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Rates of oral contraceptive pill use have declined over the past decade in Australia. While some women use highly effective methods, others rely on less effective methods such as condoms, withdrawal and fertility awareness. We aimed to understand motivations for relying on these methods among young women in Australia. Women aged 18–23 years who reported using less effective methods and participated in the Contraceptive Use, Pregnancy Intention and Decisions (CUPID) study formed the sample for this analysis. Using thematic analysis, we analysed 140 free-text comments. Findings suggest that less effective methods were used when they were assessed as being best suited to current reproductive needs. These methods were perceived as offering benefits that hormonal and more invasive methods did not, and participants were largely satisfied with them. By contrast, some less effective method use was driven by a lack of choice or alternative options, previous bad experiences with hormonal methods, a lack of appropriate information about alternatives and difficulty accessing other methods. It is therefore essential to move beyond 'LARC-first' contraceptive counselling approaches to ensure young women are provided with accurate information regarding all contraceptive options available (including how to negotiate their use) and how to use them to their greatest efficacy. [ABSTRACT FROM AUTHOR]

Health promotion researchers and practitioners are grappling with how to address growing health inequalities for population groups. In particular, critiques of dominant behaviour change approaches draw attention to the need to engage with social theories to better understand the social and relational drivers of health. Public health researchers are increasingly acknowledging intersectionality as an important theoretical approach, providing a framework for investigating health inequalities by highlighting intersections of individuals' multiple identities within social systems of power that compound and exacerbate experiences of ill health. This article provides an overview of the diverse ways public health researchers and practitioners have applied intersectionality theory to better understand and address health inequalities. We map three key applications of intersectionality theory in public health: as an epistemological approach, as a methodological approach, and as a tool for action and intervention. Drawing on this work, we argue that health promotion researchers and practitioners can enhance engagement with intersectionality theory to address important challenges within the field. Through this article, we aim to inspire the continued exploration of intersectionality and offer some insights into opportunities and challenges for doing so in health promotion. [ABSTRACT FROM AUTHOR]

There is growing consensus around the limited attention given to documenting the process of intervention development, specifically the role of qualitative research. In this article, we seek to describe a missing piece of this process: how qualitative research, and related methodologies and theories, informs intervention development. We use our research as a case study of "reflexive intervention development." We begin by describing our interview study, consisting of 23 in-depth interviews with women diagnosed with metastatic breast cancer, and go on to detail our methodological framework and research team. We then explain how this interview study directly informed our development of the intervention materials, allowing us to attend carefully to language and its potential implications for women. We conclude by inviting researchers to reflect on the knowledge production process that is inherent in intervention development to consider not only their role in this process but also the role of qualitative research. [ABSTRACT FROM AUTHOR]

Four non-Indigenous academics share lessons learned through our reflective processes while working with Indigenous Australian partners on a health research project. We foregrounded reflexivity in our work to raise consciousness regarding how colonizing mindsets—that do not privilege Indigenous ways of knowing or recognize Indigenous land and sovereignty—exist within ourselves and the institutions within which we operate. We share our self-analyses and invite non-Indigenous colleagues to also consider socialized, unquestioned, and possibly unconscious assumptions about the dominance of Western paradigms, asking what contributions, if any, non-Indigenous researchers can offer toward decolonizing health research. Our processes comprise of three iterative features—prioritizing attempts to decolonize ourselves, acknowledging the necessary role of discomfort in doing so, and moving through nonbinary and toward nondualistic thinking. With a nondual lens, working to decolonize ourselves may itself be seen as one contribution non-Indigenous researchers may offer to the collective project of decolonizing health research. [ABSTRACT FROM AUTHOR]

This article explores how women account for their experiences of pregnancy distress in light of cultural imperatives to be the perfect, happy mother. Our analysis is based on the accounts of 18 Australian women, interviewed during pregnancy on the basis of their reports of experiencing depression and/or anxiety. Working within a feminist discursive framework, we focus on the discourses that informed (and threatened) women's positions as a good mother. In particular, we focus on the discourses women relied on to explain their distress and the discursive strategies they used in the construction of their ("distressed") maternal identity(ies). We ask how women articulate and label distress, and with what rhetorical effects. Our analysis explores how women's experiences of negative moods and distress were in direct opposition to cultural imperatives for mothers to stay happy and positive during pregnancy and beyond, posing rhetorical challenges to women's accounts and hence their capacity to make meaning of their (negative) experiences. Three discursive strategies are explored: distancing from the depressed self, speaking between/around/without words, and in search of a balance. We close by considering the implications of the complex ways in which women account for idealised motherhood and how this serves to oppress vulnerable women. [ABSTRACT FROM AUTHOR]

Scholarship on stigma, originally theorised as a ‘mark’ of social disgrace or difference, has since moved away from individual-level analyses to consider the socio-cultural context in the ‘marking’ of groups of people. In response to this theoretical shift, scholars have demonstrated how extensive tobacco denormalisation policies have contributed to the stigmatisation of smokers, documenting smokers’ experiences of stigma across a number of developed countries. We extend this analysis to the Australian context, examining smokers’ constructions of stigma and their reactions to policies that would give smokers differential access to healthcare. Based on 29 interviews with Australian smokers, we focus on what constitutes evidence of stigma and how participants use social comparisons to respond to stigma. We then explore an assumption underpinning participants’ accounts of stigma: that only smokers committed to cessation are ‘deserving’ of treatment. We close by discussing theoretical perspectives and opportunities in stigma research and the need to extend a stigma lens to study emerging public health issues, such as electronic cigarettes. [ABSTRACT FROM PUBLISHER]

Since the 1980s, it has been widely accepted that nicotine is an addictive drug. While discussions of smoking inevitably lead smokers to reflect on their addiction, smokers’ perceptions of nicotine addiction specifically are rarely studied. Smokers’ understandings of nicotine addiction are increasingly relevant in light of the emergence of electronic cigarettes and other cessation aids containing nicotine, and their potential use as long-term replacements for cigarettes. This article is based on a thematic discourse analysis of interviews with 29 smokers from a large metropolitan city in Australia. We explore how smokers negotiate the concept of nicotine addiction in relation to themselves and other smokers, and how this influences their views of smoking cessation methods. Starting with the image of a nicotine addict, we show how participants accept or distance themselves from this image by re-framing the source of their addiction as habit-addicted, rather than nicotine-addicted. We also discuss the function of ‘habit talk’ as a way of contextualising their addiction, and report on how notions of addiction shape participants' views of cessation methods. Finally, we discuss the implications of these findings for future research and for health professionals working with smokers. [ABSTRACT FROM PUBLISHER]

Drawing on public and private accounts of smoking during pregnancy (interviews, survey responses, and a public media article), we examine how women discursively manage the ‘spoiled’ identity associated with inhabiting the body of a ‘pregnant smoker’. We focus on two salient identities ‘the silenced smoker’ and ‘the bad mother’ and explore the discursive and material consequences of these identities. We found that references to smoker and maternal identities were largely absent in women's accounts, and discuss how these absences enabled women to evade stigma and the rhetorical harm of these identities. Further, we discuss the material consequences of stigma including women's need to conceal their ‘pregnant smoker’ body in the face of heightened surveillance. We propose ‘discursive silencing’ to explain how dominant motherhood and anti-smoking discourses serve to render women's experiences as ‘untellable’ and therefore reduce women's capacity to seek help or support to quit smoking. [ABSTRACT FROM AUTHOR]