Using a Sober Curious Framework to Explore Barriers and Facilitators to Helping Sexual Minority Women Reduce Alcohol-Related Harms: Protocol for a Descriptive Study

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 (eg, lesbian, bisexual, and queer) are at notably high risk. An emerging body of literature suggests that in addition to minority stress (eg, stigma, discrimination), drinking norms and drinking cultures likely influence sexual minority women’s drinking. Almost no research has explored these factors as possible targets of interventions. Sober curiosity is a rapidly growing wellness movement that may be particularly salient for sexual minority women. It encourages individuals to be “curious” about the reasons they choose to drink and alcohol’s effects on their life and health. Objective: The aims of this research are to (1) explore the perspectives of the drinking social worlds of sexual minority women, 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 sexual minority women. Methods: We conducted a comprehensive review of the literature on alcohol interventions with sexual minority women. The handful of studies we found paid scant attention to drinking cultures, normative beliefs, or other key elements of sober curiosity. To address the study aims, we are conducting 2 descriptive studies with adult (>18 years) sexual minority women using mixed methods. One includes focus group interviews (n=24-36) and a national survey (n=100-120) with sexual minority women in Scotland. The other includes in-depth interviews (n=18-20) with sexual minority women in the United States. Data from the 2 countries and 3 sources will be analyzed using qualitative and quantitative methods to identify patterns and relationships across data to validate or corroborate findings. Results: Each of the studies received ethics approval in August 2023 and is currently open for recruitment. We anticipate completing data collection in spring 2025. The results of qualitative analyses will be summarized as themes, and results of survey data analyses will be summarized in tables. Findings will be presented to 2 panels of international experts who will assist in identifying critical elements of an alcohol reduction intervention tailored to the unique needs of sexual minority women. Conclusions: With the assistance of the expert panels, we will use Acceptability, Practicability, Effectiveness, Affordability, Side-Effects, and Equity criteria to inform the development of a tailored intervention building on tenants of sober curiosity to assist sexual minority women in reducing harmful drinking.