Protective behavioral strategies and alcohol consequences following a group-based motivational intervention for young adults experiencing homelessness.

Abstract

Objective: 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.

Method: 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 (M_age = 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.

Results: 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).

Conclusions: 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. (PsycInfo Database Record (c) 2025 APA, all rights reserved).