Examining within-person associations between alcohol and cannabis use and hooking up among adolescents and young adults in the United States.

OBJECTIVE: This study examined daily associations between alcohol use, cannabis use, and simultaneous alcohol and cannabis/marijuana (SAM) use with the likelihood of hooking up (uncommitted sexual encounter that may or may not include intercourse). METHOD: We used a longitudinal measurement burst ecological momentary assessment (EMA) design with 3-week EMA bursts with daily measurements repeated quarterly across 12 months. 1,009 (57 % female, Mean age = 20.00 [SD = 3.21]) Texan adolescents and young adults ages 15-25 participated in the study. Mixed effects logistic regression models were estimated using maximum likelihood estimation to evaluate the associations between substance use and hooking up. RESULTS: Within-person results indicated that participants were more likely to hook up on days with alcohol use and on days with cannabis use, but not on days with SAM use. Participants were also more likely to hook up on drinking days with higher-than-usual alcohol use. Between-person results indicated that participants who used alcohol more often or cannabis more often on average were more likely to hook up, and participants who tended to drink more on drinking days were more likely to hook up. CONCLUSIONS: Given the significant daily-level associations between alcohol and cannabis use and hooking up behavior, public health initiatives should focus on developing interventions to reduce alcohol and cannabis use and promote safer hooking up behavior among adolescents and young adults.

A daily-level examination of willingness to pregame, blackout, and hook up across drinking days: Associations with respective behavioral outcomes among adolescents and young adults.

Research indicates general willingness to drink (i.e., "How willing are you to drink tonight?") fluctuates day-to-day and is associated with daily-level drinking. However, it is unknown whether willingness to engage in specific alcohol-related behaviors is associated with actual engagement in those behaviors above and beyond general willingness to drink at the daily level. The present study examined whether daily-level willingness to engage in specific behaviors (i.e., pre-gaming, blacking out, hooking up) predicted engaging in those respective behaviors on drinking days above and beyond one's general willingness to drink. Participants included adolescents and young adults who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. Participants (N = 675; 43 % male) who reported drinking on weekend days (i.e., Friday and Saturday [N = 3,727 days]), were included. The study involved a 3-week EMA burst design with bursts occurring quarterly over 12 months. Multilevel logistic regressions indicated on drinking days when participants reported being more willing than their own average to pre-game (OR = 1.77, p <.001), black out (OR = 1.46, p <.05), or drink before hooking up (OR = 1.68, p <.001), they were more likely to pregame, black out, and hook up, respectively, whereas general willingness to drink was not associated with any outcomes at the daily level.Results suggest willingness to engage in specific behaviors may be essential to target in prevention programming in comparison to general willingness to drink when aiming to reduce specific risk behaviors.

Using the Plan-Do-Study-Act Evaluation Framework to Improve the Recruitment of Women Experiencing Homelessness: Lessons Learned.

BACKGROUND AND OBJECTIVES: Strategic recruitment is necessary to reach recruiting goals when conducting research with vulnerable and transient populations, such as postpartum women experiencing homelessness. The current study evaluated the recruitment process for a qualitative study using the Plan-Do-Study-Act (PDSA) method. METHODS: In a study conducting semistructured interviews about reproductive interconception care barriers and facilitators for local women who were recently pregnant and homeless in 2022, PDSA cycles were used to improve community organizations' assistance with identifying participants, facilitate screening and interviewing processes, and ensure participants were safeguarded. RESULTS: Iterative PDSA cycles were conducted across a 20-week period. Ultimately, 12 women were interviewed, with increasing participant location and organizational assistance over time. Following 4 key lessons were identified: provide in-person and remote options for conducting data collection; include fair compensation that balances time versus study coercion; weigh feasibility versus importance of sample size with eligibility criteria; and support partnerships with organization connections. CONCLUSIONS: The PDSA method served as a parsimonious framework for evaluation. The lessons learned will help facilitate future recruitment efforts for this difficult-to-recruit and vulnerable population.

Reproductive Interconception Care Among Women Recently Pregnant and Homeless: A Qualitative Analysis.

Reproductive interconception care provided at maternal postpartum visits may help reduce unintended pregnancies and elongate birth intervals for women experiencing homelessness. To improve interconception care uptake, this qualitative study aimed to identify barriers and facilitators to reproductive interconception care from the perspectives of women who were recently pregnant and homeless. A semi-structured interview guide and demographic survey were developed based on epidemiological findings, Information-Motivation-Behavioral Skill framework components, and a review by community health workers for content validity. After conducting 12 interviews with women recently pregnant and homeless in a local continuum of care in 2022, audio-recorded interviews were transcribed, iteratively coded using a priori and emerging codes, and thematically analyzed. Key themes were identified to determine implications and next steps to improving reproductive interconception care uptake. Interrelated themes focused on information (e.g., knowledge and misconceptions about pregnancy, birth intervals, contraception), motivation (e.g., attitudes about interconception care experiences, perinatal social influences), behavioral skills (e.g., objective ability to obtain interconception care and perceived self-efficacy related to attending maternal postpartum visits and increasing birth intervals), and macro-level factors (e.g., obtaining housing, contextualizing socioeconomic factors, navigating COVID-19). The findings suggest the need for flexible, streamlined, and personalized interconception care delivery that acknowledges pressing housing and relationship considerations and supports women's autonomy. Improvements to reproductive interconception care may reduce future unintended pregnancies, increase birth intervals, and improve birth outcomes among women experiencing homelessness.

Homelessness in the Perinatal Period and Associations With Reproductive Interconception Care: 2016-2019 Pregnancy Risk Assessment Monitoring System.

OBJECTIVES: Women experiencing homelessness have higher rates of unintended pregnancy than stably housed women and may benefit from reproductive interconception care. How reproductive interconception care differs between women who did and did not experience perinatal homelessness is not known. We estimated prevalence ratios of reproductive interconception behaviors among US women experiencing homelessness during the perinatal period. METHODS: We used data from the 2016-2019 Pregnancy Risk Assessment Monitoring System to calculate the prevalence of 5 reproductive interconception care outcomes: attending a maternal postpartum checkup, participating in a conversation with a health care provider about birth intervals, receiving family planning counseling, obtaining a prescription for short-acting contraception, and having a long-acting reversible contraceptive inserted. We used complex survey weights, stratified by perinatal homelessness, and converted adjusted logistic regression odds ratios between housing status and outcome variables to adjusted prevalence ratios (aPRs) and 95% CIs. RESULTS: Among participants, approximately 2.4% (weighted percentage; unweighted 2953 of 100 706) experienced homelessness sometime in the 12 months before their children were born; the majority were non-Hispanic (83.2%) and White (69.4%), were not married (82.2%), and had public health insurance (56.8%). Perinatal homelessness was significantly associated with a lower prevalence of attending a postpartum maternal visit (aPR = 0.90; 95% CI, 0.87-0.94) and a higher prevalence of having a conversation about birth intervals with their health care providers (aPR = 1.13; 95% CI, 1.03-1.21). CONCLUSIONS: Findings suggest that improving attendance at postpartum visits and evaluating birth interval conversations may strengthen interconception care practices while contextualizing social determinants such as housing stability. Improving uptake of postpartum visits may reduce unintended pregnancy, short birth intervals, and adverse birth outcomes in future pregnancies among women experiencing homelessness.

Daily level examination indicates that positive affect, but not negative affect, is associated with alcohol and marijuana use among adolescents and young adults.

OBJECTIVE: Although there is growing evidence that alcohol use at the daily level is associated with positive but not negative affect, results are mixed when examining marijuana use and simultaneous alcohol and marijuana (SAM) use (i.e., use with overlapping effects). In addition, less is known about these daily level associations among diverse samples of adolescents and young adults. The present study will address these gaps. METHOD: Participants (N = 1,006; 57.3% female, 43.1% White, Non-Hispanic, ages 15-25; Mage = 20.0) were part of a study on substance use that consisted of a 3-week ecological momentary assessment (EMA) burst design (eight surveys per week, up to 2×/day) that was repeated quarterly over a 12-month period. RESULTS: Within-person results indicated that on days with elevated positive affect, participants reported consuming more drinks, whereas positive affect was not significant for hours high from marijuana. In addition, on days with elevated negative affect, participants reported fewer hours high from marijuana. No association was found between negative affect and number of drinks. Finally, within-person results indicated that on alcohol or marijuana days with elevated positive affect, individuals were more likely to report SAM use. There was no association found between negative affect and SAM use. CONCLUSIONS: Results have implications such that in-the-moment interventions for alcohol and SAM use may be more salient when individuals have higher positive affect than average, whereas such interventions may be more relevant for marijuana use when negative affect is lower compared to average levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Experimental Test of Abstaining-and-Drinking Social Media Content on Adolescent and Young Adult Social Norms and Alcohol Use.

OBJECTIVE: Experimental research has demonstrated that when alcohol-related content is viewed on social media, adolescents and young adults tend to have favorable attitudes toward alcohol use. However, limited research focuses on social media norms for abstaining from alcohol use. The current study examined the role of descriptive and injunctive alcohol-abstaining-and-drinking norms via experimentally manipulated social media profiles. Experimental effects on descriptive and injunctive normative perceptions and subsequent behavior were tested. METHOD: Participants (N = 306; ages 15-20 years) were recruited from the Seattle metropolitan area to complete a baseline survey and view researcher-fabricated social media profiles. Using stratified random assignment (birth sex and age), participants were randomized into one of three conditions: (a) alcohol abstaining and drinking, (b) alcohol abstaining, and (c) attention control. RESULTS: The alcohol-abstaining-and-drinking condition reported greater drinking descriptive norms compared with participants in either the alcohol-abstaining or the attention-control conditions at post-experiment and 1-month follow-up. The alcohol-abstaining-and-drinking condition reported lower abstaining descriptive norms (i.e., perceiving fewer peers abstain) compared with those in the alcohol-abstaining condition at post-experiment and lower abstaining injunctive norms compared with those in the attention-control condition at 1-month follow-up. CONCLUSIONS: Exposure to social media profiles containing both alcohol-drinking and alcohol-abstaining messages was respectively associated with individuals perceiving that peers were consuming alcohol more often and that fewer peers were abstaining. The present findings are consistent with prior experimental research that indicates alcohol displays on social media are associated with riskier drinking cognitions.

First Comes Substance Use, Then Comes Social Media Posts? Examining the Temporal Ordering and Relative Strength of Relations Across Alcohol, Tobacco and Marijuana Use and Posting Behavior.

Social media posts represent a major route by which youth share their substance use cognitions and experiences with others. Extant research has primarily examined relations between alcohol-related posts and posters' own alcohol use, yet little is known about the role of social media in the use of less socially accepted substances, namely tobacco and marijuana. Our study represents the first to examine the relative strength of this relation across alcohol, tobacco, and marijuana. The current research used a one-month time lag to tease apart the temporal ordering of substance-use-posting and participants' own substance use. A sample of 282 15-20-year-olds (Mage = 18.4, SD = 1.3, 52.9% female) in the United States completed two self-report surveys, one month apart. Results of a cross-lagged panel model revealed significant effects of alcohol and marijuana consumption on subsequent alcohol- and marijuana-related posting, respectively (i.e., selection effects). However, reverse relations (i.e., self-effects) were not significant. Further, we found no differences in the strength of selection effects across substances, suggesting they are similar for both more (alcohol) and less (marijuana and tobacco) socially acceptable substances. Results point to the importance of using young people's social media posts as a way to help identify individuals at risk for heightened substance use and social media as a mechanism for targeted prevention programming.

Cannabis Use Among Female Community College Students Who Use Alcohol in a State With and a State Without Nonmedical Cannabis Legalization in the US.

INTRODUCTION: Female community college students who use alcohol may be an at-risk group for cannabis use, especially in US states with nonmedical cannabis legalization. This study examined cannabis use among this population. We tested differences in current cannabis use across a state with versus a state without (Washington vs Wisconsin, respectively) nonmedical cannabis legalization. METHODS: This cross-sectional study included female students aged 18-29 who were current alcohol users attending a community college. An online survey assessed lifetime and current cannabis use (last 60 days) via the Customary Drinking and Drug Use Record. Logistic regression tested whether community college state and demographic characteristics were associated with current cannabis use. RESULTS: Among 148 participants, 75.0% (n = 111) reported lifetime cannabis use. The majority of participants from Washington (81.1%, n = 77) and Wisconsin (64.2%, n = 34) reported ever trying cannabis. Almost half of participants (45.3%, n = 67) indicated current cannabis use. Among Washington participants, 57.9% (n = 55) reported current use compared to 22.6% (n = 12) of Wisconsin participants. Washington school attendance was positively associated with current cannabis use (OR = 5.97; 95% CI, 2.50-14.28, P < 0.001), after controlling for age, race, ethnicity, grade point average, and income. CONCLUSIONS: High cannabis use in this sample of female drinkers - particularly in a state with nonmedical cannabis legalization - underscores the need for prevention and intervention efforts targeted to community college students.

Frequency and Timing of Sent and Received Alcohol-Related Text Messages: Associations with Alcohol Use and Related Consequences among Adolescents and Young Adults.

Background: Research supports the notion that adolescents and young adults communicate about alcohol via text messages and that this form of communication is associated with alcohol use. However, little is known about how this compares to social media content sharing or about the timing of sending and receiving alcohol-related text messages and associations with alcohol-related outcomes. The present study aimed to 1) document whether adolescents and young adults are willing to share alcohol content via text messages they are not willing to share via social media, and 2) determine associations between frequency and timing of alcohol-related text messages (both sent and received) with self-reported alcohol use and consequences. Methods: A total of 409 participants (63.30% female; age 15-25, M = 21.10, SD = 2.69) completed a baseline survey as part of a larger study. Results: While 84.50% of participants reported that they were willing to send text messages referencing alcohol that they would not share on social media, 90.00% reported that their friends would be willing to do so. Results of negative binomial regressions indicated that sending and receiving more alcohol-related text messages per week and sending and receiving text messages before and during drinking, but not after drinking, were positively associated with typical drinks per week. Neither frequency of sending and receiving text messages or timing (before, during, after) were associated with negative consequences. Conclusions: Results suggest that frequency and timing of alcohol-related text messaging may provide insights into alcohol consumption patterns among adolescents and young adults and warrants future research.

Age and Fear of Missing Out as Moderators of the Association between Peak Drinks and Alcohol-Induced Blackouts among Adolescents and Young Adults.

Background: Alcohol-induced blackouts are periods of impaired memory in which an individual is unable to recount events that occurred while they were intoxicated and are associated with heavier drinking episodes. Objectives: The present study examined age and Fear of Missing Out (FoMO) as moderators of the association between peak number of drinks and experiencing alcohol-induced blackouts. Participants ages 15-25 (N = 411; Mean age = 21.4 (SD = 2.5); 61.6% female) completed baseline and daily surveys as part of a larger ecological momentary assessment study. Past month blackout experiences and peak number of drinks were reported at baseline and FoMO was reported in daily surveys one to three weeks following the baseline survey. Results: A zero-inflated negative binomial model was fit to examine the interaction between peak number of drinks with age and FoMO on alcohol-induced blacking out, controlling for relevant covariates. Findings indicated the association between peak number of drinks on the likelihood of alcohol-induced blacking out was significantly moderated by age. The association was stronger for younger compared to older individuals. Findings further indicated the associations between peak number of drinks on both the likelihood and average number of alcohol-induced blacking out was significantly moderated by FoMO. For individuals with higher levels of FoMO, the association between peak drinks and alcohol-induced blacking out was weaker for the likelihood of experiencing any blackouts and stronger for the number of blackouts. Conclusions: Findings provide support to previous literature examining age and FoMO as risk factors for alcohol-induced blackouts among adolescents and young adults.

Daily-level associations between alcohol use cognitions and normative perceptions among adolescents: An intensive longitudinal study.

BACKGROUND: Adolescence is an important developmental period in which to understand the cognitive underpinnings of risky alcohol use. Normative perceptions, such as descriptive and injunctive norms, are one of the strongest and most consistent predictors in adolescent drinking research. Thus, it is essential to examine which drinking cognitions (e.g., attitudes, prototypes, perceived vulnerability) are associated with normative drinking perceptions using repeated daily-level data among adolescents. The present study assessed associations between drinking cognitions and normative perceptions using an intensive daily longitudinal design. METHODS: Participants were ages 15-17 years (N = 306; 61.4% female; Mage (SD) = 16.0 (0.8)) who were part of a larger ecological momentary assessment study (EMA) on drinking cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week, up to 2x/day) that was repeated quarterly over the 12-month study. The present analyses used the afternoon assessment for all measures. RESULTS: Our multilevel model results demonstrated that drinking attitudes, prototypes of a typical drinker, and perceived vulnerability were positively associated with both descriptive and injunctive drinking norms between individuals and within individuals across days. CONCLUSIONS: Current findings have important clinical implications as they demonstrated how specific drinking cognitions were associated with variability in normative perceptions at the daily level. Findings support the delivery of intervention messaging to adolescents on days when drinking attitudes, prototypes of a typical drinker, and perceived vulnerability are elevated.

Cross-Tailoring Integrative Alcohol and Risky Sexual Behavior Feedback for College Students: Protocol for a Hybrid Type 1 Effectiveness-Implementation Trial.

BACKGROUND: Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions (PFIs) are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approach with regard to alcohol-related RSB. OBJECTIVE: The aims of this study are to (1) evaluate the impact of a brief PFI that integrates content on alcohol use and RSB and is adapted to include a novel cross-tailored dynamic feedback (CDF) component for at-risk first-year college students and (2) identify implementation factors critical to the CDF's success to facilitate future scale-up in campus settings. METHODS: This study uses a hybrid type 1 effectiveness-implementation design and will be conducted in 3 phases. Phase 1 is a stakeholder-engaged PFI+CDF adaptation guided by focus groups and usability testing. In phase 2, 600 first-year college students who drink and are sexually active will be recruited from 2 sites (n=300 per site) to participate in a 4-group randomized controlled trial to examine the effectiveness of PFI+CDF in reducing alcohol-related RSB. Eligible participants will complete a baseline survey during the first week of the semester and follow-up surveys at 1, 2, 3, 6, and 13 months post baseline. Phase 3 is a qualitative evaluation with stakeholders to better understand relevant implementation factors. RESULTS: Recruitment and enrollment for phase 1 began in January 2022. Recruitment for phases 2 and 3 is planned for the summer of 2023 and 2024, respectively. Upon collection of data, the effectiveness of PFI+CDF will be examined, and factors critical to implementation will be evaluated. CONCLUSIONS: This hybrid type 1 trial is designed to impact the field by testing an innovative adaptation that extends evidence-based alcohol programs to reduce alcohol-related RSB and provides insights related to implementation to bridge the gap between research and practice at the university level. TRIAL REGISTRATION: ClinicalTrials.gov NCT05011903; https://clinicaltrials.gov/ct2/show/NCT05011903. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/43986.

Injunctive and descriptive normative feedback for college drinking prevention: Is the whole greater than the sum of its parts?

OBJECTIVE: Single-component personalized normative feedback (PNF) interventions and multicomponent personalized feedback interventions (PFI) have been shown to reduce alcohol consumption among college students. The present study compared the efficacy of PNF interventions targeting descriptive norms alone (descriptive PNF), injunctive norms alone (injunctive PNF), or their combination (combined PNF), against a multicomponent PFI and an attention control condition. METHOD: Undergraduates (N = 1,137) across two universities who reported a minimum of one past-month episode of heavy episodic drinking (i.e., 4 +/5 + drinks on a single occasion for females/males) completed assessments at baseline and 3, 6, and 12 months postintervention. RESULTS: Relative to the attention control, participants in each of the four intervention conditions showed greater reductions in perceived descriptive/injunctive norms, total drinks per week, and alcohol-related consequences. Peak estimated blood alcohol concentration was also reduced in the injunctive PNF, combined PNF, and multicomponent PFI conditions, with the latter two conditions showing an advantage for duration of effects. The multicomponent PFI condition also evidenced greater reductions than the injunctive PNF in descriptive norms at 3-month and injunctive norms at 6- and 12-month follow-ups. No other group comparisons on any outcome were significant. CONCLUSIONS: Each intervention has merit for use in college student harm reduction efforts. Single-component or combined PNF could be considered a potential starting point, as PNF is less burdensome than a multicomponent PFI when considering ease and length of delivery. Results can inform optimization of norms-based interventions and guide recommendations on efficacious components for reducing alcohol use and harms on college campuses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Polysubstance use among young adults and differences in negative alcohol-related sexual experiences.

This study aimed to compare negative alcohol-related sexual experiences among individuals who used (1) alcohol only, (2) alcohol plus marijuana, and (3) alcohol plus marijuana and stimulants. Participants in the analytic sample (N = 1,015; Mean age = 19.16 (SD = 0.79); 45.42% male) completed an online baseline survey as part of an intervention study. A hurdle negative binomial model examined the associations between polysubstance use and negative alcohol-related sexual experiences. Models examined if experiences varied by demographic factors. Compared to participants that only used alcohol, those who used alcohol plus marijuana and stimulants reported a higher likelihood and average number of negative alcohol-related sexual experiences in the past 3 months. Participants that used alcohol plus marijuana had a higher likelihood of having a negative alcohol-related sexual experience in the past 3 months compared to those who only used alcohol. These findings suggest the number and risk for negative alcohol-related sexual experiences increases with the number of substances being used.

Occasion-level investigation of playing drinking games: Associations with cognitions, situational factors, alcohol use, and negative consequences among adolescents and young adults.

The present study examined occasion-level associations between cognitions (willingness to drink, descriptive norms, and injunctive norms) and situational factors (familiarity with people and locations) with playing drinking games (DGs) among adolescents and young adults. Further, this study tested the associations between playing DGs, the number of drinks consumed, and the negative consequences experienced at the occasion level. Participants were 15-25-year-olds (N = 688; 43% male, 47% White, Non-Hispanic, Mean age = 21.18) who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week) that was repeated quarterly over the 12-month study (up to 2x/day) per participant. Multilevel models showed that occasion-level risks (higher willingness, higher descriptive norms, and less familiarity with people) were associated with playing DGs. When examining the within-person associations between DGs and number of drinks, results showed that playing DGs was associated with consuming more drinks. For consequences, DGs were not uniquely predictive of experiencing more consequences and riding in a vehicle with a driver who had been drinking. This study contributes to the literature by examining associations between cognitions and situational factors with DGs and the role DGs play in experiencing negative consequences among a diverse sample of adolescents and young adults.

Examining the viewing pattern of Web-delivered personalized feedback interventions aimed at reducing alcohol-related risky sexual behavior among young adults.

OBJECTIVE: The present study examined young adults' completion of the Web-based intervention content in a randomized trial that tested two Personalized Feedback Interventions (PFIs) for alcohol use and risky sex behavior (RSB). METHOD: Data are from a study that evaluated efficacy of two Web-delivered PFIs (combined PFI and integrated PFI) among 269 sexually active young adults between the ages of 18 and 25. We described the view patterns of the Web-based intervention and examined if baseline sociodemographic and alcohol- and sex-related behavioral factors were associated with the completion of PFI. RESULTS: Many participants viewed the intervention more than one time, and the majority finished all intervention pages in at least one session. Older participants and participants who drink more frequently prior to or during sex were more likely to complete. CONCLUSIONS: Most participants, especially the young adults who were at higher risk, utilized the intervention contents as intended.

A Parent-Based Intervention for Reducing High-risk Social Media Cognitions, Alcohol Use, and Negative Consequences Among Adolescents: Protocol for a Randomized Controlled Pilot Study.

BACKGROUND: The prevalence of adolescent alcohol use continues to be a public health concern. Although adolescents spend an increasing amount of time with their friends, parents remain an important source of support and continue to play a key role in the lives of their adolescents. Extensive research in this area has resulted in parent-based intervention (PBI) efforts to prevent or reduce adolescent alcohol use. However, one major limitation of PBIs is that they do not currently consider the large role that social media plays in adolescents' lives and in relation to their alcohol use. We will add to the literature by developing and refining a web-based PBI designed to reduce both high-risk social media cognitions and alcohol use among adolescents. OBJECTIVE: The central goal of the proposed study is to develop, refine, and pilot a web-based PBI to reduce both high-risk social media cognitions and alcohol use among adolescents. METHODS: A total of 100 parent-teen dyads will be randomly assigned to one of the following 2 conditions: intervention or control. Parents in the intervention group will be given access to the web-based PBI and suggestions for working through the PBI modules with their teens. The parent-teen dyads will fill out 3 questionnaires: a baseline questionnaire, 1-month questionnaire, and 6-month questionnaire. RESULTS: Recruitment and enrollment will begin in August 2022. Upon completion of the intervention trial, we will examine the feasibility, acceptability, and preliminary effect sizes of the newly developed web-based PBI. CONCLUSIONS: This study has the potential to open doors for future studies examining the clinical implications of an efficacious web-based PBI to reduce alcohol use and high-risk cognitions about alcohol displays on social media. TRIAL REGISTRATION: ClinicalTrials.gov NCT04333966; https://clinicaltrials.gov/ct2/show/NCT04333966. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/38543.

Likelihood of Posting Alcohol-Related Content on Social Networking Sites - Measurement Development and Initial Validation.

Background: The vast majority of adolescents and young adults are active on social networking sites (SNSs). SNSs are influential, risk-conducive environments for alcohol use among adolescents and young adults. Specifically, posting or sharing alcohol-related content (ARC) is associated with higher levels of alcohol use. However, it is unknown if sharing different types of ARC associates differentially with alcohol use and consequences. Objective: The goal of the current project was to develop a measure of the likelihood of posting key types of ARC posted by adolescents and young adults and to examine their associations with SNS use patterns and actual alcohol-related behavior. Method: Participants were 15-20 years of age (n = 306; 46.7% male; 56.6% Caucasian/White; 27.0% Asian) who completed a battery of self-report measures. Results: Results from an exploratory factor analysis revealed four types of ARC: (1) self and friend consumption, (2) memes and viral photos, (3) status updates: others' drinking and consequences, and (4) pictures: others' drinking and consequences. Conclusions: Participants' likelihood of posting self and Friend Consumption was significantly associated with heightened Snapchat use, typical drinks per week, peak drinking, and negative drinking consequences. Whereas youth appear to share more readily alcohol-related viral posts and memes, it seems that the sharing of ARC that is specifically related to the participants' own use or friends' use is salient concerning alcohol use and problems. Therefore, interventions might consider sending targeted prevention messages to individuals who share certain types of ARC which are more associated with problematic alcohol behaviors.

Investigating Why and How Young Adults Use Protective Behavioral Strategies for Alcohol and Marijuana Use: Protocol for Developing a Randomized Controlled Trial.

BACKGROUND: Young adulthood is associated with increased alcohol and marijuana use compared with other developmental periods. Alcohol and marijuana use place individuals at high risk for acute and long-term negative consequences. Despite the relatively large cross-sectional and longitudinal literature on protective behavioral strategies (PBS; behaviors that individuals can use to limit consequences and reduce substance use), little is known about why young adults choose to use PBS on specific occasions or why they might use PBS differently across occasions (ie, quality and consistency). There is significant room for improvement in the conceptualization, application, and understanding of PBS. OBJECTIVE: This study aims to develop a novel, brief web-based and SMS text messaging intervention, with input from young adults who use alcohol and marijuana, which addresses the extent to which motivations for PBS use and nonuse (marijuana or alcohol) and the quality of PBS use (the degree of effectiveness or degree of implementation) differ when using alcohol alone versus concurrently or simultaneously with marijuana. METHODS: This research will be conducted in 2 phases. Phase 1 will involve web-based focus groups (N=100) and cognitive interviews (N=10) to determine why young adults (aged 18-24 years) use or do not use specific PBS related to alcohol and marijuana use and elicit feedback on how motivations and the quality of PBS could be incorporated into a web-based and SMS text messaging PBS intervention as well as elicit feedback on developed intervention material. In phase 2, young adults (N=200; aged 18-24 years), who typically use alcohol and marijuana for at least 2 days per week, will be randomized to either the intervention or waitlist control group. The intervention will be brief, web-based, focusing on self-selected alcohol and marijuana PBS messages and motives for using alcohol- and marijuana-related PBS, and including intervention content delivered via SMS text messages 3 days a week (random day, Friday, and Saturday) over 8 consecutive weeks. All participants will report on PBS use, motivations for PBS use (and nonuse), quality of PBS use, and alcohol and marijuana use in morning surveys timed to occur the day after the intervention SMS text messages for those in the intervention group. RESULTS: Recruitment and enrollment for phase 1 began in January 2022. Recruitment for phase 2 is anticipated to begin in January 2023. Upon completion of the phase 2 pilot, we will examine the feasibility, acceptability, and preliminary effect sizes of the newly developed brief web-based and SMS text messaging intervention. CONCLUSIONS: This study will provide an in-depth understanding of young adults' PBS use and has the potential to develop a more efficacious intervention for co-occurring or simultaneous alcohol and marijuana behaviors. TRIAL REGISTRATION: ClinicalTrials.gov NCT04978129; https://clinicaltrials.gov/ct2/show/NCT04978129. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37106.