(PS1-2) An Examination of Novel Alcohol Protective Behavioral Strategies Generated by College Students Who Engage in Heavy Drinking

Protective behavioral strategies (PBS) are specific behaviors individuals can use to reduce the negative consequences of alcohol use. PBS are heterogenious and generally encompass efforts to limit alcohol intake (e.g., pacing the number of drinks consumed per hour), to reduce the effects of intoxication (e.g., alternating between alcohol and non-alcoholic beverages), to prevent serious alcohol-related consequences (e.g., avoiding shots or drinking games that rapidly increase blood alcohol levels), or to avoid alcohol altogether (e.g., abstinence). Based on our team’s research experience, we believe that the existing measurement tools of PBS contain obsolete terminology (i.e., certain items reflect behaviors that have become outdated or are rarely endorsed; e.g., using a designated driver). Additionally, technological advances (e.g., smartphones, location-sharing apps, ride sharing apps) have given rise to new PBS that are not currently captured in existing measures (i.e., domain underrepresentation). The present study was designed to qualitatively examine self-generated PBS strategies from college students to identify novel strategies that are not captured in existing PBS measures.

Two hundred college students from two US universities generated alcohol PBS in response to a written prompt; this activity was administered in an RCT designed to reduce problematic alcohol use and related consequences. Participants were asked to list ways that other students could avoid alcohol-related consequences in their own lives, with no word or time limit. Three independent raters inductively coded the complete database of responses to identify underlying themes and patterns in the written responses. The database was then reexamined by two additional coders who assessed the strategies for novelty and utility.
Novel protective strategies related to the following topics were identified: experimenting safely with alcohol (e.g., drink with trusted friends first to learn effects), practicing bodily awareness (e.g., know your limits/tolerance), advanced planning (e.g., predetermine how you will get home or how much to drink), eating and hydration (e.g., eat a meal with friends before going out, bring a water bottle with you), engaging in social accountability (e.g., tell a friend your drink limit) and social safety (e.g., walk home with a friend), drinking slowly (e.g., extend the time between drinks as night progresses), using technology for safety (e.g., share your location with a friend), understanding emotions (e.g., don’t drink to cope), taking breaks (e.g., walk away from the bar area), learning from mistakes (e.g., reflect on past consequences and impact on others), measuring alcohol content (e.g., premeasure all alcohol for the night), counting drinks (e.g., text a friend for each drink, take a picture of each drink with your phone), limiting drink quantity, type and duration (e.g., tell the bartender the maximum number of drinks to serve you, avoid “jungle juice”, set an alarm for the time you want to stop drinking), and reducing risk exposure (e.g., never go out alone, mark your cup). Findings have implications for future measure development and intervention target.