Abstract: Clinicians' Attitudes and Practices Related to Medications for Opioid Use Disorder: An Application of the Theory of Planned Behavior (Society for Social Work and Research 26th Annual Conference - Social Work Science for Racial, Social, and Political Justice)

629P Clinicians' Attitudes and Practices Related to Medications for Opioid Use Disorder: An Application of the Theory of Planned Behavior

Sunday, January 16, 2022
Marquis BR Salon 6, ML 2 (Marriott Marquis Washington, DC)
* noted as presenting author
Aaron Brown, PhD LCSW, Assistant Professor, Western Carolina University, Cullowhee, NC
Background and Purpose: Medications for opioid use disorder (MOUDs) are safe and effective but underutilized in the United States. It is important to improve the implementation of MOUDs in order to increase access and utilization. Although non-prescribing clinicians (NPCs) such as social workers and counselors do not prescribe medications used to treat opioid use disorder (OUD), they influence MOUDs implementation through their frequent interactions with patients, treatment planning, and referral practices. Extant literature has shown that attitudes towards MOUDs held by NPCs affect their willingness to discuss MOUDs and make referrals for MOUDs. Compared to prescribers less is known about factors which affect NPCs’ attitudes and practices related to MOUDs. Better understanding these underlying factors is important for the development of educational interventions for NPCs. The present study aims to examine factors associated with attitudes and practices related to MOUDs among NPCs who are involved in treating OUD by reporting the findings from a recent survey of NPCs and applying a model representing the Theory of Planned Behavior (TPB).
Method: NPCs involved with the treatment of OUD were recruited to participate in an online cross-sectional survey. Multiple recruitment methods were utilized to obtain a purposive sample including social media and a list of substance abuse professionals certified by the U.S. Department of Transportation. The survey probed attitudes and practices related to MOUDs as well as demographic and practice characteristics. The Abstinence Orientation Scale (AOS) was used to measure treatment orientation for OUD.
Descriptive statistics were generated, and structural equation modeling was conducted to examine models representing the TPB. Models representing TPB with and without antecedents to attitudes included were examined to identify factors related to attitudes and practice behaviors and to estimate the predictive utility of each model.
Results: Among a sample of 620 NPCs, the average participant was middle-aged (M = 47, SD = 13.53), female (74.1%), non-Hispanic White (79.5%), and had completed a graduate degree (83.2%). Most (79.0%) indicated agreement with the use of MOUDs. Most (82.8%) reported discussing MOUDs with clients with OUD. The average AOS score was slightly oriented towards abstinence. AOS items with the highest level of agreement indicated that many felt that MOUDs should be time-limited and individuals should be withdrawn from upon achieving stability. Both the default TPB model (CFI = .982; RMSEA = .057) and the model with antecedents for attitudes included (CFI = .954; RMSEA = .052) achieved adequate fit, predicting 68% and 69% of the variance in practice behaviors respectively. Abstinence orientation (β = -0.42) and exposure (β = 0.53) were significantly related to attitudes towards MOUDs within the model.
Conclusions: Results indicate that misinformation about best practices for implementing MOUDs is still prevalent among NPCs involved with treating OUD. Results identified abstinence orientation and exposure as important factors underlying attitudes towards MOUDs
and provided evidence that the TPB is a useful model to understand and predict NPCs’ practice behaviors related to MOUDs. Implications for future research as well as for future educational interventions for NPCs are discussed.