Development and Validation of a Spanish-Language Protective Behavioral Strategies Scale for People Who Snort Cocaine: Evidence from Mexico, Colombia, and Chile

Cocaine use poses significant health risks. Protective behavioral strategies are effective in mitigating the negative consequences of drug use. This study aimed to develop and conduct an initial psychometric evaluation of the Protective Behavioral Strategies Scale, specifically designed for Spanish-speaking individuals who snort cocaine. This scale serves as a fundamental tool for assessing and designing harm reduction interventions. Method: A total of 550 individuals who snorted cocaine participated in the study by completing a survey assessing protective behavioral strategies, along with sociodemographics, substance use characterization, and consequence-related questionnaires. Results: Principal Component Analysis identified a seven-factor structure comprising 24 items. Protective Behavioral Strategies Scale scores were negatively associated with both cocaine consumption frequency and substance-related negative consequences, supporting its criterion-related validity. Conclusions: The findings suggest that protective behavioral strategies constitute a measurable construct that plays a critical role in reducing harm among people who use cocaine. This scale provides a standardized instrument for evaluating these strategies and serves as valuable tool for assessing protective behaviors and informing harm reduction interventions.