Examining Familiarity with Location and People in Association with Protective Behavioral Strategy Use Among Adolescents and Young Adults at the Daily-Level




Cross, Allison
Zhou, Zhengyang
Fairlie, Anne
Graupensperger, Scott
Lewis, Melissa


0000-0001-6572-4649 (Cross, Allison)

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Purpose: Despite protective behavioral strategies (PBS) often being a central component to alcohol prevention programs, many adolescents and young adults who drink alcohol use few to no PBS. Therefore, it is important to determine factors associated with PBS use. Situational factors such as social and physical environments have shown to influence drinking behavior. In addition, many PBS are often related to peers and location and thus may influence PBS use or nonuse. The study aimed to investigate the associations between situational familiarity (i.e., familiarity with locations and people) and PBS use at the daily level among adolescents and young adults. Method: Participants were recruited in Texas for a longitudinal ecological momentary assessment (EMA) study that involved a 3-week EMA burst design (8 surveys per week; up to 2x/day) with bursts occurring quarterly over 12-months. Participants who reported drinking days and answered PBS items were included in the current analyses. Data: The analytical sample consisted of 3,921 drinking days from 579 participants (55.44% females; 45.12% White, Non-Hispanic; ages 15 to 25 (mean = 21.04)). Data were analyzed with mixed effects zero-inflated Poisson models for each PBS outcome (i.e., serious harm reduction, limiting/stopping, manner of drinking). Results: Within-person results indicated when participants had elevated (i.e., higher than their own average) familiarity with location (e.g., How familiar are you with the locations you were at yesterday?), they were less likely to use harm reduction PBS (RR) = 0.94, p < 0.001) and limiting/stopping PBS (RR = 0.96, p = 0.001). Results showed that on drinking days with elevated familiarity with people (e.g., How familiar are you with the people you were with yesterday?), individuals were more likely to use limiting/stopping PBS (RR = 1.04, p = 0.01). There were no significant daily-level associations between familiarity with people or location and manner of drinking PBS. Conclusion: Results suggest that adolescent and young adult PBS use, particularly serious harm reduction and limiting/stopping PBS, can vary based on familiarity with people and location on a daily level. Alcohol prevention approaches, such as just-in-time intervention strategies, should consider how to increase PBS use even when drinking in more familiar situations or with less familiar people.


Research Appreciation Day Award Winner - School of Public Health, 2023 Research Award - 1st Place