​​Understanding the co-occurrence of alcohol consumption and physical activity in UK adults: A multi-method approach ​

Akwa, Lady Gwendoline

Abstract

Background
Alcohol consumption and physical inactivity are leading risk factors for disease and mortality in adults globally. Despite growing interest in the co-occurrence of health behaviours, there is limited evidence on the co-occurrence of alcohol consumption and physical activity in UK adults. The overall aim of this thesis was to gain a deeper understanding of how alcohol consumption and physical activity co-occur in UK adults.
Methods
This PhD consisted of four studies: 1. a scoping review to map out evidence on the association between alcohol consumption and physical activity in adults; 2. a systematic review of longitudinal studies on the association between physical activity and alcohol consumption; 3. secondary analysis of the Health Behaviours during the COVID-19 Pandemic Study (HEBECO) to examine the association between physical activity, sedentary behaviour, and alcohol consumption and; 4. semi-structured interviews to explore the factors that influence daily decision making about alcohol consumption and physical activity. To ensure consistency with the quantitative study sample, the qualitative phase involved interviews with women who drink above the UK low-risk alcohol guidelines (risky drinkers). A framework approach was used to analyse interviews and findings were underpinned by the Theoretical Domains Framework (TDF).
Results
The scoping review demonstrated that evidence on the association between physical activity and alcohol consumption was primarily cross-sectional. A systematic review of the longitudinal evidence showed that alcohol consumption and physical activity are positively associated but evidence of temporality was limited and inconsistent. Cross-sectional analysis of HEBECO data in UK adults aged 18 years and above (n=1,944) demonstrated a positive association between muscle strengthening activity rather than moderate to vigorous physical activity and alcohol consumption (frequency of alcohol consumption, quantity of alcohol consumption (units), frequency of heavy episodic drinking and risky drinking status). Analysis of interview data derived 3 themes: routine, reward and regulation underpinning women’s views on their alcohol consumption and physical activity. Sub-themes aligned with 9 TDF domains namely ‘knowledge’, ‘nature of behaviours’, ‘beliefs about capabilities’, ‘behavioural regulation’, ‘beliefs about consequences’, ‘environmental context and resources’, ‘emotion’, ‘social influences’, and ‘motivation and goals’.
Conclusion
This thesis has provided evidence on the co-occurrence of alcohol consumption and physical activity in UK adults. The theoretical and methodological approach has provided rich evidence that can be used to develop potential intervention strategies to reduce alcohol consumption in physically active women. Findings may further help address challenges behind behaviour interventions and guidelines when health-promoting, and health-risk behaviours co-occur in adults.

Citation

Akwa, L. G. (2024). ​​Understanding the co-occurrence of alcohol consumption and physical activity in UK adults: A multi-method approach ​. (Thesis). University of Hull. https://hull-repository.worktribe.com/output/4910580

• Thesis Type: Thesis
• Deposit Date: Nov 7, 2024
• Publicly Available Date: Nov 29, 2025
• Keywords: Health sciences
• Public URL: https://hull-repository.worktribe.com/output/4910580
• Additional Information: Health Studies; Institute of Clinical and Applied Health Sciences; University of Hull
• Award Date: Aug 12, 2024