Dutch adolescents often start drinking alcohol at an early age. The life-time prevalence for drinking alcohol is 56% for twelve year olds and 93% for sixteen year olds. Also, 16% of twelve year olds and 78% of sixteen year olds drink alcohol regularly. In comparison with other young people in Europe, Dutch adolescents drink more frequently and are more likely to be binge drinkers (episodic excessive alcohol consumption, defined as drinking 5 glasses or more on a single occasion in the last four weeks) [1
Despite a sharp decline in the excessive consumption of alcohol (6 or more glasses at least once a week for the last 6
months) among adolescents in the Netherlands, the alcohol consumption is still high [2
]. Data from the Regional Health Services (RHS) in the province of North Brabant [3
] also show this. Although the number of young people who regularly consume alcohol (at least once in the past 4
weeks) declined from 54% in 2003 to 44% in 2007, 28% of the 12 to 17
year olds in the area of the RHS “Hart voor Brabant” can be identified as binge drinkers. Moreover, 25% of the under 16s are regular drinkers, and 13% are even binge drinkers.
Alcohol consumption by adolescents under 16 causes severe health risks. Firstly, young people's brains are particularly vulnerable because the brain is still developing during their teenage years. Alcohol can damage parts of the brain, affecting behavior and the ability to learn and remember [4
]. Secondly, there is a link between alcohol consumption and violent and aggressive behavior [5
] and violence-related injuries. Thirdly, young people run a greater risk of alcohol poisoning when they drink a large amount of alcohol in a short period of time [8
]. Finally, the earlier the onset of drinking, the greater is the chance of excessive consumption and addiction in later life [9
The policy of the Dutch Ministry of Health is aimed at preventing alcohol consumption among adolescents younger than 16, and at reducing harmful and excessive drinking among 16–24
years old young adults [12
]. Local Authorities are responsible for the implementation of national alcohol policy at a local level. RHSs and regional organizations for the care and treatment of addicts carry out prevention activities at a regional and local level, often commissioned by Local Authorities.
Current policies and interventions are mainly directed at settings such as schools and sports clubs. However, it is unlikely that this approach will have sufficient impact on adolescents, because the groups in these settings are heterogeneous. Adolescents differ in their drinking habits and have different attitudes towards alcohol. This means that one intervention reaches only a part of all adolescents, and doesn’t reach other adolescents, with a different drinking habit or a different attitude.
Market research has revealed the importance and effectiveness of tailoring messages and incentives to meet the needs of different population segments. Not every individual is a potential consumer of a given product, idea, or service; so tailoring messages to specific groups will be more effective than broadcasting the same message to everyone [13
Audience segmentation is a method for dividing a large and heterogeneous population into separate, relatively homogeneous segments on the basis of shared characteristics known or presumed to be associated with a given outcome of interest [15
Audience segmentation is fairly common in the field of public health. However, such segmentation is usually based on socioeconomic and demographic variables, such as age, ethnicity, gender, education and income. Unfortunately, demographic segmentation alone may be of limited use for constructing meaningful messages [16
]. While psychographic and lifestyle analyses have long been standard practice in business marketing, their use in public health communication efforts is still much less common [16
]. Since health messages can be fine-tuned to the differences in lifestyle such as attitudes and values, segments based on aspects of lifestyle are expected to be more useful for health communication strategies [14
]. We assume that attitudes, values, and motives in relation to alcohol consumption among adolescents will vary, and may therefore offer a better starting point for segmentation than socio-demographic characteristics alone. For example, previous research has shown that motives for drinking give rise to a substantial part of the variance in alcohol consumption [17
]. Moreover, personality traits, such as sensation seeking, are associated with quantity and frequency of alcohol use [19
Despite the promising characteristics of audience segmentation based on lifestyle aspects, it has never been used in the Netherlands in relation to the prevention of alcohol consumption. That is why the RHS “Hart voor Brabant”, in cooperation with market research office Motivaction®, conducted a study to find out whether it is possible to identify different segments on the basis of the motives, attitudes, and values of adolescents towards alcohol. The first results of this study were already published in a Dutch article [20