Summary of the impact

This case has generated a new model of communication practice to deal with sensitive issues and risk behaviours. A range of personal and policy community impacts were achieved through implementing peer-led dialogue workshops focused on young people's experiences and discussion around the issue of alcohol. This intervention programme provided evidence of self-realization, self-esteem and personal growth benefits among pupils in five secondary schools in Edinburgh. The programme had an impact on the thinking of the Scottish policy community in relation to public health communication approaches on the issue of young people and alcohol.

Underpinning research

The project responded to the need identified by the Scottish Government following its establishment of the Scottish Youth Commission on Alcohol (SYCA), a 12-month project set up to enable young people to conduct their own inquiry into the social problem of alcohol in Scotland. The Commission, which reported in March 2010, articulated the need to promote and evaluate peer education approaches and the desirability of young people acting as `co-designers of alcohol and education packages'. This project addressed these recommendations and, in the process, effected personal change and influenced policy perspectives.

The project drew on theories of dialogue and deliberative democracy which combined a strong stance on the ethics and role of social communication with extensive empirical insights, particularly in the fields of community development and public policy. The key themes in the literature can be seen as addressing the problem of social capital and governance, the nature of social relationships constituted through communication practices, the question of the relationship between knowledge, action and policy (Habermas, 1987; Putnam, 2000; Fischer, 2009; Gastil, 2008; Anderson et al, 2004). The project focused in particular on the extensive argument about the transformative power of dialogic communication (Gastil and Levine, 2005) ascribed to its ability to build common ground (if not always consensus) while at the same time acknowledging difference as legitimate and an enriching feature of social life.

The project adopted the methodological approach of action research to help young people to change their practices of learning about alcohol (focusing on three types of knowledge: reflective, relational and practical) through a peer-led collaborative approach. The intervention was designed to create learning and self-reflection, and was carried out through pupil-led dialogue groups in a two-meeting programme working with diverse groups of pupils. The programme was supported by a custom-made education film (meeting 1) that led to modelling of constructive behaviours, including communication behaviours and through a game designed for this purpose by the original group of volunteers (meeting 2). The project delivered relevant outcomes at individual and group levels and influenced the ways in which policy-makers and health communicators think about how young people approach the issue of alcohol.

The case study, built on critical research on dialogue and its application in a range of applied and policy contexts, was conducted by Magda Pieczka, Emma Wood and Oliver Escobar at the Queen Margaret University Centre for Dialogue and disseminated among a range of practitioner and academic audiences through conference presentations and scholarly outputs, for example Pieczka, Wood & Escobar (2010), Escobar (2010), (Pieczka & Wood (2013) (see References to Research). The AlcoLOLs project was an intervention designed collaboratively with pupils from the Portobello High School (PHS) and piloted initially on 350 PHS pupils. The AlcoLOLs project received £58K funding from the Robertson Trust (Scottish independent grant-making body) in October 2012 to fund fully the first year of a three-year project to extend the project to five high schools in North East Edinburgh, in areas of the highest levels of social deprivation in the city (Scottish Index of Multiple Deprivation, 2012). The project will involve approximately 500 teenagers by December 2013 and 3500 teenagers by December 2015. On 19 November 2013, The Trustees gave verbal notification that the Trust would support the project for a further two years.

The impact case study also drew on interdisciplinary connections within QMU between colleagues working within applied communication (public relations) and health ( Alcohol and Health subtheme of Social Determinants of Health Theme) http://www.qmu.ac.uk/research_knowledge/social- determinants-health/research.htm

The conceptual phase of the research started in 2009; research is currently on-going and planned to continue until 2015. The key researchers were:

• Dr Magda Pieczka, Lecturer, Media, Communication & Sociology; from June 2010, Reader Media, Communication & Performing Arts
• Emma Wood, Senior Lecturer, Media, Communication & Performing Arts
• Oliver Escobar, Research Assistant, part-time, September 2008-August 2010

References to the research

Details of the impact

The project aimed to:

1) produce ideas and solutions for how young people can be assisted and encouraged in learning together, and from one another, about dealing with alcohol;

2) deliver outcomes at the level of personal development and citizenship skills for participants;

3) offer policy-makers and public health communicators a well designed and tested way of introducing peer-led education as an accepted element of the range of approaches and communication methods used in this specific area.

The `ground up' intervention offered a distinctive dialogic model of handling young people's learning about alcohol as a risk issue in order to demonstrate its potential for individual change by improving communication skills in relation to sensitive subjects. The project was presented to the policy community as an innovative approach that was different to established persuasive social marketing approaches. There is evidence that the project has raised awareness within key communities of the value and contribution of peer education. This claim is based upon individual testimonies of participants, their schools and those in the medical and policy communities who have offered platforms to disseminate the project findings. A specific example of corroboration is given in Dr MacGilchrist's statement.

Impact was embedded in the action research approach. The young people developed personal skills through the implementation of their own programme of alcohol education, running dialogue groups, making a film and a game that modelled constructive behaviours. By providing the opportunity to design their own projects, the intervention contributed to the young people's confidence and autonomy.

The project had an impact on the lives of young people at PHS as demonstrated by their own proactive agency in mentoring new volunteers who have extended the project to younger generations at PHS and four other schools. Evidence of personal change and growth was captured on film (see below) and in feedback sheets. Project reach will continue to extend via the young people who act as ambassadors for the dialogue workshops. The workshops specifically enhance young people's social and citizenship skills (self-reflection, respect and civility, listening skills, openness, constructive attentiveness to differences and collaborative learning). Such capacities have potential to contribute to civil society over the longer term.

Sources to corroborate the impact

The case has altered the culture of alcohol intervention in schools away from rational-choice `push' models toward a ground-up approach. The evidence of impact has emerged through the researchers' action research approach and involvement in a diverse range of networks.

The following outputs explained how impacts were achieved and corroborated:

• Pieczka, M. and Wood, E. (2013) Action research and public relations: dialogue, peer learning and the issue of alcohol. Public relations Inquiry 2(2): 61-181.
• Pieczka, M. and Wood, E. (2013) Action research and public relations: dialogue, peer learning, and the issue of alcohol, Top Paper (1st Prize), Public Relations Division, International Communication Association, June 2013.

Dissemination leading to impact at the policy and practitioner level

• Invited presentation on 28 March 2012 at the Scottish Parliament dissemination to policymakers and the community of experts involved in education and policing of the AlcoLOLs project.
• Invited presentation of AlcoLOLs project, at the Young People and Alcohol Conference organised by Comic Relief, 25 October 2012.
• Presentation to the Scottish Government, 28 November 2012 including communications and social marketing leads.
• Scottish Learning Festival, Glasgow, September 2012 (workshop) - http://www.educationscotland.gov.uk/Images/slfprogramme_tcm4-722745.pdf.
• Royal Infirmary, Edinburgh, invited presentation to Gastroenterology and Liver Unit meeting, 23 October 2012.
• Invited presentation of the AlcoLoLs project to the Robertson Trust representatives, QMU, 23 August 2012.
• Presentation to North East Drugs and Alcohol Forum, Edinburgh, 8 May 2012 (Minutes available).

Individual level of impact.

Pupils: own reflection captured on film (QMU holds statements and comments from 180 feedback sheets at Portobello High School):

"Now I am more accepting of other people... if you don't want to drink.. then of course..."

Impact at school and local community level

1) Edinburgh Community Alcohol Partnership (http://www.communityalcoholpartnerships.co.uk/) 26th April 2012 minute extract available on impact of the project on the local community

2) Head teacher interview: September 2012 (untranscribed digital record). There were 180 volunteers who at this school participated in dialogue groups run by the AlcoLoLs in spring/summer 2012.

3) Eric Chen, Project Worker (Alcohol and Emotional Health), Health Opportunities Team, Interview, August 2013:

"From what I've read [the Community Alcohol Partnership were] not so much about work with young people specifically. It was much more about licensing, the business side... that's why at the last meeting we were both at, I thought, I'm doing the education side... we are talking about cultural shift...CAP needs to bring about that kind of change. AlcoLOLs have already started that conversation. [My colleague's project] is in Portobello and Piershill, so a lot of young people would be [from] Portobello and Craigmillar area so being at Portobello [High School] and having done the AlcoLOLs adds to the conversation. I think there is [more need] to build on the dialogue that is already happening in Portobello High [School] .... We work with different schools Castlebrae, Holy Rood, Portobello in the area .... My sense from the education side of things is that young people in Portobello seem to have more openness to speaking about attitudes towards alcohol. They've got a broader understanding of the social control, influences and impact of alcohol use and that to me is quite different comparing to, for example to Castlebrae. The pupils there don't have the same level of awareness, I would say. ... In Portobello, especially the older year groups, I work with them and they seem to have a very open attitude towards alcohol. It's not to say that they are necessarily not drinking or ...but they seem to be more informed in making choices about alcohol use.... That they can articulate...it could be because the school is very supportive but just the way they were talking about it is very similar to the principles of AlcoLOLs, I would say based on watching [your video at the event]. Some of the young people that were at that event I met them later at schools and they were able to articulate within the group. So in some way I think that directly contributed to giving them confidence in speaking about alcohol."

Impact on Health

Dr Alastair MacGilchrist, Consultant Gastroenterologist/Hepatologist, NHS Lothian:

"I am a liver specialist, working every day with patients whose health and lives are being blighted by the adverse consequences of drinking too much alcohol. Despite many public health campaigns regarding the dangers of alcohol, the problem has continued to increase until liver disease is now the second commonest cause of death amongst adults of working age. It is striking, and alarming, how many young patients I now see with this problem. The ineffectiveness of previous public health campaigns is this area may be due to the "top down" approach to education. I was therefore greatly impressed and encouraged by the AlcoLOLs film which takes an entirely fresh approach with the emphasis on peer-to-peer education and support. It appears to be strikingly successful and has been rolled out from the original to five further local schools. As well as viewing the original film, I have contributed to group sessions where the youngsters are being trained to inform, help and support their fellow schoolchildren. Again, I was most impressed with the vigour and enthusiasm of both the leaders and the participants, and have genuine hopes that this approach could herald a breakthrough in this crucial area. Therefore, I fully support this application to remake the film to make it suitable for a wider audience as I am convinced that there is merit in pursuing this schoolchildren-directed approach to reducing alcohol harm in young people".