OP179 Reward, regulation and routine: Using the theoretical domains framework to understand the link between physical activity and alcohol consumption among women who are risky drinkers

Background

Risky alcohol consumption and physical inactivity contribute significantly to the global burden of disease and mortality. There is conflicting observational evidence regarding the association between physical activity and alcohol consumption in adults. Some studies have found that more active women tend to drink less, while other studies link physical activity to risky drinking in women. An understanding of how physical activity and alcohol consumption fits into the lives of women is warranted, but current qualitative evidence is sparse and often lacks depth. This study aims to apply the Theoretical Domains Framework (TDF) to understand the link between physical activity and alcohol consumption through the experiences of women who are risky drinkers.

Methods

We adopted a qualitative study design. Using purposive sampling, we recruited women (aged 18 years and above) who scored ≥7 on the AUDIT-C test and were physically active. Online semi-structured interviews informed by the TDF were conducted between May and September 2022. Interviews were recorded, transcribed and analysed inductively and deductively using the framework approach.

Results

Twenty UK women 24–64 years old were interviewed. Three overarching themes, reward, regulation, and routine were found to account for the physical activity-alcohol relationship and their respective sub-themes were mapped to eight domains of the TDF. Celebrating physical activity events with alcohol and using alcohol as a ‘treat’ following exercise were key to the concept of reward. Drinking was justified within the reward theme because it was viewed as a pleasurable pursuit, whereas physical activity was viewed as health promoting yet challenging. Physical activity was perceived as a ‘damage control’ mechanism for hangovers, unpleasant emotional states and increased calories resulting from drinking because of its health benefits. In the context of routine, we identified four possible physical activity-alcohol patterns namely: within day – physical activity before drinking, within day – drinking before physical activity, previous day drinking – next day physical activity and contemporaneous drinking and physical activity. Factors such as social influences and environment were associated with changes in women’s physical activity-alcohol patterns.

Conclusion

Physical activity and alcohol consumption are important health behaviours in the lives of women. Our findings suggest that complex motivations underlie the physical activity-alcohol relationship in women. Physical activity is an appealing intervention strategy for reducing alcohol consumption due to its broad positive effects and universal safety profile, but its implementation may be complex and inapplicable to all risky drinkers.