Transformation and time-out: the role of alcohol in identity construction among Scottish women in early midlife

Despite the increase in drinking by women in early midlife, little alcohol research has focused on this group. We explore how alcohol is associated with the construction of gender identities among women aged 30 to 50 years in the west of Scotland, United Kingdom. We draw on qualitative data from 11 focus groups (five all-female, six mixed-sex) with pre-existing groups of friends and work colleagues in which women and men discuss their drinking behaviours. Analysis demonstrated how alcohol represented a time and space away from paid and unpaid work for women in a range of domestic circumstances, allowing them to relax and unwind. While women used alcohol to construct a range of identities, traditional notions of femininity remained salient (e.g. attention to appearance, drinking ‘girly’ drinks). Drinking enabled women to assert their identity beyond the roles and responsibilities often associated with being a woman in early midlife. For example, some respondents with young children described the transformative effects of excessive drinking which allowed them to return temporarily to a younger, carefree version of themselves. Thus, our data suggest that women's drinking in early midlife revolves around notions of ‘idealised’ femininity but simultaneously represents a way of achieving ‘time out’ from traditional female responsibilities such as caring for others. We consider these findings within a broader social and cultural context including alcohol marketing, domestic roles and motherhood and their implications for health promotion

Negotiating the social consequences of stopping or reducing alcohol consumption

There are compelling health reasons to limit alcohol consumption, but this consumption is ingrained in Australian culture, playing an important role in the rituals of many social occasions. This can make reducing or stopping alcohol consumption challenging, as one risks rejecting, not just a drink, but also the valued social meanings that drink represents. In this thesis, I aimed to identify how Australians who stop or reduce their alcohol consumption negotiate the social consequences of this change. I employed a sequential exploratory research design, involving three qualitative studies: (1) interviews with 16 people who had recently stopped or significantly reduced their alcohol consumption; (2) interviews with 13 people with a significant other who had recently stopped or significantly reduced their alcohol consumption; and (3) analysis of campaign materials from two temporary alcohol abstinence campaigns, Dry July™ and Ocsober™. In the first study, I found that people could be stigmatised for violating expectations around alcohol consumption when they stopped or reduced their drinking. They could manage this stigma within drinking occasions by downplaying their non-drinking or presenting it as socially acceptable, for example, linked to a fundraiser like Dry July™. However, in the longer term, they preferred to modify their social interactions to accommodate non-drinking. These modifications required the support of their social companions, and were more readily accepted where they still carried the same meanings as those previously conveyed by alcohol. Given the importance of support from social companions, in the second study, I identified the types of accounts people draw on to justify providing this support: (1) deontological accounts referring to duty or obligation; (2) consequentialist accounts in which costs for providing support were minimised or balanced; and (3) accounts which attended to the importance of maintaining relationships through shared experiences. Deontological accounts positioned supporter and recipient asymmetrically, while the other account types positioned each party symmetrically, consistent with friendship norms. As the first study identified temporary abstinence campaigns as an acceptable reason for (short-term) non-drinking, in the third study I explored how two of these campaigns portrayed participant experiences. Both campaigns featured an overarching portrayal of a hero’s journey, with participants embarking on a quest to fundraise for their cause, and returning from their experience transformed. However, the campaigns differed in the way they positioned participants, with only Dry July™ consistently positioning participants in ways that encouraged longer-term behaviour changes—suggesting that not all temporary abstinence campaigns may be equally effective as health promotion tools. Overall, my findings emphasise that health promotion campaigns must move beyond individualistic conceptions of behaviour, to attend to the social as well as health consequences of reducing alcohol consumption. Although individualistic strategies, such as participating in temporary abstinence campaigns, can help in managing social situations in the short-term, more ongoing changes to alcohol consumption can risk one’s social group memberships, unless the changes are supported by the group. By attending to how people can negotiate this support, health promotion campaigns may better assist people to stop or reduce their drinking, without sacrificing their social well-being.Thesis (Ph.D.) (Research by Publication) -- University of Adelaide, School of Public Health, 201

Backpacker selves in a hostel: discourse, identity, and existential authenticity

Backpacker tourists are able to boldly lay claim to authenticity to local place—especially as they see themselves in relation to more (by their categorization) mainstream tourists—through the feeling of an authentic self that arises through backpacking tourism. Backpacker discourse about travel embodied travel experiences reflects and shapes sense of existential authenticity, a transformative travel euphoria in which the backpacker’s true identity is discovered through intense, sensuous experiences and perception of immersion in a foreign culture. This thesis uses ethnographic information and methods collected in a number of hostels—but primarily in Bogotá, Colombia—in order to demonstrate the relationship between the material, discursive, and phenomenological construction of identity and understanding of “authentic” local place. Through backpacking travel, these young travelers are constructing understanding of self, community, and the local, making backpacking a productive area of study for the study of tourist identity formation through language and bodily engagement

Content, perceptions and impact of alcoholic drink promotions in nightlife venues that are targeted towards students.

Background: Binge drinking is generally considered socially acceptable for students across Western culture. Social norms within the student population have meant that excessive drinking plays a key role in socialising and reinforcing peer group identity. Research has highlighted the United Kingdom (UK) as having elevated levels of alcohol consumption especially within the student population, and the role that drink promotions have in influencing consumption practices. This paper considers promotions of alcoholic drinks in UK nightlife venues and student perceptions of these promotions. Bourdieu's concepts of social and cultural capital are applied to the findings. Method: Content analysis of social media posts by nightlife venues (n = 12), observations of nightlife venues (n = 20) and semi-structured focus groups and paired interviews with 32 undergraduate students, from one city in the North West of England. Results: Nightlife venues target promotions of alcoholic drinks at students through social media, advertisements throughout nightlife venues, and by promoters outside of venues. These promotions will often influence the course of a night out in terms of venues visited and the drinks consumed. Alcohol holds importance within mainstream student culture; it plays a key role in achieving cultural capital and is a means for students to obtain social capital through the creation of shared experiences, which are key for those who are new to university. Conclusions: Nightlife venues will target alcoholic drink promotions at students and will use the notion of creating a shared experience as part of this targeted promotion. This contributes to the overall social and cultural capital that alcohol holds within the student population. This is an important consideration for alcohol policy - it demonstrates how prevention activities need to take into consideration the importance of shared experiences for the students; alternatives to excessive alcohol consumption need to offer a similar opportunity

Exploring industry driven marketing influences on young people who drink alcohol

PhD ThesisBackground: While the overall proportion of young people who report drinking alcohol in the UK appears to have decreased over the past fifteen years, those who do drink are consuming in larger quantities, and drinking more frequently. An association between industry-driven alcohol marketing and young people’s drinking behaviour has been demonstrated in a number of cross-sectional, longitudinal and qualitative studies, but less is known about how young people are affected by alcohol marketing and how marketing processes knit with other widely studied influences on young people’s drinking behaviour. This study aimed to investigate the influence of industrydriven alcohol marketing processes (price, promotion, product branding and placing) on young people’s drinking choices and behaviour. Methods: A mixed-methods approach underpinned by a critical realist perspective was adopted. A systematic review examined empirical studies concerning the impact of industry-driven price and other marketing techniques on young people’s drinking behaviour. Qualitative interviews were conducted with young people aged 14-17 from NE England (n=31) to explore accounts of when, why, where and how they drink alcohol. Q methodology was used to derive ‘factors’ underlying alcohol choices, based on the results of a card sorting procedure undertaken with young people aged 14-17 from NE England (n=28). Findings: The systematic review identified 32 papers which were predominantly crosssectional in design, and focused on the impact of alcohol promotion on young people’s alcohol use. Although industry-driven alcohol marketing appeared to influence young people’s drinking behaviour, studies reported on a variety of populations, study designs, exposure measures and outcome measures, making synthesis and extrapolation difficult, as well as underlining a shortage of longitudinal work establishing the effect of alcohol marketing over time. The review highlighted a paucity of studies conducted in the UK as well as a lack of research examining the influence of price for those under the legal drinking age only and exploring the impact of digital or social media marketing on young people’s drinking behaviour. Young people interviewed in the qualitative study appeared to make micro-level choices about alcohol (between products and brands), positioning themselves as autonomous agents and unaffected by overt forms of alcohol marketing. However, the majority of participants were able to recount brands and slogans, did not recognise less visible aspects of promotion (e.g. sponsorship, viral and digital marketing) and did not associate the pricing of alcohol as a form of marketing. Therefore, advertising and other promotional activity seemed to play a role in building recognisable imagery linked to alcohol products, as well as associations and expectancies related to drinking. The advisability of drinking per se did not appear to have been questioned by participants and was considered an acceptable and normal practice. Participants reported that they were not exclusively price-led and choices were made in conjunction with other criteria (e.g. taste, availability, strength and image). Q factor analysis revealed three accounts: Factor one illustrates a sense of individuality, autonomy, and maturity in alcohol choices; factor two is price-led, choosing to drink whatever is most accessible, cheapest or on special offer; and factor three is an account of bounded adventure, pleasure and hedonism. Conclusions: Bourdieu’s concept of ‘habitus’ is drawn on to illustrate that young people’s alcohol choices are influenced by structural predispositions (including industry processes and alcohol marketing) but that ‘taste’, social norms and interpersonal relationships (recognised as agency) can also play a role in reinforcing, normalising and driving behaviour. Deeply embedded social norms and industry processes culminate in ‘political economies of health’ where health behaviours are governed by historical traditions and the logic of advanced capitalism (the need to make a profit), and choices constrained into seemingly free, naturalised directions. Thus, a description of young people as individual, rational agents, who can make the ‘correct’ choices about alcohol use, minimises structural and cultural factors that are, in part, shaped by the alcohol industry in conjunction with other influences such as inter-personal relationships and social norms, and which constrain health choices and behaviours of young people. Public Responsibility Deals and voluntary self-regulation of alcohol marketing may be inadequate to counter this. Instead, it needs to be identified that young people are being subtly bombarded and further work is required to ‘unravel’ this impact. Nevertheless, tighter restrictions on the marketing of alcohol, such as a policy resembling France’s Loi Evin should be given consideration. The current alcohol strategy for England and Wales includes a commitment to implementing an alcohol minimum unit price. However, findings from this doctoral work demonstrate that it is difficult to disentangle the four elements of the marketing mix. Price encompasses just one facet of alcohol marketing and makes up only a small part of the external world in which young people are becoming acculturated. The effect that price changes alone could have on young people’s alcohol use should not be overemphasised. Thus, as well as examining the impact of price on young people’s drinking behaviour pre and post legislative change, further work should also explore the changing nature of industry-driven alcohol marketing processes. In particular, the influence of digital and social media marketing on young people’s drinking behaviour needs to be examined further, as well as the combined contribution that alcohol marketing, long-standing social norms and inter-personal relationships (‘the alcohol habitus’) all can make towards a ubiquitous culture of alcohol consumption.ESRC and Fuse (a UKCRC Centre of Excellence in Public Health

The Journey of a Public Sector Broadcaster: The 7- Step Interview Framework

Talk is a fundamental activity of broadcasters, but the gradual erosion of public service broadcasting has left the critical relationship between media, public opinion and public knowledge susceptible to lack of trust (Lowe and Bardoel, 2007). Interviews occupy a prominent place in broadcast journalism and as Atkinson and Silverman (1997) argue, we live in an 'interview culture', which is our anchor to world events and people's lives. This thesis assumes an interpretivist epistemological approach to illustrate and critically reflect through media discourse analysis, using the frameworks of Scannell (2007) and Montgomery (2007), a selection of radio interviews broadcast live on the Cyprus Broadcasting Corporation’s Channel 4 between 2018 - 2021. Using my process as a case study and exploring the concepts of power, audience and performance, I demonstrate how emerging broadcasters can conduct live, in-depth interviews while contributing towards public sector knowledge. This is presented as the 7-Step Interview Framework for Emerging Broadcasters. Change in the public sector does not come rapidly and requires considerable reflexivity, persistence and resistance. I elucidate through a professional narrative, the importance of gatekeeping and how my interview praxis can be utilised to relate to overhearing audiences in specific, inclusive and cooperative ways. Furthermore, I elaborate on the importance of ethically transporting the interviewees' personal experiences, work, culture and values into the public domain. Collaborative forms of communication can make learning and change possible both in self and others. Silence exacerbates issues. When public servants cannot speak out, they suffer psychologically, physically and emotionally. This thesis illustrates my utilization of ‘power’ as an interviewer to raise awareness of contemporary issues for my audience. Although emotions have been considered unsuitable for rigorous research (Ashkanasy, 2002), public administration scholars realise unhappiness diminishes health (Jung, Bozeman and Guaghan, 2018). By making my research and experience public, broadcasters can reflect on how they can substantially contribute to state broadcasting

The Lived Experiences of Sexual Minority Women Who Have Recently Reduced Their Alcohol Intake

Background: Sexual minority women (SMW) are more likely to report hazardous alcohol consumption than their heterosexual counterparts. However, despite a recent growth of interest in drinking transitions to reduced or no drinking, no studies to date have explored this in the context of SMW. The little research available focuses only on sobriety in SMW following alcohol addiction, rather than drinking trends from a general health promotion perspective. Aims: Given the gaps within the literature, the study sought to investigate the experiences of SMW who have reduced alcohol consumption and the factors that contributed to this decision. This was also explored in the context of the COVID-19 pandemic guidance on social distancing. Methods: A qualitative approach was adopted to investigate the experiences of eight SMW who had reduced their alcohol intake within the previous 18 months. Participants were recruited using social media and participated in semi-structured interviews. Interview transcripts were subjected to interpretative phenomenological analysis. Results: Three super-ordinate themes were found across participant interviews: 1) Personal, Relational and Contextual Triggers for Changing Relationship with Alcohol; 2) Navigating the Public Arena; 3) Renegotiating the Relationship with Alcohol. Conclusion: Findings demonstrated the commonality of experience that included facing peer pressure to consume alcohol and the need to develop coping tools to manage, such as consuming alcohol-free beverages or avoiding alcohol-centric venues. Uniquely for SMW, this avoidance also meant a transition from the LGBT+ Scene entirely due to the lack of sober venues. Reasons for reducing intake included fear of reliance on alcohol, familial history of alcohol misuse, achieving physical and mental health benefits, and intimate relationships. The context of lockdown was significant in providing an opportunity to reduce consumption away from the usual pressures. Implications for clinical practice, policy and research are proposed

Social Media Alcohol Marketing and Its Impact on Young People’s Alcohol Use: A Comparison between India and Australia

A cross-national comparison of 1) marketing strategies used by leading Indian and Australian alcohol brands on their official social media (SM) pages and 2) the association between exposure to SM alcohol marketing and alcohol use among young Indians and Australians, was conducted. Results suggest that alcohol companies tailor strategies to specific national contexts to engage users with these strategies. Significant associations were identified between alcohol-related content posted on SM and young people’s alcohol use

Addressing Rural America’s Suicide Disparity Among Men: How Mental Health Stigma Is Communicated Through Storytelling Networks

The suicide rate disparity of men in rural America has continued to increase year after year. While this is a complex public health problem with many contributing factors, this study examines the stigma of mental illness in men, a recognized contributing factor to increased suicide rates among rural men. Grounded in communication infrastructure theory and the model of stigma communication, this study sought to collect data for the first phase in the development of a stigma communication intervention program for Rabun County, GA, a rural Appalachian community in north Georgia. Twenty-four in-depth interviews were conducted with Rabun County residents to assess the communication infrastructure, where stigma narratives are encountered in the communication infrastructure, and what stigma narratives are present in the communication infrastructure. Findings showed that stigma narratives were most encountered on the micro-level, specifically through conversations with family and friends. On the meso-level, church organizations were also reported as highly influential in the spread of stigma messages surrounding men with mental health issues. Some of the most prominent stigma messages associated with men with mental illness were weakness, lacking faith, and dangerousness. Suicide stigma also appeared to be much stronger than the stigma of mental illness. Through this research, a theoretical model was also developed to aid in future intervention studies of this type. The model of stigma storytelling combines concepts from communication infrastructure theory and the model of stigma communication. Future research should use this model to continue the development and implementation of the multi-phase stigma communication intervention program in Rabun County. Additional research in this area should continue to explore how the stigma of mental health issues in men contributes to the rising rates of suicide rates. The stigma of suicide and suicidal ideation in rural populations should also be explored further as this topic does not seem to be perceived the same as mental illness, suggesting the topic of suicide is more taboo, carrying a stronger stigma than mental illness in general

Sex on Campus : Investigating Sexual Health Promotion in Australian Universities

Background: Sexual health is a state of being that goes far beyond the absence of sexually transmissible infections, encompassing the absence of coercion and the possibility of pleasure among other factors. Young Australians in general have been identified as a priority population in terms of sexual health, with a dramatic rise in the rate of notifications of sexually transmissible infections (STIs) among those aged 16 – 30, higher partner numbers, higher rates of sexual assault and less access to sexual health services and information. Besides the fact that many Australians from this age bracket are university students, university environments are important venues for sexual health promotion due to the high proportion of LGBTI and international students. This thesis aimed to determine the current state of sexual health promotion in Australian universities, how these events can better reach different groups of students and whether a peer-led, socially focused event can change attitudes towards sexual health testing. Methods: Interviews were conducted with university peer educators and professionals who had a role related to sexual health in the Australian Capital Territory (ACT). These interviews focused on the nature and challenges of the role, previous successful sexual health promotions and ideas for future improvement. Results from these interviews were used to design two anonymous cross-sectional surveys. The Promotion Survey was completed by student leaders in 23 universities across Australia allowing investigation of peer educator roles and current sexual health promotion events. The Student Survey was completed by randomly selected students at a university in the ACT and focused on previous sexual health learning, sexual experiences and preferences relating to sexual health promotion events at university. Results from interviews and surveys were used to inform the design of a peer-led, socially focused sexual health promotion event, Sexy Trivia. This event was run by peer educators at two university organisations, and participants were randomly assigned to either Sexy Trivia, or a sexual health talk from a local sexual health and family planning centre for comparison. Results: Peer educators were often not given sufficient support in their roles, leading to certain groups, such as international and LGBTI students missing out on relevant sexual health promotion opportunities. Students from these groups, along with higher-risk students, showed marked differences in preferences for sexual health promotion events, however common features included the presence of friends as a motivator to attend and low self-perception of risk, even amongst higher-risk students. Sexy Trivia was successful in attracting attendees and was significantly more effective than a sexual health talk at increasing subjective norm scores about sexual health testing. Conclusion: While current university sexual health events include some features that align with student group priorities, elements beyond sexual health information, such as social activity, alcohol incentives and on-site sexual health testing, can be helpful tools to attract students not currently engaged with sexual health messages. This research will help to empower peer educators to more effectively engage different groups of university students and change attitudes towards sexual health