What We Have Learned : Key Canadian FASD Awareness Campaigns

Table of Contents

Acknowledgments
Executive Summary

1. The Survey

1.1 Purpose
1.2 Methods
1.3 Limitations
1.4 Respondents

2. The Role of Awareness Campaigns

2.1 Types of Prevention
2.2 Stages of Change
2.3 Threat and Efficacy
2.4 Reasons for Awareness Campaigns

3. The Issue: Prenatal Alcohol Exposure

3.1 Alcohol Use and Pregnancy
3.2 Stigma and Judgmental Attitudes
3.3 Raising Awareness About FASD

4. Geographic Trends
5. Preparing for an Awareness Campaign

5.1 Gathering Information
5.2 Funding Sources
5.3 Timing of Campaign
5.4 Campaign Objectives

6. Partnerships
7. Population of Interest
8. Campaign Messages and Identity

8.1 Tone
8.2 Key Messages
8.3 Images

9. Campaign Strategies

9.1 Choosing Strategies
9.2 Campaign Resources
9.3 Use of Mass Media
9.4 Warning Strategies

10. Evidence of Campaign Effectiveness
11. Campaign Strengths
12. Areas to Reconsider

12.1 Negative Responses
12.2 Things to Do Differently
12.3 Areas of Controversy

13. Support for Local Initiatives
14. Advice to Others
15. Featured Campaign
16. Implications
17. References
18. Appendices

Appendix 1: Survey Respondents
Appendix 2: Survey Instruments
Appendix 3: Helpful Resources
Appendix 4: Insights

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Acknowledgments

The Best Start Resource Centre would like to acknowledge the many groups and organizations that shared information about their fetal alcohol spectrum disorder (FASD) campaigns and activities, as well as the individuals who linked the Best Start Resource Centre to others who were working in this area. Without their careful work, passion for this topic and willingness to share information, this report would not have been possible.

The Best Start Resource Centre would also like to acknowledge the contributions of the project advisors who assisted in the development and design of the national survey and resulting report:

Lois Crossman, Saskatchewan Prevention Institute

Nancy Dubois, The Health Communication Unit, Centre for Health Promotion, University of Toronto
Annamaria Feltracco, Feltracco Consulting
Anne George, Community Child Health Research, and H.E.L.P., University of British Columbia
Laura Heal, Alberta Alcohol and Drug Abuse Commission
Della Maguire, Mi'kmaq First Nation Healing Society
Louise Morin, SAFERA
Karen Palmer, FASD Information and Consultation Service
Nancy Poole, BC Women's Hospital
Susan Santiago, Motherisk
Pat Spadetto, Timiskaming Brighter Futures

Executive Summary

The Best Start Resource Centre was contracted by the Public Health Agency of Canada to review recent Canadian awareness campaigns about prenatal alcohol exposure. Phone surveys were completed with respondents who had developed large-scale campaigns, or smaller, innovative campaigns. The campaign topics ranged from preventing prenatal alcohol exposure to supports for those affected by fetal alcohol spectrum disorder (FASD).

The purpose of this review was to gather information to assist groups that are planning future awareness strategies related to FASD or alcohol use in pregnancy. Valuable information was gathered about campaign effectiveness, development, design, and sensitive and respectful approaches.

The resulting report reinforces that, when planning awareness campaigns about alcohol use in pregnancy or FASD, it is critical to:

• follow basic accepted practices related to the development of effective health communication campaigns

• carefully consider and test all aspects of the campaign to ensure that they are as respectful and sensitive as possible to women who are struggling with alcohol use and to families affected by FASD

The main themes are :

• FASD Campaigns: Awareness strategies are one component of a broader strategy to address prenatal exposure to alcohol. Awareness campaigns have the potential to influence levels of awareness, knowledge and attitudes; encourage information seeking behaviour; show how to make change; indicate where to get services; and clarify, remind, reinforce and encourage people who already know the facts. With sufficient exposure, an awareness campaign can result in changes in risk behaviour.

  Strategies to address FASD are mutually reinforcing and can be combined to create a comprehensive approach. FASD campaigns should be connected to other FASD strategies. Careful planning is required to avoid unnecessary repercussions for women who drink alcohol and for families affected by FASD.

• Preparing for a Campaign: The planning stages of campaign development are important and lay the groundwork for effective, sensitive approaches. It is helpful to gather information about other FASD campaigns, effective strategies and knowledge levels in the population of interest. Campaign objectives should be specific, measurable, attainable, realistic and time-specific. Campaigns are often scheduled for times of the year when others will also be addressing FASD, such as International FASday, or at times of the year when alcohol use is more prevalent.

  Funding can assist in campaign development, implementation and evaluation. Funding can come from a wide variety of sources. Some groups, through teamwork and creative thinking, succeeded in implementing an awareness campaign with little or no funding.

• Partnerships : Involving a wide range of partners in campaign planning, including the population of interest, helps groups to understand and address FASD in an appropriate manner and can increase the staff time and funding for a campaign.

• Population of Interest : Campaigns should be carefully designed for a specific population of interest. They are most effective with a large, well-defined group of individuals who are at lower risk.

• Campaign Messages and Identity: A positive, supportive approach is recommended for FASD campaigns, avoiding the use of blame, shame and fear-based strategies.

  Campaign messages can be used to increase knowledge and awareness. They can also link people to further information, services and support. Information about levels of awareness can help when selecting campaign messages. Images are powerful and are as much a part of the message as the chosen words. Both campaign messages and images should be chosen with care and be tested with the population of interest.

• Campaign Strategies: A wide variety of strategies can be used in campaigns, including media, personal contact or events. Careful planning and creative thinking are important when selecting campaign strategies. It can be helpful to find out about the strategies used in other campaigns.

  There are many excellent FASD campaign resources. Groups with minimal budgets can make good use of existing resources. There are also benefits to developing new FASD campaign resources for specific populations and messages. All resources should be tested with the population of interest, whether they are new or existing.

  The media are important in providing message exposure. Creative approaches are needed to continue to bring this issue to their attention.

  Warnings about alcohol use in pregnancy can also be used to raise awareness. There are many different ways to present warning messages, such as signs in restaurants and bars, on liquor bags and on cash register receipts.

• Evaluation: Most respondents were able to measure the impact of their campaigns only through informal means such as qualitative feedback.

  Four recent Canadian awareness campaigns had the funding for pre- and/or post-campaign surveys. These four campaigns resulted in measurable increases in awareness, and good campaign and/or message recall. Successful campaigns have common characteristics: they were carefully planned, used multiple strategies, focused on a specific problem, used carefully selected messages and images, had good reach and considered current levels of awareness. Successful campaigns focused on large populations and were designed for populations at lower risk.

  Respondents recognized that some negative comments are to be expected, even when a campaign is planned carefully. These negative comments often stem from misinformation about FASD.