{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:38:59Z","timestamp":1790195939326,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Alcohol consumption is causally associated with long-term health-related consequences, such as cancer and cardiovascular disease, and short-term harms, such as accidents and injuries. Alcohol consumption has increased among midlife women (aged 40\u201365) over the last two decades in high-income countries. This study aimed to centre women\u2019s voices by using co-design methodologies to investigate what women identify as strategies that could assist them and other women their age to reduce their alcohol consumption. Human-centred design workshops were undertaken with 39 women, and conventional qualitative content analysis was used to analyse information from written workshop materials to develop categories in the data and count their occurrence. Six categories, or strategies, emerged, listed here from most to least represented: \u2018Participate in alternative activities to drinking alcohol\u2019, \u2018Track alcohol consumption and set goals\u2019, \u2018Seek support from family and friends\u2019, \u2018Drink alcohol-free beverages\u2019, \u2018Reduce supply of alcohol in the home\u2019 and \u2018Seek professional support\u2019. Our findings identify strategies that are realistic and feasible to midlife women; our sample, however, likely reflects a more affluent subsection of this group, and as such, any focus on individual-level strategies must be complemented by policies that increase equitable access to healthcare and act on the social and commercial determinants of health. An intersectional approach to alcohol and other drug research is required to examine how the interplay of gender and other markers of social identities shape alcohol consumption.<\/jats:p>","DOI":"10.1093\/heapro\/daad175","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T20:48:22Z","timestamp":1703191702000},"source":"Crossref","is-referenced-by-count":11,"title":["Strategies to support midlife women to reduce their alcohol consumption: an Australian study using human-centred design"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0755-8624","authenticated-orcid":false,"given":"Mia","family":"Miller","sequence":"first","affiliation":[{"name":"Menzies School of Health Research, Charles Darwin University , Darwin , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Kuntsche","sequence":"additional","affiliation":[{"name":"Centre for Alcohol Policy Research, La Trobe University , Melbourne , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Kuntsche","sequence":"additional","affiliation":[{"name":"Centre for Alcohol Policy Research, La Trobe University , Melbourne , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0832-4291","authenticated-orcid":false,"given":"Megan","family":"Cook","sequence":"additional","affiliation":[{"name":"Centre for Alcohol Policy Research, La Trobe University , Melbourne , Australia"},{"name":"Institute for Social Marketing, University of Stirling , Stirling, Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra J C","family":"Wright","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research, Charles Darwin University , Darwin , Australia"},{"name":"Institute for Social Marketing, University of Stirling , Stirling, Scotland"},{"name":"Burnet Institute , Melbourne , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"key":"2023122120481194200_CIT0001","doi-asserted-by":"crossref","first-page":"103547","DOI":"10.1016\/j.drugpo.2021.103547","article-title":"Pretty in pink\u2019and \u2018Girl Power\u2019: an analysis of the targeting and representation of women in alcohol brand marketing on Facebook and Instagram","volume":"101","author":"Atkinson","year":"2022","journal-title":"International Journal of Drug Policy"},{"key":"2023122120481194200_CIT0002","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780192844484.001.0001","volume-title":"Alcohol: No Ordinary Commodity: Research and Public Policy","author":"Babor","year":"2022"},{"key":"2023122120481194200_CIT0003","doi-asserted-by":"crossref","first-page":"e0186744","DOI":"10.1371\/journal.pone.0186744","article-title":"Human-centred design in global health: a scoping review of applications and contexts","volume":"12","author":"Bazzano","year":"2017","journal-title":"PLoS One"},{"key":"2023122120481194200_CIT0004","first-page":"1","article-title":"Reducing confucion about grounded theory and qualitative content analysis: similarities and differences","volume":"19","author":"Cho","year":"2014","journal-title":"The Qualitative Report"},{"key":"2023122120481194200_CIT0005","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/1467-9566.12991","article-title":"\u2018Women of my age tend to drink\u2019: the social construction of alcohol use by Australian and Danish women aged 50\u201370 years","volume":"42","author":"Dare","year":"2020","journal-title":"Sociology of Health & Illness"},{"key":"2023122120481194200_CIT0006","doi-asserted-by":"crossref","first-page":"e15964","DOI":"10.2196\/15964","article-title":"A digital pornography literacy resource co-designed with vulnerable young people: development of \u2018The Gist\u2019","volume":"22","author":"Davis","year":"2020","journal-title":"Journal of Medical Internet Research"},{"key":"2023122120481194200_CIT0007","doi-asserted-by":"crossref","first-page":"186","DOI":"10.3109\/16066359.2013.806651","article-title":"Alcohol in the life narratives of women: commonalities and differences by sexual orientation","volume":"22","author":"Drabble","year":"2014","journal-title":"Addiction Research & Theory"},{"key":"2023122120481194200_CIT0008","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/j.1467-9566.2011.01424.x","article-title":"Older and wiser? Men\u2019s and women\u2019s accounts of drinking in early mid-life","volume":"34","author":"Emslie","year":"2011","journal-title":"Sociology of Health and Illness"},{"key":"2023122120481194200_CIT0009","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.drugpo.2014.12.006","article-title":"Transformation and time-out: the role of alcohol in identity construction among Scottish women in early midlife","volume":"26","author":"Emslie","year":"2015","journal-title":"The International Journal on Drug Policy"},{"key":"2023122120481194200_CIT0010","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1111\/1467-9566.12605","article-title":"The role of alcohol in identity construction among LGBT people: a qualitative study","volume":"39","author":"Emslie","year":"2017","journal-title":"Sociology of Health & Illness"},{"key":"2023122120481194200_CIT0011","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-49282-3_4","volume-title":"Co-creating Persona Scenarios with Diverse Users Enriching Inclusive Design","author":"Fuglerud","year":"2020"},{"key":"2023122120481194200_CIT0012","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1111\/acer.13859","article-title":"Trends in adult alcohol use and binge drinking in the early 21st-century United States: a meta-analysis of 6 National Survey Series","volume":"42","author":"Grucza","year":"2018","journal-title":"Alcoholism: Clinical and Experimental Research"},{"key":"2023122120481194200_CIT0013","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qualitative Health Research"},{"key":"2023122120481194200_CIT0014","first-page":"70","article-title":"Gender and intoxication: from masculinity to intersectionality","volume":"26","author":"Hunt","year":"2020","journal-title":"Drugs: Education, Prevention and Policy"},{"key":"2023122120481194200_CIT0015","doi-asserted-by":"crossref","first-page":"396","DOI":"10.4135\/9781473921986.n23","article-title":"The increasing visibility of gender in the alcohol and drug fields","volume-title":"Handbook of Drug and Alcohol Studies: Social Science Approaches","author":"Hunt","year":"2016"},{"key":"2023122120481194200_CIT0016","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s12905-018-0629-6","article-title":"Understanding alcohol as an element of \u2018care practices\u2019 in adult White British women\u2019s everyday personal relationships: a qualitative study","volume":"18","author":"Jackson","year":"2018","journal-title":"BMC Women\u2019s Health"},{"key":"2023122120481194200_CIT0017","doi-asserted-by":"crossref","first-page":"103453","DOI":"10.1016\/j.drugpo.2021.103453","article-title":"Alcohol and drinking within the lives of midlife women: a meta-study systematic review","volume":"99","author":"Kersey","year":"2022","journal-title":"The International Journal on Drug Policy"},{"key":"2023122120481194200_CIT0018","doi-asserted-by":"crossref","first-page":"514","DOI":"10.15171\/ijhpm.2019.56","article-title":"How neoliberalism is shaping the supply of unhealthy commodities and what this means for NCD prevention","volume":"8","author":"Lencucha","year":"2019","journal-title":"International Journal of Health Policy and Management"},{"key":"2023122120481194200_CIT0019","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1037\/a0021444","article-title":"Comparison of participatively set and assigned goals in the reduction of alcohol use","volume":"24","author":"Lozano","year":"2010","journal-title":"Psychology of Addictive Behaviours"},{"key":"2023122120481194200_CIT0020","doi-asserted-by":"crossref","first-page":"daac097","DOI":"10.1093\/heapro\/daac097","article-title":"\u2018I have a healthy relationship with alcohol\u2019: Australian midlife women, alcohol consumption and social class","volume":"37","author":"Lunnay","year":"2022","journal-title":"Health Promotion International"},{"key":"2023122120481194200_CIT0021","doi-asserted-by":"crossref","first-page":"14788","DOI":"10.3390\/ijerph192214788","article-title":"Sober curiosity: a qualitative study exploring women\u2019s preparedness to reduce alcohol by social class","volume":"19","author":"Lunnay","year":"2022","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"2023122120481194200_CIT0022","doi-asserted-by":"crossref","first-page":"104046","DOI":"10.1016\/j.drugpo.2023.104046","article-title":"Through the wine glass: how biographical midlife transitions and women\u2019s affective interpretations interact with alcohol consumption","volume":"117","author":"Lunnay","year":"2023","journal-title":"International Journal on Drug Policy"},{"key":"2023122120481194200_CIT0023","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/1467-9566.12103","article-title":"Staying \u2018in the zone\u2019 but not passing the \u2018point of no return\u2019: embodiment, gender and drinking in mid-life","volume":"36","author":"Lyons","year":"2014","journal-title":"Sociology of Health and Illness"},{"key":"2023122120481194200_CIT0024","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/dar.13610","article-title":"Home drinking practices among middle-class adults in midlife during the COVID-19 pandemic: material ubiquity, automatic routines and embodied states","volume":"42","author":"Lyons","year":"2023","journal-title":"Drug and Alcohol Review"},{"key":"2023122120481194200_CIT0025","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s13722-021-00271-5","article-title":"Reimaging brief interventions for alcohol: towards a paradigm fit for the twenty first century","volume":"16","author":"McCambridge","year":"2021","journal-title":"Addiction Science and Clinical Practice"},{"key":"2023122120481194200_CIT0026","doi-asserted-by":"crossref","first-page":"daad076","DOI":"10.1093\/heapro\/daad076","article-title":"Women and the commercial determinants of health","volume":"38","author":"McCarthy","year":"2023","journal-title":"Health Promotion International"},{"key":"2023122120481194200_CIT0027","doi-asserted-by":"crossref","first-page":"e0270936","DOI":"10.1371\/journal.pone.0270936","article-title":"Examining social class as it relates to heuristics women use to determine the trustworthiness of information regarding the link between alcohol and breast cancer risk","volume":"17","author":"Meyer","year":"2022","journal-title":"PLoS One"},{"key":"2023122120481194200_CIT0028","doi-asserted-by":"crossref","first-page":"e013921","DOI":"10.1136\/bmjopen-2016-013921","article-title":"How Australian general practitioners engage in discussions about alcohol with their patients: a cross-sectional study","volume":"6","author":"Miller","year":"2016","journal-title":"BMJ Open"},{"key":"2023122120481194200_CIT0029","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1111\/dar.13428","article-title":"The who and what of women\u2019s drinking: examining risky drinking and associated socio-demographic factors among women aged 40\u201365 years in Australia","volume":"41","author":"Miller","year":"2022","journal-title":"Drug and Alcohol Review"},{"key":"2023122120481194200_CIT0030","first-page":"1","article-title":"Should we promote alcohol problems as a continuum? Implications for policy and practice","author":"Morris","year":"2023","journal-title":"Drugs: Education, Prevention and Policy"},{"key":"2023122120481194200_CIT0031","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1186\/s12889-018-5948-x","article-title":"Constructions of alcohol consumption by non-problematised middle-aged drinkers: a qualitative systematic review","volume":"18","author":"Muhlack","year":"2018","journal-title":"BMC Public Health"},{"key":"2023122120481194200_CIT0032","first-page":"1","article-title":"Human-centred design thinking and public health education: a scoping review","author":"Romero","year":"2023","journal-title":"Health Promotion Journal of Australia"},{"key":"2023122120481194200_CIT0033","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/09581596.2010.529424","article-title":"Addiction and personal responsibility as solutions to the contradictions of neoliberal consumerism","volume":"21","author":"Room","year":"2011","journal-title":"Critical Public Health"},{"key":"2023122120481194200_CIT0034","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/S1470-2045(21)00279-5","article-title":"Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study","volume":"22","author":"Rumgay","year":"2021","journal-title":"The Lancet Oncology"},{"key":"2023122120481194200_CIT0035","volume-title":"Drinking in the UK: An Exploration of Trends","author":"Smith","year":"2009"},{"key":"2023122120481194200_CIT0036","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2296-14-121","article-title":"Australian general practitioner perceptions of the detection and screening of at-risk drinking, and the role of the AUDIT-C: a qualitative study","volume":"14","author":"Tam","year":"2013","journal-title":"BMC Family Practice"},{"key":"2023122120481194200_CIT0037","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1111\/1467-9566.13440","article-title":"Place of alcohol in the \u2018wellness toolkits\u2019 of midlife women in different social classes: a qualitative study in South Australia","volume":"44","author":"Ward","year":"2022","journal-title":"Sociology of Health & Illness"},{"key":"2023122120481194200_CIT0038","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/acer.13559","article-title":"Trends in alcohol-related emergency department visits in the United States: results from the Nationwide Emergency Department Sample, 2006 to 2014","volume":"42","author":"White","year":"2018","journal-title":"Alcoholism: Clinical and Experimental Research"},{"key":"2023122120481194200_CIT0039","doi-asserted-by":"crossref","first-page":"103560","DOI":"10.1016\/j.drugpo.2021.103560","article-title":"What makes up wine o\u2019clock? Understanding social practices involved in alcohol use among women aged 40\u201365 years in Australia","volume":"101","author":"Wright","year":"2022","journal-title":"International Journal of Drug Policy"}],"container-title":["Health Promotion International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/38\/6\/daad175\/54729598\/daad175.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/38\/6\/daad175\/54729598\/daad175.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T20:48:49Z","timestamp":1703191729000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/heapro\/article\/doi\/10.1093\/heapro\/daad175\/7486591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,1]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/heapro\/daad175","relation":{},"ISSN":["0957-4824","1460-2245"],"issn-type":[{"value":"0957-4824","type":"print"},{"value":"1460-2245","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,12,1]]},"published":{"date-parts":[[2023,12,1]]},"article-number":"daad175"}}