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The impact of a theory-based web-intervention on the intention to use prescription drugs for non-medical purposes among college students: a randomized controlled trial.

ABSTRACT: The non-medical use of prescription drugs (NMUPD) among college students is escalating at an alarming rate. A limited number of studies have utilized a theoretical framework to influence this behavior. To utilize the reasoned-action approach theory to design and evaluate a web-based intervention to influence students' attitudes, perceived norms (PNs), perceived behavioral control (PBC) and intentions toward NMUPD. Using a two-group post-test only controlled trial, students were randomized to view either a general health website or a web-based intervention focused on NMUPD. The intervention was presented in multiple sections to address each component of the reasoned-action approach. Subsequently, respondents completed a web-survey. Independent t-tests were used to compare responses between the two groups. Of 391 respondents, 112 (28.9%) students indicated previous NMUPD. The intervention group had significantly (P = 0.04) more negative attitudes toward NMUPD. No significant differences were found in PNs (P = 0.11), PBC (P = 0.68) or intentions to NMUPD (P = 0.97). The intervention was successful in changing attitudes toward NMUPD. Targeting the intervention toward college students regardless of previous experiences of NMUPD might have led to insufficiency of the intervention to influence intentions. Additional research is needed to improve the intervention dissemination and utilization.

SUBMITTER: Arabyat RM

PROVIDER: S-EPMC6735692 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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The impact of a theory-based web-intervention on the intention to use prescription drugs for non-medical purposes among college students: a randomized controlled trial.

Arabyat Rasha M RM Borrego Matthew M Hamidovic Ajna A Sleath Betsy B Raisch Dennis W DW

Health education research 20190401 2

The non-medical use of prescription drugs (NMUPD) among college students is escalating at an alarming rate. A limited number of studies have utilized a theoretical framework to influence this behavior. To utilize the reasoned-action approach theory to design and evaluate a web-based intervention to influence students' attitudes, perceived norms (PNs), perceived behavioral control (PBC) and intentions toward NMUPD. Using a two-group post-test only controlled trial, students were randomized to vie ...[more]

PMID: 30590472

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Project description:BackgroundUnited States college students, particularly those attending community colleges, have higher smoking rates than the national average. Recruitment of such smokers into research studies has not been studied in depth, despite a moderate amount information on study recruitment success with smokers from traditional four-year colleges. Recruitment channels and success are evolving as technology evolves, so it is important to understand how to best target, implement, and evaluate recruitment strategies.ObjectiveThe aim of this paper is to both qualitatively and quantitatively explore recruitment channels (eg, mass email, in-person referral, posted materials) and their success with enrollment into a Web-Assisted Tobacco Intervention study in this priority population of underserved and understudied smokers.MethodsQualitative research methods included key informant interviews (n=18) and four focus groups (n=37). Quantitative research methods included observed online responsiveness to any channel (n=10,914), responses from those completing online screening and study consent (n=2696), and responses to a baseline questionnaire from the fully enrolled study participants (n=1452).ResultsQualitative results prior to recruitment provided insights regarding the selection of a variety of recruitment channels proposed to be successful, and provided context for the unique attributes of the study sample. Quantitative analysis of self-reported channels used to engage with students, and to enroll participants into the study, revealed the relative utilization of channels at several recruitment points. The use of mass emails to the student body was reported by the final sample as the most influential channel, accounting for 60.54% (879/1452) of the total enrolled sample.ConclusionsRelative channel efficiency was analyzed across a wide variety of channels. One primary channel (mass emails) and a small number of secondary channels (including college websites and learning management systems) accounted for most of the recruitment success.Trial registrationClinicalTrials.gov NCT01692730; https://clinicaltrials.gov/ct2/show/NCT01692730 (Archived by WebCite at http://www.webcitation.org/6qEcFQN9Q).

Project description:BackgroundBystander intervention approaches offer promise for reducing rates of sexual violence on college campuses. Most interventions are in-person small-group formats, which limit their reach and reduce their overall public health impact.ObjectiveThis study evaluated the efficacy of RealConsent, a Web-based bystander approach to sexual violence prevention, in enhancing prosocial intervening behaviors and preventing sexual violence perpetration.MethodsA random probability sample of 743 male undergraduate students (aged 18 to 24 years) attending a large, urban university located in the southeastern United States was recruited online and randomized to either RealConsent (n=376) or a Web-based general health promotion program (n=367). Participants were surveyed online at baseline, postintervention, and 6-months postintervention. RealConsent was delivered via a password-protected Web portal that contained six 30-minute media-based and interactive modules covering knowledge of informed consent, communication skills regarding sex, the role of alcohol and male socialization in sexual violence, empathy for rape victims, and bystander education. Primary outcomes were self-reported prosocial intervening behaviors and sexual violence perpetration. Secondary outcomes were theoretical mediators (eg, knowledge, attitudes).ResultsAt 6-month follow-up RealConsent participants intervened more often (P=.04) and engaged in less sexual violence perpetration (P=.04) compared to controls. In addition, RealConsent participants reported greater legal knowledge of sexual assault (P<.001), greater knowledge of effective consent (P<.001), less rape myths (P<.001), greater empathy for rape victims (P<.001), less negative date rape attitudes (P<.001), less hostility toward women (P=.01), greater intentions to intervene (P=.04), less hyper-gender ideology (P<.001), less positive outcome expectancies for nonconsensual sex (P=.03), more positive outcome expectancies for intervening (P<.001), and less comfort with other men's inappropriate behaviors (P<.001).ConclusionsOur results support the efficacy of RealConsent. Due to its Web-based format, RealConsent has potential for broad-based dissemination thereby increasing its overall public health impact on sexual violence.Trial registrationClinicaltrials.gov: NCT01903876; http://clinicaltrials.gov/show/NCT01903876 (Archived by WebCite at http://www.webcitation.org/6S1PXxWKt).

Project description:BackgroundPrescription drug misuse is an escalating public health problem that is prevalent among college students. Various factors, such as sex, age, race, mental health conditions, and fraternity and sorority membership, increase the risk for prescription drug misuse. Peer influences may also pose significant risks for starting prescription drug misuse, because peers are the primary source of misused prescription drugs among college students.ObjectivesTo examine college students' beliefs about prescription drug misuse among their peers and to understand their beliefs about the available and potential intervention efforts to reduce prescription drug misuse.MethodWe conducted a cross-sectional survey of 312 college students aged 18 to 30 years who were enrolled in a large midwestern US university. The survey included questions about the responders' demographic characteristics, beliefs, and perceptions regarding prescription drug misuse among their peers and potential reduction programs for prescription drug misuse.ResultsThe respondents' mean age was 21 years, and most (65%) respondents were women. A majority (90%) of the respondents were enrolled in the university as full-time students. More than 60% of the respondents reported knowing someone with prescription drug misuse in the past 12 months. Fraternity or sorority members were more likely to report peer prescription drug misuse than nonmembers (83% vs 60%, respectively; P = .017). Stimulants were the most misused drug class, accounting for 75% of all reported peer prescription drug misuse. Approximately 60% of the misused prescription drugs were sourced from peers, which included friends, roommates, and classmates. A total of 73% of respondents said that prescription drug misuse was a problem among college students and 67% agreed that interventions were needed to reduce prescription drug misuse. The perceived need for interventions varied by peer prescription drug misuse. A total of 90% of students whose peers did not misuse prescription drugs said that interventions were needed, but only 67% of those with peer prescription drug misuse thought that interventions were needed.ConclusionOur findings indicate that peer prescription drug misuse is very common among college students, and the most misused drug class is stimulants. Survey respondents perceived that the current interventions used to address prescription drug misuse are not very effective or may not be targeting the right population. Peer prescription drug misuse influences college students' perceptions about the risks and harms of prescription drug misuse, as well as the need for interventions.

Project description:BackgroundPhysical ailments and mental illness among college students are surging in recent years, which warrants urgent and comprehensive health research.ObjectiveTo investigate whether there is a disparity in allostatic load between medical and non-medical college students, and to identify the influencing factors on allostatic load.MethodsA cross-sectional study involving 8,253 college students was conducted. We used modified Poisson regression analysis of generalized linear models to examine allostatic load between the two groups of students based on biological, psychological, and sociological factors.ResultsThe prevalence risk of allostatic load in non-medical students was significantly higher than that in medical students (18.9% vs. 14.1%, P < 0.001). Modified Poisson regression revealed that risk factors like non-medical background (RR = 1.200, 95%CI 1.088-1.324), being female (RR = 1.121, 95%CI 1.004-1.251), history of hospitalization (RR = 1.170, 95%CI 1.053-1.300), alcohol drinking (RR = 1.321, 95%CI 1.034-1.687), total stress (RR = 1.042, 95%CI 1.014-1.070), abnormal illness behavior (RR = 1.106, 95%CI 1.079-1.134), anxiety (RR = 1.214, 95%CI 1.055-1.396), depression (RR = 1.230, 95%CI 1.051-1.440), somatization (RR = 1.319, 95%CI 1.147-1.517), and insomnia (RR = 1.811, 95%CI 1.610-2.036) were positively correlated with allostatic load, while protective factors like originating from the western region (RR = 0.682, 95%CI 0.546-0.851, P = 0.001), studying for more than 4 h per day, especially 6-8 h (RR = 0.748, 95%CI 0.657-0.852), exercising for 0.5 to 1 h (RR = 0.900, 95%CI 0.814-0.995), having a high level of global well-being (RR = 0.930, 95%CI 0.903-0.957), and multi-dimensional health perception (RR = 0.753, 95%CI 0.681-0.833) were negatively correlated with allostatic load.ConclusionThis study proposes a multidimensional approach to understanding the health of college students. Non-medical and medical students show differences in health perception, behavior, lifestyle, emotional problems, and the social environment, leading to varied allostatic load risks and necessitating tailored health interventions.Clinical trial registrationNot applicable.

Project description:Direct-to-consumer advertising (DTCA) of prescription drugs can be both beneficial and harmful to healthcare consumers. Therefore, DTCA for prescription drugs is a topic that should be considered crucially, at this point, when the interests of patients as well as pharmaceutical companies in DTCA of prescription drugs are growing in South Korea. The goals of this study were to investigate Korean college students' perceptions and attitudes about DTCA of prescription drugs through a survey as well as to analyze data according to their college majors in order to identify differences in their perceptions and attitudes about prescription drug DTCAs as future health care professionals and consumers, respectively. A descriptive, cross-sectional survey was conducted between September and November 2015. Participants were recruited from Chosun University in Gwangju, South Korea. Ethical approval for this study was obtained from the Chosun University Institutional Review Board. Of 1,040 questionnaires initially distributed, 774 were collected, and 742 were included in the analysis. The results of this study indicated that most students who had participated in the survey did not have sufficient knowledge of DTCA for prescription drugs. Approximately, 17% reported being cognizant of DTCA for prescription drugs. More healthcare students (24.6%) knew this term than non-healthcare students did (6.3%). In this study, most of the students were likely to feel that healthcare professionals (e.g., doctors and pharmacists) had the responsibility of delivering information about prescription drugs to patients, and that all prescription drugs DTCA, if it were permitted, had to be pre-approved by the Korean government. The results of this study indicated that DTCA for prescription drugs had to be permitted under the condition of pre-approval of the DTCA contents by the Korean government, and prescription drugs should not be advertised through the Internet. It is recommended that the Korean government cautiously examine whether DTCA of prescription drugs should be permitted, after considering the current marketing strategies of pharmaceutical companies on the Internet and the effects of online electronic-DTCA on Korean consumers.

Dataset Information

The impact of a theory-based web-intervention on the intention to use prescription drugs for non-medical purposes among college students: a randomized controlled trial.

Publications

The impact of a theory-based web-intervention on the intention to use prescription drugs for non-medical purposes among college students: a randomized controlled trial.

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