each presented and discussed one at a time.

Regardless of the specific concept, the video overall is effective at grabbing attention and at presenting the seriousness of the situation and the negative impact of addiction issues. The use of the cinder block representing the weight of addiction provides strong imagery that establishes personal relevance, while effectively conveying the burden addiction takes on someone’s life. At the same time, the video provides a sense of hope that help is available. The familiar scenarios and the emotional charge make the approach relevant to people working in the trades and the general message is considered credible and using the right tone. That being said, none of the three video concepts tested has a strong call-to-action. While the message of seeking or offering help is clear, the way this can be achieved is unclear. As such, making the URL more prominent, improving the contrast of the on-screen text on the last frame, and speaking it out loud were suggested ways to achieve that, along with ensuring that the type of information or support available online is clearly specified. The primary audience is viewed as people experiencing addiction.

Some of the reactions were more specific to each video concept. Notably, limiting the on-screen text and voice-over (aka narration) in Video Concept A contributed to the dramatic effect that grabbed attention, and allowed viewers to relate based on their personal interpretation of the situation featured. Speaking of addiction also broadened the appeal to include a variety of workplace issues related to mental health and addiction (e.g., stress, anxiety, workplace, workplace safety) which was appreciated by some, despite causing message confusion.

While still presenting addiction more broadly, Video Concept B introduces the notion of assistance more strongly. In terms of speaking of addiction broadly, the same message confusion reported with Video Concept A is also experienced with Concept B. That said, specifying that addiction can get better with support introduces a stronger sense of hope and implies a positive outcome is possible. The primary audience continues to be those experiencing addiction.

Video Concept C has greater message clarity in speaking of substance use specifically, and speaking to both those seeking help and people around them. Introducing the topic upfront helped clarify the video’s intent. That said, increased narration (on-screen and voice-over) reduced the dramatic effect and as a result, the video’s ability to command attention. The primary audience was considered those who have substance use issues.

After reviewing all video concepts, participants were asked to select which one is most effective at achieving different things. While Video Concept C is viewed as having the clearest message given the additional information provided and the specific reference to substance use, none of the video concepts clearly outperforms the others in terms of being personally compelling or inspiring action. There is also a variety of opinions regarding personal preference. Based on these findings, it is suggested that Video Concept C be further developed with some changes. Most notably, consideration should be given to provide clearer direction as to where help is available or what resources can be accessed (for example by putting more emphasis on the URL or being more specific in terms of the type of information or support available) and to enhance gender diversity shown on the worksite.

Call-to-Action

The three call-to-action statements presented in the video concepts were discussed on their own, without the related creative. Overall reactions are more strongly positive towards the statement C and as such, the call-to-action “Learn how you can help or get help at Canada.ca/EaseTheBurden (Découvrez comment offrir ou obtenir de l’aide à : Canada.ca/AllegeonsLeFardeau)” should be included in the campaign for its ability to convey a specific action and for inviting those who are living with an addiction and those around them to take action. The call-to-action Concept A (Learn how at Canada.ca/EaseTheBurden (Apprenez comment à : Canada.ca/AllegeonsLeFardeau) was felt to lack in direction, while the call-to-action Concept B (Make it easier for yourself and others. See how at Canada.ca/EaseTheBurden (Allégez votre fardeau et celui des autres. Découvrez comment à : Canada.ca/AllegeonsLeFardeau) was too long and believed to wrongly imply that dealing with addiction is easy. While the first sentence of the call-to-action Concept B elicited negative reactions, the use of “see how” in the statement was preferred over the use of “learn how” from other call-to-action statements. The idea of learning implied a more time-consuming search and review of information than the level of effort participants want to invest.

Audio Assets

Two concepts for an audio ad that could be used online or on radio were presented and discussed one at a time, prior to participants choosing their preferred option. Reactions to Audio Concept 2 were generally more favourable for its ability to grab attention through the use of a variety of audio cues (different voices; background workplace noises; use of silence) and conveyance of the seriousness of the topic. Combined with the script and the slower tempo, it contributed to effectively convey the intended message. By contrast, Audio Concept 1 was felt to provide too much information, too quickly and in a monotone way to command attention and be memorable, which also made it difficult to identify the main message. Consideration should be given to further develop Audio Concept 2, although to avoid further stigmatization, reference to the construction industry should be replaced by a reference to trades more generally when finalizing the audio assets.

Digital Display

Two concepts for an animated digital display were presented in the form of a storyboard, with each option including three frames. Participants were informed that the ads would be clickable to reach a website. Of the two concepts presented, Digital Display Option 2 was clearly preferred and should be further developed. Participants liked that it clearly identifies that addiction impacts men in trades more than others, and that a message of hope follows (it takes strength to ask for help). That said, the final statement should be changed to ensure it does not imply that dealing with addiction is easy. Reactions to Digital Display Option 1 were lukewarm, as the message or intent of the ad is unclear, notably with respect to the type of addiction.

In finalizing the development of the digital display ads, attention should be paid to ensure some consistency in design elements, notably the font type and colour and showing the same individuals throughout the ad, as well as ensuring that the people illustrated realistically reflect construction workers. Finally, there would be merit in reminding viewers that the ad is clickable.

Social Media Posts

In five of the six focus groups, participants were asked to comment on three social media posts presented side-by-side during a brief group discussion. In general, the provision of factual information supported by statistics held high appeal, grabbed attention, provided context and contributed to making the message credible. It was helpful to explain why men in the construction industry are targeted by the campaign. In addition, referring to the trades, rather than the construction industry, spoke to a broader audience and minimized any stigma associated with the latter group.

Introduction

Context

The growing number of overdoses and deaths related to the use of opioids is a national public health crisis that has been exacerbated by the COVID-19 pandemic. Health Canada reports that it is estimated that 30,843 people in Canada have died from apparent opioid-related overdoses between January 2016 and March 2022. Because of the COVID-19 pandemic, the period of April 2020 to March 2022has been the most fatal to date for the opioid overdose crisis with a 91% increase in apparent opioid toxicity deaths occurring from the same time period prior to the pandemic (7,906 deaths between April 2018 and March 2020). A total of 7,902 apparent opioid toxicity deaths occurred in 2021. This is approximately 21 deaths per day. For a similar timeframe in the years prior to the pandemic, there were between 8 (in 2016) and 11 (in 2018) deaths per day.

The opioid crisis is complex, and it affects all communities, all age groups and all socioeconomic groups. However, men working in physically demanding jobs are at increased risk from opioid-related harms, as young to middle-aged men account for approximately three-quarters of apparent opioid overdose related deaths. Disproportionate amounts of these men are employed in physically demanding, male-dominated occupations, such as construction and other trades. There is an urgent need to address the overrepresentation of this group in the opioid overdose crisis.

In an effort to target and create messaging that resonates with men in physically demanding jobs, a new creative concept with a new visual identity has been developed as part of Health Canada’s multi-year marketing campaign to address the growing opioid overdose crisis. The campaign aims to:

• Provide men in physically demanding professions with tools and resources to learn more and access supports for substance use and addiction.
• Inform men in physically demanding professions of risks associated with substance use and promote help-seeking and resources for mental health, substance use and pain management.
• Provide resources for those who want to support men in physically demanding professions who may be struggling with substance use and addiction.
• Reduce the stigma associated with addiction and help-seeking/accessing treatment.
• Shift Canadians’ (especially men aged 20-59) attitudes and perceptions that contribute to stigma of those struggling with substance use (de-stigmatization).

Objectives

In this context, Health Canada was interested in testing creative concepts developed as part of this marketing campaign. The test was designed to determine which concepts resonate most with the targeted audiences. More specifically, the goal of the research was to:

• Evaluate various concepts for creative materials and determine if the content of each was:
• clearly understood by the audiences
• credible, relevant and of value to the audiences
• appealing and appropriate to the audiences
• able to motivate the audiences to take intended actions
• Compare content options to select the best language and presentation of key messages to the target audiences
• Provide suggestions for potential changes to ensure the messages and products resonate with the target audiences

Ultimately, results from this study will be used to assist Health Canada in making final creative concept selections for production.

This report presents the findings of the research. It includes a high-level executive summary, the description of the detailed methodology used and the detailed findings of the online focus group discussions, including recommendations made. The working documents are appended to the report, including the recruitment screener (Appendix A), the moderator’s guide (Appendix B), and the material reviewed (Appendix C).

Research Methodology

Target Audience

The target audience for the study included males 20 to 59 years old working in physically demanding professions who live in six key regions.

Research Approach

The study included a total of six online focus groups conducted between July 28 and August 3, 2022. More specifically, one group was conducted in targeted communities within each of six regions:

• British Columbia (BC) (Vancouver, Thompson-Caribou, Fraser)
• Prairies (Medicine Hat, Edmonton, Calgary, Saskatchewan, Manitoba)
• Ontario (Thunder Bay, Sudbury, Toronto, Guelph, Ottawa)
• Quebec (Montreal, Québec City)
• Atlantic (Fredericton, Moncton, Halifax)
• Northern territories and northern regions of provinces

In total, 10 people were recruited for each session. From 59 recruited individuals, 45 took part across all sessions. Each group discussion lasted between 90 minutes and two hours and participants received a cash incentive of $125 in appreciation for their time. In total, 47 incentives were distributed, including two recruits who were unable to participate due to technical difficulties. All group discussions were held in English except in Quebec where the session was held in French.

Each group included individuals who were currently employed (or in the past) from designated occupations. In each focus group, six to eight participants were recruited from the trades and construction industry, while two to four participants were recruited from various other industries including transportation and warehousing; manufacturing; and transport and equipment operator (which included heavy and tractor-trailer truck drivers, material moving machine operators, cargo and freight agents, forklift operator / driver, machine operator, material handler, material mover, heavy equipment operator, backhoe operator, shovel operator, loader operator, bulldozer operator, and front end loader operator). In addition, each group included a mix of cultural backgrounds, including Indigenous representation and aimed to include a mix of education and household income.

All participants were recruited per the recruitment specifications for the Government of Canada. Recruitment was conducted through qualitative panels stored on Canadian servers, with follow-up calls to confirm the details provided and to ensure quotas were met. Those with current or past employment in sensitive occupations were excluded from the research, in addition to those who had others in the household in this situation. These sectors included marketing, marketing research, advertising, media, public relations, graphic design, a political party, federal or provincial government, the field of drug treatment, law enforcement, and the medical and/or pharmaceutical sector. In addition, individuals who had been to at least five qualitative sessions in the past five years and those who had attended a session in the past six months were excluded from the research during the recruitment process.

Acknowledging that the subject matter of the focus group discussions could trigger an emotional response from some participants, information was provided at the end of each session regarding mental health resources and support for substance use and addiction available to the public.

Context of Qualitative Research

Qualitative discussions are intended as moderator-directed, informal, non-threatening discussions with participants whose characteristics, habits and attitudes are considered relevant to the topic of discussion. The primary benefits of individual or group qualitative discussions are that they allow for in-depth probing with qualifying participants on behavioural habits, usage patterns, perceptions and attitudes related to the subject matter. This type of discussion allows for flexibility in exploring other areas that may be pertinent to the investigation. Qualitative research allows for more complete understanding of the segment in that the thoughts or feelings are expressed in the participants’ “own language” and at their “own levels of passion.” Qualitative techniques are used in marketing research as a means of developing insight and direction, rather than collecting quantitatively precise data or absolute measures. As such, results are directional only and cannot be projected to the overall population under study.

Research Findings

Video

Participants were presented with three 30-second videos with each including slight content variations. The videos were shown and discussed one at a time, with the presentation order being consistent across sessions. Each video was shown twice, followed by an individual exercise that preceded a group discussion.

Reactions Across Video Concepts

The video concept overall is effective at grabbing attention and presenting the seriousness of the situation related to addiction, while giving a sense of hope. That said, the desired call to action is unclear.

The following provides overall reactions across video concepts:

The video concept, regardless of variation, tested strongly, particularly with respect to grabbing attention, raising awareness, memorability, and holding personal relevance. All three videos were well received for depicting a situation that is familiar and relevant to participants – that of addiction in the trades industry, and the difficulty to seek help. Moreover, this was considered to be the main campaign theme, with the intent to encourage workers to seek help for themselves or others in need and address the situation.

The familiar settings and situations, as well as the imagery of the cinder block representing addiction, left a strong impression with participants. The concept effectively conveyed that addiction impacts all facets of life – at work, at home and socially – and showed the significant burden it represents in a realistic manner. It also suggests how the weight of addiction or substance use can impact not only the substance users, but also those around them.

“The guy is getting abandoned, and he needs help. If this help is not provided, the brick will drop and hit other people. It shows how if we don’t do anything about addiction it affects [all of] us.” Northern territories/regions

While the concept of feeling isolated and hopeless when dealing with addiction is considered to be well represented in the scenarios, it was felt as presenting the person as being alone in their struggles, despite the intended message and call-to-action that others are there to help.

“Carrying a cinder block resonates with what I see addiction being in the trade. Isolation when dealing with mental health and addiction issues is well done.” Atlantic

“Everyone was aware of the cinder block but they didn’t see the bruising. It shows the struggle of those with addiction, but that those around don’t know what to do.” BC

“It would be more relatable if they represented a lot of people dealing with the weight. I went through depression, and you feel isolated so … if I watch this at my lowest, I would think this is a solo problem whereas even if he is watching the game with his buddies one or two others could have been carrying a load as well.” Northern territories/regions

The video concept was seen as having the right tone, presenting the situation as serious and needing attention, yet implying that it can be addressed. This led to the approach being seen as credible and a good way to approach the topic. Many felt that a public education campaign on the topic of addiction is both warranted and timely, especially with the current public focus on mental health. The lighting used in the video was considered reflective of the seriousness of the issue and was deemed appropriate.

“Everything is dark [in the video]. But when asking for help it is light. The lighting suggests gloom until he gets help or opens up.” Atlantic

While the call to action is clear (reach out or offer help), the desired actions are unclear. To varying degrees, the videos all suggest that it is ok to reach out or offer help to address addiction. That said, none effectively specify how this can be done. While the website address was provided on the screen, it was often missed as it is not spoken out loud. This issue may have also resulted from the short amount of time it is shown on the screen and the lack of strong contrast between the letters and the background.

[Concept A] “Le message est qu’il faut demander de l’aide mais comment? De quelle façon? De qui? On ne sait pas.” (The message is that you have to ask for help, but how? In what way? From whom? We don’t know.) Quebec

The focus on construction workers reinforced the prevalence of addiction in this industry and is broadly endorsed. The approach was especially effective at demonstrating the stigma of trade workers being tough, bearing excessive burdens emotionally and physically, and often being unable to open up or share their problems with others.

“It really brought to light mental health and addiction that specific men go through. Men carry lots of roles and always have to hold the family together.” BC

While the video’s ethnic diversity was appreciated, the concept was criticized for lacking gender diversity, particularly because it does not reflect current construction sites and a shift towards more women on worksites. It is interesting to note that the video left the impression of lacking gender diversity despite several women included as tradespeople in the scenario.

The use of both voice-over and text on screen are deemed equally important. Further, it was believed that both voice-over and text on screen should be used concurrently to convey important information, such as the website URL or key words that convey the message, intent, or tone, to ensure the information is not missed. Opinions in this regard were consistent across all three videos, and regardless of media.

“They should be used together. I am the kind of guy who has the subtitles on for the movies all the time. The website at the end I missed that so it should be said out loud. If that would be said out loud that would have a big impact. The word ‘strength’ seeing it on the screen and spoken at the same time that would work best.” Northern territories/regions

“Un mix des deux c’est parfait. Il y a du monde qui sont analphabètes et on n’a pas toujours la télé avec le son.” (A mix of both is perfect. There are people who are illiterate and we do not always watch TV with the sound on.) Quebec

Reactions by Video Variant:

While the video concept was seen as similar across all three versions, some differences were perceived in terms of the target audience and the intended message that impacted how each version was received.

Video Concept A

While limiting the on-screen text and voice-over (aka narration) in Video Concept A contributed to the dramatic effect that grabbed attention, it contributed to making the message unclear, along with the reference to addiction more broadly.

In general, this concept grabbed the attention of participants, notably by limiting the on-screen text and voice-over, and not having any music playing in the background. This approach caused some to pay more attention to try to understand the message, given that minimizing the audio cues suggests a topic that is serious and in need of attention. In addition, the use of the cinder block to represent the weight of living with addiction is considered a strong imagery that is relatable. Showing the impact of living with addiction on work and personal life is also considered a realistic and credible portrayal of the situation.

“J’ai trouvé que visuellement c’était clair. Se promener avec un bloc de béton pour visualiser un fardeau c’est clair; ça attire l’attention. J’ai aussi aimé qu’on voit sa femme; c’est réaliste.” (I found that visually it was clear. Walking around with a concrete block to visualize a burden is clear; it attracts attention. I also liked that we saw his wife; it is realistic.) Quebec

“This is definitely credible. You know someone is going through something, but how do you bring it to the forefront?” BC

“The block was basic symbolism. He intuitively switched the load. It’s a monkey on your back. I’m a recovering addict and know how everything becomes harder. You make your life harder – your homelife, your friends.” AB/Prairies

Limiting the information shared on screen or through the voice-over upfront in the video also allowed the viewer to establish personal relevance, something that was appreciated by some participants. This approach also aligns the message to addiction more broadly, particularly when participants have not personally experienced substance use / addiction.

“Le fait qu’il n’y a de musique fait que c’est plus urgent, plus ‘sec’; c’est bon! ” (The fact that there is no music makes it more urgent, drier; it’s good!) Quebec

That said, despite broadening the message’s appeal, the lack of detailed information and the reference to addiction more broadly caused some message confusion. Indeed, there were many reported addictions affecting workers in the trades to varying degrees (e.g., gambling, work, sexual) and the “heavy load” carried by the worker implied other facets of life affecting someone’s mental health (e.g., stress, financial hardships, marital problems), thus suggesting that the overall message spoke more of the impact of poor mental health than of substance use / addiction. Further, addiction is identified as the topic late in the video, resulting in the potential for the message to be seen as work- or safety-related (e.g., workplace safety) if the video is not watched until the end. As such, there is a risk of lost viewer attention prior to the topic being disclosed. It was suggested that showing other employees who may not be expected to carry a cement block as part of their work, for example an administrative assistant, would be more effective at grabbing the attention of viewers.

“C’est juste quasiment à la fin qu’on comprend que la dépendance peut être un fardeau lourd.” (It is just almost at the end that we understand that addiction can be a heavy burden.) Quebec

“There can be so many different addictions; some examples of different addictions can be drug addiction and it can be gambling addiction, or other unhealthy addictions.” Northern territories/regions

“It was going off to a mental health thing and I was surprised when the word addiction was shown on the screen. Addiction can be so many kinds of addictions out there.” Northern territories/regions

Perhaps because of limited information and a focus on addiction broadly, the overall message was felt to be directed specifically at those experiencing addiction or mental health issues and not substance addiction specifically. As such, those who did not experience addiction did not feel compelled by the message. That said, the scenario implies that anyone could be living with addiction and that this situation is not easily recognized just by looking at someone or interacting with them.

“As soon as I seen him carrying the brick everywhere I thought this was a mental health commercial or message and right now it made me think of legalizing the so-called illicit drugs in BC, and maybe they are looking to expand on that.” BC

“On a tout le temps quelqu’un à l’entour de nous pour qui la dépendance doit être un poids, des gens qui souffrent.” (We always have someone around us for whom addiction must be a burden, people who are suffering.) Quebec

“En ayant pas de problème de dépendance, ce n’est pas venu chercher une émotion ou une réaction intense ou directe chez moi.” (Because I do not have addiction problems, it did not evoke a direct or intense emotion or reaction in me.) Quebec

A few participants mentioned that while the message implies that asking for, or offering help, is important, the imagery suggests that this is something that is difficult to achieve.

“It’s about having addiction and that having an addiction can be hard for your whole life; and it can be hard to get help if you have addiction.” Ontario

“His friend wants to say something, but you don’t want to feel weak by looking like someone is caring.” BC

“I would like to see a friend share the weight or hold up the shoulder. Shown that you can lean on your friend or talk about it.” AB/Prairies

Further, the video was felt to have a weak call-to-action, primarily because it does not provide a compelling reason to act. While it establishes the value of reaching out or offering help, it does not provide sufficient insight into the reasons for doing so, or the resulting benefits. The stated call-to-action to ‘learn how to ask for help or offer it’ isn’t specific enough to inform viewers of why they should look for more information, and what they are likely to find online. Not clearly understanding the intent of the campaign also led to a few indicating that they may become more aware of the situation, but just for a short time.

“It might make me be a little more observant for a while but that’s it.” AB/Prairies

“Who can we ask? How do we ask? That needs to be shown, where we can get help.” BC

“It misses to me that you need to recognize it in someone.” Ontario

“It opens your eyes. Don’t assume that you and others are ok. Be more alert of the surroundings, talk to them and work through the ‘old boy school’ we have.” Atlantic

Video Concept B

While still presenting addiction broadly, Video Concept B introduces the notion of assistance more strongly.

While still presenting addiction broadly, this concept was liked for being hopeful in suggesting that addiction can be addressed. It introduces the concept of support which suggests that those living with addictions are not alone, and that help is available. This small difference shifted the focus slightly by putting more emphasis on the need to support others, in addition to the need to seek support.

“The second video was that your friends could help you. But the first was more this guy will do all on his own. In the second they emphasized it with having friends around and saying to ask for help.” Ontario

“The second video makes me want to help other people that might have addiction.” BC

“If I were to watch this ad to me, I would be more looking to help someone than looking for someone to help me.” Ontario

“This is way better. It shows the light at the end of the tunnel. That there is no shame in accepting help. It showed him making contact with his buddy and the brick being off his shoulder.” BC

Nonetheless, there were still some participants that felt that the topic of addiction was introduced too late into the scenario, was not well represented in the visuals, and remained too broad to be effective.

“Je partirais l’annonce avec quelqu’un qui consomme pour mettre ça clair. Sinon on pense que ça peut [parler] d’autres stress, pas juste la dépendance.” (I would start the ad by showing someone who is consuming, to make it clear. Otherwise we think it can [talk about] other stresses, not just addiction.) Quebec

The voice-over helped to provided increased clarity on the intended message of the ad.

“It was the same video, but the voice over changed. That helped grab attention. The guy talking left it less open ended.” Ontario

Once again, this video spoke more specifically to those living with addictions, inviting them to seek assistance. As with Concept A, the concept of addiction is presented mid-way, thus presenting the risk of losing viewers’ attention before the topic is introduced.

Video Concept C

Video Concept C has greater message clarity in speaking of substance use and speaking to both those seeking help and people around them, although it is less effective at grabbing attention.

This approach provided greater message clarity by introducing the topic of addiction early in the video and by specifying the topic of substance use. The use of increased voice-over also helped to clarify the message, although it was felt to be too much to process by some.

“J’aime qu’ils aient mis que la dépendance peut être lourde au début de l’annonce, dans la deuxième image. On voit qu’ils parlent de dépendance. Ils te le disent tout de suite au début.” (I like that they say that addiction can be heavy at the beginning of the ad, in the second image. We know that they’re talking about addiction. They tell you right away at the beginning.) Quebec

“Je trouve que c’est similaire [au Concept A] mais il me semble qu’on annonce dès le départ la dépendance. Il y a plus de clarté. Mais la fin c’est aussi ambiguë.” (I think it's similar [to Concept A] but it seems to me that addiction is announced from the start. There is more clarity. But the end is also ambiguous.") Quebec

“It grabs me quicker. The narrative was better. It started by saying what the commercial was about. It wasn’t a guessing game. The early audio helped to create more impact.” AB/Prairies

“There was just too much dialogue. This one felt like just another addiction commercial. I really like the idea of using your imagination a little.” BC

While this approach provided more clarity, it also narrowed the target audience, with some commenting that they preferred an approach where they had to ‘figure it out’ and where they could more easily align the topic broadly to their personal lives. Nonetheless, the call to action (learn how you can help or get help) implied that the message targets both those experiencing addictions and those around them.

"There is one thing I like about this one: the recognition that it is not easy to ask for help when it comes to addiction.” Atlantic

“What made it so good [in the first video] was that you had to use your imagination. You let the viewer figure it out.” Ontario

“This one came right out and let you focus on the rest of the commercial. It tells you what it’s about. The message is more clear, but it is less engaging.” AB/Prairies

“You could be watching it, but if you know it’s about addiction too soon, you could tune it out. Less is more. You need to engage the person watching so they feel something. With the stigma [with addiction] some people will tune you out if it’s not a Cinderella moment.” Atlantic

One participant in Quebec felt that the spoken or written message did not always align with the visual, thus lessening the overall impact. For example, saying that it makes it hard to stop using substances did not have any relevance to seeing the construction worker in the bathroom. Likewise, the following scene showing the worker surrounded by friends and seemingly enjoying the game did not reflect the statement that implied a desire to seek help.

Video Preferences

Video Concept C was considered as having the clearest message, while none of the video concepts clearly outperforms the others in terms of being personally compelling or inspiring action.

Following the discussion of each of the three videos, participants were asked to choose, through an individual exercise, which variation was most effective at achieving different things. Overall, none of the concepts clearly stands above the others for all factors assessed, suggesting that they all held appeal for different reasons. The following provides an overview of those choices based on the preference tallies:

Concept C was considered the clearest. Identifying substance use as being the type of addiction referred to, encouraging both those living with addiction and others around them to get involved, and identifying the topic early in the video all contributed to making Concept C the clearest.

Concept C: “It provided more information about what they were talking about: substance abuse.” AB/Prairies

“Je disais que la deuxième version (Concept B) était plus facile à comprendre et celle-ci (Concept C) est encore plus explicative. L’ajout du texte à l’écran et le narrateur parlent plus. Ça facilite plus à comprendre ce dont l’annonce parle : la dépendance peut être lourde à porter. On comprend vite le sujet de l’annonce.” (I was saying that the second version (Concept B) was easier to understand and this one (Concept C) is even more explanatory. Adding on-screen text and having the narrator speak more. It makes it easier to understand what the ad is about: addiction can be heavy to bear. We quickly understand the subject of the ad.) Quebec

“I’m a fan of Concept C. No messing around with the message and it shows that burdens are not just at home.” Atlantic

A few participants preferred the clarity of messaging in Concept B, primarily as the slower tempo allows the viewer to focus on the spoken message.

“La B nous laisse le temps de voir les séquences et comprendre le message.” (Concept B gives us time to see the footage and understand the message.) Quebec

Concept B resonated the most personally, though only slightly above the other two. Concept B was appreciated for introducing the concept of support being available.

“Concept B flowed better, with a good wrap up at the end.” BC

Some, however, appreciated the level of details provided by Concept C which made the message more compelling to them personally.

Others felt that the seriousness of the situation was better conveyed by fewer words as presented in Concept A. This variation also allowed the viewer to align the message to their personal situation, which may not hold any relevance to substance use and addiction.

Concept A: “The first was the one that most hit home and it brought a tear in my eyes and I could see the metaphor. Almost like the video shot of him coming home to his wife looked a bit longer where you can see he did not want to bring this [weight] home.” Northern territories/regions

Concept A: “J’ai aimé le moment de silence pour essayer de comprendre ou ça s’en va. Capte mon attention le fait qu’il n’y ait pas de musique et qu’on ne parle pas.” (I liked the moment of silence to try to understand where it goes. The fact that there is no music and we don't talk [in the ad] captured my attention.) Quebec

“[Concept A]: The silence does it. It leaves it to the viewer to decide. Saying it takes courage is good wording.” BC

Concept C was best at inspiring to think differently or take action, although only slightly above the other two. This variation spoke most clearly to two distinct audiences, namely those living with an addiction problem and those who may know someone experiencing an addiction problem. Accordingly, it was more effective at encouraging action given that it directs viewers to either learn how they can help or get help. Others were triggered to think differently or take action by the inclusion of the word support in Concept B, or the thought-provoking nature of Option A.

“When I hear the word ‘support’ [in Concept B,] that clicks with me.” Atlantic

“The most inspirational is when you have to figure it out yourself [in Concept A].” Atlantic

Overall, Concepts A and C are both preferred, although only slightly more than Concept B. Concepts A and C were both preferred but for very different reasons. The minimal approach to Concept A provides viewers who experience stress at work the opportunity to relate regardless of their situation. Not using words allowed greater focus on the imagery and helped convey the seriousness of the situation (creating a more dramatic effect). By contrast, the level of detail in Concept C and its inclusion of both those living with addiction and those around them appealed to others.

Concept A : “C’est une des meilleures annonces que j’ai vu du gouvernement. Ça me touche beaucoup. C’est pas juste le fardeau de la drogue, mais aussi le fardeau de la vie. Un fardeau qu’on apporte à la maison.” (This is one of the best ads I have seen from the government. It touches me a lot. It's not just the burden of drugs, but also the burden of life. A burden that we bring home.) Quebec

Yet others preferred how Concept B broadly described addiction, while focusing on the availability of support. Some also felt that the message was clearest.

Concept B: “[This one has the] best script: asking for help is tough but it takes strength to offer help.” Atlantic

Call-to-Action

The Concept C call-to-action was considered most motivating to take action, having the clearest message and having the strongest personal appeal, thus being chosen most often as the preferred overall.

Participants were asked to compare three call-to-action messages included in the videos and select which one is most effective at achieving different things. The call-to-action messages were presented together as statements, separate from the creative. The call-to-action messages are:

Concept A: Learn how at Canada.ca/EaseTheBurden (Apprenez comment à : Canada.ca/AllegeonsLeFardeau)

Concept B: Make it easier for yourself and others. See how at Canada.ca/EaseTheBurden (Allégez votre fardeau et celui des autres. Découvrez comment à : Canada.ca/AllegeonsLeFardeau)

Concept C: Learn how you can help or get help at Canada.ca/EaseTheBurden (Découvrez comment offrir ou obtenir de l’aide à : Canada.ca/AllegeonsLeFardeau)

The following provides an overview of participants’ choices:

Most Motivating to Take Action

The Concept C call-to-action was consistently seen as best to motivate viewers to seek help or offer help, in a manner that is respectful and not forceful. Across locations and languages, Concept C was consistently considered best at motivating participants to seek help or offer help if the need arose. The ask was clearly specified in the statement (learn how you can help or get help) in a respectful manner.

“Je trouve que le concept C’est le plus motivant parce que ça m’incite à aller voir ce qui se passe. [La phrase ‘Découvrez comment offrir ou obtenir de l’aide’] me donne une motivation d’aller voir ce qui se passe comme genre d’aide ou directive.” (I think concept C is the most motivating because it makes me want to go and see what's going on. [The sentence 'Learn how you can help or get help'] gives me a motivation to go and see what's going on as a kind of help or direction.) Quebec

“This is straightforward and to the point. It talks about yourself, and also others.” Ontario

By contrast, Concept A was considered as lacking in direction (learn what?), while Concept B was seen as being too vague and wrongly implying to some that it is easy to deal with addiction.

“Option B is a slight guilt trip. You need to look after yourself. It is not anyone’s responsibility. This adds to the burden.” AB/Prairies

Regardless of the concept chosen, it was suggested by one participant to show a QR code with the call-to-action, as an alternate method to access the website, if the approach is used in a media format that is conducive to it.

Clearest Message

Concept C was consistently viewed as clearest in providing a call-to-action that is simple and directional. Across locations and languages, Concept C was viewed as being the clearest call-to-action for providing direction on what can be done.

By contrast, both Concepts A and B lacked clarity in terms of what someone might find on the website, or what someone might want to learn about support. Some took exception to the implication that dealing with addiction can be made easier, with those who had experienced addiction consistently sharing that dealing with it is incredibly difficult to manage.

“Option B is a bit aggressive. The first three words – make it easier -…kicking a habit is not easy at all. This suggests it can be easier.” AB/Prairies

“Make it easier for yourself sounds selfish.” Ontario

Resonates the Most Personally

Concept C was the top choice for resonating with participants the most personally. Across locations and languages, Concept C was most often selected as the message that resonates the most personally, inviting both those living with addiction and those around them to address the situation.

“La version A non, il n’y a pas d’émotion, c’est ‘débrouille-toi’ et c’est pas mal ça. Pour la version B, ils mettent ça extrêmement gros. La version C [ça dit qu’on] est capable d’offrir de l’aide si on voit quelqu’un qui en a besoin.” (Concept A, no, there is no emotion and it tells you ‘figure it out yourself’ and that’s about it. For Concept B, they put the bar very high. Concept C says that we are able to offer help if we see someone who needs it.) Quebec

Preferred Call-to-Action Message

Overall, Concept C is the preferred message. Again, this preference was primarily attributed to the increased clarity compared to other options in terms of the promise of what information will be provided, as well as the fact that it spoke clearly to two distinct audiences – those living with addiction and those who know someone experiencing addiction.

“[Concept] C is the most meaningful to me because it doesn't seem like I’m the bad guy, but if I want to help others then it might make me think that someone else might have this problem and it’s not only me that can have this problem.” Atlantic

Audio Assets

The Audio Concept 2 was preferred for its use of various audio cues that grab attention, and the simplicity of its message.

Participants were presented with recordings for two 30-second audio ads that could be used online or on the radio. Each audio ad was played twice and discussed as a group, one at a time.

Reactions Across Audio Concepts

The following provides reactions for both audio ads:

Focusing on the construction industry in the audio script further stigmatizes it. The mention that substance use is more common in the construction industry was seen as reflective of the current situation by some, though it was perceived by others as contributing to a negative stigma. It was felt consideration should be given to refer to the trades more generally, rather than focusing on the construction industry.

Audio Concept 1

Reactions to audio concept 1 were lukewarm, with the execution negatively affecting the delivery of the intended message.

While many appreciated that it spoke to the trade industry in general rather than focusing on the construction sector, and that it provided useful information, some felt that the delivery lacked impact. Indeed, this concept was seen as providing a lot of information in a short time, in a monotone way and without pauses. This affected recall and did not provide listeners with key elements to grab their attention.

“J’ai trouvé que c’était vite. Ça a passé vite. Il n’y avait pas un souffle entre les deux personnes qui parlaient. Pas de pause, pas de sentiment.” (I thought it was fast. It went by quickly. There was not a breath between the two people who were talking. No break, no feelings.) Quebec

Some even felt that the fast tempo affected recall of the information provided, which was most notable for the call-to-action message near the end of the audio concept.

“Quand ils donnent les infos pour contacter le gouvernement, ça ressemble aux annonces qui passent le soir à la télé pour vendre des choses : ils te garochent les conditions à la fin [de l’annonce].” (When they give the information to contact the government, it reminds me of ads that we see in the evening on TV to sell things: they tell you the conditions very quickly at the end [of the ad].) Quebec

Further, to a few, the relationship between addiction and the construction/trade industry specifically was unclear (or the reasons to focus on that industry specifically). For those participants, Audio Concept 1 did not effectively explain why the construction or trade industry is targeted.

“I am still trying to find the connection between how they go to the construction path and then they immediately switch to the addiction part. I feel like the two don’t relate; there is a missing link.” Northern territories/regions

Some criticized the tone, considering it too upbeat or positive for the topic at hand.

“It was too happy for the content / topic. It would have spoken more to me if it was more serious.” BC

Audio Concept 2

Reactions to Audio Concept 2 were generally positive, and the execution grabbed attention in addition to effectively conveying the intended message.

The combination of background sounds, two voices and dead silence contributed to grabbing attention (due to the variety of audio cues). While some liked the dramatic effect it created, others did not.

“The use of the sound of silence to make a point was power. It was very attention getting. It did a better job at conveying that drugs and alcohol are used as coping mechanisms.” BC

“This is much clearer. I could hear the guy talking. More simple, easy words. The silence speaks for itself.” AB/Prairies

A few were also bothered by the reference to drugs and alcohol use which could imply that these types of addiction are more prevalent among construction workers. Further, some considered drugs to exclude prescription drugs. Nonetheless, some appreciated that the message specifies that only “some guys use drugs and alcohol to cope”, implying that the situation isn’t widespread. It was suggested by one participant to reword the statement to imply that this is the situation in the construction industry, like in many other demanding industries.

“On aurait pu dire ‘substances’ au lieu de ‘drogues et alcool’. C’est comme si [ils disent qu’on] prenait un coup et qu’on est tous des dépendants de la drogue dans la construction.” (They could have said 'substances' instead of 'drugs and alcohol'. It's as if they are saying that we get drunk once, and then we all get labeled as though we're all drug addicts in the construction industry.) Quebec

“As soon as you talk drugs and alcohol it pigeonholes it. I don’t have a drug problem, I just take pills for my back. Substance would be broader and speak to more. Prescriptions are taken to numb the physical pain we endure.” BC

Again, the focus on the construction industry was seen as further stigmatizing the industry and participants would have liked to see a reference to trades more generally, or to other industries. Finally, a few participants perceived that the construction worker in the ad appeared to have a New Jersey accent that is not necessarily reflective of a Canadian construction worker.

“I didn’t know Canada had guys from Jersey!” BC

Audio Concept Preference

Audio Concept 2 was largely preferred for more effectively conveying the message through the use of various audio cues.

Following the discussion of each of the two audio ads, participants were asked to choose through an individual exercise which one was most effective at achieving different things. Consistently, Audio Concept 2 was the preferred version overall, being considered the clearest, the best at inspiring listeners to think differently or take action, and the one that resonates the most personally. For the most part, the impact of the various audio cues, including the use of silence, commanded listeners to pay attention to the message. Combined with the testimonial approach, it made the concept more personally relevant.

“The last audio is more clear and it is showing some of the reasons why people end up being into these addictions. It is coming from the challenges they are facing on a daily basis. It’s more touching. It’s about what people go through.” AB/Prairies

Digital Display Ads

Digital Display Option 2 was preferred for its clarity in messaging, specific target audience, and stronger call-to-action, despite some issues.

Two versions for a digital ad were presented and briefly discussed one at a time. For each, participants were shown three still frames side-by-side on the screen and asked to consider that the ad, once produced, would be in the form of an animated banner with frames shown one after the other, not simultaneously. They were also informed that like any other banner ads, these are clickable to reach a specific website.

The following provides reactions to the digital ads shown, based on a brief group discussion:

Reactions Across Digital Ads

A number of comments pertained to both digital ad concepts:

Across both digital ads, inconsistencies in the font format made the ads looked unfinished. In Digital Display Option 2, the font spacing in the first frame was considered too tight, while the varied font in Digital Display Option 1’s first frame seemed inconsistent with the rest of the ad, and more akin to the font used in a truck commercial.

The construction workers lacked credibility in that they appear “too clean” and are not wearing proper safety equipment. In a few instances, participants believed that the settings and people shown did not reflect their own experience of a construction worksite, despite the concept design having been informed by worksite health and safety consultants. Showing different construction workers in Digital Display Option 1 (between the first frame and the others) was also problematic and confusing for some, as it did not appear to tell one person’s story.

[Digital Display Option 1] “Without the context of the other ads, the first panel is a bit confusing and I am not relating that to addiction. And in the second panel it is strange that they change actors around.” BC

[Digital Display Option 1] “No one has safety glasses on; this is put together by someone not knowing the industry.” Ontario

[Digital Display Option 1] “It looks like a Marks Work Wearhouse ad – a little too clean.” Atlantic

Although participants were informed that the digital ads would be clickable to reach the relevant website, many still requested more clarity in the call-to-action. In fact, suggestions were made to include instructions to ‘click here to find out more’ or ‘click here to learn how to help or get help’ on the last frame. Some participants were not readily aware that they would be able to click on the box on the last frame.

“It would be awesome if it said ‘get help here’ [at the end]. I would like to see a ‘get help’ button where you can access help right away.” Northern territories/regions

“It should say click here. Don’t assume that people know. When I see banner ads I totally zone out.” AB/Prairies

Digital Display Option 1

The first concept for a digital ad was shown on the screen and briefly discussed as a group. The following provides an overview of participants’ initial reactions:

Digital Display Option 1 is considered unclear in the type of addiction it refers to. While a few felt that it was more encompassing of different people (including in different industries), most others believed that it ‘muddied’ the message and did not effectively reach the target audience.

“C’est un peu dur à comprendre avec la première photo. Dépendance de quoi? De gambling? De drogue? De quoi? Il y a bien des dépendances différentes.” (It's a bit hard to understand with the first photo. Addiction to what? Gambling? Drugs? What? There are many different types of addiction.) Quebec

Further, the concept of addiction was not effectively reflected in the visual on the first frame. Inconsistencies in the construction worker shown on the first frame compared to the other two frames caused confusion. Finally, the visuals did not appear to be supporting the message whereby it is unclear that the cinder block represents a burden, the same way it is understood in the video.

“Without having seen the video, there is nothing to provide context. It assumes every construction worker has an addiction. He seems normal?” BC

Digital Display Option 2

A brief group discussion provided an opportunity to also capture top-of-mind reactions to the Digital Display Option 2:

Digital Display Option 2 was considered more specific in identifying the type of addiction and the audience, although questions were raised as to why men are targeted. Showing the image of alcohol and drugs helped to specify the type of addiction referred to, although a few questioned why the message limited itself to addressing only those types of addictions. Overall, Digital Display Option 2 was generally preferred and considered more motivating, based on top-of-mind reactions.

“Chaque image explique bien ce qu’ils veulent faire comprendre. C’est simple, et droit au but.” (Each frame explains well what they want to make clear. It's simple, and straight to the point.) Quebec

That said, some questioned why the same picture is repeated in the final frame.

“The third image is a little repetitive. It would be better just to have the words and no picture.” BC

It should be noted that several participants expressed a lack of comfort with the call-to-action statement on the last frame, for implying that dealing with addiction is easy and can only get easier with support.

Social Media Posts

The social media post that provides statistics was generally preferred, primarily because it provides context and explains why men are targeted by the campaign.

In five of the six groups, the session ended with a very brief discussion on three different concepts for a social media post that could be seen online. Concepts were shown side-by-side on the screen and reactions were obtained through a brief group discussion.

Text below the social media graphic for concept 3 says: “Addiction and overdoses are not rare in the trades. We can do and say things to make it easier for people to reach out for help when they need it. See how at Canada.ca/EaseTheBurden”

Overall, the brief text and yellow colour were deemed attention getting and impactful. Attention was primarily placed on the large text on the coloured frame.

“The larger text shows how serious it is. It sticks out to me more. The numbers grab you – but what does the picture have to do with the text? Seeing the numbers in your face shows the magnitude and how prominent it is. It takes the stigma out of it – I like reading the stats.” BC

The first social media post was generally preferred, primarily because of its inclusion of statistics which provided context. For most, statistics grabbed attention, and provided confirmation of the severity of the problem in the sector, and that it is most evident among males. This also helped some to feel less alone, given its demonstration of just how prevalent the problem is.

“I like the first one; the stats ring out a bit more for me. Saying 3 out of 4 is pretty substantial.” Northern territories/regions

Specifying the trades (versus construction) was felt to speak to a broader audience, without adding to a perceived stigma that those in construction are more likely to be experiencing addiction. Some, however, felt there was too much information on the ad.

The second social media ad was appreciated for its simplicity and clarity, as well as its mention of helping yourself or others. The implication of making it easier was criticized by some, given the difficulty of dealing with addiction.

The third social media ad was deemed clear and to the point but spoke more so to the person experiencing addiction, rather than those who may know others living with addiction. This message was seen as implying that an individual recognizes that they have a problem and needs help. A few mentioned that ‘it takes strength to ask for help’ could imply that someone is weak, which is counter to the ‘tough guy’ stigma of workers in the trades. Further, given that each social media post would be on its own, this option was criticized for not specifying what someone is asking for help for.

“What am I asking for help for? The people who are afraid to ask for help don’t have that strength. You are rubbing it in.” BC

Conclusions

The following provides broad conclusions from the summary of research findings.

• The video concept overall is effective at grabbing attention and presenting the seriousness of the situation related to addiction, while giving a sense of hope. That said, the desired actions are unclear.

  A number of reactions were common across all three video concepts tested. Most importantly, the overall creative approach for the video is very well received, grabs attention, and is personally relevant to those in the trades industry. Situations depicted are familiar, and the use of a cinder block representing addiction is very impactful. The tone is also considered appropriate and aligned with the message, suggesting the seriousness of an addiction problem, while at the same time conveying hope in that help is available. As such, it contributes to enhancing the message’s credibility.

  Perhaps one of the areas that is most in need of attention is to strengthen the call to action. While the message clearly invites the viewer to offer or seek help to address addiction, how this can be achieved is less clear to viewers. This may in part be due to the website URL shown on the screen not being noticed, as it lacks contrast with the background and is not spoken out loud.

  A few other common points were raised. While there is recognition that the construction industry is faced with an addiction problem, the approach reinforces the stigma of trade workers being tough and often unable to reach out for help. Overall, the video’s ethnic diversity is appreciated, but was seen to lack gender diversity to be reflective of today’s construction sites, despite the concept featuring a higher proportion of female actors than is actually represented in the trades workforce – but they weren’t always distinguishable from their male co-workers since they were all wearing similar worksite safety attire, etc. Finally, the use of both voice-over and text on screen are deemed equally important in effectively conveying the message.

• While limiting the on-screen text and voice-over in Video Concept A created a dramatic effect that grabbed attention, it contributed to making the message unclear, along with the reference to addiction more broadly.

  This version was considered one of the most attention-grabbing due to limiting the on-screen text and voice-over and avoiding background music. This approach forced the viewer to pay attention to try to understand the message, while creating tension that highlighted the seriousness of the topic. That said, the lack of clear direction upfront also caused message confusion in that it could be perceived as speaking of the workplace more broadly. At the same time, identifying addiction as the topic also contributed to message confusion, as there are many types of addictions experienced by workers, beyond substance use. Some liked that it applied to mental health issues more broadly, while others felt that it misrepresented the intended message. The overall message was felt to be directed specifically at those experiencing addiction or mental health issues, and not to substance use and addiction specifically.

• While still presenting addiction more broadly, Video Concept B introduces the notion of assistance more strongly.

  Although introducing the topic of addiction broadly later in the video caused some message confusion, the mention that addiction can get better with support introduced a stronger sense of hope and provided a greater sense of confidence in the ability to address the issues. While the words invite those suffering to seek help, the images imply that those around can provide support. Nonetheless, the primary audience is felt to be people living with addiction. As with the first video concept, speaking of addiction broadly has broader appeal, but is more likely to link a variety of issues affecting one’s mental health beyond substance use.

• Video Concept C has greater message clarity in speaking of substance use and speaking to both those seeking help and people around them, although it is less effective at grabbing attention.

  Introducing the topic of addiction upfront and specifying that it refers to substance use improves the message clarity. Further, inviting viewers to learn how they can help or get help broadens the target audience to include those who suffer from substance use and people around them who could offer help. That said, the increased voice-over reduces the ad’s dramatic effect and its ability to command attention. Focusing on substance use also speaks only to those with this type of addiction, rather than being compelling to those who may suffer from other stress on and off of the job site.

• Video Concept C is considered as having the clearest message, although none of the video concepts outperforms the others in terms of being personally compelling or inspiring action.

  In choosing the preferred video concept, Video Concept C was the clear choice in terms of having the clearest message, both in how it introduces addiction early in the video and how it specifies that it refers to substance use. That said, none of the three video concepts clearly outperforms the others in how they personally resonate with participants. The dramatic tone and broad topic of Video Concept A appeals to some, while the focus on the message of hope conveyed in Video Concept B appeals to others. Yet, the clarity in messaging from Video Concept C is what makes it more personally relevant to others. There is also no clear winner in terms of the approach that inspires most to think differently or take action. In this regard, Video Concept C is only slightly above the others again for being clear as to the type of addiction referred to, and the encouragement to seek or offer support.

  When asked for an overall preference, Video Concepts A and C are slightly preferred to Video Concept B. The first version was most appreciated for its dramatic tone that commanded attention and for providing the viewers who experience stress at work the ability to relate regardless of their situation, while the last version was preferred for its message clarity.

• The Concept C call-to-action was most often preferred overall and was considered most motivating to take action, having the clearest message and having the strongest personal appeal.

  Of the three call-to-action statements discussed, the Concept C option (Learn how you can help or get help at Canada.ca/EaseTheBurden (Découvrez comment offrir ou obtenir de l’aide à : Canada.ca/AllegeonsLeFardeau) was consistently preferred. It clearly specifies the purpose – learn how you can help or get help – in a manner that is direct, simple, and directional. In addition, the language used is considered simple and respectful. The call-to-action Concept A (Learn how at Canada.ca/EaseTheBurden (Apprenez comment à : Canada.ca/AllegeonsLeFardeau) was felt to be vague and lack in direction, while the call-to-action Concept B (Make it easier for yourself and others. See how at Canada.ca/EaseTheBurden (Allégez votre fardeau et celui des autres. Découvrez comment à : Canada.ca/AllegeonsLeFardeau) was too long and believed to wrongly imply that dealing with addiction is easy.

• Audio Concept 2 was preferred for its use of various audio cues that grabs attention and the simplicity of its message.

  The use of various audio cues in Audio Concept 2 (voice of a narrator and construction worker, background sounds of a construction site, silence) grabbed attention and set a serious tone, thus effectively conveying the intended message. By contrast, Audio Concept 1 was felt to provide too much information too quickly, using monotone audio cues. Regardless of the preferred option, it was believed that the focus on the construction sector in the script further stigmatized it in terms of being an industry where substance use is common. As such, consideration should be given to refer to trades more generally, or construction as one of the many industries where this applies, or even referring to high-stress types of work more broadly.

• Digital Ad Concept 2 was preferred for its clarity in messaging, specific target audience, and stronger call-to-action, despite some issues.

  Of the two concepts presented for a digital ad, Concept 2 was preferred for clearly identifying the topic upfront – addiction impacts men in trades more than others – and for following up with a message of hope in that it takes strength to ask for help. As with the video concepts, the last statement is questioned, however, for implying that living with addiction is easy. By comparison, reactions to Digital Ad Concept 1 were lukewarm as it lacks clarity on the type of addiction referred to, and because of some inconsistency in visuals and the inability of the visuals to effectively convey the message.

  Across both digital ad concepts, inconsistencies in design elements were noted, notably in the type and colour of font between frames. Some also felt that the construction workers shown were not wearing proper protective equipment, thus the ad lacking credibility. Finally, while participants were reminded that the ads are clickable, it was believed that this should be more clearly specified on the last frame.

• The social media post that provides statistics was generally preferred, primarily as it provides context and explains why men are targeted by the campaign.

  In five of the six focus groups, three versions of a social media post were reviewed side-by-side and briefly discussed. The provision of statistics – namely that three out of four opioid-related deaths were men, and that between 30% and 50% of those who were employed worked in trades at the time of their death, grabbed attention and provided the context needed to lend message credibility. In general, the text and yellow colour is what grabbed participants’ attention and was considered most impactful. Specifying the trades spoke to a broader audience and minimized the stigma associated with the construction industry.

Direction

As Health Canada moves to finalize development of the final creative concepts for its advertising campaign, the following should be considered:

1. Addressing opioids use is considered an important message about a serious topic that holds personal relevance to many.

   Regardless of the final creative, findings suggest that increasing awareness of addiction and the impact it has on a person’s mental health is important, notably in how it affects men. As such, there is a great desire for a campaign to invite discussions and engagement. Overall, the proposed campaign tested strongly and is deemed impactful, attention-getting and personally relevant to those in the trades. The campaign was strongly endorsed overall, and minimal tweaks are required.

2. The Video Concept C should be further developed, with some changes.

   Video Concept C performed strongly in its ability to grab attention, be memorable, and convey the message effectively (both in addressing substance use and engaging a broad audience). That said, it did not give clear enough direction as to where help is available or what resources can be accessed. More emphasis should therefore be placed on the website URL, notably by leaving it on the screen for a longer period of time, reading it out loud, and improving the contrast against the background image. The inclusion of a QR code on relevant media could also be considered to provide a quick reference to the resource for those who do not want to take the time to take note of the URL. Consideration should also be given to be more specific and directive in terms of the type of information or support available online. While gender and ethnic diversity is well represented in the video, consideration should be given to making gender diversity in the workplace more obvious. Finally, dialogue should be kept short and direct, with slightly better message alignment between the voice-over and the visuals.

   In fine tuning the final concept, consideration should be given to retaining a number of elements found in the Video Concept C that are effective. Most notably, identifying the topic of addiction early in the video is important to ensure message clarity and eliminate the potential confusion with other workplace-related topics such as workplace safety, stress related to performance, or mental health. The use of a combination of voice-over and text on screen should continue to be used, with both being used concurrently for important information.

3. Audio Concept 2 should be further developed given its ability to grab attention, convey the seriousness of the topic, and clearly convey the message.

   The use of several audio cues, such as multiple voices, background sounds illustrative of a job site, and the use of silence, provides audio interest that grabs attention. This approach also helps to convey a sense of urgency and seriousness that is appropriate for the topic. That said, to avoid stigmatization, reference to the construction industry should be replaced by a reference to trades more generally.

4. The call-to-action “Learn how you can help or get help at Canada.ca/EaseTheBurden (Découvrez comment offrir ou obtenir de l’aide à : Canada.ca/AllegeonsLeFardeau)” should be included in the campaign.

   For its ability to convey a specific action – learn how – and for inviting both those who live with an addiction and those around them to take action, this call-to-action should be further developed. In the choice of final messaging and creative materials, care must be taken not to imply that dealing with addiction is ‘easy’.

5. The Digital Ad Concept 2 should be further developed with some design modifications.

   In further developing the digital ads, consideration should be given to being more specific with the call-to-action. Indeed, while it is expected that the ad will be clickable, viewers should be invited to ‘click here for more information’ on the last frame. It should be noted that the use of visuals is deemed effective, but care must be taken to ensure they realistically reflect trade workers (i.e., not too pristine or photo-shopped and wearing proper safety equipment), and that if individuals are shown, that the same individual be shown consistently to tell one person’s story.

6. The use of statistics should be used in social media posts to command attention and lend credibility to the message.

   The use of statistics is highly effective at grabbing attention and providing context and thus, the first social media post held greater appeal. Reinforcing statistics in social media ad copy will help to increase awareness of the prevalence of the problem and further legitimize the campaign’s focus on men and the construction industry or trades. It will also likely help address or minimize any stigma associated with the targeted groups, whether it be men or those working in the construction or trades industry.

Appendix A:

Recruitment Screener

Stigma and Opioid Harm Reduction Creatives and Message Focus Testing (HC POR 22-03)

Recruitment Screener - Final

Name:______________________________________________________________________________

Home phone: ________________ Work phone:___________________ Cell: ____________________

Email: ______________________________________________________________________________

Community: __________________________________ Province: ______________________________

SECTION 1: Schedule & Specifications

NETFOCUS GROUP SCHEDULE

RECRUITER NOTE - WHEN TERMINATING AN INTERVIEW, SAY: "Thank you very much for your cooperation. We are unable to invite you to participate because we have enough participants who have a similar profile to yours."

RECRUITER NOTE: If a respondent wishes to verify the validity of the study, please contact:

Narrative Research: 888-414-1336; focusgroups@narrativeresearch.ca

NOTE THAT THROUGHOUT THE SCREENER, INSTRUCTIONS APPEAR BELOW EACH QUESTION

SECTION G: General Introduction

Hello, my name is _______________ and I am calling on behalf of Narrative Research, a national market research company. Let me assure you that we are not trying to sell you anything. As part of a research project that we are conducting on behalf of the Government of Canada, we are looking for males aged 20 to 59 years old who currently work or have worked in the past in construction and other physically challenging jobs to take part in a small online group discussion the week of <INSERT DATE>. Those who qualify and take part in the focus group will receive a $125 financial incentive. Is this something you might be interested in?

Yes...................................................... 1

No....................................................... 2

THANK & TERMINATE

Do you prefer to continue in English or French? / Préférez-vous continuer en français ou anglais?

RECRUITER NOTE - FOR ENGLISH GROUPS, IF PARTICIPANT WOULD PREFER TO CONTINUE IN FRENCH, PLEASE RESPOND WITH : « Malheureusement, nous recherchons des gens qui parlent anglais pour participer à ces groupes de discussion. »

« Nous vous remercions de votre intérêt. » OR « Désirez-vous que l'on communique avec vous à nouveau afin de vous inviter à participer à un groupe de discussion en français? »

The purpose of this group discussion is to hear people's views on communications materials currently being developed. Participation in this research is voluntary and completely anonymous and confidential. No attempt will be made to sell you anything or change your point of view. The format of the focus group is an informal online small group discussion led by a professional moderator. May I ask you a few quick questions to see if you have the profile we are looking? This should take about 6 or 7 minutes.

Yes...................................................... 1

No....................................................... 2

IF NO, THANK & TERMINATE

SECTION P: Profiling Questions

To begin…

Are you…?

Male................................................... 1

Female............................................... 2

Gender diverse................................. 3

Prefer not to say............................... 8

P1 INSTRUCTIONS: Consider if code 1 (male); Others, thank & terminate

Into which age group are you? [READ RESPONSES IN ORDER]

Less than 18...................................... 1

18-19.................................................. 2

20-29.................................................. 3

30-39.................................................. 4

40-49.................................................. 5

50-59.................................................. 6

60 or older......................................... 7

P2 INSTRUCTIONS: If less than 20 or 60 and older (code 1, 2 or 7), thank & terminate; Recruit good mix of ages in each session across the 20-59 age groups

In which province or territory do you currently live?

Record name of province/territory: ______________________

P3 INSTRUCTIONS: Aim for mix within each region where applicable

In which city, town or village do you currently live?

Record name of city/town/village: ______________________

P4 INSTRUCTIONS: Check against community quotas. Recruit equal mix of designated locations within each region

How long have you lived in <INSERT RESPONSE FROM P4>? [RECORD # of Years: _________]

Less than 2 years.............................. 1

At least 2 years or more.................. 2

P5 INSTRUCTIONS: Thank & Terminate if less than 2 years

Do you or any member of your household currently work in or has retired from working in…? [READ LIST - ROTATE ORDER]

Marketing/Market Research............................................................................................................... 1

Public relations, advertising, media (TV, Radio, Newspaper), graphic design.................................................................................................................... 2

A political party...................................................................................................................... 3

Federal or provincial government.......................................................................................................... 4

The field of drug treatment.............................................................................................................. 5

Law enforcement......................................................................................................... 6

The medical and/or pharmaceutical sector.................................................................................................................... 7

None of these...................................................................................................................... 8

P6 INSTRUCTIONS: If yes to any of code 1-7, thank & terminate. Continue if none of the above (code 8).

What is your current employment status?

Working full-time (at least 30 hours per week)...................................................................................................................................................... 1

Working part-time (less than 30 hours per week)...................................................................................................................................................... 2

Self-employed................................................................................................................................................ 3

Unemployed......................................................................................................... 4

On work leave (including seasonal workers)................................................................................................................ 5

Not in the workforce, and not looking for work (e.g., full-time homemaker)......................................................................................................... 6

Retired.................................................................................................................................................... 7

Student attending school full-time......................................................................................................................................................... 8

Other (Specify: _____)..................................................................................................................................................... 9

Prefer not to say........................................................................................................................................................... 10

P7 INSTRUCTIONS: If WORKING OR SELF-EMPLOYED (codes 1-3), continue to P8. If UNEMPLOYED or ON LEAVE or RETIRED (codes 4, 5 or 7), go to P9.

Recruit min 6 who are WORKING OR SELF-EMPLOYED (codes 1-3) and max 4 who are UNEMPLOYED, on WORK LEAVE or RETIRED (codes 4, 5 or 7); All others, thank & terminate

IF EMPLOYED IN P7 (codes 1-3), ASK: In what sector do you work and what is your current occupation?

Sector: ____________________________________

Occupation: ________________________________

P8 INSTRUCTIONS: Exclude sensitive occupations/industries identified at P6; Recruit only physically-demanding occupations in the designated sectors (e.g., no office workers or administrative staff and executives);

Recruit mix of occupations among the following physically demanding professions/sector:

- Recruit 6-8 participants in trade and construction (including electrician, carpentry, plumbing, masonry / stone work, drywalling, roofing, framing, demolition, welding, carpet layer/flooring, millwright, painter, pipefitter, plasterer, insulation installer, scaffolding, steeplejacking)

- Recruit 2-4 participants in the following occupations: transportation and warehousing; manufacturing; and transport and equipment operator (including heavy and tractor-trailer truck drivers, material moving machine operators, cargo and freight agents, forklift operator / driver, machine operator, material handler, material mover, heavy equipment operator, backhoe operator, shovel operator, loader operator, bulldozer operator, front end loader operator, forklift operator)

IF UNEMPLOYED OR ON WORK LEAVE OR RETIRED AT P7 (codes 4, 5 OR 7), ASK: Which of the following statements apply to your personal situation .

Within the last six months, I worked at some point in construction trades, long-haul trucking,

or heavy machinery operation.............................................................................................................. 1

Within the last five years, I worked for at least two years in construction trades, long-haul

trucking, or heavy machinery operation.............................................................................................................. 2

At any time in the past, I worked for a period of at least ten years in construction trades, long-haul

trucking, or heavy machinery operation.............................................................................................................. 3

None of the above..................................................................................................................... 4

P9 INSTRUCTIONS: Recruit min 1 and max 4 who answer code 1-3; if NONE (code 4) thank & terminate

[ASK IF CODE 1-3 AT P7 OR CODE 1-3 AT P9] [IF CODES 1-3 AT P7: Do] [IF CODES 1-3 AT P9: Did] you supervise others in your [IF CODES 1-3 AT P7: current] [IF CODES 1-3 AT P9: most recent] work position?

Yes...................................................... 1

No....................................................... 2

P10 INSTRUCTIONS: Recruit max 3 who answer yes in each group

What is the highest level of education that you have completed?

Some high school or less........................................................................................................................................ 1

Completed high school................................................................................................................................... 2

Some vocational studies................................................................................................................... 3

Completed vocational studies (without high school diploma)................................................................................................................ 4

Completed vocational studies (with high school diploma)................................................................................................................ 5

Some CEGEP/college/university.................................................................................................. 6

Completed CEGEP/college/university................................................................................... 7

Postgraduate studies above bachelor's level....................................................................................................................................... 8

Prefer not to say......................................................................................................................................... 9

P11 INSTRUCTIONS: Aim for a mix

What was your household's total income last year? That is, the total income of all persons in your household combined, before taxes?

Under $20,000.................................. 1

$20,000 to under $40,000.............. 2

$40,000 to under $60,000.............. 3

$60,000 to under $80,000.............. 4

$80,000 to under $100,000............ 5

$100,000 to under $150,000.......... 6

$150,000 or more............................ 7

Prefer not to say............................... 8

P12 INSTRUCTIONS: Aim for a mix

To make sure that we speak to a diversity of people, could you tell me what is your ethnic background?

White/European (for example, German, Irish, English, Italian, French, Polish, etc.)........................................................................................................................ 1

Hispanic, Latino, Spanish (for example, Mexican, Cuban, Salvadoran, Columbian, etc.)........................................................................................................................ 2

Black or African Canadian (for example, African Canadian, Jamaican, Haitian, Nigerian,

Ethiopian, etc.) ................................................................................................................................ 3

East Asian (for example, Chinese, Filipino, Vietnamese, Korean, etc.)........................................................................................................................ 4

South Asian (for example, East Indian, Pakistani, etc.) ................................................................................................................................ 5

Middle Eastern or North African (for example, Lebanese, Iranian, Syrian, Moroccan, Algerian, etc.)........................................................................................................................ 6

Indigenous (e.g. First Nations, Métis, Inuit)...................................................................................................................... 7

Other (Specify: ___)........................................................................................................................ 8

Unsure/Prefer not to say ................................................................................................................................ 9

P13 INSTRUCTIONS: Multiple responses allowed. Aim for a mix in each group; Recruit min 1 max 2 Indigenous in each group (code 7)

SECTION N: Netfocus Questions

The discussion groups for this project will be conducted over the phone and online simultaneously and will require the use of a laptop or a desktop computer to login to a website and a telephone line (either landline or cell phone) to join a conference call for the duration of the focus group session. Note that you can use a smart phone to join the telephone conference call but not to login on the web meeting, as the screen size is too small to see the material that will be shared with participants. For this reason, we also ask that you do not use a computer tablet to join the session.

NF1. Do you have access to a laptop or desktop computer with high-speed Internet to take part in this focus group?

Yes............................................................................... 1

No................................................................................ 2

NF1 INSTRUCTIONS: If no, thank & terminate

NF2. Once you are online for the session you will also be required to join a separate telephone conference call to be connected to the discussion with the rest of the group. You will need to use a telephone line and NOT your computer audio. Will you have access to a dedicated telephone (either landline or cellular) located near your computer to join the conference call? Note that you will not incur long-distance charges.

Yes ..................................................... 1

No....................................................... 2

NF2 INSTRUCTIONS: If no, thank & terminate

NF3. You will need to be in a place that is quiet and free of distractions for the duration of the session. This includes ensuring you can be on your own, without pets or other people nearby and in a quiet room. You will not be able to take part in the focus group from an outdoor area, a vehicle, or a public place, as these locations are too noisy. Are you able to secure a quiet and private environment without distractions or noises for the duration of the focus group session?

Yes ..................................................... 1

No....................................................... 2

NF3 INSTRUCTIONS: If no, thank & terminate

INSTRUCTIONS FOR NF1-NF3 THANK & TERMINATE: Based on your responses, we are unable to invite you to take part in this online focus group, as you do not meet the technical requirements. We thank you for your interest in this research.

SECTION R: Previous Focus Group Experience Questions

I just have a few more questions about your past participation in market research…

I1. Have you ever attended a group discussion or interview for which you received a sum of money?

Yes...................................................... 1

No ...................................................... 2

Max 5 per group who answer YES, then continue; If NO, go to SECTION I: INVITATION

I2. When was the last time you attended a group discussion or interview? _____________

I3. [ASK IF WITHIN PAST 5 YEARS IN R2] How many groups or interviews have you attended in the past 5 years? ____________

I4. What was the subject(s) of the focus group(s) or interview? __________________________

THANK AND TERMINATE IF THEY HAVE…

- been to 5 or more groups in the past 5 years (max 4 groups/interviews attended)

- attended a focus group in the past six months

SECTION I: Invitation

Based on your responses so far, we would like to invite you to participate in a small group discussion that will be conducted simultaneously over the telephone and online at<INSERT TIME> on <INSERT DATE>. The session will bring together 7 to 10 people and it will last between 90 minutes and 2 hours. The discussion will be about communications materials, including advertisements, currently being considered by the Government of Canada and you will receive $125 in appreciation for your time. To take part, you would simply log on to a secure website from your computer and at the same time join in a group discussion on the phone via conference call.

Are you available and interested in taking part in this focus group?

Yes...................................................... 1

No ...................................................... 2

I1 INSTRUCTIONS: If NO, thank & terminate

The discussion in which you will be participating will be recorded for research purposes only. Be assured that your comments and responses are strictly confidential and that your name will not be included in the research report. Are you comfortable with the discussion being recorded?

Yes...................................................... 1

No ...................................................... 2

I2 INSTRUCTIONS: If NO, thank & terminate

There may also be employees from the Government of Canada and a marketing company they are working with, who will be listening in on the discussion. They will not be given the last names of participants. Are you comfortable with having observers?

Yes...................................................... 1

No ...................................................... 2

I3 INSTRUCTIONS: If NO, thank & terminate

The group discussion will be held [GROUPS 1-4 & 6: in English] [GROUP 5: in French] . Participants may also be asked to read text, write responses and/or review images during the session. Are you able to take part in these activities [GROUPS 1-4 & 6: in English] [GROUP 5: in French] on your own, without assistance?

Yes...................................................... 1

No....................................................... 2

I am unsure....................................... 8

I4 INSTRUCTIONS: If NO or UNSURE, thank & terminate

Could we please confirm the email address where we can send you the detailed instructions for logging in to the group?

Record email address (and verify): ________________________________________________.

We will send you the instructions by email at least 1 day in advance of the group. The group discussion will begin promptly at<INSERT TIME> and will last between 90 minutes and 2 hours. Please log in 15 minutes in advance to ensure that the session is not delayed. If you arrive late, we will not be able to include you in the discussion and you will not receive the financial incentive.

As mentioned, we will be pleased to provide everyone who participates with $125, provided by e-Transfer or cheque, as you'd prefer. It takes approximately 3 business days to receive an incentive by e-Transfer or approximately 2-3 weeks following your participation to receive an incentive by cheque.

Would you prefer to receive your incentive by e-Transfer or cheque?

e-Transfer.......................................... 1

Cheque............................................... 2

I5 INSTRUCTIONS: If E-TRANSFER, continue to I6; If CHEQUE, skip to I7

Could you please confirm the e-mail address where you would like the e-transfer sent after the focus groups, as well as the proper spelling of your name? Note that the e-transfer password will be provided to you via email following the focus group.

RECORD EMAIL ADDRESS: ________________________

RECORD FIRST NAME: ___________________________

RECORD LAST NAME: ____________________________

Could I have the mailing address where you would like the cheque mailed after the focus groups, as well as the proper spelling of your name?

Mailing address:______________________________________________________________

City: _______________________________________________________________________

Province: ____________________________________Postal Code: _____________________

First name: ___________________ Last name: _____________________________________

As these are very small groups and with even one person missing, the overall success of the group may be affected, I would ask that once you have decided to attend that you make every effort to do so. If you are unable to take part in the study, please call_____ (collect) at ________, or email __________ as soon as possible so a replacement may be found. Please do not arrange for your own replacement.

So that we can call you to remind you about the focus group or contact you should there be any last-minute changes, can you please confirm your name and contact information for me?

First Name: ____________________________________________

Last Name: ____________________________________________

Email: ________________________________________________

Cell Phone: ____________________________________________

Home Phone: __________________________________________

Work Phone: ___________________________________________

I8 INSTRUCTIONS: Insert information already collected, for confirmation. If the respondent refuses to give his/her first or last name or phone number please assure them that this information will be kept strictly confidential in accordance with the privacy law and that it is used strictly to contact them to confirm their attendance and to inform them of any changes to the focus group. If they still refuse THANK & TERMINATE.

Thank you for your interest in our study. We look forward to hearing your thoughts and opinions!

Attention Recruiters

Recruit 10 participants per group
CHECK QUOTAS
Ensure participant has a good speaking (overall responses) ability-If in doubt, DO NOT INVITE
Do not put names on profile sheet unless you have a firm commitment.
Repeat the date, time and verify email before hanging up.

Confirming - DAY BEFORE GROUP

1. Confirm in person with the participant the day prior to the group- do not leave a message unless necessary
2. Confirm all key qualifying questions
3. Confirm date and time
4. Confirm they have received the login instructions

Appendix B:

Moderator's Guide

Health Canada:

Stigma and Opioid Harm Reduction Creatives and Message Focus Testing (HC POR 22-03)

Moderator's Guide - FINAL

Study Goals ( Confidential - Not read to participants)

• Evaluate various concepts for creative materials and determine if the content of each is:
• clearly understood by the audiences
• credible, relevant and of value to the audiences
• appealing and appropriate to the audiences
• able to motivate the audiences to take intended actions
• Compare content options to select the best language and presentation of key messages to the target audiences
• Elicit suggestions for potential changes to ensure the messages and products resonate with the target audiences

Introduction 10 minutes

• Welcome: Introduce Narrative Research as an independent marketing research company; introduce self and function of a moderator
• Topic & Sponsor: Today I'd like to explore your thoughts on advertising that is currently being considered by the Government of Canada for a public education campaign. We don't have a lot of time together, so we are going to try to really focus on this campaign.
• Length: Discussion will last between 1.5 and 2 hours.
• Participants' Role: All opinions are important; no right/wrong answers; need to understand agreement/disagreement;
• Confidentiality: Individual comments are confidential; no names in report; voluntary participation; ask participants to keep content of discussion in confidence.
• Logistics: Session recording; government employees & marketing firm representatives as observers, will not be taking part in the discussion
• Consent Form: We have sent you a consent form to participate in this research, and will require that sent back to us before we are able to pay you your incentive. The form outlines your agreement to take part, that your participation is voluntary, and details your rights under the privacy act.
• Platform Tools: Raise hand; chat window; mute/unmute; rejoining the audio if necessary
• Participant Introduction: In which city or community you live; who lives in your home; and what you like to do in your spare time

Creative Testing - Video 40-55 minutes

[10-15 min per concept] As I mentioned earlier, I'd like to show you a number of ideas for advertisements that could be used by the Government of Canada. We will start by looking at an idea for a 30-second video. Hold your thoughts as I show you the video; once I am done, I will ask for your individual opinion before we discuss this idea as a group. Please pay attention to both the message and how it is communicated, as we will be discussing and focusing on those aspects. I will play the video twice to give you more time to see its content. MODERATOR PRESENTS VIDEO VARIANT A - PLAY TWICE

AFTER PLAYING THE VIDEO: Before we talk about this idea, take a moment to answer, each on your own, the questions you see on the screen. Keep in mind, I can see your responses, but other participants will not.

[POLL A-C - OPINIONS CONCEPT A-C] Indicate on a 1-10 scale the extent to which the statement aligns with what you think (where 1 means "no, not at all" and 10 means "yes, absolutely"):

• Q1. This video grabs my attention.
• Q2. I would remember this video.
• Q3. This video motivates me to do something.

AFTER THE EXERCISE: Now let's talk about your reactions together…

• Message : What is this trying to communicate? What does the message suggest about addiction and help seeking? Is this credible? Is anything surprising? Have you learned anything?
• Call-to-Action : What impact does the message have on you? Does it change how you feel about anything? Does it motivate you to take action? If so, what would you do? Why? What else is this asking of people?
• Appeal/Tone : How does this video make you feel? How would you describe the tone? Is it appropriate given the topic?
• Relevance/Impact : What do you think about the way the message is communicated? Do any of the statements/taglines, words or expressions stand out? Which ones and why? FOR VIDEO VARIANT A ONLY: What do you think of the situations, scenarios, settings and people featured - are they realistic and relevant to you?
• Personal Relevance : Who is the message intended for: you, or someone different? IF NOT THEM: Why not you? What would make it feel (even) more compelling?
• Clarity/Appropriateness : Is anything (else) unclear, confusing or problematic?

I'd like to show you a variation of the video. It is very similar to the first one we looked at, with a few changes. PLAY VARIANT B TWICE AND REPEAT QUESTIONS AND GO THROUGH THE SAME PROCESS FOR VARIANT C

[10 min] AFTER THE THREE VIDEO VARIANTS HAVE BEEN REVIEWED/DISCUSSED : We have looked at three different versions of the video. Let's compare them. I will play each video one more time, and then I will ask you to choose the one that is the clearest, the one that resonates the most with you, and the one you like best. They can be the same or different choices. PLAY EACH VIDEO VARIANT ONCE

[POLL D - PREFERRENCES - VIDEO] Take a moment to complete a few questions:

• Q1. Which ad did you find the clearest? A, B or C?
• Q2. What message resonates the most with you personally? A, B or C?
• Q3. Which video inspires you to think differently or take action? A, B or C?
• Q4. Overall, which ad do you like best? A, B or C?

AFTER THE EXERCISE: Let's briefly chat about your choices:

• Clearest : And which one is the clearest? Explore reasons with 2-3 participants
• Resonate Most : Which one resonates the most with you? Explore reasons with 2-3 participants
• Take Action: Which video inspires you to think differently or take action?
• Like Best : Which ad did you like best? Explore reasons with 2-3 participants

Messages testing - wording in Calls to action 13 min

Now that we have discussed the videos, we would like to focus on the calls to action seen in these videos. I'd like to show you the three call to action messages that were included in the videos, and then I will ask you to answer a few questions.

POLL E - PREFERENCES - VIDEO] Take a moment to complete a few questions:

• Q1. Which message would motivate you to seek help or offer help?
• Q2. Which message did you find the clearest? A, B or C?
• Q3. What message resonates the most with you personally? A, B or C?
• Q4. Overall, which message do you like best? A, B or C?

AFTER THE EXERCISE: Let's briefly chat about your choices:

• Resonate Most : Which call to action resonates the most with you? Explore reasons with 2-3 participants
• Clearest : And which one is the clearest? Explore reasons with 2-3 participants
• Action: What, if anything, would you do after seeing / hearing this call to action?

Creative Testing - Audio Assets 25 minutes

[7 min per concept] I'd like to get your thoughts on two audio ads that could be used online or on the radio. Each one is 30 seconds long and we will discuss them one at a time. Let's listen to the first one - again, I will play it twice to help you remember its content. PLAY AUDIO CONCEPT 3 TWICE

Let's discuss your reactions together…

• Message : What is this trying to communicate?
• Appeal/Tone : How does it make you feel? How would you describe the tone? Is it appropriate given the topic?
• Personal Relevance : Does this speak to you personally? Why/why not? What would make it (even) more relevant to you?
• Call-to-Action : What impact does the message have on you? What would you do after hearing it? Why?

Let's review the second audio advertisement. PLAY AUDIO CONCEPT 4 TWICE AND REPEAT QUESTIONS

[5 min] [POLL F- PREFERENCES - AUDIO] Now that we heard two versions of the audio, I'd like you to answer a few questions:

• Q1. Which ad did you find the clearest?
• Q2. What message resonates the most with you personally?
• Q3. Which audio clip inspires you to think differently or take action?
• Q4. Overall, which ad do you like best?

AFTER THE EXERCISE: Let's briefly chat about your choices:

• Clearest : And which one is the clearest? Explore reasons with 1-2 participants
• Resonate Most : Which one resonates the most with you? Explore reasons with 1-2 participants
• Like Best : Which ad did you like best? Explore reasons with 1-2 participants
• Action: Which audio clip inspires you to take action?

(5 min) -

Videos could either include a voice-over (where you hear someone speaking) or only show text on-screen.

• Which approach do you think is stronger? Why?
• Is that the same for all video versions or would voice-over work with some but not others?
• Would you want sound if watching in some media but not others (social media vs. YouTube, etc.)?

IF TIME PERMITS: Creative Testing - Digital Ad 10 minutes

[5 min per option] Let's spend a few minutes looking at two versions of a digital ad that could be seen online. These are animated banner ads, meaning that they show a sequence of visuals with moving effects, in a rotational pattern. Each of the animated banners we will look at includes three frames. What I am showing you today are still images but you will need to consider that these would be combined into only one animated banner ad - you would see one frame after the other, in a loop. Like any other banner ads, these are clickable to reach a specific website. SHOW DIGITAL AD OPTION 1 ON THE SCREEN

Let's discuss your reactions together…

• Appeal/Personal Relevance : How does it make you feel? Does this speak to you personally? What would make it feel (even) more relevant?
• Call-to-Action : What impact does the message have on you? What would be your reaction seeing this online? What, if anything, would you do when seeing this? Why?

Let's review the second version. SHOW OPTION 2 ON THE SCREEN AND REPEAT QUESTIONS

Let's discuss your reactions together…

• Personal Relevance : Is one option more motivating for you personally? Which one and why? What would make these ads feel (even) more motivating?
• How do these ads make you feel about reaching out for help with addiction?
• Like Best: Which digital ad did you like best?

IF TIME PERMITS: Creative Testing - Social Media Posts 5-10 minutes

To finish up, I'd like to show you three social media posts that could be seen online. We will look at those side-by side and discuss them together. Keep in mind that these are independent ads - they would be shown separately. SHOW SOCIAL MEDIA POSTS (7130-social-mockup.jpg) ON THE SCREEN

Let's discuss your reactions together…

• Personal Relevance : Is one option more motivating for you personally? Which one and why? What would make these ads feel (even) more motivating?
• How do these ads make you feel about reaching out for help with addiction?
• Like Best: Which banner ad did you like best?

Thanks & Closure:

That's all my questions; thank you for taking part in our discussion. We will follow up with you by email regarding the incentive. Note that once finalized, the study report for this project will be available to the public through a government agency called Library and Archives Canada.

We appreciate that this discussion includes a serious topic that may trigger emotions for some. Resources are available if you need help. [show information on screen]

Wellness Together Canada offers free and confidential mental health and substance use services. You can talk one-on-one to a counsellor. Call 1-866-585-0445 or visit wellnesstogether.ca

Espace Mieux Être Canada offre des services confidentiels gratuits en santé mentale et pour la consommation de substances psychoactives. C'est possible de parler en tête à tête avec un conseiller. 1-866-585-0445) ou en ligne wellnesstogether.ca/fr-CA

Canada.ca/EaseTheBurden

canada.ca/allegeonslefardeau

Appendix C:

Materials Tested