Examining Motivations for and Quality of Alcohol and Marijuana Protective Behavior Strategy Use: Improving Prevention of Hazardous Young Adult Substance Use

项目摘要/摘要 与其他发育阶段相比，青壮年与酒精和大麻的使用增加有关 期间(Schulenberg等人，2019年)。酒精和大麻的使用使个人处于急性和长期的高危状态 术语负面后果(Volkow等人，2014；White&Hingson，2014)。SAM使用与 与单独使用大麻或使用CAM相比，后果的风险增加(Lipperman-Kreda等人， 2017年)。在这项拟议的研究中，所有参与者都将是目前的酒精和大麻使用者，这允许我们 考虑同时使用酒精和大麻(CAM)和同时使用酒精和大麻(SAM)。在……里面 本申请，CAM使用指的是在同一天使用这两种物质，但不是说它们的效果重叠， 而SAM的使用是指同时使用酒精和大麻，从而使它们的影响重叠。尽管 较大的关于保护性行为策略的横向和纵向文献(PBS； 皮尔逊，2013)，关于为什么年轻人选择在特定场合使用PBS，或者为什么年轻人 成年人可能会在不同的场合使用不同的PBS。此外，对于PBS作为一种 干预效果的调解人(Reid&Carey，2015)。因此，在以下方面有很大的改进空间： 酒精和大麻的概念化、应用和理解。拟议的研究是 需要确定年轻人何时、为什么以及如何使用PBS的动机或原因 在使用酒精和/或大麻时要有质量。这些获得的知识可以用来增强 通过在几天内提供的干预内容中解决这些动机来实现干预效果。研究 尚未研究某一天的酒精和大麻PBS的使用与个人的酒精使用之间的关系 或者只吸大麻，而不是CAM或SAM的日子。目前的研究有可能做出贡献 对文献意义重大，因为它将允许对酒精和大麻PBS如何进行细粒度检查 日常使用与酒精、大麻和CAM/SAM有关。综上所述，拟议的研究将 通过利用在线焦点小组和认知访谈来填补这些空白，以确定年轻人为什么使用或这样做 不使用PBS(大麻或酒精)，以及检查PBS的使用质量以及质量是否不同 纯酒精日、CAM日或SAM日(目标1)。AIM 1的发现将为一项试点研究(AIM 2)提供信息 测试新开发的在线和短信酒精和大麻PBS酒精之间的干预 以及年龄在18-24岁之间的大麻使用者。试点研究包括在8个周末收集事件级数据，以 确定酒精或大麻PBS是否同样有效地减少使用或在CAM或 与单独使用酒精相比，使用SAM会发生。在试点研究(第一阶段；N=200)中，我们将确定 可接受性、可行性和初步效果大小，以确定全面疗效试验的准备情况。 由于拟议的干预措施将针对公共广播公司的酒精和大麻使用 干预措施将与更广泛的高危青年群体相关。

PROJECT SUMMARY/ABSTRACT Young adulthood is associated with increased alcohol and marijuana use compared to other developmental periods (Schulenberg et al., 2019). Alcohol and marijuana use place individuals at high risk for acute and long- term negative consequences (Volkow et al., 2014; White & Hingson, 2014). SAM use is associated with increased risk for consequences, compared to marijuana use alone or CAM use (Lipperman-Kreda et al., 2017). In the proposed research, all participants will be current alcohol and marijuana users allowing us to consider Concurrent Alcohol and Marijuana (CAM) use and Simultaneous Alcohol and Marijuana (SAM) use. In this application, CAM use refers to use of both substances on the same day, but not so their effects overlap, whereas SAM use refers to use of alcohol and marijuana at the same time so that their effects overlap. Despite the relatively large cross-sectional and longitudinal literature on protective behavioral strategies (PBS; Pearson, 2013), little is known about why young adults choose to use PBS on specific occasions or why young adults might use PBS differently across occasions. Moreover, findings have been mixed for PBS use as a mediator of intervention effects (Reid & Carey, 2015). Thus, there is significant room for improvement in the conceptualization, application, and understanding of alcohol and marijuana PBS. The proposed research is needed to determine motivations, or reasons, for when, why, and how young adults may or may not use PBS in a quality manner when using alcohol and/or marijuana. This gained knowledge can be used to enhance intervention efficacy by addressing these motivations in intervention content delivered across days. Research has yet to examine how alcohol and marijuana PBS use on a given day relates to an individual’s use of alcohol or marijuana alone in comparison to CAM or SAM days. The current study has potential to contribute significantly to the literature as it will allow for a fine-grained examination of how alcohol and marijuana PBS use relate to alcohol, marijuana, and CAM/SAM use at the daily level. Taken together, the proposed study will fill these gaps by utilizing online focus groups and cognitive interviews to identify “why” young adults use or do not use PBS (for marijuana or alcohol) as well as to examine quality of PBS use and if quality differs on alcohol-only days, CAM days, or SAM days (Aim 1). Findings from Aim 1 will inform a pilot study (Aim 2) testing a newly developed online and text message alcohol and marijuana PBS intervention among alcohol and marijuana users age 18-24. The pilot study includes event-level data collection over 8 weekends to determine whether alcohol or marijuana PBS are as effective at reducing use or consequences when CAM or SAM use occurs, compared to using alcohol alone. In the pilot study (Stage I; N=200), we will establish acceptability, feasibility, and preliminary effect sizes to determine readiness for a full-scale efficacy trial. Because the proposed intervention will be designed to target PBS for alcohol and marijuana use the intervention will be relevant to a wider group of at-risk young adults.