Publication Date


Date of Final Oral Examination (Defense)


Type of Culminating Activity


Degree Title

Master of Health Science in Health Promotion


Community and Environmental Health

Major Advisor

Megan Smith, Ph.D.

Major Advisor

Sarah Toevs, Ph.D.


Mike Mann, Ph.D.


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. The Centers for Disease Control and Prevention indicates overprescribing and dispensing of prescription opioids is a 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 and in pharmacist perceptions toward performing SBIRT for prescription opioid misuse.

The purpose of this study was to develop an instrument based on the Theory of Planned Behavior (TPB) to measure pharmacist perceptions toward using SBIRT for prescription misuse and then test initial validity and reliability. To construct appropriate questions, survey items for attitude, subjective norms, perceived behavioral control, past behavior, and intention were developed from a previous TPB instrument on the utilization of 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 subscales. A Principal 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. These results offer a foundation for future research to build on the instrument and inform interventions that may shape pharmacist readiness in prescription misuse early intervention strategies.