Background: Sexual minority women (SMW; e.g., lesbian, bisexual women) are at substantially higher risk for hazardous drinking (HD) than their heterosexual, cisgender counterparts. There is considerable evidence that minority stressors at the individual (e.g., internalized stigma) and interpersonal (e.g., discrimination) levels are associated with HD among SMW, but minority stressors at the structural level (e.g., structural stigma) are understudied. Further, there is a wide gap in the literature on the relationships between multilevel minority stressors and HD. Additionally, there is evidence that these associations may differ by race/ethnicity and sexual identity, but relatively little is known about these differences, particularly in a multilevel context. Methods: This dissertation includes three studies that were guided by an adaptation of the minority stress model and the social ecological model. In the first study we conducted a systematic review of quantitative research studies that examined associations between structural stigma and alcohol-related outcomes among sexual and gender minority (SGM) adults in the United States. In the second study we used data from a diverse sample of SMW enrolled in the Chicago Health and Life Experiences of Women (CHLEW) study to determine whether structural stigma at Wave 4 (2017-2019) was prospectively associated with HD at Wave 5 (2019-2022), and whether this association was attenuated when accounting for individual- (i.e., internalized stigma, stigma consciousness) and interpersonal- (i.e., discrimination, sexual identity concealment) level minority stressors. In the third study we used data from Waves 4 and 5 of the CHLEW study to examine whether associations between multilevel minority stressors (i.e., internalized stigma, stigma consciousness, discrimination, sexual identity concealment, structural stigma) and HD varied by race/ethnicity and sexual identity. Results: The systematic review included 11 studies. There was moderate to strong support for a positive association between structural stigma and poor alcohol-related outcomes among SGM people, with differences by gender, sexual identity, race, and ethnicity. All studies used cross-sectional designs, and nearly half utilized non-probability samples. Transgender and nonbinary people, SGM people of color, and sexual identity subgroups beyond gay, lesbian, and heterosexual were underrepresented. Multilevel stigma and resiliency factors were understudied. In the second study, structural stigma was positively associated with HD alone, and when combined with interpersonal-level minority stressors. With the addition of individual-level minority stressors, the association between structural stigma and HD was attenuated, with partial attenuation (i.e., structural stigma was still significant) in the model combining all three levels, and full attenuation (i.e., structural stigma was no longer significant) in the model with only structural stigma and individual-level stressors. Discrimination was negatively associated with HD in the fully combined model and was not associated with HD in any other models. In the third study, we found that associations between structural stigma and HD did not vary by race/ethnicity or sexual identity. However, the associations between individual-level minority stressors (i.e., internalized stigma, stigma consciousness) and interpersonal-level minority stressors (i.e., sexual identity concealment) with HD varied somewhat by race/ethnicity and sexual identity. Conclusions: Findings from this dissertation highlight the importance of structural stigma in SMW’s HD and underscore the importance of both structural-level and multilevel minority stressors in designing interventions to effectively address HD drinking disparities and inequities among SMW. Future research is needed using intersectional approaches with probability samples, longitudinal designs, expanded measures of structural stigma, and samples that reflect the diversity of SGM people.

Thesis (M Social Work)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Fetal alcohol spectrum disorders (FASD) is caused by maternal drinking during pregnancy. Pre-natal drinking has a range of deleterious effects including physical, mental and behavioural consequences for the affected child. Although FASD is completely preventable, it is irreversible with consequences that last into adulthood. The range of effects of FASD forms a spectrum with fully developed FAS on the one end and no effects on the other end of the spectrum. The Western Cape has one of the highest recorded rates of FAS in the world. This seriously affects almost all systems in society and strains the already overburdened educational-, health-, social- and judicial systems. For this reason preventing FASD is of the utmost importance and requires a comprehensive approach on multiple levels. This study explores and describes FASD prevention services in the Bonnievale, Robertson, Ashton and Montagu-areas – a wine-producing area in the Western Cape. Available FASD prevention services on all levels of prevention, the focus-areas of the different prevention activities, collaboration and co-ordination between the role-players and obstacles in delivering prevention services, was examined. By adopting an ecological approach, FASD prevention services could be investigated on multiple levels. This study used a combination of quantitative and qualitative research. An exploratory design and a purposive sampling method were used. Participants were interviewed individually and with the help of a semi-structured questionnaire. The findings of the empirical investigation show that, although prevention efforts are applied on the universal, selective and indicated levels of prevention, a lack of formal prevention efforts that are actively pursued - especially on the level of indicated prevention - exists. This is aggravated by the absence of formal co-ordination of services and structured systems of referrals. NGO‟s and government departments are, as a result, not clear about their respective roles and responsibilities and women with the highest risk for having a child with FAS, therefore, fall through the cracks of the system. This happens partly because social workers are often perceived as the only agents for social change in the community. According to the ecological approach all levels (micro, meso and macro) of organizations in the social environment should work together for change by repeating prevention messages on the different levels and thereby reinforcing it. In the study area, however, most FAS prevention services were on the micro-level with few on the meso-level and virtually none on macro-level. Participants identified a lack of co-ordination, unplanned families, a lack of resources, a lack of training and training material and low levels of education as obstacles in service delivery. Recommendations resulting from the study indicate that FAS prevention will benefit from structured, formal programs on all levels of prevention. This will require non-government organizations and government departments to co-ordinate services and to develop a formal system of referral amongst the role-players. Training of personnel in clinics, NGO‟s, government departments and volunteers, as well as the development of training material targeted at people on different levels of education, should receive attention. It is, in conclusion, recommended that community organizations and structures such as churches, places of business, farmer‟s associations and liquor outlets are actively involved in the prevention of FASD. / AFRIKAANSE OPSOMMING: Fetale Alkohol Spektrum Afwykings (FASA) word veroorsaak deur alkoholgebruik tydens swangerskap. Alkoholgebruik tydens swangerskap het „n reeks skadelike effekte, insluitend fisiese, psigiese en gedragsafwykings in die geaffekteerde kind. Alhoewel FASA heeltemal voorkombaar is, is dit onomkeerbaar en duur die gevolge daarvan voort in volwassenheid. Die reeks effekte van FASA vorm „n spektrum met volledig ontwikkelde FAS aan die een kant en geen effekte nie aan die ander kant van die spektrum. Die Wes-Kaap het een van die hoogste aangetekende voorkomssyfers van FAS in die wêreld. Dit affekteer feitlik alle sisteme in die samelewing en plaas nog meer druk op die reeds oorlaaide opvoedkundige-, gesondheids-, maatskaplike- en regssisteme. Om hierdie rede is die voorkoming van FASA van uiterste belang en word „n omvattende benadering op veelvuldige vlakke vereis. Hierdie studie ondersoek en beskryf FASA voorkomingsdienste in die Bonnievale-, Robertson-, Ashton- en Montagu-area – „n wynproduserende streek in die Wes-Kaap. Die beskikbaarheid van FASA voorkomingsdienste op alle vlakke van voorkoming, die fokus-areas van die verskillende voorkomingsaktiwiteite, samewerking en koördinering van dienste tussen die rolspelers, sowel as struikelblokke in voorkomingsdienste, is ondersoek. Deur die ekologiese benadering aan te neem, kon FASA voorkomingsdienste op veelvuldige vlakke ondersoek word. Die studie kombineer kwantitatiewe en kwalitatiewe navorsing. Die ontwerp van die studie is verkennend en daar is „n doelbewuste steekproef gedoen. Indivuduele onderhoude met deelnemers is met behulp van semi-gestruktureeerde vraelyste gevoer. Die bevindinge van die empiriese ondersoek toon dat, alhoewel voorkomingspogings aangewend word op die universele, selektiewe en indikatiewe voorkomingsvlakke, daar 'n gebrek bestaan aan formele voorkomingspogings wat aktief nagestreef word, veral op die indikatiewe vlak. Dit word vererger deur die afwesigheid van formele koördinering van dienste en gestruktureerde verwysingsisteme. Nie-regeringsorganisasies en staatsdepartemente het gevolglik nie duidelikheid oor hul onderskeie rolle en verantwoordelikhede nie. Die gevolg hiervan is dat vroue met die hoogste risiko om geboorte te skenk aan kinders met FAS, deur die krake in die sisteem val. Dit geskied deels omdat maatskaplike werkers dikwels gesien word as die enigste agente vir maatskaplike verandering in die gemeenskap. Volgens die ekologiese benadering behoort alle vlakke (mikro, meso en makro) van organisasie in die sosiale omgewing saam te werk om verandering teweeg te bring deurdat voorkomingsboodskappe op die verskillende vlakke te herhaal en sodoende te versterk word. In die studie-area is die meeste voorkomingsdienste egter op mikro-vlak gelewer met min op meso-vlak en feilik geen op makro-vlak nie. Deelnemers aan die studie het „n gebrek aan koördinasie van dienste, onbeplande gesinne, „n gebrek aan hulpbronne, „n gebrek aan opleiding en opleidingsmateriaal en lae vlakke van geletterdheid geïdentifiseer as struikelblokke in dienslewering. Aanbevelings wat uit die studie voortvloei, dui aan dat FASA voorkomingsdienste sal baat vind by gestruktureerde, formele programme op alle vlakke van voorkoming. Dit sal vereis dat nie-regeringsorganisasies en staatdepartemente hul dienste koördineer en „n formele verwysingstelsel tussen die verskillende rolspelers ontwikkel. Opleiding van personeel in klinieke, NRO‟s, staatsdepartemente en vrywilligers, sowel as die ontwikkeling van opleidingsmateriaal wat persone op verskillende vlakke van opvoeding teiken, behoort aandag te geniet. Dit word laastens ook aanbeveel dat gemeenskapsorganisasies en strukture byvoorbeeld kerke, besighede, boere-verenigings en verkoopspunte vir alkohol, aktief betrek word by die voorkoming van FASA.

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Fetal Alcohol Spectrum Disorder, which is the most common cause of mental and learning disabilities in the world, is totally preventable. Fetal Alcohol Spectrum Disorder is not a genetic or inherited condition; however, it is permanent and reduces human potential. There is no cure or treatment. Fetal Alcohol Spectrum Disorder does not distinguish between race, class or culture and can affect children from all socio-economic groups. It is however more prevalent amongst poor, uneducated, uninformed and marginalised (minority groups) or aboriginal communities due to a variety of historical, sociopolitical and economic reasons. Fetal Alcohol Spectrum Disorder has become a public health problem in South Africa in provinces like the Western and Northern Cape (winegrowing areas), where substantial research has been conducted and where alcohol abuse can be traced back to the ‘dop’ system. The highest documented prevalence of Fetal Alcohol Spectrum Disorder in the world has been identified in these provinces amongst a marginalised group of people classified in South Africa as ‘coloured’. A substantial amount of research has been conducted on the characteristics, manifestation and prevalence of Fetal Alcohol Spectrum Disorder in South Africa, but no research has yet been done to ascertain educators’ knowledge of and attitude to learners with Fetal Alcohol Spectrum Disorder. In view of the high prevalence of Fetal Alcohol Spectrum Disorder in South Africa, and the possibility that many of the learners with learning and behavioural problems in our schools could be victims of Fetal Alcohol Spectrum Disorder (also known as a ‘hidden disability’) I concentrated my research on schools situated in low socio-economic areas on the Cape Flats where poverty and unemployment are high and shebeens are plentiful. Through this research I firstly wished to establish how much knowledge educators have of Fetal Alcohol Spectrum Disorder and what their attitudes are toward learners manifesting the disorder. Secondly, my aim was to ascertain to what extent educators are able to support and identify these learners. Qualitative research methods and an interpretive constructivist paradigm were used to conduct the study. Data was primarily collected through the use of interviews, focus group discussions, observations and a research journal. Nine participants, from three different low socio-economic schools (one from each educational phase) on the Cape Flats, were involved. Themes that emerged from the data were analysed and recorded through the constant comparative method. They are discussed together with the research findings. This study revealed important issues pertaining to educators’ knowledge of Fetal Alcohol Spectrum Disorder and whether they are able to assist learners presenting with this disorder in mainstream education in South Africa. A number of recommendations are made for further research in this field. / AFRIKAANSE OPSOMMING: Fetale Alkohol Spektrumsindroom, wat as die algemeenste oorsaak van verstandelike en leergestremdhede in die wêreld beskou word, is ʼn sindroom wat voorkom kan word. Die sindroom is nie geneties of oorerflik nie, maar die skade is permanent omdat daar geen behandeling en teenmiddel is nie. Dit het gevolglik ʼn negatiewe impak op menslike vermoëns. Fetale Alkohol Spektrumsindroom kan kinders van alle sosioekonomiese groepe affekteer en alhoewel dit nie kultuur-, ras- of klasgebonde is nie, is dit oorwegend ʼn algemene verskynsel onder groepe met ʼn lae opvoedingspeil, diegene wat oningelig en gemarginaliseer is (minderheidsgroepe) of dié wat as inboorlinggemeenskappe bekend staan, wat toegeskryf kan word aan verskeie historiese, sosio-politieke en ekonomiese redes. Fetale Alkohol Spektrumsindroom is tans ʼn openbare gesondheidsprobleem in Suid-Afrika, veral in die wynstreke van die Wes- en Noord-Kaap. Omvattende navorsing is al in genoemde provinsies gedoen waar alkoholmisbruik ʼn lang aanloop het en verbind word met die dopstelsel. Die Wes-Kaap en Noord-Kaap is alombekend as provinsies met die hoogste voorkomsyfer van Fetale Alkohol Spektrumsindroom FASD in die wêreld, veral onder ʼn gemarginaliseerde groep mense wat as die kleurlinge’ bekend staan. Alhoewel omvattende navorsing oor die karaktereienskappe, manifestasies en voorkoms van Fetale Alkohol Spektrumsindroom in Suid-Afrika reeds gedoen is, kon geen navorsing gevind word wat die kennis van opvoeders en hul en houdings jeens leerders met Fetale Alkohol Spektrumsindroom probeer vasstel nie. As die hoë voorkoms van Fetale Alkohol Spektrumsindroom in ag geneem word, asook die moontlikheid dat baie leerders in ons skole leer- en gedragsprobleme manifesteer, kan daar waarskynlik slagoffers van Fetale Alkohol Spektrumsindroom wees en wie se gestremdhede dus ‘onsigbaar’ is. My navorsing fokus daarom hoofsaaklik op skole in die lae sosio-ekonomiese areas van die Kaapse Vlakte, waar armoede en werkloosheid hoogty vier en waar daar ʼn hoë voorkoms van onwettige drankwinkels (‘sjebiens’) is. My primêre doel met hierdie navorsing was om die kennis van onderwysers oor Fetale Alkohol Spektrumsindroom te bepaal en om die houding van opvoeders jeens leerders wat met kenmerke van hierdie sindroom vas te stel. Ek wou ook vasstel tot welke mate opvoeders bevoeg om is leerders met Fetale Alkohol Spektrumsindroom te identifiseer en te ondersteun. Kwalitatiewe navorsingsmetodes en ʼn interpretatiewe konstruktivistiese paradigma is in die studie gebruik. Data is primêr ingesamel met behulp van onderhoude, fokusgroep-besprekings, observasies en ʼn navorsingsjoernaal. Nege deelnemers verbonde aan drie verskillende skole met lae sosio-ekonomiese vlakke (een opvoeder van elke opvoedingsfase), op die Kaapse Vlakte was by die studie betrokke. Temas wat blootgelê is deur die data is ontleed en by wyse van die konstante vergelykende metode opgeneem. Hulle word saam met die navorsingsbevindings bespreek. Die navorsing toon belangrike aspekte van opvoeders se kennis van Fetale Alkohol Spektrumsindroom. Dit bevraagteken ook of hoofstroom-opvoeders in staat is om leerders met Fetale Alkohol Spektrumsindroom te ondersteun. Voortspruitend uit die bevindings word aanbevelings gemaak vir verdere ondersoeke op hierdie gebied.

Birthweight is powerful predictor of infant growth and survival. Premature birth and intrauterine growth retardation of birthweight. Maternal environment is important underlying determinant of birthweight. Common lifestyle risk factors include maternal under-nutrition, smoking, alcohol and social factors and stress. The Winelands/West Coast region has high rates of low birthweight. In addition, alcohol abuse and smoking are major problems in this area. The aim of this quantitative case-control study was to determine the epidemiology of low birthweight, related to lifestyle behaviours in pregnant women, with particular attention to lifestyle factors such as alcohol, smoking, and stress-related factors.

Thesis (MA. (Clinical Psychology)) -- University of Limpopo, 2014 / A study investigating alcohol use amongst female undergraduate students was conducted at the University of Limpopo Turfloop Campus. The study was quantitative in nature and used a cross-sectional survey design. A purposive sample of 200 undergraduate female psychology students across 1st, 2nd and 3rd year levels was used. The Protection Motivation Theory (PMT) was used as a framework which guided the study and the reporting of the research results. The self-report questionnaire was made up of several standardized questionnaires and open-ended questions. Quantitative data was analyzed using descriptive statistics namely, frequency tables and figures as they gave a clear overall picture of the data. The chi square (X2) statistic was also used to see if there was significant difference in drinking trends between 1st, 2nd and 3rd year female psychology students. Nearly 89% of the entire sample reported to being Christian, it was expected that they would have moral values associated with the religion which would either call for moderate drinking or abstinence. The results of this study generally underpin this statement. Overall, a significant difference in drinking patterns across year levels, with first years more likely to report problem behaviours relating to alcohol consumption, than second or third year levels was found. In terms of the PMT, the majority of the respondents reported responsible drinking behaviours and patterns. However, a notable number of participants, although not statistically significant, did report a number of problems associated with alcohol consumption. The study recommends that future research be undertaken into alcohol use amongst both genders at different year levels at the institution. It was also recommended that qualitative research, to find out students motivations for drinking, be undertaken amongst both genders.

Includes bibliographical references (leaves 320-415) Investigates female drinking patterns and how they impacted on women's lives in the sixteenth and seventeenth centuries in early modern England. Deals with female drinking as a site of contention between insubordinate women and the dominant paradigm of male expectations about drinking and drunkeness. Female drinking patterns integrated drinking and drunkeness into women's lives in ways that enhanced bonding with their female friends, even if it inconvenienced their husbands and male authorities. Drunken sociability empowered women.

Includes bibliographical references (leaves 320-415) / viii, 415 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Investigates female drinking patterns and how they impacted on women's lives in the sixteenth and seventeenth centuries in early modern England. Deals with female drinking as a site of contention between insubordinate women and the dominant paradigm of male expectations about drinking and drunkeness. Female drinking patterns integrated drinking and drunkeness into women's lives in ways that enhanced bonding with their female friends, even if it inconvenienced their husbands and male authorities. Drunken sociability empowered women. / Thesis (Ph.D.)--University of Adelaide, Dept. of History, 2002

Birthweight is powerful predictor of infant growth and survival. Premature birth and intrauterine growth retardation of birthweight. Maternal environment is important underlying determinant of birthweight. Common lifestyle risk factors include maternal under-nutrition, smoking, alcohol and social factors and stress. The Winelands/West Coast region has high rates of low birthweight. In addition, alcohol abuse and smoking are major problems in this area. The aim of this quantitative case-control study was to determine the epidemiology of low birthweight, related to lifestyle behaviours in pregnant women, with particular attention to lifestyle factors such as alcohol, smoking, and stress-related factors. / Master of Public Health - MPH

Birthweight is powerful predictor of infant growth and survival. Premature birth and intrauterine growth retardation of birthweight. Maternal environment is important underlying determinant of birthweight. Common lifestyle risk factors include maternal under-nutrition, smoking, alcohol and social factors and stress. The Winelands/West Coast region has high rates of low birthweight. In addition, alcohol abuse and smoking are major problems in this area. The aim of this quantitative case-control study was to determine the epidemiology of low birthweight, related to lifestyle behaviours in pregnant women, with particular attention to lifestyle factors such as alcohol, smoking, and stress-related factors.

In 2011, representatives from the Multnomah County Health Departments and several Native-serving organizations came together to address substance-exposed pregnancies among urban Native Americans in Portland, Oregon. From these partnerships, the Future Generations Collaborative was formed representing a significant shift toward community-led maternal child health research and planning. Additionally, the Future Generations Collaborative adopted a historical trauma-informed community based participatory research and planning process. This is particularly significant considering government agencies' role in colonization within Native communities. The purpose of this case study is to explore partnerships between government agencies and the Portland Native community within the Future Generations Collaborative. Given the profound influence of historical trauma in Native communities, this paper addresses how the partnerships between government agencies and the Portland Native community pose distinct opportunities, challenges, and implications. Drawing from FGC members' lived experiences and an interdisciplinary body of research, I develop a theoretical model for explaining the government's role in creating and sustaining historical trauma within Native communities. This analysis provides critical context for examining the impact of historical trauma on the relationships between government agencies and the Portland Native community within the FGC. By entering methodological discussions of Native-specific community-based participatory research, this study also addresses how the use of a trauma-informed research and planning model affects the relationships between government agencies and the Portland Native community within the FGC.