Challenging Dogma - Spring 2011

Friday, May 20, 2011

Analyzing the Rebellion Against the Authoritarian National Drunk Driving Campaign – Norwin Espiritu

In an effort to reduce drunk driving in the US, the National Highway Traffic Safety Administration (NHTSA) implemented a “Drunk Driving. Over the limit. Under arrest.” campaign in 2006 (1). The target audience includes high-risk populations such as those under 21 years old, young adults aged 21 to 34, repeat offenders, and high-BAC (blood alcohol concentration) offenders (2). The NHTSA released public service announcements on television and radio that delivered messages of increased law enforcement presence on roads and zero tolerance for driving under the influence of alcohol among those that are caught by an officer (1).

The NHTSA drunk driving campaign uses imagery of police sirens, law enforcement officers, intoxicated drivers in alcohol-filled cars, sobriety tests, and arrests (1, 3). Television advertisements focused on young, primarily white, male adults driving through urban, rural, and suburban settings and getting arrested for drunk driving (1, 3). In a strong and dominant voice, the narrator of the radio and television commercials says, “All across America, police are stepping up enforcement, and if you drink and drive you will be arrested (1,3).” The NHTSA advertisements attempt to give listeners and viewers the impression that law enforcement is omnipresent and that any driver under the influence of alcohol will always get caught and arrested. These advertisement images, in combination with a stern male voiceover heard over commercials (3), sends a message of authority and punishment to deter the audience from drunk driving.

Several components of NHTSA’s “Over the limit. Under arrest.” campaign are flawed from a social behavioral standpoint, which limits its effectiveness in helping to changing driving behavior and to reduce the number of intoxicated drivers on the road. Messages of authority and punishment are used by the NHTSA to incite fear of the legal consequences of drunk driving among the public who are exposed to the campaign. The same authoritative message implicitly states that one should not drive impaired, but does not provide safer alternatives. The use of authority figures creates dissimilarity between viewer and communicator of the public health message. The campaign singles out young adult white males and fails to target other populations; it lacks representation of other populations that viewers can relate to. Another significant flaw of the campaign is the use of the Health Belief Model to influence driving after drinking behavior. The NHTSA campaign fails to examine the external factors—beyond the individual’s beliefs, attitudes, and perceptions—that also influence health behaviors. This paper will address the inherent flaws of the “Over the limit. Under arrest.” campaign using social science theories, principles, and research. An alternative approach to addressing alcohol-impaired driving will be proposed in an attempt to correct the existing campaign’s flaws. This new approach will incorporate elements from several social science theories, principles, and research to create a more effective alcohol-impaired driving intervention.

Critique Argument 1 –Threatening with Punishment Invokes Psychological Reactance

One major flaw of the “Over the limit. Under arrest.” campaign is that it is likely to induce psychological reactance among some viewers. The theory of psychological reactance states that if a person’s freedom of choice is threatened or reduced—especially if he or she is told not to perform a behavior, form an opinion, or have a specific attitude—then he or she is likely to react to restore the perceived loss of freedom (4, 5). Reactance is a motivational state aimed at restoring the threatened freedom (4). One way to restore freedom is to perform the forbidden act (5, 6). Watching or listening to the NHTSA public service announcements threatens a person’s freedom because the themes of authority and punishment immediately come to mind when exposed to these commercials. The viewer or listener can restore their perceived loss of freedom by performing the forbidden behavior of driving under the influence of alcohol. Although the campaign slogan and the dialogue of the narrator of the NHTSA commercials do not mention any commands similar to phrase “don’t drink and drive,” elements and themes of the commercials still incite psychological reactance.

The physical act of being arrested by a police officer automatically reduces one’s freedom for a period of time. Not only is the word “arrest” a part of the NHTSA slogan, but also the stern male voice in the television and radio commercials says the word “arrested.” A person watching or listening to this announcement may perceive their freedom as being threatened as a result of hearing the statement “you will be arrested” and seeing images of drunk drivers put in handcuffs. The freedom for one to be able to drive a vehicle in an intoxicated state is also threatened. The law enforcement figures also act as a symbol of a threat to freedom since they are the ones that perform the act of arresting people for driving while intoxicated. Viewing these police officers in the commercial can also incite reactance. In response to the advertisement and in order to restore personal freedom, one may choose to ignore the threat of punishment and choose to operate a vehicle while intoxicated. A drunk driver that does not get pulled over by law enforcement for impaired driving and arrives to a destination safely would be the ultimate act of defiance against the NHTSA public service announcement and law enforcement.

The use of law enforcement and acts of arrests to send a message against drunk drivers in a public heath campaign can be seen as a scare tactic. Public health campaigns that ineffectively use fear can produce the opposite of the desired effects by making the target audience more likely to continue with the unhealthy behavior (7). The reasons why the NHTSA alcohol-impaired driving campaign is ineffective in using fear to dissuade people from driving impaired can be explained by psychological reactance. As mentioned previously, the use of authority and punishment to convey a message against drunk driving causes psychological reactance. In addition, the more directive and controlling a persuasive message is perceived to be, the more likely its position is to be rejected (8). Restoring one’s freedom by continuing to drive impaired makes the fear tactic of this campaign ineffective because it is ignored and has no effect on behavior. The lack of similarity and the use of the Health Belief Model to attempt to change perceived susceptibility and severity, as explained in the following sections of this paper, give additional reasons why the NHTSA’s use of fear tactics to ‘scare’ people out of a risky behavior is ineffective.

Critique Argument 2 - No Similarity Means More Reactance

The use of authoritative figures in the NHTSA drunk driving commercial creates a feeling of disconnect between the officers in the commercial and viewers of the commercial. Unless the viewer is also in law enforcement, he or she will not feel any interpersonal connection with the police officers in the advertisement. This feeling of disconnect is caused by little or no similarity between viewers and authoritative figures. In the advertisement, the police officer is on the job, dressed in a uniform, drives a marked police car, and is authorized to stop drivers to perform tests if sobriety is in question. In contrast, persons viewing the commercial (represented by the intoxicated drivers in the commercial) are likely to be civilians wearing casual clothing, drive personal cars, and are subject to questioning and arrest if impaired driving is suspected. Similarity is an effective method of overcoming reactance when freedoms are threatened because attraction to the communicator is likely to lead to compliance of the health message being delivered (5). Liking another person increases the tendency to like the objects that the other person likes (9). In this case, the audience is not likely to view the narrator and law enforcement in the NHTSA commercial as attractive; as a result, they will be unfavorable of the public health message and stray away from compliance. Similarity also enhances the communicator’s credibility, which further increases the likelihood of compliance (5). Although police officers are credible with respect to law enforcement and public safety, viewers may find incredibility in their messages about increase police presence and sobriety checkpoints on roads and see it as a bluff; this gives drunk drivers another reason to not be compliant with the public health message.

Critique Argument 3 – Ineffective Use of the Health Belief Model and Optimistic Bias

The Health Belief Model attempts to explain and predict health behaviors. The primary components of this model are perceived susceptibility and perceived severity of a potential health threat and the perceived benefits of and perceived barriers to adopting the recommended health behavior (10,11). Each component is defined as follows: susceptibility is the perceived likelihood of developing a health risk; severity is the perceived seriousness of a health condition and its consequences; benefits is the perceived benefits of adopting the recommended behavior that will prevent the health problem from occurring; and barriers are the factors that might prevent the adoption of the suggested health behavior (10,11). The Health Belief Model also has the following assumptions: 1) Individuals are responsible for their own health and can implement changes to enhance their health, 2) People value good health and will make the necessary changes to reduce behaviors that adversely affect health, 3) Behavior is willingly controlled by an individual, and 4) Beliefs, attitudes, and perceptions drives health behavior (12). In addition, the Health Belief Model is focused on the individual level and does not factor in a person’s own personal experiences, demographics, the social and environmental contexts of which a person is making a health decision or performing a health behavior, and interpersonal relationships (13).

The “Over the Limit. Under Arrest.” campaign uses the Health Belief Model to attempt to change the public’s perception of the susceptibility getting pulled over by police for drunk driving and the severity of the consequences of drunk driving. The attempt to change perceived susceptibility of potential drunk drivers getting pulled over by law enforcement is done by announcing that police officers are increasing their presence on the streets (the commercial shows images of sobriety checkpoints and an officer circle areas of a map to strategize the location of such checkpoints) (1, 3). The campaign attempts to alter the perceived severity of the consequences of driving drunk by threatening potential drunk drivers with getting arrested and jailed, rather than addressing the likelihood of severe injuries or fatalities from an accident. The campaign then assumes that a person will take their own perceptions and beliefs about drunk driving and then make a decision on whether or not to not adopt the risky behavior of driving while intoxicated. The problem with using the Health Belief Model in a campaign to prevent drunk driving is that not all individuals will necessarily weigh the costs and benefits of drunk driving before making the decision of whether or not to drive while intoxicated. Although the campaign advertisement does not mention any health benefits or risk, it assumes that people will value not getting arrested or thrown in jail. Certain people may value the freedom of being able to drive their own car, intoxicated or sober, more than not taking the chance to avoid getting arrested or thrown in jail. The NHTSA’s drunk driving campaign does not address the other factors that can influence a person’s decision to drive under the influence of alcohol such as interpersonal relationships, the social and environmental context in which a person decides to drink and drive, and core values that an individual considers most important.

The problem with the NHTSA using the Health Belief Model to counteract drunk driving is that some people believe that they have low to zero risk of getting caught by law enforcement due to past experiences and due to optimistic bias. Optimistic bias, or unrealistic optimism, refers to the notion of perceiving oneself as being less likely than average to experience a negative event (14). Persons who decide to drive while alcohol-impaired are overly confident in that they believe they are less likely than others to get caught by police or be involved in an accident. If a person’s perception of susceptibility of getting arrested by police for drunk driving is already low to begin with, then it will be difficult for a public health campaign using the Health Belief Model to take advantage of perceived susceptibility and severity to convince the public to avoid the behavior of driving while intoxicated.

The results of an experiment to test the theory of optimistic bias by Weinstein showed that a group of students tended to believe that they were more likely than their peers to experience positive events and less likely to experience negative events (14). We can assume the drunk drivers believe that they are less likely than their peers to get caught by an offer for alcohol-impaired driving. This experiment also revealed event characteristics that are likely to influence optimistic bias of drunk drivers: degree of desirability, personal experience and perceived controllability (14). The act of getting pulled over, arrested, and thrown in jail by law enforcement can be considered as a highly undesirable event; therefore, drunk drivers will have the tendency to believe that their own chances of receiving punishment for alcohol-impaired driving is less than average. Persons who drive while intoxicated on multiple occasions without getting caught by police will increase the likelihood that they will believe their own chances of receiving punishment is less than average. And because a person is in the driver’s seat and in control of the car, then there will also be an increased likelihood that he or she perceives her chances of punishment for driving under the influence of alcohol is less than average. Because of optimistic bias, people believe that their chances of getting arrested are low; so they will be less inclined to change their existing behavior (i.e., driving while alcohol-impaired) to lessen the probability of that negative outcome. The “Over the Limit. Under Arrest.” campaign and the Health Belief Model fail to take into account optimistic bias and its ability to distort a person’s perceived susceptibility.

Proposed Intervention – “Be Driven”

The “Over the Limit. Under Arrest.” campaign is filled with many flaws that can be corrected using social-level theories. In combating alcohol-impaired driving, a campaign should not focus on the negative consequences; rather it should focus on the positive alternative solutions to drunk driving. A public health campaign that centers on punishment and authority will likely result in psychological reactance, dislike of the communicator of the health message, and unchanged risk behavior. So the first step in reforming the NHTSA campaign is to remove all negative connotations and images—this starts with the campaign slogan “Over the Limit. Under Arrest.” Because this slogan contains the word “arrest,” it may lead to a perceived threat of freedom and psychological reactance, as described earlier. A simple slogan can be deemed ineffective if it conjures up a negative reaction by the public.

A potential replacement for the existing NHTSA slogan would be the term “Be Driven.” This phrase has two meanings. First, it says that you should “be driven,” literally, by someone else—a taxi driver, a sober friend, a chauffeur, etc. The second meaning of “Be Driven” suggests that you should have the motivation (i.e., have the emotional drive) to arrive to your destination in a safe manner so that you can reap the rewards of what awaits you at that destination. The encouragement to find a safer alternative to drunk driving will be supported by images of various transportation options. Unlike the “Over the Limit. Under Arrest.” campaign, the “Be Driven” advertisements will not use scare tactics to force people out of a risk behavior, and will not leave the public with no alternative options. The rewards can be almost anything such as the comfort of one’s bed, a spouse or partner, food, etc. Both meanings of this new slogan can be supported by images and characters in various forms of advertisements such as television commercials, web advertisements, and billboards.

This new public health campaign against drunk driving will not focus on negative health consequences or legal punishments. Instead, different forms of advertisement will display the various options that people have to move from one destination to the next after a night (or day for some) of drinking alcoholic beverages. One advertisement may display a group of friends leaving a nightclub, riding a taxi, singing along to music, and then finally arriving to a diner to enjoy a late night meal. Another advertisement can show a person leaving with a sober friend from a party and being driven back home to his or her spouse. In order to be more relatable to the audience, characters in advertisements will be of varied race/ethnicity, gender, and socioeconomic status. No single demographic population will be singled out for this campaign.

In each advertisement, characters will say the phrase beginning with “I want to Be Driven…” and ending with a choice of a destination to emphasize the fact that they desire to be driven to a location safely. The slogan itself will be displayed at the end of each commercial and on every billboard advertisement.

Defense of Intervention 1 – Reduces Psychological Reactance

The goal of the “Be Driven” campaign is to minimize or eliminate any tendencies to provoke resistance or dislike among the public. Dillard and Shen state that explicitness, dominance, and reason are factors that influence the degree to which a message induces psychological reactance in an audience (6). Explicitness is defined as the degree to which the language of a message makes plain the source’s intent (6). The NHTSA campaign uses explicit language such as “you will be caught” or “you will be arrested” to reveal its intention of threatening the audience with punishment in order to scare people out of alcohol-impaired driving. The “Be Driven” campaign will be free of similar explicit messages and contain more implicit messages to suggest the alternative methods to drunk driving. Dominance can be paralleled with forcefulness or authoritarianism; it captures the extent to which a messenger believes he or she can control the recipient of the message (6). The NHTSA campaign uses police officers and an authoritative narrator to display its perceived dominance over the audience. The “Be Driven” campaign will be removed of any authority figures and will not attempt to explicitly control the audience to perform a suggested behavior. Reason is the justifications offered in support of the claim that the audience should adopt the position advocated by the source (6). Arrest and jail sentencing are reasons the NHTSA is justifying for not drinking and driving. These reasons are forms of punishment and therefore a scare tactic that the audience may not take seriously and may find it as a threat to freedom that will cause reactance. In contrast, the “Be Driven” campaign will use the reasons of social interaction, love (between spouses or partners), and satisfying hunger to justifying finding safer alternative to drunk driving. The audience may find these themes more welcoming and less threatening to their freedoms.

The existing NHTSA drunk driving campaign uses explicit images and language pertaining to drunk driving. The audience is immediately made aware that the campaign is about and against drunk driving. The “Over the Limit. Under Arrest.” campaign uses explicitness and dominance to condemn the act of driving under the influence of alcohol. Given the potential ineffectiveness and audience reactance to a fear-based campaign, the tendency to view health promotion as the removal of unhealthy behavior should be resisted in favor of viewing health promotion as the promotion of healthy alterative behaviors (7). Rather than explicitly stating that the public should not perform an unhealthy behavior, the “Be Driven” campaign promotes the alternative behaviors to drunk driving.

Defense of Intervention 2 – Using Similarity to Promote Compliance

Similarity can have a significant impact on mitigating reactance against a public health message in two ways: 1) it increases the likelihood of compliance by increase a liking for the health communicator, and 2) it takes away from resistance by creating a positive interpretation of the communicator’s actions and threat to freedom (5). The “Be Driven” campaign uses similarity to achieve these objectives. Characters and communicators in television commercials, billboards, and other advertisement will represent people of various demographic backgrounds. Viewers will see people in these advertisements as less threatening; as a result, they will have a positive interpretation of the health message and will be more likely to comply with the communicators.

Similarity has been proven in research to be influential in compliance with a message, even if the message is a threat to freedom. In an experiment by Paul Silvia (5), people developed reactance against a threatening message from communicators that were dissimilar or anonymous. Yet a threatening message from a similar communicator was just as persuasive as a non-threatening message. This experiment shows that people will comply with a public health message, even if it threatens personal freedom, as long as the communicator is similar and likeable. The “Be Driven” campaign will consist of characters that the general audience can relate to based on gender, race/ethnicity, socioeconomic status, and personality. Viewers will more likely be attracted to the characters in the advertisement because of similarity. Thus, messages about alternate behaviors to drunk driving will be perceived as positive and credible.

Defense of Intervention 3 – Social Norms Approach is More Effective than the Health Belief Model approach

The “Over the Limit. Under Arrest” is largely driven by the health belief model and attempts to change behavior on the individual level. The NHTSA campaign assumes that individuals will use their perceptions on severity and susceptibility to outweigh the costs and benefits of not drunk driving. On the other hand, The “Be Driven” campaign strays away from the individual level model and takes a social norms and social marketing approach to change behavior on a population level.

The social norms approach addresses the accurate, positive norms currently existing in a population (15). In terms of alcohol consumption and driving, some of the positive norms are finding a sober designated driver, calling a taxi, or performing other activities while waiting to sober up. Fear-based media efforts can compete with the positive social norms messages by exacerbating the misconceptions about the prevalence of impaired driving (15). The “Be Driven” campaign eliminates the use of scare tactics in media and promotes the social norms revolved around alcohol and driving.

A social norm campaign has proven to be successful on a state level. In Montana, a social norms media campaign was launched to reduce the prevalence of driving after drunk among young adults (15). The campaign successfully reduced the target population’s misperceptions of the frequency of impaired driving among their peers by centering around the slogan “MOST of Us Prevent Drinking and Driving” (15). This change in perception was associated with a 13.7-percent relative decrease in the percentage that reported driving after drinking and a 15-percent relative increase in the percentage that reported always using non-drinking designated drivers (15). This intervention shows that social norms campaigns can be successful on changing perceptions, reported behaviors, and attitudes on a large scale.

The “Be Driven” campaign takes advantage of social marketing theory to promote alternative health behaviors. Branding is defined as a set of associations linked to a name, mark, or symbol associated with a product or service (16). By utilizing branding, the “Be Driven” campaign associates its slogan with positive health behaviors of taking a taxi or having a sober designated driver after becoming intoxicated with alcohol. By using positive reinforcement, the campaign becomes associated with ideas of choice, control, social interaction, etc. The audience can associate the positive images in the campaign advertisements with the positive outcomes of choosing behaviors other than drunk driving. By taking a social approach, the “Be Driven” campaign does not have to work on changing individual perceptions, beliefs, attitudes, and behaviors. Taking a social approach to driving after driving avoids having to overcome the difficulties with optimistic bias amongst drunk drivers and its effect on perceived susceptibility.

Conclusion

The “Be Driven” campaign has the potential to be an effective tool to combat drunk driving. This new campaign corrects the inherent flaws of NHTSA’s “Over the Limit. Under Arrest.” campaign. Authority, dominance, and punishment are used by the NHTSA campaign to incite fear in the public about drunk driving; it is likely to encounter psychological reactance because these themes are considered a threat to freedom. The NHTSA campaign also relies on perceived susceptibility and perceived severity to be high in order to be effective. However, optimistic bias among drunk drivers comes into play, which lowers perceived susceptibility. The “Be Driven” campaign uses a less-threatening approach to combat drunk driving by promoting alternative behaviors and removing the themes of dominance, explicitness, and punishment. Using social norms and social marketing promotes the use of positive images that are likely to encourage positive alternatives to drinking and driving.

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