Beliefs and attitudes regarding drug treatment: Application of the Theory of Planned Behavior in African-American cocaine users

Background: The Theory of Planned Behavior (TPB) can provide insights into perceived need for cocaine treatment among African American cocaine users. Methods: A cross-sectional community sample of 400 (50% rural) not-in-treatment African-American cocaine users was identified through respondent-driven sampling in one urban and two rural counties in Arkansas. Measures included self-reports of attitudes and beliefs about cocaine treatment, perceived need and perceived effectiveness of treatment, and positive and negative cocaine expectancies. Normative beliefs were measured by perceived stigma and consequences of stigma regarding drug use and drug treatment. Perceived control was measured by readiness for treatment, prior drug treatment, and perceived ability to cut down on cocaine use without treatment. Findings: Multiple regression analysis found that older age (standardized regression coefficient β. = 0.15, P<. 0.001), rural residence (β. = -. 0.09, P= 0.025), effectiveness of treatment (β. = 0.39, P<. 0.001), negative cocaine expectancies (β. = 0.138, P= 0.003), experiences of rejection (β. = 0.18, P<. 0.001), need for secrecy (β. = 0.12, P= 0.002), and readiness for treatment (β. = 0.15, P<. 0.001) were independently associated with perceived need for cocaine treatment. Conclusions: TPB is a relevant model for understanding perceived need for treatment among African-American cocaine users. Research has shown perceived need to be a major correlate of treatment participation. Study results should be applicable for designing interventions to encourage treatment participation.