Abstract

Introduction: Psychoactive substances pose a significant threat to the health and socio economic fabric of the general population. The use of these substances is quite common among commercial drivers because of the general belief that it reduces the job strain and combats fatigue. However psychoactive substance use increases the risk of road traffic accidents and development of non-communicable diseases like lung cancers and liver disease. Proper education about the use of psychoactive substances can help deter its use among commercial drivers in order to prevent the occurrence of motor vehicle accidents and associated morbidities and mortalities.
The general objective of the study was to assess the effect of a trans-theoretical model based health education program to achieve behaviour change on psychoactive substance use among commercial vehicle drivers in Lagos state.
Methodology
This was a quasi-experimental study which consisted of two groups, a study (intervention) and control groups. There was a health education intervention on the effects of psychoactive substance use among the study group. A multistage sampling technique was used to recruit 435 drivers made up of 215 study and 220 controls. The study and control groups were selected from motor parks in Ikeja and Lagos Mainland local government areas (LGAs) respectively. A simple random sampling method was used to select drivers from the respective parks. The study was carried out in three phases. The first phase was the pre-intervention baseline assessment and it involved the administration of a structured questionnaire to assess knowledge, attitude and psychoactive substance use behaviour among commercial bus drivers. Drivers had breath
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analysis with the Alcosense breathalyzer and urine testing with the Atlas medical multi-drug one panel urine test kit during the pre-intervention phase. The second phase which was the health education intervention was conducted alongside the distribution of hand bills and posters. The third phase was the collection of post intervention data. Quantitative and qualitative data collection methods were used in this study.
The outcome variables were knowledge, attitude and practice of psychoactive substance use and behaviour change among commercial bus drivers. Bivariate analyses such as Chi square and McNemar test were conducted and the level of significance was set at p < 0.05. The knowledge, attitude and practices of the drivers were compared between the pre-intervention and post-intervention phases and also between the study and control groups.
Results
At baseline, socio demographic and socio economic characteristics of respondents in both groups were comparable. Over 75% of the respondents in both groups had a poor knowledge about psychoactive substances. More respondents in the study group had a negative attitude. The psychoactive substances most commonly used were; alcohol (76.3%) in the study group and (70.5%) in the control group, tobacco (49.8%) in the study group and (49.0%) in the control group, Cannabis (35.3%) in the study group and (31.8%) in the control group) and other substances (8.8%) in the study group and (9.1%) in the control group. Pre intervention findings also showed that 27.4% of the respondents in the study group and 22.3% in the control group tested positive for alcohol. In the study group 79.5% of the respondents and 77.8% of the respondents in the control group tested positive for at least on psychoactive substance. The commonest psychoactive substance detected by the Atlas urine test was Cannabis, 50% in the study group and 57.7% in the control group.
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Factors associated with psychoactive substance use included; age, ethnicity, marital status, driving duration, bus ownership and income earned. A higher percentage of the respondents in both groups were at the precontemplation stage at baseline.
At the post intervention phase, there was an increase in the number of respondents with a good knowledge in the study group, with 78.6% of the respondents now having a good knowledge grade and this was found to be statistically significant (p< 0.05). The proportion of respondents with positive attitudes increased significantly in the study group with 85.6% of the respondents now having a positive attitude. There was no change in the reported use of psychoactive substances in both study and control groups, as a higher proportion of the respondents were still at the stage of moderate addiction. This study also revealed the spiritual and cultural reasons for psychoactive substance use among some commercial drivers.
There was a 12.4% decrease in the number of respondents who tested positive for alcohol in the study group post intervention. There was also a decrease in the number of drivers who tested positive for psychoactive substances in their urine with only 19 (44.2%) respondents testing positive for at least one psychoactive substance, which shows there was a decrease in the actual use of psychoactive substances. With regards to behaviour change, there was a 4.3% increase in the number respondents who moved to the contemplation stage with the difference between the groups being statistically significant (p < 0.05). At the pre intervention stage, a higher proportion of respondents were at the precontemplation stage.
Conclusion
This study proves that the health education (Trans-theoretical model based education) for commercial bus drivers in Lagos state is an appropriate intervention program which improved
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their knowledge, modified their attitude and practices. It also motivated a desire to quit psychoactive substance use among commercial bus drivers.
It is recommended that regular health education sessions such as this should routinely be organised for these drivers in form of seminars and workshops as a way of follow up.

PSYCHOACTIVE SUBSTANCES USE AMONG COMMERCIAL BUS DRIVERS IN LAGOS STATE: EFFECT OF TRANS-THEORETICAL MODEL BASED EDUCATION ON BEHAVIOUR CHANGE