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Tara Fouts

October 23 @ 1:00 pm - 2:00 pm MDT

Thesis Information

Title: Pharmacist Perceptions Towards Screening Brief Intervention and Referral to Treatment for Prescription Opioid Misuse: Initial Instrument Reliability and Validity

Program: Master of Health Science in Health Promotion

Advisor: Dr. Sarah Toevs, Community and Environmental Health

Committee Members: Dr. Megan Smith, Community and Environmental Health and Dr. Michael J. Mann, Community and Environmental Health

Abstract

Prescription opioid misuse has become a growing problem in the United States, and there has been a significant increase in the number of nonfatal overdose and overdose deaths since the 1990s. Idaho has also experienced an increase in the number of drug-induced deaths over time, increasing nearly 30% from 2012 to 2016 (Drug-Induced Deaths: Idaho Residents 2016 summary, 2017). The Centers for Disease Control and Prevention indicated overprescribing and dispensing of prescription opioids as the main driver to the increase in overdoses. Evidence-based early intervention methods, such as screening, brief intervention, and referral to treatment (SBIRT), can be utilized in health care settings to identify risky behaviors among individuals who may not be seeking help for substance problems. However, limited research has been done to examine SBIRT in a pharmacy setting.

The purpose of this study was to develop an instrument based on the Theory of Planned Behavior (TPB) to measure pharmacist perceptions toward deploying SBIRT for prescription opioid misuse. The TPB constructs in the instrument examine attitude, subjective norm, and perceived behavioral control in relation to behavioral intention and past behavior. This thesis also administered a pilot study to perform initial validity and reliability tests.

To construct questions, survey items for attitude, subjective norm, perceived behavioral control, past behavior, and intention were developed based on a previous TPB instrument on utilizing the prescription monitoring program. After data was collected, psychometric testing was initiated and included factor analysis, testing the internal consistency of the subscales, and a correlation to determine the degree of similarity between items. A Principle Component Analysis (PCA) was used to extract factors in this study with a non-orthogonal rotation (Direct Oblimin). Items were retained if they loaded onto a factor at |0.4| or higher. Findings supported the eight-factor solution that was conceptually hypothesized with strong internal consistency for each construct. Cronbach’s alpha scores were 0.7 and above for all factors except for past behavior. Results from this study offer a foundation for future research to continue developing the instrument and to inform facilitators that may shape pharmacist readiness in early intervention strategies for prescription misuse.