Shannon D. Glenn

Alcohol-induced blackouts (AIBs) are more likely to occur when large quantities of alcohol are consumed quickly. Protective behavioral strategies (PBS) may mitigate the risk of experiencing an AIB by reducing the level, speed, and duration of drinking. This study examines daily associations between PBS, drinking measured using a transdermal alcohol concentration (TAC) biosensor, and AIBs among young adults. Participants (N = 168, M_age = 20.8, 53% female, 87% White, 10% Hispanic) wore TAC biosensors and completed daily surveys about their PBS use and AIBs over six social weekends (i.e., Thursday-Sunday). TAC drinking features (peak, rise rate, and rise duration) were extracted from TAC data for each day. Two-level multilevel structural equation models were conducted to examine the associations between PBS (total and individual domains: manner of drinking, stopping/limiting drinking, and serious harm reduction) and AIBs. Approximately 80% of participants experienced at least one AIB (M = 3.08, SD = 2.99). On days when individuals reported using more total PBS and manner of drinking, the associated decrease in TAC features was associated with decreased odds of experiencing an AIB. Days when individuals used more serious harm reduction, the associated increase in TAC features was associated with increased AIB odds. Days when participants used above-average total PBS and manner of drinking were less indicative of risky TAC drinking and AIBs. Days with above-average serious harm reduction were more indicative of risky TAC drinking and AIBs. Findings demonstrate the associations between PBS, real-world intoxication dynamics measured by TAC biosensors, and subsequent AIBs among young adults who engage in risky drinking. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Background: Alcohol use is necessary—but not sufficient—for understanding why individuals experience an alcohol‐induced blackout (AIB). Drinking motives are one of the most proximal risk factors for alcohol use. This study conducts a comprehensive within‐person examination of AIBs predicted by prospective daily reports of drinking motives and alcohol use measured using a transdermal alcohol concentration (TAC) biosensor. Methods: Participants were young adults who engaged in risky drinking and experienced at least 1 AIB in the past 3‐months ( N = 169, M _age = 20.8, 53% female, 87% White, 10% Hispanic). They wore TAC biosensors and completed twice daily surveys about drinking motives and AIBs over six social weekends (i.e., Thursday–Sunday). TAC drinking features (peak, rise rate, and rise duration) were extracted from TAC data for each day. Two‐level multilevel structural equation models were conducted to examine the associations between drinking motives, latent intoxication estimated from TAC features, and AIBs. Aim 1 examined separate models for each motive (enhancement, social, coping, conformity). Aim 2 examined a single model with each motive adjusting for the others. Results: In Aim 1, on days when participants reported higher enhancement, social, coping, and conformity motives, the associated increase in TAC intoxication was associated with increased odds of experiencing an AIB. In Aim 2, when all motives were entered into a single model, only social motives resulted in increased TAC, which subsequently increased the odds of an AIB occurring. Conclusions: Findings demonstrate that days when an individual reports above average drinking motives relative to their own average, they are at increased risk of engaging in riskier drinking, which may result in subsequent AIBs. These findings suggest that daily changes in drinking motives may be an important intervention pathway for preventing risky drinking and subsequent AIBs.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: There is a need for evidence-based substance use prevention efforts that target high school-aged youth that are easy to implement and suitable for dissemination in school and community groups. The Youth Message Development (YMD) program, a 4-lesson, in-person curriculum which develops media literacy and critical thinking skills among youth, has demonstrated evidence of success but is limited by its delivery method and focus on alcohol and smoking. Objective: To adapt the in-person YMD curriculum for youth ages 13-15 to a self-paced, interactive, e-learning format targeting several commonly used substances for implementation and dissemination in a national youth organization and subsequently test the feasibility of this approach. Methods: An iterative process was employed in partnership with the 4-H youth development organization and a technology developer and consisted of six phases: (1) focus groups with the target audience, (2) adaptation to e-learning format, renamed REAL media, (3) pilot testing, (4) program revisions, (5) usability testing, and (6) final revisions. Results: Focus group feedback guided the build of an e-learning prototype of REAL media, which consisted on five online levels and interactive content guided by a mix of narration and on-screen text. Results of a pilot test of the prototype were neutral to positive, and the program was refined based on end-user feedback. An independent usability test indicated that youth 4-H members felt favorably about navigating REAL media, and they reported high self-efficacy in applying skills learned in the program. Additional refinements to the program were made based upon their feedback. Conclusions: The iterative build process involving the end-user from the outset yielded an overall successful technology-driven adaptation of an evidence-based curriculum. This should increase the likelihood of effectively impacting behavioral outcomes as well as uptake within community organizations.

BACKGROUND There is a need for evidence-based substance use prevention efforts that target high school-aged youth that are easy to implement and suitable for dissemination in school and community groups. The Youth Message Development (YMD) program is a brief, four-lesson, in-person curriculum that aims to prevent youth substance use through the development of youth media literacy. Specifically, YMD aims to increase understanding of advertising reach and costs, along with the techniques used to sell products; develop counterarguing and critical thinking skills in response to advertisements; and facilitate application of these skills to the development of youth-generated antisubstance messages. Although YMD has demonstrated evidence of success, it is limited by its delivery method and focus on alcohol and smoking. OBJECTIVE Study objectives were two-fold: (1) to adapt the YMD curriculum to a self-paced, interactive, electronic-learning (e-learning) format and expand its content to cover alcohol, combustible cigarettes, e-cigarettes, smokeless tobacco, marijuana, and prescription drugs, and (2) to test the feasibility of the adapted curriculum in partnership with a national youth organization. METHODS An iterative process was employed in partnership with the 4-H youth development organization and a technology developer and consisted of six phases: (1) focus groups to guide adaptation, (2) adaptation to an e-learning format renamed REAL media, (3) pilot-testing of the REAL media prototype to determine feasibility and acceptability, (4) program revisions, (5) usability testing of the revised prototype, and (6) final revisions. Focus groups and pilot and usability testing were conducted with 4-H youth club members and adult club leaders. RESULTS Focus group feedback guided the build of an e-learning prototype of REAL media, which consisted of five online levels and interactive content guided by a mix of narration and on-screen text. Results of a pilot test of the prototype were neutral to positive, and the program was refined based on end-user feedback. An independent usability test indicated that youth 4-H members felt favorably about navigating REAL media, and they reported high self-efficacy in applying skills learned in the program. Additional refinements to the program were made based on their feedback. CONCLUSIONS The iterative build process involving the end user from the outset yielded an overall successful technology-driven adaptation of an evidence-based curriculum. This should increase the likelihood of effectively impacting behavioral outcomes as well as uptake within community organizations.