Daily associations among protective behavioral strategies, alcohol use, and consequences in a sample of adolescents and young adults: The influence of drinking context and neighborhood disadvantage.

OBJECTIVE: Protective behavioral strategies (PBS) may be less effective in certain contexts, as high-risk situations and structural disadvantage can undermine individuals' ability to implement these strategies. Pregaming and drinking games are common among adolescents and young adults and linked to rapid consumption and greater consequences, while neighborhood disadvantage reflects structural stressors and limited resources that may heighten risk. The present study examined the moderating effects of pregaming, drinking games, and neighborhood disadvantage on daily associations between PBS (limiting/stopping, manner of drinking, serious harm reduction) and alcohol outcomes (number of drinks, negative consequences [any and number]). METHODS: Participants aged 15-25 in Texas (N=581; Mage=21.04, SD=2.80; 55.25% female; 45.14% White non-Hispanic) completed a longitudinal ecological momentary assessment study. Two negative binomial mixed-effects models were used. RESULTS: Within-person results showed that greater limiting/stopping or manner of drinking PBS than one's usual was associated with fewer drinks, whereas greater serious harm reduction PBS use was associated with consuming more drinks. Higher-than-usual manner of drinking PBS use was also associated with fewer consequences. The association between serious harm reduction PBS and number of drinks was weaker on days participants played drinking games. Neighborhood disadvantage strengthened the association between serious harm reduction PBS and number of consequences. CONCLUSION: Drinking games and neighborhood disadvantage significantly moderated PBS-outcome associations, suggesting PBS effectiveness is selectively sensitive to certain high-risk situational and structural contexts. These findings indicate PBS vary day-to-day, highlighting the importance of targeting specific contexts where strategies may be less protective to inform tailored, context-responsive interventions.