JMIR Publications

ABSTRACT

Background:

Globally, women consume less alcohol than men but alcohol consumption among women has declined less in recent years than among men. Drinking rates and alcohol-related harms vary substantially across population groups of women, and sexual minority women (SMW; e.g., lesbian, bisexual, queer) are a population group at notably high-risk for heavy drinking. An emerging body of literature suggests that in addition to minority stress (e.g., stigma, marginalization, discrimination), drinking norms and drinking cultures are likely factors that influence SMW’s drinking patterns. Unfortunately, almost no research has explored these factors as possible targets of interventions for heavy drinking SMW. Sober curiosity is a rapidly growing wellness movement that may be particularly salient for SMW who wish to reduce their alcohol consumption. It implies having the option to choose, to question, or to change one’s drinking behaviors or to be ‘curious’ about the reasons one chooses to drink and the way alcohol affects one’s life and health. It emphasizes alcohol and its addictive properties rather than the person as the ‘problem’.

Objective:

The aims of this research are to: 1) explore the perspectives of the drinking social worlds of SMW, their awareness of the sober curious movement, perceptions of their own and their peers’ drinking and desire to drink less, and perceived barriers and facilitations to changing their drinking behaviors; and 2) identify key elements of an alcohol reduction intervention tailored for SMW.

Methods:

We conducted a comprehensive review of the literature on alcohol interventions with SMW. We found just a handful of studies and scant attention to drinking cultures, normative beliefs, or other key elements of the sober curiosity movement. To better understand how social and cultural contexts influence diverse SMW’s drinking, barriers and facilitators to reducing drinking, and the usefulness of approaches based on sober curiosity, we are conducting two descriptive studies with adult (>18 years) SMW used mixed methods. One of these studies includes focus group interviews with 24-36 SMW and a national survey with 100-120 SMW in Scotland. The other includes in-depth interviews with 18-20 SMW in the United States. Data will be analyzed using qualitative and quantitative methods. We will identify similarities and differences in findings from the two countries and the three sources of data to identify patterns and relationships across data to validate or corroborate findings. We expect that these comparisons will provide a more comprehensive understanding of factors that serve as facilitators or barriers to SMW who wish to reduce their alcohol intake.

Results:

Each of the studies received ethical approval in August 2023 and are currently open for recruitment. We anticipate completing data collection in Spring 2025. Results of qualitative analyses (focus groups and individual interviews) will be organized and summarized as themes, and results of survey data analyses will be summarized in tables. Findings from the studies will be presented to two panels of international experts who will assist in identifying critical elements of an alcohol reduction intervention tailored to the unique needs of SMW.

Conclusions:

With the assistance of the expert panels, we will employ APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side-effects, and Equity) criteria to consider socioecological and cultural factors to capture an overarching understanding of key factors and components to inform the development of a tailored intervention that builds on tenants of the sober curiosity movement to assist SMW to reduce harmful drinking practices.