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Original Research
Riding the rural radio wave: The impact of a community-led
drug and alcohol radio advertising campaign in a remote
Australian Aboriginal community
Alice Munro, BSW (Hons), BA,
1
Julaine Allan, BSW PhD,
2
Anthony Shakeshaft, BA,
PhD,
1
and Mieke Snijder, MSc
1
1
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, and
2
The Lyndon Community, Orange, New South Wales, Australia
Abstract
Objective:Aboriginal people experience a higher
burden of disease as a consequence of drug and
alcohol (D&A) abuse. Although media campaigns
can be a popular tool for disseminating health pro-
motion messages, evidence of the extent to which
they reduce the impact of substance abuse is limited,
especially for rural Aboriginal communities. This
paper is the first to examine the impact a locally
designed D&A radio advertising campaign for Abo-
riginal people in a remote community in Western
NSW.
Design:A post-intervention evaluation.
Setting:The radio campaign was implemented in
Bourke, (population 2465, 30% Aboriginal).
Participants:Fifty-three community surveys were
completed.
Main outcome measure(s):The self-reported level of
awareness of the campaign and the number of self-
referrals to local D&A workers in the intervention
period.
Results:Most respondents (79%) reported they listen
to radio on a daily basis, with 75% reporting that
they had heard one or more of the advertisements.
The advertisement that was remembered best con-
tained the voice of a respected, local person. There
was one self-referral to local health services during the
intervention timeframe.
Conclusion:The community-led radio advertising
campaign increased community awareness of substance
abuse harms, but had limited impact on formal help-
seeking. This paper highlights the value of radio as a
commonly used, trusted and culturally relevant health
promotion medium for rural communities, especially
when engaging local respected Aboriginal presenters.
KEY WORDS: Aboriginal, community-led, drug and
alcohol, health promotion, radio.
Introduction
Indigenous people of Australia (hereafter Aboriginal
Australians as the term recommended by the Aborigi-
nal Health and Medical Research Council for New
South Wales) experience a higher burden of health-
related harm compared to non-Aboriginal Australians,
which is most starkly evidenced by the Aboriginal life
expectancy being an estimated 10 years less than non-
Aboriginal Australians.
1
This health disadvantage
imposed on Aboriginal Australians is a consequence
of the complex legacy of generational trauma, the
aetiology of which includes colonisation (disposses-
sion, forced relocation, stolen generations), racism,
social disadvantage and exclusion.
1–4
For the purpose
of this paper, the specific manifestation of genera-
tional trauma on which the community-designed inter-
vention aimed to impact is the disproportionately high
rates of substance abuse harm among Aboriginal,
compared to non-Aboriginal Australians.
1,5,6
The
alcohol related burden of disease, for example is 6.1
times higher for Aboriginal men than non-Aboriginal
men.
5
Smoking rates are approximately three times
higher for Aboriginal Australians (45–50% preva-
lence) than for non-Aboriginal Australians (17%
prevalence).
1,7
Furthermore, people living in regional
and remote areas (which generally have higher pro-
portions of Aboriginal populations) have higher rates
of smoking and heavier alcohol use compared to
cities.
1,8
Harm minimisation has underpinned the Australian
National Drug Strategy for over 20 years and
Correspondence: Alice Munro, National Drug and Alcohol
Research Centre, University of New South Wales, Sydney, New
SouthWales2052,Australia.Email:a.munro@unsw.edu.au
Conflicts of interest: None.
Accepted for publication 17 November 2016.
doi: 10.1111/ajr.12345©2017 National Rural Health Alliance Inc.
Aust. J. Rural Health (2017) ,–
bs_bs_banner
incorporates three approaches: supply reduction,
demand reduction and harm reduction.
9
Demand
reduction prevention, or ‘upstream’ strategies, such as
mass media campaigns are designed to influence beha-
viour in the general population by removing or lower-
ing obstacles to change, encouraging people to adopt
healthy behaviours, identifying unhealthy social norms
and invoking cognitive or emotional responses
designed to positively influence individuals’ decision-
making processes.
10
While there is some evidence that mass media cam-
paigns are effective in the general population,
10–12
there is a lack of evidence that they are effective in
reducing drug and alcohol (D&A) use for rural Abo-
riginal populations. A recent review concluded only
that culturally specific campaigns for Aboriginal Aus-
tralians are more likely to be effective because they
reflect Aboriginal worldviews,
13
whereas one small
study found that a mainstream anti-smoking campaign
positively influenced the thoughts and behaviours of
Aboriginal smokers towards quitting.
14
This lack of Aboriginal-specific evidence clearly
indicates scope for further evaluations of the impact of
media campaigns aimed at reducing the burden of
D&A related harms among Aboriginal rural popula-
tions. Radio advertising as a D&A demand reduction
strategy is promising because radio has comparable
ratings to television advertising on understanding,
believability, highlighting the D&A harms, and
increasing self-reported motivation to quit, but is rated
significantly higher on unprompted recall.
15
Further-
more, compared to television, radio campaigns are
usually cheaper for broadcasting health messages,
potentially have a greater reach into low and middle-
income communities, and have been shown to be a
trusted source of media for minority groups, such as
African-American populations.
15
This paper is the first to examine the impact of a
D&A radio advertising campaign aimed at, and
designed by, Aboriginal people in a remote community
in New South Wales (NSW).
Method
Context
The radio campaign was implemented in Bourke, popu-
lation of 2465 people (30.2% Aboriginal),
16
a remote
community located in north western NSW. The radio
campaign was developed under the guidance of the
Bourke Alcohol & Drug Working Group (known
locally as ‘BAWG’). BAWG membership included
health staff and managers, representatives from the
Murdi Paaki Drug and Alcohol Network (MPDAN),
police, local government representatives and Aboriginal
Elders. BAWG formed in response to the perception of
these community experts of escalating D&A issues in
Bourke in the mid-2000s. Figure 1
17
illustrates the
accuracy of the community perception in relation to
alcohol-related harm, indicating that alcohol-related
crime in Bourke peaked in 2004/5. Community leader-
ship around the escalating D&A trends resulted in
Bourke being the first community in NSW to introduce
voluntary alcohol restrictions in February 2009.
18
To
complement these restrictions, BAWG was awarded a
2011 Community Drug Action Team (CDAT) grant of
$10 000 to develop and broadcast local radio advertise-
ments that aimed to challenge listeners to consider their
own or their family’s substance use, increase awareness
of D&A harms and prompt them to refer themselves or
their family members to a local D&A worker for spe-
cialist advice about how to reduce those harms.
What is already known on this subject:
Aboriginal people living in rural areas
experience a higher burden of disease as a
consequence of substance abuse compared to
non-Aboriginal Australians.
Although mass media campaigns are a popu-
lar method of disseminating health promo-
tion messages across Aboriginal and rural
communities in Australia and internationally,
their effectiveness in reducing the impact of
substance abuse is variable.
There is limited research on the use and
impact of radio as a relevant and well-trusted
form of media in Aboriginal communities.
What does this study adds:
This evaluation has demonstrated that radio
can be a relevant and well-trusted form of
media in Aboriginal communities, reaching a
large cross-section of Aboriginal listeners
and achieving high recall of substance abuse
related messages, provided those messages
are derived from meaningful consultation
with the community.
Identifying complementary strategies to fur-
ther improve the impact of radio advertise-
ments on behaviour change, such as formal
help-seeking, would enhance the evidence for
mass media as a key strategy for reducing
substance abuse harms in rural Aboriginal
communities.
©2017 National Rural Health Alliance Inc.
2A. MUNRO ET AL.
Intervention development and
implementation
The content of seven radio advertisements was devel-
oped in collaboration with local community members.
A young mum’s group, for example helped write one
of the scripts relating to peer pressure. This iterative
process ensured that the radio advertisements were
meaningful and relevant by reflecting local issues and
the use of locally used terms and language. Table 1
summarises the topics and scripts used in the
advertisements.
The advertisements were produced by a locally run
and owned Aboriginal radio station, called ‘2CUZ.’
Locally known and respected Aboriginal and non-
Aboriginal community members were used to voice
the radio advertisements. The advertisements were
played concurrently on two radio stations (‘2 Cuz’
and ‘2WEB’) that collectively transmit a signal across
a 500 km radius from Bourke. The radio advertise-
ments were broadcast 25 times a week on both radio
stations for 4 months (December 2011–April 2012)
during off-peak hours. Summer was thought to be an
appropriate time to broadcast the advertisements as
D&A related harms tend to be higher due to seasonal
festivities and holidays. Off-peak times were preferred
because BAWG members reported people drinking at
those times and listening to the radio stations while
they were drinking. The radio advertisements
were also less expensive to run during off-peak
broadcasting.
Data sources
Survey
The primary outcome was the awareness of the radio
advertisement. A 15-item community survey was
developed in consultation with the BAWG divided in
three domains: (i) demographics; (ii) use of radio and
recognition of the advertisements and (iii) impact of
the radio advertisements. The survey utilised tick
boxes, circling pictorial symbols and open-ended
questions.
Drug and alcohol referral records
The number of referrals to local services in the com-
munity was reported by the D&A workers situated at
the local health services.
Participants
A total of 53 survey participants were randomly sam-
pled from the Bourke community. A total of 60% of
the participants identified as Aboriginal, half (53%)
were employed; and the majority (94%) resided in
the township of Bourke. Table 2 outlines the demo-
graphics of the participants.
Data collection procedure
Surveys were conducted on a Thursday afternoon
after the broadcasting period by two Aboriginal
0
20
40
60
80
100
120
140
160
180
200
2002: Jan - March
2002: July - Sept
2003: Jan - March
2003: July - Sept
2004: Jan - March
2004: July - Sept
2005: Jan - March
2005: July - Sept
2006: Jan - March
2006: July - Sept
2007: Jan - March
2007: July - Sept
2008: Jan - March
2008: July - Sept
2009: Jan - March
2009: July - Sept
2010: Jan - March
2010: July - Sept
2011: Jan - March
2011: July - Sept
2012: Jan - March
2012: July - Sept
2013: Jan - March
2013: July - Sept
2014: Jan - March
2014: July - Sept
No. of incidents
Quarters of the year
Bourke
alcohol
restricons
introduced in
February
2009
Radio
adversing
project
commenced
in December
2012
FIGURE 1: Rates of alcohol-related crime in Bourke from 2002–2014.
©2017 National Rural Health Alliance Inc.
3RIDING THE RURAL RADIO WAVE
TABLE 1: Overview of the radio advertisement campaign messages
Topic Radio advertisement script
Effects of alcohol use
Scene: the grog is
talking to you as you
drink it, ‘Who am I’
question)
‘Who am I? My first name is ‘Al.’ (short pause) I can be your best friend and I can be your worst
enemy at the same time. I can lose you your wife or husband, house, kids, dignity, freedom,
money, respect, job, licence... and more. I can make you say things you don’t mean. I can make
you do things you wouldn’t normally do. Any idea of who I am?... (PAUSE) I’m alcohol’
Announcer: Grog –it’s not the answer to the problem..... It’s the problem. So be strong... if you
or someone close to you needs help, please contact Bourke Community Health or Bourke
Aboriginal Health Service or your local Aboriginal Medical Service. Sponsored by the Bourke
Alcohol & Drug Working Group
Financial cost of
substance use
Scene: Conscience is
talking to an
intoxicated person
about getting a hit over
spending money on
food for kids
Conscience: ‘Good Job’
Intoxicated person: ‘Huh?’
Conscience: ‘Good Job’
Intoxicated person: ‘Oh yeah?’
Conscience: ‘You spent your last few dollars to get like this’
Intoxicated person: ‘(Giggles) Yeah... I did’
Conscience: ‘What are ya gunna get the kids for dinner, sis?’
Intoxicated person: ‘Uh, I dunno...’
Conscience: ‘How much longer you gunna last?’
Intoxicated person: ‘Maybe an hour?’
Conscience: ‘Well that was money well spent, wasn’t it?’
Announcer: Drugs won’t fill your kid’s belly. If you or someone close to you needs help, please
contact Bourke Community Health or Bourke Aboriginal Health Service or your local Aboriginal
Medical Service. Sponsored by the Bourke Alcohol and Drug Working Group
Effects of
methamphetamines
Scene: Aboriginal
Health Worker is
talking to the
community about the
harmful effect of the
drug, ice
‘Hey there, all of us at the Bourke Alcohol and Drug Working Group wanted to talk for a moment
about the drug, Ice. Do you know much about it? It’s actually hard to know about it as every
batch of ice can be different and very unpredictable. It is the most potent stimulant or
amphetamine out there. This also means it has far stronger side effects and you can experience
worse downers. Spinning out when using ice can also often occur and is caused by high and
frequent doses. It is characterised by paranoid delusions, hallucinations, and bizarre and violent,
aggressive behaviour. These symptoms usually disappear a few days after the person stops using
ice, but by that time you can get you in trouble with the police or your family. So be strong... if
you or someone close to you is using ice and wants help, please contact Bourke Community
Health or Bourke Aboriginal Health Service or your local Aboriginal Medical Service.’
Announcer: Sponsored by the Bourke Alcohol and Drug Working Group.
Peer pressure and
substance use
Scene: Lots of voices,
like they’re in your
head, peer pressuring
you to use a substance
Voice 1: ‘Don’t worry... just do it’
Voice 2: ‘C’mon.... try me... you’ll like it. I’ll be your best friend, be by your side when you’re
alone, we’ll be together forever’
Voice 1: ‘I’ll make you feel good, give you energy, I’ll solve all your problems, I’ll make you
party all night long.’
Voice 2: ‘Now, I’ve got you’ (demanding / domineering)
Voice 1: ‘I’ll get you addicted, use all your money. I’ll destroy your relationships; make you lose
your children.’ (getting stronger)
Voice 2: ‘I’ll make you steal; I’ll make you lie... All you will want in life is me
Voice 1: ‘But most of all, in the end I’ll take your life one way or another’
Voice 2: ‘What’s wrong? It’s not MY fault... you made the choice to take me, didn’t you?’
(sneering)
Announcer: If you have a grog or drug problem, go see the staff at Bourke Aboriginal Health
Service or Bourke Community Health or Bourke Aboriginal Health Service or your local
Aboriginal Medical Service. Sponsored by the Bourke Alcohol and Drug Working Group with
the help of the Bourke Young Mum’s group
(continued)
©2017 National Rural Health Alliance Inc.
4A. MUNRO ET AL.
TABLE 1: (continued)
Topic Radio advertisement script
Effects of yarndi use
Scene: Female and
male teenage cousins
talking to each other
Boy: ‘Hi sis’
Girl: ‘Hey bro –what’s doing, haven’t see ya in a while?’
Boy (depressed): ‘(sigh) Nuthin... am bored, nuthin to do round ‘ere’
Girl: ‘That’s no good my brother –I just bin for a run and now I got some homework to get
done!’ (PAUSE)
Boy: ‘You wanna go for a smoke and catch up –I really need it’
Girl: ‘Nah bro, I don’t do that sort of stuff. I’m too busy to get involved with stuff like that....
But I’ve noticed you’re different since you’ve started smokin’ the yarndi –less like yourself or
sumthin’
Boy: (angrily) ‘You’re making that up... I got no worries’
Girl: ‘Well I heard people bin saying they worried bout you smoking that crap –just thought I’d
let ya know that’s all, cos you’re me family and I care bout ya...’ (PAUSE)
Girl: ‘Well if ya want help with it, you can go talk to someone at the Bourke AMS or
community health. Anyways, I’m off to do me homework for tomorrow!’
Announcer: Yarndi –it’s not in our way. Go to school and play sport –don’t choose yarndi. If
you or someone close to you needs help to cut back on yarndi, please contact Bourke
Community Health or Bourke Aboriginal Health Service or your local Aboriginal Medical
Service. Sponsored by the Bourke Alcohol and Drug Working Group
Effects of tobacco
smoking
Scene: Father confronts
teenage son about
finding a packet of
smokes in washing
Father: Boy, is this yours? (angrily)
Son: No... (defensive)
Father: Your mum found this pack of ciggies in your washing...
Son: I dunno.... Maybe one of the fellas? (defensive)
Father: One of the fellas? Whaddya mean? (ANGRILY)
Son: Look Dad... I don’t wanna talk about it. (defensive)
Father: Where did you get these smokes? Answer me boy (pushy, angrily)
Son: LOOK DAD... It doesn’t matter where I got them, I have seen YOU and MUM smokin’
ALL my life (PAUSE) Maybe YOU should have thought about THAT before you yell at me.
(Emphasis in the capital words)
Announcer: Parents who use drugs have kids who use drugs –break the cycle before it becomes
your kid’s habit. If you need help to give up smoking, please see the staff at Bourke Aboriginal
Health Service or Bourke Community Health. Sponsored by the Bourke Alcohol and Drug
Working Group
Safe partying message
Scene: Nephew and
Uncle talking about a
Chrissy party on the
weekend
Uncle: ‘Hey Reece, whatchya been up to mate?’
Reece: ‘Not much Unc but am getting keen for this party on the weekend aye!’
Uncle: ‘Oh are you going are ya?’
Reece: ‘Sure am... gunna be a BIIIIGGGG one –Chrissy break-up and all!You better be getting
stuck in with me...’
Uncle: ‘Nah mate, I’ll come but gotta drive to Dubbo Sunday so gotta make sure I’m under. Are
you drinking, eh?’
Reece: ‘God yeah... I need it’
Uncle: ‘Member last time you had a big one? I couldn’t wake you for hours... was really
worried bout ya and almost called the ambos..’
Reece: ‘What are you saying... stop being me father...’
Uncle: ‘Look, I’m not telling you to not drink... you deserve a bit of fun. But this time just do it
a bit safer bro. Like you could try having a water in between, or have a big feed before you go.
Do you drink heavies or mid strength?’
(continued)
©2017 National Rural Health Alliance Inc.
5RIDING THE RURAL RADIO WAVE
Health workers. Thursday afternoon was identified as
a favourable day to maximise responses, as families
are paid government allowances on this day. As an
extra incentive to participate, respondents had the
chance of winning a $50 meat voucher from a local
butcher.
Ethical considerations
The project meets the Standards for Quality Improve-
ment Reporting Excellence Guidelines (SQUIRE).
19
A
post-intervention evaluation of the radio campaign
was implemented as a component of the MPDAN
Evaluation Framework. MPDAN was funded by the
Council of Australian Governments in 2008 to reduce
the harms related to D&A use in remote Aboriginal
communities in the Murdi Paaki region of Western
NSW. The network comprised three Aboriginal Medi-
cal Services, a public health service and a D&A treat-
ment agency. The evaluation framework aimed to
identify any impact of MPDAN activities on the com-
munities and to monitor and improve the service
delivery activities of the network as a result.
Results
Survey participants
The characteristics of survey participants are shown in
Table 2. More than half (60%) identified as Aborigi-
nal, about half (53%) were employed and the majority
(94%) resided in Bourke.
Use of radio and recognition of the
advertisements
The majority of participants (79%) reported listening
to radio daily, whereas 15% reported that they some-
times listen to the radio and 6% reported that they do
not listen to the radio. Three-quarters of respondents
TABLE 1: (continued)
Topic Radio advertisement script
Reece: ‘Heavies mate... why, what’s the difference?’
Uncle: ‘Mid-strength cans are only 1 standard drink, and heavies are 1.5 standards drinks... so a
bit less alcohol can mean ya won’t pass out or start bluen’ like you did last time
Reece: Well, maybe I’ll try middies this time... they’re a bit cheaper too!Tar Unc’
Uncle: ‘No worries brother, see ya Saturday.’
Announcer: ‘Party safe this summer. Look after yourself and your mates. And make sure,
whatever you do... your kids are safe, as you can look after yourself –but they can’t.’ Sponsored
by the Bourke Alcohol and Drug Working Group
TABLE 2: Characteristics, radio use and advertisement
recognition of survey participants
Characteristic N %
Total 53 100
Sex
Male 26 49
Female 27 51
Age
18–25 7 13
26–34 9 17
35–44 10 19
45–54 16 30
55+11 21
Aboriginal status
Aboriginal 32 60
Non-Aboriginal 16 32
Did not specify 5 8
Usual residence
Bourke area 50 94
Other 3 6
Employment status
Employed 28 53
Unemployed 6 11
Retired 5 9
Other 14 27
Use of radio
Listen to radio daily 42 79
Sometimes listen
to radio
815
Do not listen to radio 3 6
Recognition of advertisements
Heard one or more
advertisements
40 75
Did not hear the radio
advertisements
815
Unsure/did not specify 5 10
©2017 National Rural Health Alliance Inc.
6A. MUNRO ET AL.
reported hearing at least one of the advertisements,
17% did not hear any advertisements, 6% were unsure
and 4% did not specify. The advertisement that
prompted the greatest recognition contained the voice
of a local well-known and respected young person from
the community. Table 2 summarises responses for the
use of radio and recognition of the advertisements.
Impact of the advertisements
More than a third of respondents considered that the
advertisements challenged their own, or their family’s
thinking about substance abuse (39%) and 22%
reported that they sought help.
Referrals to drug and alcohol workers
Drug and alcohol workers reported one self-referral dur-
ing the period that the advertisements were broadcast.
Discussion
The current evidence-base for media campaigns to
reduce D&A harms in rural Aboriginal communities
comprises very limited research.
5
However, it is known
that tailoring media campaigns, specifically using radio
as a medium, can be an effective way to target messages
to Aboriginal Australians.
5,6
The results of this project
indicate that the community led radio advertising cam-
paign increased community awareness given the high
level of recognition of the radio advertisements, but
had a limited impact on formal help-seeking, given
low numbers of self-referrals. Furthermore, based on
the trend in Figure 1, a reduction in alcohol-related
crime can be identified after the implementation of the
radio advertisements, but it is not possible to infer cau-
sation due to the retrospective, single setting design of
the study.
In addition to the primary outcomes, this evaluation
highlights that a high percentage of the sample (94%)
self-reported that they listen to the radio on a ‘daily
basis’ or ‘sometimes.’ This finding supports the pre-
mise that radio is a commonly used, trusted and cul-
turally relevant medium for health promotion
14,15
and is highly relevant to rural or remote Aboriginal
communities.
A strength of the project was the process of design-
ing and implementing the radio advertisements to
reflect local issues, language and culture, which
ensured that the content was optimally meaningful
and engaged with the target audience. Given the
unique characteristics of the Bourke community, rele-
vant community members and groups participated
throughout all phases of the project to develop or pro-
vide feedback on the content for the advertisements.
The MPDAN evaluation framework that supported
the project was also important in identifying the need
for research on D&A projects and encouraged com-
munity members to evaluate the impact of their cam-
paign. The community and MPDAN staff were able to
develop an appropriate, practical evaluation methodol-
ogy capable of assessing and explaining community
led D&A project outcomes, albeit with some method-
ological limitations.
Engaging with researchers or evaluation experts at
the time the radio advertisement was being developed
would have better facilitated the evaluation process
and likely delivered a more methodologically robust
evaluation. For example a pre-radio advertisement
survey could have provided baseline data, against
which to compare the post-test data. In addition, a
literature search to identify and adapt best-evidence
measures of awareness and best-evidence methods for
optimising the accuracy of participants’ recall could
have been undertaken and the results applied to this
evaluation. It may also have been possible to imple-
ment the radio advertisements in one or two other
communities, which would have enabled an analysis
of routinely collected data, such as the crime data
presented in Figure 1, using a multiple baseline
design.
20
In addition to utilising higher quality
research methods, collaboration with academic part-
ners may even generate ideas to further improve
community-designed programmes: for this pro-
gramme, the inclusion of complementary social media
and text messaging services, for example may have
achieved enhanced outcomes.
1,5
Conclusion
The research evidence-base for effective media cam-
paigns targeting substance abuse among Aboriginal
Australians in rural and remote communities is cur-
rently insufficient. This evaluation has demonstrated
that radio can be a relevant and well-trusted form of
media in Aboriginal communities, reaching a large
cross-section of Aboriginal listeners and achieving high
recall of substance abuse-related messages, provided
those messages are derived from meaningful consulta-
tion with the community. Identifying complementary
strategies to further improve the impact of radio
advertisements on behaviour change, such as formal
help-seeking, would enhance the evidence for mass
media as a key strategy for reducing substance abuse
harms in rural Aboriginal communities.
Acknowledgements
The authors would like to acknowledge the Bourke
Alcohol Working Group (BAWG) and the Murdi
©2017 National Rural Health Alliance Inc.
7RIDING THE RURAL RADIO WAVE
Paaki Drug and Alcohol Program (MPDAN) for their
assistance with developing the programme and con-
ducting the evaluation. We also thank Lillian Lucas,
Chair of the Bourke Aboriginal Health Service
(BAHS), for her timely advice about the importance of
linking current, specific substance abuse harms to gen-
erational trauma.
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©2017 National Rural Health Alliance Inc.
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