Examining the Utility of the Theory of Planned Behavior in Explaining the Diversion of Prescription Stimulant Medications among Undergraduate Students

Purpose: The purpose of this study was to assess the ability of the constructs of the Theory of Planned Behavior (TPB) in explaining the diversion of prescription stimulants during the lifetime of undergraduate students between the ages of 18 and 24. Methods: 1,024 undergraduates between the ages of 18 and 24 completed a paper-and-pencil in class survey. This survey consisted of 88 questions designed to assess the prevalence, motivations, and the indirect determinants of the Theory Planned Behavior that were significantly associated with the misuse and diversion of prescription stimulant medications. Results: From the total sample, 142 participants had a current prescription for a stimulant medication and completed the required survey questions. From the sample, 44.3% of prescription holders had sold their medication and 76.5% had given it away during their lifetime. A logistic regression identified a significant model (df =10, x2=41.947, p<0.001) that correctly classified 72.5% of cases and explained 37.3% of the variance. Of the variables entered into the regression, only a history of nonmedical use (OR=3.738, CI= 1.592-8.778, p<0.01) and a positive attitude toward diversion (OR= 2.306, CI=1.353-3.931, p<0.01) were significant predictors of lifetime diversion among undergraduates. Conclusions: Results identified diversion rates that were higher than those previously published rates. However, outcomes of the model suggests that changing an undergraduate's attitude toward diversion and preventing misuse of prescription stimulants may reduce the diversion behavior. However, the constructs of TPB did not adequately explain the behavior. Future research should examine the utility of other theories in explaining diversion.