Bringing sociological theories of care and care practices into understandings of, and intervention approaches for, women's alcohol use.

Patterns of heavy alcohol use that have the potential to cause health harms and social problems (such as difficulties in families and at work) have increased in British women aged over 25 years and affect women in the most socially deprived groups the most (Public Health England, 2016; NHS Digital, 2018). In Britain, some of the main approaches to supporting women to reduce heavy alcohol use are focused on individuals taking responsibility for changing their drinking themselves. For example, through guidance about how much alcohol women should drink to lower their risk of alcohol related harm. These approaches draw on the idea that telling people about health harms will change their behaviour and give little consideration to the positive roles that alcohol may play in some women's lives.
Research that focuses on what women tell us about their experiences of alcohol use can provide insights into what alcohol means to women in their everyday lives. Sociological ideas help us understand how the circumstances of women's lives such as their roles in families, or financial circumstances can alter; how they drink, and the appropriateness of different types of support to reduce their drinking. There is a distinct gap in research that places British women's drinking in the context of real lives and lived experiences, and practical approaches to reducing women's drinking which draw on these insights.
This fellowship will extend the findings from my PhD in which I carried out interviews with women with a range of different circumstances and drew on a number of sociological ideas (including feminist theories of care, and social practice theory) to develop our understanding of women's everyday alcohol use in relation to stress. I found that women's relationships and identities in relationships (e.g. as a good mother) are central to their drinking practices. There were gaps in receiving care in women's everyday lives and alcohol was one way in which women created spaces of care - or performed care practices in different relationships. For example, alcohol could be seen as a way of being caring/spending time together in couple relationships and drinking with friends could be used as an opportunity for women to gain support and talk about their problems. I also found that the opportunities women had to drink in practices of care was altered by their personal circumstances. Most of the time, the role alcohol plays in providing openings for care was more important to the women than the health harms of heavy drinking. The findings from this work suggest that ways of supporting women to reduce their drinking through recognising that alcohol is part of care practices could be more relevant to women than the main approaches which are currently used.
There are five objectives for the fellowship which seek to incorporate sociological ideas from my research into academic research and into the work of those who develop, fund and deliver support to reduce women's drinking. I also intend to engage with women themselves, policy makers and practitioners to develop ideas for future research on this topic. I retain a commitment to feminist approaches. I will:
1) pursue a programme of activity which is focused on sharing findings and considering the implications of the findings for future methods of support, with users who are women themselves and practitioners and policy makers who develop policy and work with women to reduce heavy drinking;
2) use the theoretical and conceptual work developed in the PhD research to publish three academic publications in high ranking journals;
3) present the findings from this work at one academic and one academic/ substance use conference;
4) plan and deliver teaching on the role of sociological theory in public health interventions;
5) build on 1-4 to develop future research projects collaboratively with women themselves.