The Development of a Cannabis Knowledge Assessment Tool (C-KAT) and Behavioural Intention (BI) Scale

Abstract

Background: Given the anticipated increase in the use of cannabis due to legalization, there is a need for more cannabis education for the general population. Since youth are particularly vulnerable to the effects of cannabis, new education programs are being implemented in some school curriculums. Evaluative tools are needed to assess cannabis knowledge, understanding and intention for use. Such tools could help determine whether these new cannabis awareness and education programs are effective.

Methods: During the first phase of this study (questionnaire development) a Cannabis Knowledge Assessment Tool (C-KAT) and Behavioural Intention (BI) scale were created through a multistage iterative process. The C-KAT development involved the use of the Delphi method, whereby a purposive sample of healthcare professionals, policymakers, academics, patients who used medical cannabis and teenage students served as the content and development experts. Four rounds of the questionnaire were distributed prior to reaching consensus on the C-KAT content. The BI scale was developed through consultation with six additional educators (with expertise in assessment, questionnaire development and biostatistics) and three students. During phase two of the study (testing), the C-KAT and BI scale were administered as a pre- and post-test in four schools (Grades 7 and 9) in Saskatoon, SK. The data were analysed to determine whether knowledge scores and behavioural intentions of the students changed after participating in a cannabis education program (REACH; Real Education About Cannabis and Health).

Results: The questionnaire was administered to 132 students, of which 73 (55.3%) were in grade 7 and 59 (44.7%) were in grade 9. In total there were 84 (63.6%) females, 46 males (34.8%) and 2 (1.5%) students who identified as “other”. The C-KAT scores increased in all students overall, and within each grade, gender, and school (p <0.05) following the REACH program, but the overall scores for the BI scale had no statistically significant change between pre- and post-test. Follow up could not be obtained with 281 students due to disruption of the study by the COVID-19 pandemic (March 2020).

Conclusion: According to the C-KAT scores, grade 7 and grade 9 students appeared to increase their knowledge about cannabis after participating in the REACH program. However, BI scores with respect to intentions for cannabis use were not impacted. More study is warranted to determine the overall usefulness of the developed questionnaires.