Using the theory of planned behavior to predict Texas community pharmacists' willingness to provide sterile syringes to known or suspected intravenous drug users

The purpose of this dissertation was to use the Theory of Planned Behavior (TPB) to predict Texas community pharmacists’ willingness to provide sterile syringes to known or suspected intravenous drug users (IDUs). The study explored the utility of the TPB constructs (attitude, subjective norm, perceived behavioral control) and recent past behavior to predict willingness to provide sterile syringes as well as determined if attitude towards the provision of sterile syringes to known or suspected IDUs differed by gender. A total of 500 surveys, developed from three structured focus groups, were mailed to practicing Texas community pharmacists. An overall response rate of 35.1 percent was obtained. In general, pharmacists were not willing to provide sterile syringes to known or suspected IDUs, held negative attitudes toward the provision of sterile syringes, were somewhat influenced by social norms and perceived to have some control over the provision of sterile syringes. For belief-based measured constructs of the TPB, attitude was the only significant predictor of willingness to provide sterile syringes to known or suspected IDUs. When recent past behavior was entered into the regression model, attitude, subjective norm and recent past behavior were significant predictors. For direct measured constructs of the TPB, attitude and subjective norm were significant predictors of willingness, whereas, attitude, subjective norm and recent past behavior were significant predictors when recent past behavior was entered into the regression model. Overall, recent past behavior contributed significantly to the regression model. Attitude did not differ by gender. Even though subjective norm was a significant predictor when recent past behavior was entered into the regression model for both belief-based and direct measured constructs of the TPB, attitude and recent past behavior were the strongest predictors of willingness. In summary, this study identified factors that partially explain why community pharmacists are willing or not willing to provide sterile syringes to known or suspected IDUs. Attitudes should be targeted to increase community pharmacists’ willingness to provide sterile syringes. Public health officials and pharmacists can then use this information to better position themselves to meet the health needs and expectations of the community.