What I’ve been up to – Spring 2017 edition

The big news is that the Club Soda Guide pilot project is now over. The Guide is still very much alive though, with over 250 venues signed-up so far, more joining every week, and the first batch of great places for mindful drinkers announced. We have also just released our evaluation report “Building a Mindful Drinking Movement” which has all the highlights from the project.

Non-alcoholic beers are becoming a bigger and bigger thing. Just the latest new entrant to the market is Nirvana, who have built the UK’s first dedicated low and no alcohol brewery in Leyton, east London. Their beers are very good, and they also do other fun stuff like non-alcoholic beer and yoga sessions. I also wrote a quick post about the five best non-alcoholic beers.

And low/no beers were a bit of a feature at Morning Advertiser’s MA500 pub event in Liverpool in May, where we were invited to talk about the Guide, and beer writer Pete Brown led a tasting of 0.5% beers and cider.

So that’s been the spring. The summer will mostly be taken by the organisation of UK’s first Mindful Drinking Festival that Club Soda is putting together in August, at Bermondsey Square. We are bringing together some of the best beers and wines under 0.5% abv as well as some great new soft drinks and even newer things like kombucha.

And we are also hoping to make some noise about the UK’s out-of-date labelling rules and regulations on low and no-alcohol drinks. It is an absolute mess at the moment, and so complicated that even lawyers are having a hard time figuring out what you can and can’t call “alcohol-free”.

Guest blog on “Behaviour change for pubs and bars”

I was asked to write something for the Society for the Study of Addiction about our Nudging Pubs work in changing the behaviour of pubs and bars.

My guest post was on the two theoretical foundations of our project: a taxonomy of behaviour change tools, and a typology of nudges. The first is a UCL-led project, the second is from Cambridge University’s Behaviour and Health Research Unit.

Read the post at SSA’s website.

A typology of nudges

We’re working on an assessment tool to use with pubs and bars. The tool is meant to measure how welcoming the venues are to their non-drinking (or “less-drinking”) customers. We have been pondering all the various factors we could include in the tool, and how to classify them.

Having met some people from the Behaviour and Health Research Unit (BHRU) at Cambridge, they pointed me to their paper “Altering micro-environments to change population health behaviour: towards an evidence base for choice architecture interventions” in BMC Public Health. It could just help us get some of our ideas in order too.

The article has a nice typology for “choice architecture interventions in micro-environments”; I’ll just call them nudges from now on. There are nine types of nudges in this scheme:

    • Ambience (aesthetic or atmospheric aspects of the environment)
    • Functional design (design or adapt equipment or function of the environment)
    • Labelling (or endorsement info to product or at point-of-choice)
    • Presentation (sensory properties & visual design)
    • Sizing (product size or quantity)
    • Availability (behavioural options)
    • Proximity (effort required for options)
    • Priming (incidental cues to alter non-conscious behavioural response)
    • Prompting (non-personalised info to promote or raise awareness)

The first five types change the properties of “objects of stimuli”, the next two the placement of them, and the final two both the properties and placement.

I can see how we could use this as a basis for our thinking on the factors we want to measure pubs and bars on. For example, some basics like the choice of non-alcoholic / low-alcohol drinks would be about Availability, display of non-alcoholic drinks could be Presentation, Proximity and also Priming, drinks promotions would be Prompting and Labelling, and staff training could perhaps be about Prompting too?

I can’t instantly think of anything that we couldn’t fit into the typology (although we might need some flexibility of interpretation!). Interestingly, when the Cambridge researchers reviewed the existing literature, they could only find alcohol related nudges of the ambience, design, labelling, priming and prompting types. And not many studies overall, especially compared to research on diet which was the most popular topic for these types of nudges.

On the other hand, we could probably also find at least one metric for every one of the nine types of nudges, but they might not be the most interesting or important ones for this project. But it could still be a useful exercise to go through.

Nudging Pubs

Nudging Pubs is the final title to a little project that Club Soda completed last year (it was called “the Dalston Burst” at the start). The final report (pdf) from the project is now out, along with a brand new website.

The aim of the project was to answer this question:

How can we encourage pubs and bars to be more welcoming to customers who want to drink less alcohol or none at all?

The report has the findings from our research and experiments, along with recommendations and key messages. And the great news is that Hackney council are funding a second year of this project, for which Club Soda has partnered with Blenheim CDP. We’ll use the Nudging Pubs website for regular updates on the project, but I’ll probably do something occasionally on this blog as well.

Digital health & wellbeing conferencing

Last week saw the second of UCL’s behaviour change conferences, this year subtitled Digital Health & Wellbeing. And quite a bit bigger than last year’s first one. I spoke in a panel on “Challenges to creating sustainable, high impact interventions” (see below), and also had a poster on Club Soda’s Month Off Booze programme (a “prize-nominated poster” no less, though the prize went to someone else…).

UCL panel tweet

Some of the themes that I picked up on over the two days were:

Tailoring of messages – e.g. app prompts, emails, social media messages and so on. The more personalised these can be made, the better the engagement. This may also include personalizing the tools by the users themselves (e.g. adding bookmarks and notes).

Importance of good design – nobody likes an ugly app. Some features divide opinion (e.g. cartoon talking heads), some are not liked by anyone, and sometimes people take you by surprise. For example, German youth much prefer factual information about alcohol harms to “fun” factoids. Well, thinking about this a bit more, perhaps it’s not so surprising that teens don’t find funny the things that public health officials think they should do…

Communities/social support – several interesting projects included some elements of this, and with good results too.

Not just apps – this is one of my personal bugbears, but I did hear other people as well talk about the fact that apps are no longer the only game in town. They may be a part of a bigger intervention, or they may not be included at all. And sometimes the preferred medium is not what you expect at all: in one example, people much preferred text messages to emails, as emails “reminded them of work”(!).

Not just RCTs – a few critical comments on these too. There are alternatives available, which can be much quicker and easier to do.

New recruitment avenues – GumTree was mentioned several times as the source of study participants!

Evaluation of eHealth/mHealth interventions – this research is making progress. A Cochrane review of digital alcohol reduction interventions is nearing completion, with some interesting findings on what seems to work and what doesn’t. I’m really looking forward to reading the full study soon.

Poor engagement levels – an oft-cited figure was the 20% of apps that are only ever used once and then ignored. And very few are used at anything like “frequently”. This creates problems for evaluation as well, as the drop-out rates in some studies can be over 90%.

Dose – again, several speakers mentioned this as an open issue. What is the “dose” of a digital intervention, can it be altered, how to measure it, and does it make a difference?

Qualitative data too! – A fascinating comment by Nikki Newhouse: when she interviewed people about their use of a website, the stories completely contradicted the researchers’ conclusions from the quantitative data. For example, people had seemingly spent lots of time on one page, but had in fact found it so confusing that they had often “gone to make tea instead” and not actually read it at all!

All in all a stimulating two days again, with lots to take away and ponder.

e-Content

Forgot to mention this earlier, but the Club Soda team (Laura, Cassie, me) wrote a little e-Book: “How to go dry this January (and make it stick)”. It is based on some free booklets we wrote and gave away to Club Soda members during (dry) January, with some extra material thrown in. The only drawback is that the book is only available for Kindle from Amazon at the moment. But we’re working on an expanded book which we’ll share more widely.

In other news, I’ve also been writing an eight-week email-based behaviour change course for people wanting to cut down or quit drinking: 8 Weeks to Change Your Drinking. The first customers are on day 23 now, and I’m looking forward to the first proper feedback from them next week.