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Salud mental

versión impresa ISSN 0185-3325

Salud Ment vol.30 no.1 México ene./feb. 2007

 

Artículos originales

Capacidad predictiva de la Teoría de la Conducta Planificada en la intención y uso de drogas ilícitas entre estudiantes mexicanos

Solveig Eréndira Rodríguez-Kuri* 

David Bruno Diaz-Negrete** 

Sara Elisa Gracia-Gutiérrez de Velasco*** 

José Abelardo Guerrero-Huesca*** 

Emilia Lucio Gómez-Maqueo**** 

* Miembro del Departamento de Investigación Psicosocial y Documental de los Centros de Integración Juvenil. Investigadora del Sistema Institucional de Investigadores de la Secretaría de Salud.

** Subdirector de Investigación de los Centros de Integración Juvenil. Investigador del Sistema Institucional de Investigadores de la Secretaría de Salud.

*** Miembro del Departamento de Investigación Clínica y Epidemiológica de los Centros de Integración Juvenil.

**** Profesora de tiempo completo de la Facultad de Psicología de la Universidad Nacional Autónoma de México. Miembro del Sistema Nacional de Investigadores. Correspondencia: Solveig E. Rodríguez-Kuri. Tlaxcala 208, 2º piso. Hipódromo Condesa, Cuauhtémoc, 06100, México, Distrito Federal. Correo electrónico: investigacion@cij.gob.mx o cijinvestigacion@yahoo.com.mx

Resumen:

La exigencia de desarrollar programas de prevención del consumo de drogas que garanticen una mayor eficacia y aprovechamiento de los recursos, ha derivado en un progresivo interés por elaborar programas científicamente sustentados. El presente estudio busca sumarse a este esfuerzo mediante la realización y evaluación de una intervención de prevención del uso de drogas ilícitas, teórica y empíricamente sustentada en el modelo de la Conducta Planificada, de Ajzen y Fishbein, que incorpora factores cognitivos y actitudinales relacionados directamente con el inicio del uso de drogas.

El objetivo de este trabajo consistió en probar la capacidad explicativa y el peso predictivo de este modelo en relación con la intención conductual de usar drogas ilícitas y el consumo de sustancias en estudiantes mexicanos de educación media básica. El estudio realizado tuvo un diseño transversal, ex post facto y correlacional, con análisis postestratificado de una muestra de 75 estudiantes usuarios de drogas y 75 no usuarios, comparados por pares por medio de sexo, edad, turno de asistencia a la escuela y ocupación, extraídos de una muestra no probabilística de 1,019 estudiantes de educación media básica de la ciudad de México.

La información fue levantada mediante un cuestionario autoaplicable con un alto índice de confiabilidad y compuesto por ocho secciones, que incluye los siguientes contenidos derivados de la teoría de la Conducta Planificada (ajustados en función de datos previamente obtenidos en grupos focales): creencias conductuales asociadas al consumo de drogas ilícitas, valor atribuido a estas creencias, creencias normativas respecto al uso de drogas, disposición para ajustarse a las expectativas normativas asociadas con el uso de sustancias, norma personal y descriptiva (como componentes adicionales de la variable de norma subjetiva), exposición a oportunidades de consumo y control conductual percibido en tales circunstancias. Un análisis factorial arrojó 16 factores apegados al modelo teórico, con una varianza explicada de 59%.

Los hallazgos indican que, comparados con los estudiantes que no han usado drogas ilícitas, aquéllos que las han consumido mantienen una actitud más favorable hacia el consumo, perciben una mayor tolerancia social ante el mismo y están más dispuestos a ceder a la presión social para usar sustancias. De igual modo, perciben que entre las personas significativas de su entorno hay un mayor número de usuarios de drogas, se enfrentan con un mayor número de oportunidades y situaciones que pueden favorecer el consumo y se perciben con una menor capacidad de autocontrol al enfrentarlas.

Se observó también que entre las variables del modelo hay correlaciones similares a las reportadas en otras poblaciones. Así mismo, mediante un análisis de regresión lineal se identificó una capacidad explicativa del modelo de 34% respecto a la intención de uso de drogas, que se incrementó a 38% al integrarse componentes adicionales de norma subjetiva. El componente que mejor predice la intención de usar drogas es el control conductual, que según el análisis de regresión logística también es el mejor predictor del uso de drogas propiamente dicho.

De los hallazgos obtenidos puede concluirse que el modelo de la Conducta Planificada puede constituir una base teórica adecuada para desarrollar una intervención preventiva dirigida a estudiantes de educación media con el fin de modificar factores “proximales” de riesgo del uso de drogas. En particular, destaca la necesidad de incluir componentes dirigidos a promover el desarrollo de habilidades de control conductual ante situaciones de riesgo, tales como habilidades de resistencia ante la presión grupal y de comunicación asertiva.

Palabras clave: Uso de drogas; teoría de la conducta planificada; actitud; norma subjetiva; control conductual percibido; programas preventivos

Summary

The need of cost-effective drug abuse prevention programs has derived in a growing interest to develop scientific based alternatives. On this context, this study forms part of a project for the design and evaluation of a theoretical and empirically sustained intervention for illicit drug abuse prevention among Mexican junior high school students.

Starting with the revision and assessment of different theoretical models that could be adapted to the conditions of the institutional context wherein the intervention will be developed, the Azjen and Fishbein’s Theory of Planned Behavior was chosen.

This theory includes proximal cognitive and attitude factors directly related to the initiation of drug use. In accordance with it, the experimental use of substances is a result of the intention of consuming them, which, in turn, depends on three elements: a) the attitude toward the drug use, b) the normative beliefs on this matter (subjective norm) and c) the perceived behavioral control regarding drug use or, in turn, confronting social pressure.

In a first instance, several items were developed adapting the constructs of the Theory of Planned Behavior to the target population’s characteristics. On this base, the reliability and validity of a self-applied questionnaire for the measurement of the variables of the model was proved.

In this work are reported the findings of the evaluation of Theory of Planned Behavior’s potential to predict both behavioral intention of using illicit drugs and consumption of substances among Mexican high school students, in order to set a precedent to apply the model later on in the design and evaluation of a preventive intervention directed to such population.

Method:

The study was carried on with an ex post facto, correlational design, and with a non-probabilistic sample of 1,019 subjects. Sample. The sample size was estimated considering the possibility of selecting a subsample of drug users and comparison subjects for a post-stratified analysis, assuring a statistical power of 80% and adequate sensibility and stability. Therefore, this work includes the performed analyses with a sample of 75 drug users and 75 non users, paired by gender, age, school grade and occupation. Instrument. The instrument was a self-applied questionnaire specially developed for the study, according to information obtained in previous focal groups interviews with high school students. The questionnaire showed a global realiability of 0.9154 and between 0.62 and 0.94 in each one of its scales, which included: behavioral beliefs (0.9121), attributed value to behavioral beliefs (0.7964), normative beliefs (0.6480), subject’s disposition to adjust to normative expectations (0.8564), descriptive norm (0.6254), drug use opportunities (0.8129) and perceived behavioral control coping with such opportunity situations (0.9442). A factorial analysis of principal components yielded 16 factors of at least three items each, with factorial weights higher than 0.4, and closely attached to Theory of Planned Behavior’s variables, with an explained variance of 59%.

Analysis. Previous to data analysis, normality tests (Kolmogorov- Smirnov) were performed, indicating the necessity to apply nonparametric tests of differences and to transform the data to be adapted to the requirements of later parametric analyses.

A correlation analysis was carried out to prove the association between behavioral intention and drug use, as well as between the different components of the Theory of Planned Behavior. Finally, linear and logistic regression analyses were conducted to determine the explicative potential of the model and the predictive weight of each variable on the model with regard to the behavioral intention and the consumption of drugs.

Findings:

According to the Mann-Whitney test, compared with students who had not used drugs, subjects that used them at least once in their life showed more favorable attitudes toward consumption (median= 6.9 vs. 3.9, z=-5.22, p=0.000), perceived more social tolerance (median=3.8 vs. 3.5, z=-2.27, p=0.023), were more willing to give in to social pressure for using substances (median=2.0 vs. 1.0, z=-5.598, p=0.000), perceived a higher number of users among their significant others, and less negative consequences Salud Mental, Vol. 30, No. 1, enero-febrero 2007 69 of drug use in themselves (median=16.3 vs. 7.1, z=-4.246, p=0.000), and felt less capable of behavioral control when coping with opportunities for consumption, which, in turn, are more frequent in their case (median=5.7 vs 1.8, z=-6.76, p=0.000).

The correlation between the intention and the behavior of drug use (r=0.41, p<0.000) was allocated inside the range reported in other populations. Drug use intention correlated with attitude toward drug use at r=0.45 (p=0.000), with subjective norm, including additional components at r=0.48 (p=0.000), and with perceived behavioral control at r=0.59 (p=0.000). Drug use correlated with attitude at r=0.51 (p=0.000), with subjective norm at r=0.28 (p=0.001), and with perceived behavioral control at r=0.37 (p=0.000).

Linear regression analysis yielded that the model explained 34% of the variance of drug use intention, which increased to 38% when adding personal and descriptive norm elements to the subjective norm construct. Behavioral control (measured on the basis of the product of exposition to drug use facilitating situations punctuations by perceived behavioral control to cope with these situations punctuations) was identified as the best predictor of drug use intention (B=0.32, p=0.001), followed by attitude toward drug use (B=0.24, p=0.004) and subjective norm, which originally showed a non-significant effect but increased its predictive weight when additional elements were added (B=0.24, p=0.004).

According to the logistic regression analysis, behavioral control is also the best predictor of illicit drug use on the model (odds ratio= 1.42, p<0.000). On the contrary, subjective norm (including personal and descriptive norm) and attitude (odds ratio=1.144, p=0.06) were not significant predictors of drug use.

Discussion:

In general, this findings indicate that the Theory of Planned Behavior showed an acceptable predictive capacity (similar to that found in other populations), and can be taken as a valid theoretical ground to develop a preventive intervention directed to Mexican students of high school education.

As is the case with other populations, the variable in the Planned Behavior Theory with more predictive weight was perceived behavioral control, followed by attitude to drug use and, in third place, by subjective norm. Despite it could be supposed that subjective norm would have a higher predictive weight in Mexican teenagers, findings probably reflected idiocentric and individualistic tendencies reported in other studies.

Results also point out to the convenience of including it in the program of intervention informative components to produce an awareness effect and an impact in the intention of using drugs. Still, they indicate above all, the need to integrate components directed to the development and reinforcement of behavioral control abilities that have an effect in the use of drugs itself.

Specifically, it is considered the convenience of including components for the development of group pressure resistance abilities and assertive communication, appropriate to the contexts in which young people face drug abuse risk situations.

Key words: Drug abuse; Planned Behavior Theory; attitude; subjective norm; perceived behavioral control; prevention programs

Texto completo disponible sólo en PDF.

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