The challenge of recruiting licensed premises to host prevention research

In September 2016, I embarked on my journey to a doctorate at Oxford Brookes University. Still enraptured having been awarded a studentship, I felt invincible; my study was going to be a trail blazer. Fuelled by temerity, I dismissed suggestions of hurdles, barriers, and walls I would have to climb. After all, my tenacity would enable me to leap higher, push harder and offer a leg-up to propel me over those walls. Oh the innocence!

Resilience: “the capacity to recover quickly from difficulties”. The proviso being you have to acknowledge these difficulties (I googled “word for acknowledging difficulties” but the best it returned was “owning up”). So here I am, owning up to the potentially huge pitfalls of my study. One vast quarry-sized pit in particular: reliance on access to licensed premises* to ensure my study has good ecological validity (meaning it reflects a real-world setting).

*I will refer to licensed premises as pubs hereafter.

So what is this fiendish study? If you have too much spare time you can witness how my study has, and continues to, evolve(d) on the Open Science Framework: https://osf.io/htx2b/. Here you can leisurely peruse two study protocols of 30+ pages each (there are two study protocols because I demoted the study from a randomised controlled trial (RCT) to a pilot RCT). In brief:

  • The study is a randomised, controlled, cross-over, pilot trial assessing the effect of alcohol strength on alcohol consumption: specifically, lager (a subset of beer that is normally carbonated and served chilled, and is typically stronger than real ales).
  • I intend to recruit pubs in the South East and London regions of the United Kingdom.
  • Participants will be briefed at act as they normally would in the pub including socialising with other participants and non-participants (the pub will continue with normal service whilst the study is being conducted).
  • …However, participants will drink only regular strength lager on one visit to the pub and only reduced strength lager on another visit to the pub.
  • The lagers need to be similar in every aspect apart from their strength so I’m running a taste experiment prior to the pilot trial to match the different strength lagers by perceived similarity of taste.

Here lies the problem: I need to be able to bring the specific pre-determined lager products into the pubs to sell to participants (yes, “sell” may also prove problematic). In an ideal world I would provide barrels of the lager to sell on draught to the participants and I’d simply cover up the brand logos to blind participants (blind in the research sense of the word; this has nothing to do with beer goggles). But most pubs are tied to breweries which means they can only sell lager that their brewery supplies.

So what can I do? And what can other prevention researchers do if they want to undertake experimental research within pubs?

The only solution I can see regarding my study is to bring supermarket-bought cans of lager, disguised by duct tape, into the hosting pubs and pour these into pint glasses to serve to participants. This means I have to target either “free-houses” (pubs which are not tied to a brewery and thus have freedom to choose which lagers they sell), or rely on landlords (pub owners) to break their contract with a brewery: unlikely. And anyway, which pub landlords are going to allow a researcher to set up a makeshift bar area (basically a table with a fridge underneath it) within their pub on a Friday or Saturday night and sell a mysterious brew to their patrons? That’s not a rhetorical question by the way; please send your answers to me (parvati.perman-howe-2016@brookes.ac.uk).

Armed with an incentive of £500 plus every single penny that participants spend on lager (that will be provided courtesy of funding from Oxford Brookes University), I’m being met with silence from pub landlords. I’ve tried pubs in deprived areas, pubs in wealthier areas, pubs in rural settings, pubs in urban settings, traditional pubs, modern gastro-style pubs, bars attached to sports clubs, bars attached to community groups. All I’ve managed to recruit thus far is a bar at a village cricket club that my father manages: this won’t do much for the external validity of the study, not to mention a conflict of interests! What’s most frustrating is that I’m not receiving any feedback as to why landlords don’t want to engage with my research. This means I’m unable to alter or tailor my approach to increase the likelihood of recruitment.

When I used to dream of winning the lottery I envisaged motorbikes, swimming pools and setting up a cat rescue centre. Now, I dream of buying a working pub in which I can spend my academic years conducting research!

It’s all too obvious why there’s a gap in the literature when it comes to experimental research based within pubs. I feel it need not to be this way. After all, I’m not out to undermine the alcohol industry. I’m not a prevention researcher who believes in partisan lines. I’m a realist who believes that for change to occur researchers have to compromise and work with the alcohol industry, rather than expecting policy change to occur at government level (especially in the present political climate of the UK).

So somehow these barriers need to be addressed, if we, as prevention researchers, are able to make inroads. My tenacity alone will unlikely suffice. So, if anybody is interested in collaborating on strategies to enable better access to pubs for research purposes, then please get in touch with me.

 

Parvati Perman-Howe is a Doctoral Student at Oxford Brookes University, UK. Her PhD project is entitled “The effect of alcohol strength on alcohol consumption: a randomised, controlled, cross-over, pilot trial”, and is supervised by Professor David Foxcroft and Dr Emma Davies. Parvati previously worked as a research assistant on a randomised controlled trial that assessed the efficacy of GP referral to commercial weight management programmes, at the University of Oxford. Parvati is interested in designing and assessing interventions that alter the physical aspects of the environment and that seek to alter behaviours related to alcohol consumption, diet, physical activity and smoking.You can find out more about her on Twitter


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