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.
