Supporting alcohol change in mid-life women: focus group insights informing refinement of the SPACES intervention logic model.

OBJECTIVES: Logic model refinement is an underreported stage of complex intervention development. SPACES (Storytelling Promoting Alcohol Choice, Empowerment and Sharing) combines narratives with Behaviour Change Techniques (BCTs) to support alcohol reduction among mid-life women. This study aimed to refine the logic model. METHODS: Eight online focus groups were conducted with 20 mid-life women and 12 other stakeholders. Theory-informed reflexive thematic analysis used the Capability, Opportunity, Motivation-Behaviour (COM-B) framework to examine drinking influences and inequalities. A public advisory group informed study materials and interpretation of findings. RESULTS: Five themes described inequality-related influences on drinking and engagement with support: (1) structural inequalities shaped physical opportunity; (2) gendered norms shaped social opportunity; (3) emotional load shaped automatic motivation; (4) cognitive bandwidth shaped psychological capability; and (5) identity and stigma shaped reflective motivation. Environmental restructuring, emotional/social support and alcohol-free activities were supported. Information, alcohol-free and low-alcohol product substitution and goal-setting were acceptable for some but required adaptation to avoid exacerbating inequalities. Findings informed refinements to COM-B determinants, BCTs, delivery through stories and toolkits, and hypothesised mechanisms of action. CONCLUSION: This study provides a worked example of inequality-sensitive logic model refinement and a strong foundation for SPACES prototyping and feasibility testing.