Exploratory Factor Analysis of a French Adapted Version of the Substance Abuse Attitude Survey among Medical Students in Belgium

Abstract

To evaluate the impact of a new Substance Use Disorder (SUD) education program on medical students’ attitudes, we selected the Substance Abuse Attitude Survey (SAAS) questionnaire, which we adapted to our curriculum and cultural context. To validate this adapted version, we conducted an exploratory factor analysis following the administration of our 29-item bSAAS questionnaire to 657 medical students in Belgium (response rate: 71.1%). Twenty-three items correlated to three factors; namely, “Stereotypes and moralism”, “Treatment optimism” and “Specialized treatment” were retained (70% of total variance explained, Cronbach’s alpha = 0.80) and constituted the new questionnaire called beSAAS. The factor “Specialized treatment” stood out from previous studies, which could be explained by our target population and the impact of the formal, informal and hidden curricula in medical education. This study was able to highlight certain factors influencing stereotypical representations such as age, gender, origin, personal or professional experience with substance use. Our study allowed us to retain the beSAAS as a good questionnaire to evaluate SUD stigma and highlighted interesting findings to improve SUD training in medicine. Further studies are needed to complete its validity and reliability.

Cluster analysis of medical students' attitudes regarding people who use drugs: a first step to design a tailored education program

“…Additionally, to investigate if the SARS-CoV-2 crisis could have impacted students' representations, we compared factors and variables according to the three student cohorts (2019, 2020 and 2021). The results did not show any relevant signi cant difference except for a slight decrease in the average score of Factor I (Stereotypes and moralism) over the years (from 2.14 to 2.02; p= 0.05) 20 .…”

“…Concerning these in uencing factors, this study explored also new interesting items. Indeed, if the question of age, gender, and experience related to substance use among medical students and doctors had already been studied a little in previous studies [5][6][7]9,[19][20][21] , this study allowed us to compare medical students on different aspects not yet studied, such as their choice of orientation. This makes possible to compare attitudes of all pro les of future specialities and not only a few of them as highlighted before in the literature 6,7 , which to our knowledge has never been explored before, especially less among medical students.…”

“…In terms of we should implement a more comprehensive and mandatory addiction training including theory, contact with people in recovery and supervised practices in appropriate settings for all medical students on a regular basis 20,26,27,40 . Our study data could therefore help to shape a more learner-centred and effective training 41,42 .…”

“…It is the result of an exploratory factor analysis on the bSAAS a French adapted version of Substance Abuse Attitude Survey (SAAS), an internationally validated questionnaire 21 . The exploratory factor analysis retained twenty-three items correlated to three factors; namely, "Stereotypes and moralism", "Treatment optimism" and "Specialized treatment" with 70% of total variance explained and Cronbach's alpha = 0.80 20 . The rst factor called "Stereotypes and moralism" includes items such as "Pregnant women who use drugs should be punished".…”

“…The objective was to be able to adapt addiction training on this basis. We have chosen the beSAAS questionnaire (see Appendix A) 20 to survey the nal year medical students. We focused on this population as they are the future generation of doctors.…”