A Comprehensive Review of Measures of Protective Behavioral Strategies Across Various Risk Factors and Associated PBS-Related Interventions

Harm reduction is a framework that places substance use on a spectrum from total abstinence to continued controlled use. Protective behavioral strategies (PBS) are a set of individually implemented harm reduction strategies that have shown to reduce the rate of use and severity of consequences from risky behaviors. Previous research has shown that PBS use effectively reduces negative consequences. The present study provides an overview of the literature on PBS measures for various risk behaviors, and common interventions used in conjunction with PBS. Of the articles reviewed, 15 validated PBS measures were found and eight distinct categories of PBS interventions. The 15 measures reviewed included risk factors such as alcohol use/consequences (n = 8), dating and sexual behaviors (n = 4), gambling (n = 1), cannabis (n = 1), and condom use (n = 1). A survey of the literature produced eight distinct categories of interventions with varying degrees of effectiveness: (a) Brief Motivational Interventions, (b) Personalized Normative Feedback, (c) PBS Skills Training, (d) PBS Instruction, (e) Deviance Regulation Theory Interventions, (f) Behavioral Economic Based Interventions, (g) Counterfactual Thinking and (h) Episodic Future Thinking. Findings from the present study corroborate the notion that PBS effectively reduce negative consequences associated with behaviors, such as negative alcohol-related consequences, harmful cannabis use, and adverse sexual outcomes. Research on interventions targeting PBS is lacking in areas outside of alcohol use. Within alcohol use, the utility of interventions varies widely. Understanding the reason for this discrepancy is an important area for future research. Public Health Significance Protective behavioral strategies (PBS) reduce negative consequences associated with risk behaviors; including both pharmacological (i.e., alcohol use/consequences, cannabis) and non-pharmacological (i.e., dating and sexual behaviors, gambling, condom use) behaviors. Eight intervention categories are reviewed, including: (a) Brief Motivational Interventions, (b) Personalized Normative Feedback, (c) PBS Skills Training, (d) PBS Instruction, (e) Deviance Regulation Theory Interventions, (f) Behavioral Economic Based Interventions, (g) Counterfactual Thinking and (h) Episodic Future Thinking.