Attitudes and Beliefs of College Students towards Pain Management Modalities: Theory of Planned Behavior Approach.

Background: Chronic pain exhibits a burdening onset and duration in young adults. It is critical to understand appropriate pain management decision-making.

Objective: To investigate the associations of attitudes and beliefs of college students with their intention and behavior toward pain management modalities using the Theory of Planned Behavior (TPB).

Methods: In this cross-sectional online survey study, we recruited college students (age≥18 years) at West Virginia University, Morgantown, West Virginia, United States. We examined four pain management modalities: Over-the-Counter (OTC) pain medications, prescription pain medications (R), mindfulness therapy, and yoga/exercise. Likert scales were used to assess TPB constructs (attitude, Subjective Norm [SN], Perceived Behavior Control [PBC], intention, and behavior). We analyzed the associations of the TPB constructs with both intention and behavior toward pain management modalities using multiple linear regression.

Results: Of the 364 returned surveys, 227 were completed and analyzed. Attitude was found to be significantly associated with the intention to use all pain management modalities, while PBC was significantly associated with the intentions to use R, mindfulness, and yoga/exercise (R: β = 0.38; 95%CI= 0.28, 0.84; p=<0.001, mindfulness: β=0.27; 95%CI=0.07, 0.76; p=0.019, and Yoga/exercise: β=0.35; 95%CI=0.25, 0.85; p=<0.001). Furthermore, the intention to use pain management modalities consistently predicted all behaviors (OTC: β=0.49; 95%CI=0.32, 0.76; p=<0.001, R: β=0.47; 95%CI=0.17, 0.58; p=<0.001, Mindfulness: β=0.62; 95%CI=0.40, 0.72; p=<0.001, Yoga/Exercise: β=0.59; 95%CI=0.42, 0.84; p=<0.001).

Conclusion: College students' attitude and PBC were the top predictors of intention to choose pain management modalities, and intention predicted behavior. Research with robust study design is needed to confirm our study findings.