PRESCRIPTION DRUG

ABUSE
Data Brief

MARCH 20, 2018

Melissa Acuna, BS, MPH(c), Luz Chavez, BA, MSEES(c), Loren Landeros, BS, RDN, MPH(c),
Keely Niemeyer, BS, DN, MPH(c), Kanale Rodrigues, BS, MPH(c)
DEPARTMENT OF HEALTH SCIENCES AND DEPARTMENT OF CHEMISTRY AND
BIOCHEMISTRY CALIFORNIA STATE UNIVERSITY SAN BERNARDINO
 Table of Contents

Abstract………………………………………………… 2
Background……………………………………………. 3
Methods………………………………………………... 3-4
Results…………………………………………………. 4
Discussion……………………………………………... 4-5
References…………………………………………….. 5
Appendix……………………………………………….. 6-20

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Abstract
Objective:
The objective of this study is to assess the effectiveness of a public service announcement
(PSA) and educational materials on attitude, knowledge, practice and self-efficacy regarding
prescription drug abuse among college students.

Methods: A survey was developed and facilitated to 10 Health Science college students who
were recruited from undergraduate and graduate courses at California State University, San
Bernardino (CSUSB). Subjects were selected for various interventions and a pre and post-test
survey was given to all participants to measure their knowledge, attitude, practice and self-
efficacy regarding prescription drug abuse. SPSS version 24 analyses were performed, and
significance was set at p-value less than 0.05.

Results: The results of the study indicate there is a significant difference in the Practice segment
(p <0.008) and Attitude segment (p <0.022) between the pre and post-test survey questions.

Conclusion: The results indicate a possibility that CSUSB students may have received adequate
knowledge from the PSA and educational materials to have modified their choices. The data
demonstrated various trends indicating students exhibited positive changes from pre and post-
test to reflect a difference in knowledge, attitude, practice and self-efficacy toward prescription
drug abuse. This was a pilot quasi experimental study; therefore, additional research is needed
to determine the validity of observed results. Public health officials could potentially achieve this
process through larger scale studies.

Keywords: Prescription drug abuse, opioid abuse, college students, health center, attitude,
Adderall, abuse

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Background
Literature review analysis indicate that one in three college students abuse prescription
drugs. Of those who abuse prescription drugs, 20% abuse Adderall and more than 50% are
asked to sell their prescription drugs (1). Prescription drug abuse is a health concern among
college students because of increased risk for addiction and negative health consequences
such as agitation, arrhythmia, overdose and death (2). Unfortunately, college students do not
often consider the negative health effects of prescription drugs because they deem prescription
drugs as safe and non-addictive according to literature research (3).

Addressing this health concern through a quasi-experimental study provides a unique

opportunity for health professionals to learn college student knowledge, attitude, practice, and
self-efficacy toward prescription drug abuse practices. As such, the purpose of our study was to
determine the effectiveness of educational materials in changing knowledge and attitude toward
prescription drugs among California State University San Bernardino (CSUSB) students. We
hypothesized that CSUSB students would alter self-efficacy, practices and attitude toward
prescription drug abuse from initial pre-test to post-test collection periods. Additionally, after
viewing of educational materials we predicted the CSUSB student knowledge of negative health
effects associated with prescription drug abuse would increase in post-test results. Overall, the
research goal included determining if knowledge, attitude, practice, and self-efficacy was
different between pre and post-test survey results for all participants in the study.

Methods
Recruitment: Ten participants from Health Science department were recruited to participate in
our survey, from CSUSB. Data was collected utilizing SPSS version 24 and significance was set
at p <0.05.

Data source: Data was collected from 10 volunteer participants from three Health Science
courses: HSCI 451, HSCI 455, and HSCI 611. Students were anonymously given a pre-test
survey instrument that included demographic information and a post-test survey instrument that
was collected after a presentation of an educational Zine and PSA. The educational materials
described general knowledge, implications of prescription drug abuse and treatment option
resources offered at CSUSB campus.

Variables: Knowledge was measured through 4 Likert scale questions, and 2 true or false
questions (refer to table 1). Attitude was measured using 3 Likert questions (refer to table 2).
Self-Efficacy was measured through 2 Likert questions (refer to table 3). Practice was measured
by 1 Likert scale question PREQ12/ POSTQ12 which stated: “I have visited the CSUSB Student
Health Center to learn about more about prescription drug abuse.”

Data analysis: was run for each research question through SPSS software. Analysis of
descriptive frequencies were run on demographic questions leading to a bivariate analysis of
pre and post-test response frequencies using Mcnemar. If McNemar did not run correctly a Chi-
square analysis was run. If Chi-Square failed, then Fisher's exact analysis was conducted to

3
provide statistical significance measures. All analysis was conducted using nominal variables
and missing values were omitted.

Results
Demographic Characteristics: indicate females made 80% of the participants. 40% were in
senior year and 90% were between the ages of 18-24. Finally, 50% of the study sample
identified as Hispanic/Latino. (refer to table 1).

Knowledge Analysis: results indicate a 40% positive trend regarding student health center
resources and prescription drug abuse. However, the p-value showed no statistical significance
between the pre and post-test results (refer to table 2).

Attitudinal Analysis: results indicate there was a 50% increase in the number of people who
said they would consider taking prescription drugs to help them study, which is statistically
significant as the p-value is less than 5%. There was also a 20% increase in students who
strongly disagree with the statement that students should be able to use Adderall for non-
medical purposes (refer to table 3).

Practice Analysis: results indicate p-value was found to be significant at 0.008. However, only
10% of the study population (one participant) changed their answer to strongly disagree about
visiting CSUSB Student health center (refer to table 4).

Self-Efficacy Analysis: indicate there is no significant difference in self-efficacy before and

after the PSA for both questions. However, there is 30% positive trend in the confidence in
ability to use CSUSB resources to treat prescription drug abuse (refer to table 5).

Survey Validation: results indicate a Cronbach’s Alpha score of: -0.009 before and 0.604 after
deleting questions 1.1, 4, and 5 for Knowledge; 0.250 before and 0.750 after deleting questions
7 and 11 for Attitude; and a score of 0.214 for self-efficacy; no Cronbach’s Alpha was run for
practice. Peer review analysis indicate pre and post-test question 2 and 3 was vague and more
attitudinal, they also indicate that pre and post-test question 11 was practice and self-efficacy
could be part of practice. Testing peer results against Cronbach’s Alpha analysis indicated our
survey questions were appropriately placed (refer to table 6)

Discussion
Final Results: Analysis of the intervention demonstrated to have mixed results from an analytic
perspective. Based on the data, two questions showed statistical significance. These included
attitude, and practice-based questions which stated, “I would consider taking a prescription drug
such as Adderall, to help me study,” providing a 0.022 p-value for attitude and “I have visited the
CSUSB Student Health Center to learn about more about prescription drug abuse,” providing a
p-value of 0.008 for practice.

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 From an observational perspective, the results from the pre and post-test revealed
trends that participants gained knowledge from the educational materials. Questions showed a
positive increase in knowledge gained. Additionally, there was a significant indication in trends
that CSUSB students gained new information regarding resources on campus. This can be
seen by the pre and post-test results for question five and for the responses from question
twenty. Overall, students were able to demonstrate an increase in knowledge, attitude, practice,
and self-efficacy toward prescription drug abuse.

Limitations: Due to the small sample size the number of participants for the study was low. The
sample was selective of Health Science Majors from CSUSB campus. Therefore, data is not
generalizable to other college students.

Strengths: Though our sample was small, the quasi-experiment was the first of its kind working
with community and academic partnerships to address health needs of CSUSB students.
Instrument development to analyze knowledge, attitude, practice and self-efficacy proved to
seek results based upon higher Cronbach’s Alpha analysis scores. Despite a small smaller
sample size results did indicate a significant difference between pre and post-tests.

Implications/ Future Directions: It is recommended that additional research with a larger

sample population randomly selected needs to be conducted to further investigate the
relationship between educational intervention materials about prescription drug abuse. Gained
knowledge of negative health effects among college students can enhance Public Health
Research Practices.

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References

1. Adderall Abuse and Prescription Addiction in College | interventionstrategies.com [Internet].

[cited 2018 Mar 16]. Available from: http://interventionstrategies.com/adderall-abuse-and-
prescription-addiction-in-college/

2. Varga MD. Adderall abuse on college campuses: a comprehensive literature review. J Evid
Based Social Work. 2012;9(3):293–313.

3. Lisa L. Weyandt, Grace Janusis, Kimberly G. Wilson, Genevieve Verdi, Gregory Paquin,
Justin Lopes, et al. Nonmedical Prescription Stimulant Use Among a Sample of College
Students: Relationship with Psychological Variables. J Atten Disord. 2009 Sep
18;13(3):284–96.

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Appendix
See attached file labeled: CSUSB_2017-2018_RX Abuse Data.sav that was utilized for all
statistical analysis in SPSS software.

Table 1: Descriptive Demographic Statistics of Survey Questions

Question Pre-Test n, % Post-Test n, % p-value
What is your sex? PREQ16 POSTQ16
Male 2, 20% --
Female 8, 80% --
Prefer not to answer 0, 0% --
What is your current year in college? PREQ17 POSTQ17
1st Year: 0, 0% --
2nd Year 0, 0% --
Junior 3, 30% --
Senior 4, 40% --
Graduate 3, 30% --
How old are you in years? PREQ18 POSTQ18
<18 0, 0% --
18-24 9, 90% --
25-39 10, 10% --
40-49 0, 0% --
50+ 0, 0% --
What is your race/ethnicity? PREQ19 POSTQ19
Asian American 3, 30% --
African American 1, 10% --
Hispanic/ Latino 5, 50% --
Caucasian 0, 0% --
Decline 1, 10% --

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 Table 2: Descriptive Knowledge Statistics of Survey Questions

Question Pre-Test, Post-Test, p-value

(n%) (n%)
(Q1.1) Which of the following statements is/are true? Adderall PREQ1.1 POSTQ1.1 *
is a drug abused among college students as a stimulant to
improve concentration during studying.
Selected 6 (60) 9 (100)
Not Selected 4 (40) 0 (0)
(Q 1.2) Which of the following statements is/are true? Use of *
Adderall for non-medical purposes is common amongst PREQ1.2 POSTQ1.2
college students. Which of the following statements is/are
true?
Selected 9 (90) 6(66.7)
Not Selected 1 (1) 3 (33.3)
(Pre Q2) Prescription drug abuse is a problem among college PRE Q2 POSTQ2 .400
students.
Do not know 1 (10) 0 (0)
Strongly Agree 0 (0) 4 (40)
Agree 9 (90) 6 (60)
Disagree 0 (0) (0)
Strongly disagree 0 (0) (0)
(Pre Q3) Prescription drug abuse is safer than illicit drug PREQ 3 POSTQ 3 .417
abuse.
Do not know 0 (0) 2 (20)
Strongly Agree 0 (0) 0 (0)
Agree 1 (11.1) 0 (0)
Disagree 7 (77.1) 1(10)
Strongly Disagree 1 (11.1) 7 (70)
(Pre Q4) Prescription drugs have side effects. PREQ4 POSTQ4 .1
Do not know 0 (0) 0 (0)
Strongly Agree 7 (70) 7 (70)
Agree 3 (30) 2 (20)
Disagree 0 (0) 1 (10)
Strongly Disagree 0 (0) 0 (0)
(Pre Q5) Free services provided at the Student Health Center PREQ5 POSTQ5 .533
include treatment for prescription drug abuse.
Do not know 1 (10) 0 (0)
Strongly Agree 1 (10) 3 (30)
Agree 8 (10) 7 (70)
Disagree 0 (0) 0 (0)
Strongly Disagree 0 (0) 0 (0)
(Pre Q20) After viewing the PSA, I know that CSUSB has PREQ20 POSTQ20 *
resources to help treat prescription drug abuse.
Do not know -- 0 (0)
Strongly Agree -- 10 (100)
Agree -- 0 (0)
Disagree -- 0 (0)
Strongly Disagree -- 0 (0)

--Question was not asked * p cannot be computed

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 Table 3: Descriptive Attitude Statistics of Survey Questions

Question Pre-Test, n (%) Post-Test, n (%) p-value

Making time to study is difficult. PREQ6 POSTQ6 0.317

Do not Know 0 (0) 0 (0)

Strongly Agree 2 (20) 1 (10)

Agree 4 (40) 5 (50)

Disagree 4 (40) 4 (40)

Strongly Disagree 0 (0) 0 (0)

College students should be able to PREQ7 POSTQ7 0.714

use Adderall (a study aide) for non-
medical purposes.
Do not Know 0 (0) 0 (0)

Strongly Agree 0 (0) 0 (0)

Agree 1 (10) 0 (0)

Disagree 5 (50) 4 (40)

Strongly Disagree 4 (40) 6 (60)

I would recommend the Student PREQ8 POSTQ8 0.267

Health Center to friends who may be
abusing prescription drugs.
Do not Know 0 (0) 0 (0)

Strongly Agree 3 (30) 8 (80)

Agree 6 (60) 2 (20)

Disagree 1 (10) 0 (0)

Strongly Disagree 0 (0) 0 (0)

I would consider taking a prescription PREQ11 POSTQ11 0.022

drug such as Adderall, to help me
study.
Do not Know 0 (0) 0 (0)

Strongly Agree 0 (0) 0 (0)

Agree 2 (20) 0 (0)

Disagree 5 (50) 2 (20)

Strongly Disagree 3 (30) 8 (80)

--Questions were not asked during the post survey.

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 Table 4: Descriptive Practice Statistics of Survey Questions
Question Pre-Test, n Post-Test, n p-value
(%) (%)
I have visited the CSUSB Student Health Center to PREQ12 POSTQ12 0.008
learn about more about prescription drug abuse.
Do not Know 0 (0) 0 (0)
Strongly Agree 1 (10) 0 (0)
Agree 0 (0) 0 (0)
Disagree 6 (60) 7 (70)
Strongly Disagree 3 (30) 3 (30)

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 Table 5: Descriptive Self Efficacy Survey Questions
Question Pre-Test, Post-Test, P-value
n (%) n (%)
I am confident in my ability to study using PREQ9 POSTQ9 0.25
resources provided at CSUSB.
Strongly Agree 4, 40% 7, 70%
Agree 5, 50% 3, 30%
Disagree 1, 10% 0, 0.0%
Strongly Disagree 0, 0.0% 0, 0.0%
Do not know 0, 0.0% 0, 0.0%
I am confident in my ability to study without using PREQ10 POSTQ10 0.50
prescription drugs.
Strongly Agree 9, 90% 9, 90%

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 Table 6: Cronbach's Alpha Analysis
Questions Cronbach's Alpha Values
Section: Knowledge on Prescription Drugs 1st run 2nd run 3rd run 4th run 5th run
Adderall is a drug abused among college students as
a stimulant to improve concentration during studying.
Which of the following statements is/are true?

Prescription drugs have side effects. 0.604

0.566
Free services provided at the Student Health Center
0.089
include treatment for prescription drug abuse.
-0.009 N/A

Use of Adderall for non-medical purposes is common

amongst college students. Which of the following x
statements is/are true?
Prescription drug abuse is a problem among college
x x
students.
Prescription drug abuse is safer than illicit drug
x x x
abuse.
Section: Attitude on Prescription Drugs 1st run 2nd run 3rd run 4th run 5th run
College students should be able to use Adderall (a
study aide) for non-medical purposes.
0.75
I would consider taking a prescription drug such as 0.602
Adderall, to help me study. 0.25 N/A N/A
Making time to study is difficult x
I would recommend the Student Health Center to
friends who may be abusing prescription drugs x x

Section: Self Efficacy on Prescription Drugs 1st run 2nd run 3rd run 4th run 5th run
I am confident in my ability to study using resources
provided at CSUSB.
0.214 N/A N/A N/A N/A
I am confident in my ability to study without using
prescription drugs.

Section: Attitude on Prescription Drugs with

1st run 2nd run 3rd run 4th run 5th run
review suggested questions
College students should be able to use Adderall (a
study aide) for non-medical purposes.
0.75
I would consider taking a prescription drug such as 0.602
Adderall, to help me study. 0.414
Making time to study is difficult x
0.263
Prescription drug abuse is a problem among college -0.005 x x
students.
I would recommend the Student Health Center to
friends who may be abusing prescription drugs x x x
(recommended Q)
Prescription drug abuse is safer than illicit drug
x x x x
abuse. (recommended Q)
Section: Practice on Prescription Drug
1st run 2nd run 3rd run 4th run 5th run
Abuse with review suggested question
I have visited the CSUSB Student Health Center to
learn about more about prescription drug abuse.
I would consider taking a prescription drug such 0.265 N/A N/A N/A N/A
as Adderall, to help me study. (recommended
Q)

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Figure 1: Attitude Pre and Post-Test Results

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Figure 2: Practice Post-Test Results

Prescription Drug Abuse is Safer than Illicit

Drugs

77.8%

11.1% 11.1%

Agree Disagree Strongly Disagree

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Figure 3: Data Dictionary

Prescription Drug Abuse Questionnaire

Version 1
January 16, 2018
Population: College Student Respondents Age 18 and Older

Authors:

Acuna, Melissa MPH(c)1

Chavez, Luz MSEES(c)2

Landeros, Loren RDN, MPH(c)1

Niemeyer, Keely RDN, MPH(c)1

Rodriguez, Kanale MPH(c)1

Affiliations: 1 Department of Health Science and Human Ecology, 2 Department of Chemistry

and Biochemistry

Contact:
Department of Health Science and Human Ecology
California State University, San Bernardino
5500 University Parkway,
San Bernardino, CA 92407
Telephone: (909) 537-5339
Web: www.health.csusb.edu/MPH

Copyright © 2016-2018 by MPH student 2016 cohort of California State University, San
Bernardino

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 Table of Contents
Section A - Demographics .................................................................................................................................................. 17
Section B - Knowledge on Prescription Drugs ........................................................................................................... 18
Section C - Attitude on Prescription Drugs ................................................................................................................. 19
Section D - Self-Efficacy on Prescription Drugs ........................................................................................................ 20
Section E - Practice on Prescription Drug Abuse...................................................................................................... 21

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 Section A – Demographics
Directions: Select one of the following

PREQ16, POSTQ16:
What is your sex? Select one of the following:

Male – 1
Female – 2
Prefer Not to Answer – 3

PREQ17, POSTQ17
What is your current year in college?

1st year – 1
2nd year – 2
Junior – 3
Senior – 4
Graduate – 5

PREQ18, POSTQ18
How old are you in years?

<18 – 1
18-24 – 2
25-39 – 3
40-49 – 4
50+ - 5

PREQ19, POSTQ19
What is your race/ethnicity?

Asian American – 1
African American – 2
Hispanic/Latino – 3
Caucasian – 4
Decline – 0

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 Section B - Knowledge on Prescription Drugs

Directions: Select one of the following

PREQ1.1, POSTQ1.1
Which of the following statements is/are true?
Adderall is a drug abused among college students as a stimulant to improve concentration
during studying. – Chosen (1) Not Chosen (2)

PREQ1.2, POSTQ1.2
Which of the following statements is/are true?
Use of Adderall for non-medical purposes is common amongst college students. – Chosen (1)
Not Chosen (2)

PREQ2, POSTQ2
Prescription drug abuse is a problem among college students.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

PREQ3, POSTQ3
Prescription drug abuse is safer than illicit drug abuse.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

PREQ4, POSTQ4
Prescription drugs have side effects.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

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PREQ5, POSTQ5
Free services provided at the Student Health Center include treatment for prescription drug abuse.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

PREQ20, POSTQ20
After viewing the PSA, I know that CSUSB has resources to help treat prescription drug abuse.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

Section C - Attitude on Prescription Drugs

Directions: Select one of the following

PREQ6, POSTQ6
Making time to study is difficult.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

PREQ7, POSTQ7
College students should be able to use Adderall (a study aide) for non-medical purposes.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

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PREQ8, POSTQ8
I would recommend the Student Health Center to friends who may be abusing prescription drugs.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

PREQ11, POSTQ11
I would consider taking a prescription drug such as Adderall, to help me study.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

Section D - Self-Efficacy on Prescription Drugs

PREQ9, POST9
I am confident in my ability to study using resources provided at CSUSB.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

PREQ10, POSTQ10
I am confident in my ability to study without using prescription drugs.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

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 Section E - Practice on Prescription Drug Abuse

Directions: Select one of the following

PREQ12, POSTQ12
I have visited the CSUSB Student Health Center to learn about more about prescription drug
abuse.

Strongly Agree – 1
Agree – 2
Disagree – 3
Strongly Disagree – 4
Do not know – 0

21