Clarifying observed relationships between protective behavioral strategies and alcohol outcomes: The importance of response options.

Abstract

Protective behavioral strategies (PBS), or harm-reduction behaviors that can potentially reduce alcohol consumption or associated problems, have been assessed in varied ways throughout the literature. Existing scales vary in focus (i.e., broad vs. narrow), and importantly, in response options (i.e., absolute frequency vs. contingent frequency). Absolute frequency conflates PBS use with number of drinking occasions, resulting in inconsistencies in the relationship between PBS use and alcohol outcomes, whereas contingent frequency is less precise, which could reduce power. The current study proposes the use of absolute frequencies to maximize precision, with an adjustment for number of drinking days to extricate PBS use from drinking occasions, resulting in a contingent score. Study 1 examined the associations between PBS subscales using the Strategy Questionnaire (Sugarman & Carey, 2007) and alcohol outcomes, finding that in raw score form the association between PBS and typical alcohol outcomes varied greatly from significantly positive to significantly negative, but adjusted score relationships were all consistent with harm reduction perspectives. In addition, curvilinear relationships with typical alcohol use were eliminated using the score adjustment, resulting in linear associations. Study 2 confirmed the findings from Study 1 with a more precise timeframe, additional alcohol assessments, and heavier college drinkers. The relationships between alcohol outcomes and PBS in raw score form were again varied, but became consistently negative using the score adjustment. Researchers examining PBS and related constructs should consider modifying current scales to include a precise frequency response scale that is adjusted to account for number of drinking occasions.

Personalized boosters for a computerized intervention targeting college drinking: The influence of protective behavioral strategies

“…The scale consists of 3 dimensions: selective avoidance of risky drinking practices (e.g., not participating in drinking games); strategies while drinking (e.g., eating before and while drinking); and alternatives to drinking (e.g., finding other ways besides drinking to reduce stress). As demonstrated in previous research, 45 raw frequency is the most appropriate metric for alternatives to drinking, whereas contingent frequency (divided by number of drinking days) is the most appropriate metric for the dimensions of selective avoidance and strategies while drinking because these items are only possible in drinking contexts. Using this modified response option and scoring adjustment results in consistent, linear relationships with alcohol outcomes across subscales, 45 therefore the total score was used for the current study.…”

“…As demonstrated in previous research, 45 raw frequency is the most appropriate metric for alternatives to drinking, whereas contingent frequency (divided by number of drinking days) is the most appropriate metric for the dimensions of selective avoidance and strategies while drinking because these items are only possible in drinking contexts. Using this modified response option and scoring adjustment results in consistent, linear relationships with alcohol outcomes across subscales, 45 therefore the total score was used for the current study. Internal consistency was good (α = .92).…”

“…Higher PBS use is often associated with less alcohol use and fewer alcohol-related problems. 42,44,45 In addition, encouraging PBS behaviors is a frequent component for successful interventions, 46,47 and PBS have shown to be responsive to targeted directions encouraging their use. 48,49 Both mechanisms (descriptive norms and PBS) were able to be succinctly communicated via email, an essential element for boosters communicated electronically to students.…”

How Mandated College Students Talk About Alcohol: Peer Communication Factors Associated with Drinking

“…This questionnaire yields 3 subscales: Strategies While Drinking (10 items; α = .85), Avoidance of Risky Drinking (7 items; α = .66), and Alternatives to Drinking (4 items; α = .60). As recommended, the drinking and avoidance strategies subscales were weighted for analyses in order to reflect frequency of using protective behavioral strategies relative to the frequency of drinking (Braitman, Henson, & Carey, 2014). …”

Strategies associated with low‐risk drinking: a population‐based study

“…The NDSHS SMD items are similar to the strategies used in PBS studies, 8,10,11 as both include alcohol‐related cognitive behaviours, however, PBS studies tend to include a broader range of strategies. In the context of college‐student studies, PBS are viewed as ways students can reduce drinking, particularly heavy episodic drinking and the negative consequences of drinking, 9 and thus are often discussed as a harm reduction strategy 12 …”