ResearchPosted on rand.org Feb 26, 2025Published in: Psychology of Addictive Behaviors (2025). DOI: 10.1037/adb0001047
Young adults experiencing homelessness are at high risk for alcohol-related consequences, but protective behavioral strategies (PBS) have not been investigated as a harm reduction approach in this population. This study examines longitudinal associations between PBS and alcohol-related consequences following a group-based alcohol intervention.
Data come from AWARE, a randomized controlled trial of a group-based motivational intervention to reduce substance use and risky sex compared to usual care. Participants include 276 young adults experiencing homelessness (Mage = 22.08, 30% female, 84% non-White) receiving drop-in center services in Los Angeles County, California. Surveys were conducted at baseline and 3-, 6-, 12-, and 24-month follow-up. Bivariate latent change score models examined cross-lagged associations between PBS and alcohol consequences for participants who drank at least once over the course of the study, controlling for demographics and intervention condition.
PBS were associated with significant wave-to-wave reductions in alcohol consequences (δ range = -2.53 to -11.22), and alcohol consequences were associated with significant reductions in PBS usage between the 3- and 6-month follow-ups (δ = -0.02, p = .01) and between the 12- and 24-month follow-ups (δ = -0.08, p = .004). In addition, the AWARE intervention was associated with increased PBS usage between the 3- and 6-month follow-ups (δ = 0.30, p = .02).
Among young adults experiencing homelessness, greater use of PBS is associated with significant reductions in alcohol consequences over time. Furthermore, PBS may increase following a group-based motivational intervention. PBS are a promising harm reduction strategy for this population.
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