Sociodemographic differences in knowledge, perceptions, and intentions regarding stimulant misuse: A theory-informed national cross-sectional survey

Background: Stimulant misuse is a rising concern in the United States. Objectives: The purpose of this study was to better understand the U.S. general public's knowledge, perceptions, and intentions regarding stimulant misuse, and to assess sociodemographic differences. Methods: Americans age ≥ 18 were recruited for a cross-sectional, anonymous online survey using Amazon Mechanical Turk. Outcomes, guided by the Health Belief Model, included: knowledge; perceived susceptibility, severity, and benefits surrounding prescription and non-prescription stimulant use/misuse; perceived barriers to medical stimulant use and seeking help for stimulant misuse; and non-medical stimulant use intentions. Mann-Whitney U tests assessed differences across age (young adults/adults [≤44] versus middle-aged/older adults [>44]), sex, race, and urbanicity. Linear regression assessed predictors of intentions. Results: Respondents (N = 303) were 48.2 % female, 80.2 % White, mean 43.65 years, and 84.2 % urban-residing. Stimulant knowledge was higher among females (p = 0.017) and White individuals (p = 0.043). Perceived severity of stimulant misuse was higher among >44-year-olds (p = 0.006), females (p = 0.007), and rural residents (p = 0.009), with rural residents perceiving greater susceptibility overall (p = 0.022). Barriers to seeking help for stimulant misuse were higher among ≤44-year-olds (p = 0.025), while non-medical stimulant use intentions were higher among >44-year-olds (p = 0.002), males (p < 0.001), and urban residents (p = 0.031). Perceived severity of prescription (β = −0.268; p < 0.001) and non-prescription misuse (β = −0.191; p = 0.001), non-prescription stimulant benefits (β = 0.239; p < 0.001), barriers to seeking help (β = 0.078; p = 0.026), and age (β = −0.006; p = 0.028) predicted non-medical stimulant use intentions. Conclusions: Knowledge, perceptions, and non-medical stimulant use intentions differed across age, sex, race, and urbanicity. Future studies should explore strategies to overcome these disparities.