Protective behavioral strategies are more helpful for avoiding alcohol-related problems for college drinkers who drink less

Purpose: Many health providers recommend that college students should use protective behavioral strategies (PBS) (e.g., setting drinking limits) to reduce negative consequences. This recommendation is derived from previous research showing that PBS can help reduce alcohol-related harm. However, more research is needed to determine whether PBS are equally protective across different demographic groups when college drinkers increase their alcohol consumption. This study examined race, gender, and alcohol use level as moderators of the association between PBS and alcohol-related problems among college students. Methods: A total of 12,011 participants (87.7% White, 61% Women) from 12 studies were selected from Project INTEGRATE that combined individual participant data from 24 intervention studies for college students. Complex samples hierarchical regressions were conducted using Mplus. Alcohol use, alcohol-related problems, and PBS use were continuous variables that were measured or estimated in latent variable modeling. Results: Moderation analyses suggested that the protective association between PBS and alcohol-related problems was greater for those who drank less. This moderated effect did not differ across men and women or across racial groups. Conclusions: Greater use of PBS may not always be beneficial for lowering alcohol problems, especially among heavier drinkers or during heavy drinking situations. College drinking prevention programs should ensure that students are aware of the limits of PBS as a harm reduction strategy for alcohol problems. Findings from this study provide evidence for public health efforts to reduce alcohol use "across the board" in addition to promoting PBS among student drinkers.