Targeted Communication Strategies for Changing Attitudes on Alcohol Policies: A Randomized Control Trial of Men's Health in Nigeria

Last registered on August 31, 2026

Pre-Trial

Trial Information

General Information

Title
Targeted Communication Strategies for Changing Attitudes on Alcohol Policies: A Randomized Control Trial of Men's Health in Nigeria
RCT ID
AEARCTR-0019522
Initial registration date
August 28, 2026

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
August 31, 2026, 8:40 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Region

Primary Investigator

Affiliation
Middlesex University

Other Primary Investigator(s)

Additional Trial Information

Status
On going
Start date
2026-08-24
End date
2026-12-31
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
This study examines how theory-driven, targeted communication strategies influence public support for men’s health policies in Nigeria, with a specific focus on alcohol-related non-communicable diseases (NCDs). It responds to the disproportionate burden of alcohol-attributable harm among Nigerian men, the limited effectiveness of conventional health promotion approaches, and the need for behaviourally grounded, gender-responsive advocacy tools that can build legitimacy for population-level policy interventions.
The research is grounded in behavioural economics, health psychology, and persuasion theory. It integrates Social Cognitive Theory (SCT), the Health Belief Model (HBM), and the Elaboration Likelihood Model (ELM) to develop a falsifiable and experimentally testable framework for targeted communication. SCT and HBM specify the belief, agency, and social modelling mechanisms through which communication may influence policy attitudes, while ELM provides the delivery rationale for using short narrative films under realistic attention constraints. Importantly, the study treats support for alcohol regulation as the primary outcome, conceptualized as an attitudinal and normative position toward collective policy instruments, rather than focusing narrowly on individual drinking behaviour. Behavioural intentions to reduce alcohol consumption are examined as secondary and exploratory outcomes.
To situate the research empirically, the study begins with a secondary analysis of data from the Global Burden of Disease (GBD) study and the World Bank, documenting gender-disaggregated trends in Disability-Adjusted Life Years (DALYs), Years of Life Lost (YLLs), Years Lived with Disability (YLDs), Healthy Life Expectancy (HALE), and health expenditure in Nigeria between 2000 and 2019. This analysis is complemented by a structured review of the literature on alcohol consumption patterns, masculinity norms, Nigeria’s NCD policy response, and prior health communication and advocacy efforts targeting men.
The core empirical component consists of an online randomized controlled experiment conducted with young adult Nigerian men recruited through digital platforms. Participants are randomly assigned to view short, AI-generated video interventions that convey identical factual information about alcohol-related harm but vary systematically in delivery format (narrative versus didactic) and messenger identity (authority-based versus relatable peer role model). The primary outcome is support for alcohol control policies, operationalized through a composite Policy Support Index. Secondary outcomes include intention to reduce alcohol consumption and theoretically specified mediators aligned with SCT and HBM, including perceived susceptibility, perceived severity, self-efficacy, perceived social norms, and identification with the messenger.
By isolating messenger and narrative effects while holding content constant, the study provides causal evidence on how specific communication features shape policy-relevant attitudes in a norm-constrained context. Methodologically, it demonstrates the feasibility and internal validity of fully online experimental evaluation for health advocacy research in low-resource settings. Substantively, it contributes to the literature on men’s health, alcohol policy, and behavioural communication by shifting the focus from individual behaviour change to public support for regulatory interventions. The findings are expected to inform policymakers, civil society actors, and donors on the design of scalable, theory-driven communication strategies capable of strengthening public legitimacy for alcohol control policies in Nigeria and comparable contexts.
External Link(s)

Registration Citation

Citation
Ikhuoria, Edwin. 2026. "Targeted Communication Strategies for Changing Attitudes on Alcohol Policies: A Randomized Control Trial of Men's Health in Nigeria." AEA RCT Registry. August 31. https://doi.org/10.1257/rct.19522-1.0
Experimental Details

Interventions

Intervention(s)
This study will evaluate alternative video-based communication strategies designed to influence support for policies intended to reduce alcohol-related harm among young Nigerian men. The study will be conducted as a four-arm, individually randomized online experiment involving eligible men aged 18–35 years who currently reside in Nigeria.

After providing informed consent, passing the eligibility screening, and completing the baseline questionnaire, each participant will be randomly assigned with equal probability to watch one of four pre-recorded videos. Participants will watch only the video corresponding to their assigned study arm. Assignment and video delivery will be automated through the online survey platform.

The videos will be delivered under standardized online conditions. The final video files, scripts, durations, links, assignment mapping, and file checksums will be archived before analysis. Video-viewing time, arrival at the post-video questionnaire, and relevant implementation checks will also be recorded. However, participants will remain in their originally assigned groups for the primary intention-to-treat analysis regardless of their viewing time, attention-check performance, recall of the video, or assessment of the messenger.
Intervention Start Date
2026-08-28
Intervention End Date
2026-12-31

Primary Outcomes

Primary Outcomes (end points)
The primary outcome is support for alcohol control policies, measured using a composite Policy Support Index (PSI).
Primary Outcomes (explanation)
It will combine responses to four seven-point policy-support questions:
- Support for increasing taxes on alcohol.
- Support for restricting alcohol advertising.
- Support for stronger enforcement of the prohibition on alcohol sales to people under 18.
- Agreement that the government should take stronger action to reduce alcohol-related harm.
Each item will range from 1, “strongly oppose,” to 7, “strongly support,” with higher scores indicating greater policy support. The four items will be standardized using the control-group means and standard deviations and then combined using equal weights. The resulting PSI will be rescaled so that the control group has a mean of approximately zero and a standard deviation of one.

Secondary Outcomes

Secondary Outcomes (end points)
The secondary outcomes and endpoints include
• Behavioural-intention endpoints
Two focused behavioural-intention outcomes will be examined:
- Alcohol-action interest: a binary indicator of whether the participant selects alcohol-related harm as an issue on which he would be interested in taking action.
- Intended next-drink quantity: the participant’s intended number or category of alcoholic drinks on his next drinking occasion, coded on the survey’s frozen 0–4 response scale. Higher values will indicate a greater intended quantity.

Budget allocation to alcohol and responses to hypothetical alcohol-price changes may also be reported, but these will be treated as descriptive supporting outcomes rather than central confirmatory endpoints.
Other mechanism-related outcomes:
• Perceived susceptibility to alcohol harm
• Perceived severity of alcohol harm
• Self-efficacy regarding behaviour change
• Identification with the messenger
• Perceived social norms
Secondary Outcomes (explanation)
Alcohol-action interest will be analysed using a linear probability model - logistic-regression average marginal effects will be a robustness check. Intended next-drink quantity will be analysed using OLS on its 0–4 ordered categories, with ordered logit as a robustness check. Budget and price-response results will be descriptive supporting analyses and will not be used for central thesis claims.

Experimental Design

Experimental Design
The study employs an individually randomized, four-arm online experiment. Participants are randomly assigned to exactly one of the following conditions:
• T0 (Control): Placebo or neutral informational video with no alcohol-related content.
• T1 (Didactic): Non-narrative informational video delivered via voiceover and infographics, with no identifiable messenger.
• T2 (Narrative–Authority): Narrative video delivered by an authority-framed messenger.
• T3 (Narrative–Peer): Narrative video delivered by a peer-framed messenger.

Randomization is implemented at the individual level. Assignment probabilities are equal across arms. Treatment exposure occurs immediately after baseline survey sections.
The four study arms will be:

1. T0: Climate-change control video - Placebo
Participants assigned to the control condition will watch a placebo video concerning climate change and environmental issues. The video will be designed to provide an engaging piece of non-alcohol-related content while controlling for the general experience of watching a short informational video. It will not contain messages about alcohol consumption, alcohol-related harm, masculinity, or alcohol-control policies.
Participants in this arm will complete the same main post-video questionnaire as participants in the alcohol-related arms. They will also be able to indicate whether they are interested in taking action on climate or environmental issues. This control-content question will help make the questionnaire relevant to their assigned video but will not constitute a primary study outcome.

2. T1: Didactic alcohol-information video
Participants in this arm will watch a non-narrative, didactic video about alcohol consumption and alcohol-related harm. The information will be communicated directly using an explanatory voiceover and supporting visual material, such as images, text, statistics, or infographics.

The video will present factual information about the individual and social consequences of harmful alcohol consumption and the possible role of alcohol-control policies. It will not rely primarily on a personal story or lived-experience narrative. This arm will provide the non-narrative alcohol-communication comparator for evaluating whether narrative communication is more effective than conventional factual communication.

3. T2: Narrative alcohol video with an authority-framed messenger
Participants in this arm will watch an alcohol-related narrative presented through a personal or experience-based story told by a medical doctor. The narrative will communicate alcohol-related risks, consequences, and the relevance of action to reduce alcohol-related harm.
The messenger will be framed as an authority or expert source. The authority framing is intended to encourage participants to interpret the message as advice or information coming from a knowledgeable and credible source. This condition will allow the study to examine the effect of narrative communication when the message is associated with an authority messenger.

4. T3: Narrative alcohol video with a peer-framed messenger
Participants in this arm will watch an alcohol-related narrative corresponding to the narrative format used in the authority condition. However, the messenger will be framed as a peer or socially relatable person (young undergraduate man) rather than as an authority figure.
The peer framing is intended to increase identification, social proximity, and the possibility that participants will see the experience presented in the video as relevant to themselves, their friends, or their families. Comparing this arm with the authority-narrative arm will test whether the social identity of the messenger changes the persuasiveness of the narrative.
Experimental Design Details
Not available
Randomization Method
The randomization is executed using the survey platform (SurveyCTO) with random assignment executed after baseline questions.
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
0
Sample size: planned number of observations
3,200 eligible randomized participants
Sample size (or number of clusters) by treatment arms
Control - T0: Climate change video - 800 individuals
Treatment 1 (T1): Didactic video - 800 individuals
Treatment 2 (T2): Authority Narrative Video - 800 individuals
Treatment 3 (T3): Peer Narrative Video - 800 individuals
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
The study is powered to detect a minimum detectable effect of 0.20 standard deviations on the Policy Support Index at the treatment-on-the-treated level. This assumption is grounded in prior experimental evidence on persuasion and policy attitudes. The analysis explicitly accounts for imperfect compliance by inflating sample size requirements to maintain adequate power for intention-to-treat estimates. The resulting target sample size of approximately 3,200 participants reflects conservative assumptions appropriate for online experimentation.
Supporting Documents and Materials

Documents

Document Name
Survey Questionnaire
Document Type
survey_instrument
Document Description
The survey instruments with full constructs for Survey CTO deployment
File
Survey Questionnaire

MD5: a080cefe9a7e30743954f7100289fc43

SHA1: b6b95d8171e05c760948c301ae5ea2b330deb6cd

Uploaded At: August 28, 2026

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IRB

Institutional Review Boards (IRBs)

IRB Name
Accounting and Finance, Economics and CEEDR
IRB Approval Date
2026-05-18
IRB Approval Number
ETH2526-0813
IRB Name
National Health Research Ethics Committee of Nigeria (NHREC)
IRB Approval Date
2026-08-17
IRB Approval Number
NHREC/01/01/2007-17/08/2026
Analysis Plan

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