Development of an instrument measuring Chinese adolescent beliefs and attitudes towards substance abuse


  • May SM Fok PhD, RN,

  • Warren YW Tsang PhD, MRPharmS

May SM Fok
School of Nursing
The Hong Kong Polytechnic University
Hung Hom
Hong Kong
Telephone: +86-852-27666542


Aim.  To develop an instrument measuring the beliefs and attitudes of Chinese adolescents towards substance abuse.

Background.  It is documented that many negative consequences for youth, including physical, mental and psychosocial health problems are associated with substance abuse. There has led to a growing concern about promoting anti-drug education among health care professionals in Hong Kong. It is therefore important to conduct research on substance abuse to promote more effective anti-drug programmes for adolescents. To conduct research on the above aspect, valid and reliable instruments for measuring factors associated with drug abuse are needed. An instrument, namely the Beliefs and Attitudes of Substance Abuse Inventory (BASAI) was developed for the purpose of this study.

Design and methods.  Both qualitative and quantitative approaches to instrument development were adopted in the study. There were two phases to the study. Relevant literature and the Delphi technique were employed in the first phase of the study. A panel of experts was interviewed for the development of a pool of items for the instrument. Content analysis was used to manage the qualitative data obtained from the interviews. Factor analysis was used for the psychometric testing of the items of the BASAI. A Cronbach's alpha coefficient was used to test the internal consistency of the instrument. The standard error of the mean (SEM) was measured to further support the reliability of the BASAI. The results are estimates of the validity and reliability of the instrument.

Results.  Three main categories and nine sub-categories were derived from the interview data in the first phase of the study. The overall inter-rater reliability of the categories was 0.89 (kappa statistics). In the second phase, a Content Validity Index (CVI) of 0.92 for the instrument was achieved with the assistance of another panel of experts. The factor structure of the instrument was identified by undertaking a Principal Component Analysis. Three factors were extracted with a total variance account of approximately 70%. Reliability was established with α = 0.82 for the entire scale and a range of 0.78–0.92 between the sub-scales of the instrument. A small SEM of 3.21% was calculated to further support the reliability.

Conclusion.  A culturally sensitive instrument was developed with a satisfactory level of validity and reliability. Further research is recommended to continuously improve and refine the instrument so that it can be useful currently in research and/or practice.

Relevance to clinical practice.  To promote the healthy development of children and adolescents, child health professionals need to implement effective health promotion strategies including anti-drug programmes. The instrument that was developed in this study will hopefully contribute to the development of more effective and evidence-based anti-drug programmes for youths.