As alcohol consumption is frequent among youth, protective behavioral strategies (PBS) that can be employed before, during, or after drinking have been proposed to mitigate the negative consequences associated with alcohol use. Although previous studies have demonstrated that PBS use is generally associated with reduced alcohol consumption and fewer adverse outcomes, they have not sufficiently addressed the daily variability in PBS use and its antecedents—particularly the situational characteristics of the social and physical contexts in which drinking typically occurs. Therefore, the present study aims to examine how familiarity with both “place” and “people” influences the daily use of alcohol-related PBS, thereby contributing to the development of more refined prevention and intervention strategies.
The study utilized 564 participants aged 15 to 25 years from Texas for a longitudinal ecological momentary assessment (EMA) study, which involved a 3-week EMA burst design repeated quarterly over 12 months along with a 12-month follow-up survey. Data were collected via morning surveys that assessed drinking behavior and the use of protective behavioral strategies (PBS) the previous day. PBS were measured using 20 items categorized into three subscales (stopping/limiting, manner of drinking, and serious harm reduction), and daily covariates such as weekend, week of burst, and burst number were incorporated. The data were analyzed using mixed-effects Poisson regression models with random intercepts to account for the nested structure of days within participants, with predictors centered at both the within-person and between-person levels.
The study indicated that 86.7% of participants reported consuming alcohol at least once a month, while 44.3% stated they drank at least weekly. Within-person analyses showed that participants utilized fewer serious harm-reduction and stopping/limiting protective behavioral strategies (PBS) on days spent in more familiar locations. Conversely, on days when they were accompanied by familiar individuals, there was a notable increase in the use of serious harm-reduction PBS, accompanied by a non-significant trend towards increased stopping/limiting PBS. No significant between-person effects of situational familiarity were identified. Additionally, on days of higher alcohol consumption, and among participants who generally consumed more than their peers, the use of serious harm-reduction PBS increased, whereas the use of stopping/limiting and manner-of-drinking PBS decreased. Furthermore, female participants and students consistently reported a higher overall usage of PBS. These findings underscore that alcohol prevention interventions—especially just-in-time interventions—should take these situational factors into account to promote PBS use.
Takeaway: Daily variations in familiarity with drinking environments and social companions have a significant impact on the implementation of protective behavioral strategies.