Effects of protective behavioral strategies in a randomized controlled trial of the cannabis eCHECKUP TO GO intervention

Abstract

College students who use cannabis may underestimate cannabis-related harm and experience negative consequences associated with using cannabis, highlighting the need for harm reduction interventions. Cannabis protective behavioral strategies (PBS) are behaviors for reducing cannabis misuse and related harm. This study is a secondary data analysis of a multisite randomized controlled trial (see Conner et al., 2024 for primary effects). This study examined PBS as a mechanism of behavior change in reducing cannabis use and negative consequences within an adapted version of the online intervention for college students, Cannabis-eCHECKUP TO GO. A total of 779 college students in the US and Canada who expressed interest in reducing or engaging in safer cannabis use were randomly assigned to an experimental or control condition. Participants completed baseline and follow-up assessments and received personalized feedback online. Results showed no significant differences in PBS use frequency between conditions and no evidence that PBS mediated program effects on cannabis use or negative consequences. However, greater PBS use was associated with reduced cannabis use and fewer negative consequences. Additionally, PBS use increased from baseline to follow-up, regardless of intervention condition. Results suggest that, while the intervention did not significantly change PBS use frequency, PBS is a valuable predictor of cannabis-related harm reduction among college students in the US and Canada. Future research could explore ways to facilitate cannabis PBS use among college students.