Development of a Drug Use Resistance
Self-efficacy (DURSE) Scale
Carrie M. Carpenter, PhD; Donna Howard, DrPH
Objectives: To develop and evalu-
ate psychometric properties of a
new instrument, the drug use re-
sistance self-efficacy (DURSE)
scale, designed for young adoles-
cents. Methods: Scale construc-
tion occurred in 3 phases: (1) initial
development, (2) pilot testing of
preliminary items, and (3)fínalscale
administration among a sample of
seventh graders (n=223) to exmaine
psychometric properties. Results:
DURSE items appeared to tap a
O ver the past 2 decades, school-based
efforts to prevent, delay initiation
of, and reduce drug use among ado-
lescents have gained momentum. Many
drug prevention curricula are based on
theoretical models of behavioral change,
which posit that drug initiation and esca-
lation of use can be delayed and decreased
by targeting attitudes, perceptions, and
behaviors related to drug use.' Recent
evidence suggests that interactive, so-
cial influence programs are the most
effective prevention approach.'"^
Drug use resistance self-efficacy (RSE),
one's beliefs about one's capability to re-
sist drug offers, has been a focus of many
social influence approaches to drug pre-
Carrie M. Carpenter, Research Scientist, Divi-
sion of Public Health Practice, Harvard School of
Public Health, Boston, MA. Donna Howard, As-
sociate Professor, Department of Public & Com-
munity Health, University of Maryland, College
Park, School of Public Health, College Park, MD.
Address correspondence to Dr Carpenter, Divi-
sion of Public Health Practice, Harvard School of
Public Health, 401 Park Drive, 3rd Floor East,
Boston, MA 02215. E-mail: carriedph@gmail.com
Am J Health Behav.™ 2009;33(2):147-157
unique dimension of resistance self-
efßcacy. Initial psychometric prop-
erties of the scale were satisfac-
tory. Conclusions: The DURSE
scale may offer an opportunity to
measure important, as yet un-
tapped, constructs related to ado-
lescents' abilities to refuse sub-
stance use in social contexts.
Key words: adolescents, resis-
tance self-effîcacy, drug use, psy-
chometrics
Am J Health Behav. 2009;33{2):1^7-lS7
vention based on theoretical notions that
adolescents will be less likely to succumb
to pressure to use drugs if they have the
confidence and skills to resist these of-
fers."*"^ Programs framed around this con-
struct aim to build and strengthen drug
resistance skills among youth through a
variety of methods, including participa-
tory learning activities such as modeling,
role playing, and practice of drug resis-
tance skills.'•'°
Despite potential influences of RSE
beliefs and resistance skills on adoles-
cent drug use, little effort has been di-
rected toward in-depth scale development
and testing. Past studies that have mea-
sured adolescents' RSE beliefs, as well as
related constructs such as attitude to-
wards drug use, personal competence,
and perceived norms,'•''•" suggest that
sound RSE scale development has been
left largely unexplored; thus, available
assessments of RSE beliefs may not ad-
equately capture the full range of RSE
beliefs among adolescents.''•^•'•'^ fj^g j g .
velopment of a theory-based, psychometri-
cally sound scale designed to measure
drug use RSE among young adolescents
should contribute to the understanding of
147
Self-efficacy (DURSE) Scale
this construct and its valid assessment.
Thus, the purpose of this study was to
develop and evaluate initial psychometric
properties of an instrument, the drug use
resistance self-efficacy (DURSE) scale,
using a multistep scale development ap-
proach. The DURSE scale was designed to
assess young adolescents' capabilities to
resist offers to use cigarettes, alcohol, and
marijuana in different social pressure
situations. The final scale was tested for
initial evidence of reliability and validity.
METHODS
Scale Construction and Pilot Test
Scale construction occurred in 3 re-
search phases; (1) initial development in-
cluding an extensive literature review,
expert panel review of initial scale items
(n=10) and adolescent focus groups (n=15);
(2) pilot testing of preliminary items (n=46);
and 3) final scale administration to exam-
ine psychometric properties (n=223). Pub-
lished literature guided the approach to
scale construction used in this study.'^"'^ A
literature review was used to obtain back-
ground information on drug use resistance
self-efficacy among adolescents and iden-
tify existing instruments that were de-
signed to measure similar constructs. An
expert panel reviewed the initial set of
items and judged each item for its rel-
evance to a conceptual definition of RSE,
which was provided by the scale developer.
Focus group respondents provided infor-
mation related to the content of the pre-
liminary DURSE items, t3rpes of drug pres-
sure settings, and other sources of pres-
sure. Next, DURSE items were developed
and pilot tested among a sample seventh-
grade students in one Maryland middle
school (n=46). Following this pilot test, stu-
dents critiqued the items in an open-ended
discussion, which was useful in obtaining
student input on the wording, content, and
overall evaluation of the scale. Pilot test-
ing served to generate initial item analy-
ses, collect qualitative feedback on the
format and interpretation of items, and
evaluate data collection procedures. These
data informed changes to the final set of
items. This article reports the psychomet-
ric properties of the DURSE and describes
central findings from final scale adminis-
tration.
Measures
The final DURSE scale contained 24-
items (Table 1). Items have a 4-point
148
Likert response format ranging from Not
sure at all (scored as 1) to Definitely sure
(scored as 4). Scale scores were obtained
iay summing raw scores across the scale
items. Total possible scores ranged from
24 to 96, with higher scores indicating
greater resistance self-efficacy. Questions
were asked as follows: "How sure are you
that you can refuse if [insert drug offer]
and you do not want it?" (eg, "How sure are
you that you cam refuse (if a friend offers
you alcohol at a party and you do not want
it?"). DURSE items include a conditional
statement specifying that the respondent
does not want to accept the drug offer.'^
This wording is intended to reduce the
possibility of potentially confounding ado-
lescents' notions of "desire" or "willing-
ness" to try or use drugs with their likeli-
hood of refusing the drug offer. A higher
score indicated a greater likelihood of
resisting drug offers.
The DURSE scale was incorporated into
a 51-item questionnaire that consisted of
additional measures including (1) 4-item
drug refusal skills (DRS) scale,'^ (2) 5-
item refusal skills (RS) scale,'® (3) aca-
demic performance item, (4) 3-item in-
tention scale, (5) 8-item short form of the
Marlowe-Crowne Social Desirability
Scale," (6) 3-item family drug use scale,
and (7) demographic questions (gender,
race/ethnicity, and age).
The drug refusal skill (DRS) scale mea-
sures perceived self-efficacy as well as
the likelihood of refusing offers to use
alcohol and marijuana from best friends.'^
The refusal skills scale (RS) assesses
perceived ability to refuse offers to use
cigarettes, alcohol, marijuana/hashish,
cocaine, or inhalants.'* Academic perfor-
mance was assessed by asking students,
"During the past year, how would you
describe your grades in school?" Students'
future intentions to use cigarettes, alco-
hol, and marijuana were assessed by the
following question: "At any time during
the next 12 months, do you think you will
(insert drug)?" A short version of the
Marlowe-Crowne Social Desirability Scale
was used to assess respondents' tendency
to respond in a socially desirable way.''
Family drug use was assessed with a 3-
item scale. Students were asked the fol-
lowing: "Do any of your family members
(parent or guardian, brother/sister) have
a problem with [alcohol, cigarettes, mari-
juana]? Because most students reported
"no" on all family use items, response

options were collapsed into a new variable
and recoded including 0= 0 on all items,
1= 1 or 2 on item (parent/guardian or
sibling), and 2= 1 and 2 on item (both
parent/guardian and sibling).
Sample and Procedure
The University of Maryland's Institu-
tional Review Board approved all study
procedures. A list of teachers was gener-
ated by the Coordinator of Health Educa-
tion for the county public school system.
Teachers were contacted through email
and asked to administer a survey to sev-
enth-grade health education classes. All
seventh graders participate in a compre-
hensive health education program.
Teachers administered the final scale to
a sample of seventh-grade students in 5
Maryland middle schools during their
health education classes. Teachers pro-
vided students with parental permission
slips before the scheduled data collection.
Students were asked to read and sign an
assent form directly before data was col-
lected. To maximize the validity of self-
reports, the confidentiality and anonym-
ity of responses were emphasized to par-
ticipants. Two hundred twenty-three sev-
enth-grade students who returned signed
parental permission forms and signed
assent forms completed the survey, re-
sulting in a response rate of 80.5%.
Participants were more likely to be
female (58%, n=130). Most of the partici-
pants (74%, n=165) were 12 years old; only
one student was older than 13 years.
Most students self-reported that they were
either white (36%, n=80). Black/African
American (26%, n=57), or Hispanic/Latino
(18%, n=39). Most participants reported
that their academic grades in the past
year were A's (35%, n=77) or B's (44%,
n=98). The majority of the sample re-
ported that they would definitely not drink
alcohol (79%, n=176), smoke a cigarette
(88%, n=197), or smoke marijuana (96%,
n=214) in the next 12 months. Most par-
ticipants also reported that their parent/
guardian or sibling did not have a problem
with alcohol (88%, n=197), smoke ciga-
rettes (71%, n=159), or smoke marijuana
(96%, n=214).
Analysis Plan
The data were cleaned by examining
outliers and missing data for errors. Data
were analyzed using SPSS (Statistical
Package for the Social Sciences, 14.0).2°
Am J Health Behav.™ 2009;33(2):147-157
Carpenter & Howard
Means, medians, and standard deviations
were calculated for each item. Pearson
product moment correlations between
each item score and total subscale score
were calculated. A correlation coefficient
of at least .20 between the item score and
the total scale score was established as
the threshold for adequacy. '* Missing data
for individual items were replaced with
item means.
Descriptive statistics were calculated
for key variables. Internal consistency for
scale items was generated using
Cronbach's a. Bivariate associations be-
tween continuous variables were tested
using Pearson correlation coefficients.
Exploratory factor analysis (EFA) using
principal component analysis (PCA), an
essential tool in scale development, was
used to determine the number and con-
tent of factors underlying the initial set of
items. The number of factors to be re-
tained was determined by a convergence
of criteria including eigenvalues > 1, the
scree plot level point, and theoretical in-
terpretability of the resulting factor struc-
ture. The DRS and RS scales were incor-
porated into a factor analysis with the
final DURSE items to assess whether
DURSE scores captured a unique dimen-
sion of RSE beliefs among young adoles-
cents. Validity was examined by correlat-
ing the DURSE scores with other resis-
tance skills measures, and measures of
academic performance, family drug use,
future intentions, and social desirability.
RESULTS
Scale Characteristics
Descriptive statistics. DURSE item
scores ranged from a minimum of 1 to a
maximum of 4. Most students answered
"Definitely sure" to items; thus, the items
were limited in variability. The mean
total DURSE score was 88.26 (SD = 15.29).
The median score was 96, and scores
ranged from 24 to 96, indicating a very
negative skew in the students' drug pres-
sure resistance self-efficacy, in the di-
rection of high resistance self-efficacy.
In general, results showed that respon-
dents self-reported the lowest RSE beliefs
about resisting alcohol and the strongest
RSE beliefs about resisting pressure to
use marijuana. Bivariate correlations
indicated that DURSE items were highly
intercorrelated (correlations ranged from
0.415-0.941).
Factorial validity. EFA of the 24 DURSE
149
Self-efficacy (DURSE) Scale

Table 1
Drug Use Resistance Self-Effîcacy (DURSE) Scale for Young
Adolescents - Description and Scoring Information
Brief This self-efficacy scale describes situations in which adolescents are likely to receive offers to
Description use alcohol, cigarettes, and marijuana. The 24-item scale was based on the original 24-item
version that requires future testing. This paper-and-peneil self-report measure uses a 4-point
Likert scale (1 = Not sure at all to 4 = Definitely sure) to rate responses to each situation.

Target Initial testing on a school sample of seventh-grade students from a suburban school district.
Population

Administrative Self-administered, paper-and-pencil instrument.

Issues

Instructions **Piease read this information
for
Administrators Thank you for helping us with this
may do in drug pressure situations.
health education for young people
to students before passing out the surveys**
survey. It has been developed so you can tell us what you
The information you give will be used to develop better
like yourself.

Please DO NOT put your name on the survey. You can mark your answers directly on the
survey. You do not have to answer any questions you do not want to answer and can stop
participating at any time. Make sure to read every question. If you have questions about any of
the survey items, you may raise your hand and ask the teacher. If he/she cannot answer your
question, please make the best possible choice or leave the answer blank.

The questions that ask about your background will be used only to describe the types of students
completing this survey. The information will not be used to find out your name. No names will
ever be reported.

You will NOT be graded on your answers and your answers will be completely anonymous
because your name will not be on the survey. Once you have completed the questionnaire, put
your pencil down and sit quietly at your desk. After everyone has completed the survey, we will
collect the questionnaire.

Scoring Scores are obtained by summing raw scores across the items on the scale. A higher score
Information indicates a greater likelihood of resisting drug offers.

Directions: The next several questions ask about resisting offers to use alcohol, cigarettes, and marijuana (pot) in
different situations. Please choose the answer that best describes your honest beliefs. There are no correct answers
to these questions.

Response Format - (insert under each question)

a. Not sure at all
b. Not very sure
c. Pretty sure
d. Definitely sure

ALCOHOL
How sure are you that you can refuse if a friend offers you alcohol at a party and you do not want it?

How sure are you that you can refuse if an older friend, brother or sister offers you alcohol at a party and you do
not want it?

How sure are you that you can refuse if a friend offers you alcohol at his/her home when no adults are home and
you do not want it?

How sure are you that you can refuse if an adult (parent, aunt/uncle, neighbor) offers you alcohol at your home and
you do not want it?
(continued)

150
 Carpenter & Howard

Table 1 (continued)
How sure are you that you can refuse if a brother, sister or cousin offers you alcohol at your home when no adults
are home and you do not want it?

How sure are you that you can refuse if a friend offers you alcohol at your home when no adults are home and you
do not want it?

How sure are you that you can refuse if a friend offers you aleohol outside of your home (at a park, field, street)
and you do not want it?

How sure are you that you can refuse if a friend offers you alcohol at school when no
adults are around and you do not want it?

CIGARETTES
How sure are you that you can refuse if a friend offers you a cigarette at a party and you do not want it?

How sure are you that you can refuse if an older friend, brother or sister offers you a cigarette at a party and you
do not want it?

How sure are you that you can refuse if a friend offers you a cigarette at his/her home when no adults are home
and you do not want it?

How sure are you that you can refuse if an adult (parent, aunt'unele, neighbor) offers you a cigarette at your home
and you do not want it?

How sure are you that you can refuse if a brother, sister, or cousin offers you a cigarette at your home when no
adults are home and you do not want it?

How sure are you that you can refuse if a friend offers you a cigarette at your home when no adults are home and
you do not want it?

How sure are you that you can refuse if a friend offers you a cigarette outside of your home (at a park, field,
street) and you do not want it?

How sure are you that you can refuse if a friend offers you a cigarette at school when no adults are around and you
do not want it?

MARIJUANA
How sure are you that you can refuse if a friend offers you marijuana at a
party and you do not want it?

How sure are you that you can refuse if an older friend, brother or sister offers you marijuana at a party and you
do not want it?

How sure are you that you can refuse if a friend offers you marijuana at his/her home when no adults are home
and you do not want it?

How sure are you that you can refuse if an adult (parent, aunt/uncle, neighbor) offers you marijuana at your home
and you do not want it?

How sure are you that you can reñise if a brother, sister, or cousin offers you marijuana at your home when no
adults are home and you do not want it?

How sure are you that you can refuse if a friend offers you marijuana at your home when no adults are home and
you do not want it?

How sure are you that you can refuse if a friend offers you marijuana outside of your home (at a park, field,
street) and you do not want it?

How sure are you that you can refuse if a friend offers you marijuana at school when no adults are around and you
do not want it?

Am J Health Behav.™ 2009;33(2): 147-157 151

Self-effîcacy (DURSE) Scale

Table 2
Exploratory Factor Analysis of DURSE scale - Eigenvalues,
Percentage of Variance Accounted for by the Rotated Factors
Factor Eigenvalue % of Variance Cumulative %

Marijuana 8.313 34.636 34.636

Cigarettes 5.828 24.285 58.921
Alcohol 5.801 24.169 83.090

items indicated that high extracted com-
munalities (above 0.5) indicated that the
factor structure explained over half of the
original variable's variance. A PCA and
orthogonal (Varimax) rotation resulted in
a 3-component solution (Table 2). The 3-
factor solution appeared to be adequate
based on the variance accounted for (83.1
%) and eigenvalues greater than one rule,
Before rotation, the third factor, however.

Table 3
Factor Structure of the DURSE - Rotated Factor Loadings Using
Varimax (Orthogonal) Procedures
Factor
Item 1 2 3

Factor 1: Marijuana
Friend party .847 .279 .282
Older friend/sibling party .859 .280 .328
Friend's home .818 .342 .318
Adult at your home .851 .332 .187
Sibling/cousin at your home .798 .325 .278
Friend your home .804 .286 .379
Outside .873 .257 .297
School .857 .227 .325
Factor 2: Cigarette
Friend party .278 .808 .407
Older friend/sibling party .299 .800 .415
Friend's home" .496 .628 .379
Adult at your home .345 .7t8 .384
Sibling/cousin at your home .343 .751 .401
Friend your home" .534 .678 .291
Outside" .591 .581 .302
School" .683 .537 .257
Factor 3: Alcohol
Friend party .211 .322 .782
Older friend/sibling party .270 .350 .789
Friend's home .273 .304 .728
Adult at your home .352 .182 .732
Sibling/cousin at your home .290 .392 .755
Friend your home .423 .376 .696
Outside" .380 .553 .675
School" .461 .576 .546

Note.
a Items with close to equal loadings on more than t factor.

152

Table 4
Number of Items and Range of Factor Loadings for the DURSE
Items and Related Scales
#of Factor
Factor Items Name
1 8 Marijuana DURSE
2 8 Cigarettes DURSE
3 8 Alcohol DURSE
4 5 Refusal Skills
5 4 Drug Refusal Skills
Total
had an eigenvalue of only 1.014 and only
accounted for 4.2% of variance.
Table 3 presents the factor solution
with factor loadings of the rotated compo-
nent matrix of the DURSE items. Items
with the strongest factor loadings on fac-
tor 1 related to pressure to use marijuana
and accounted for 34.6% of the variance.
Items with the strongest loadings on fac-
tor 2 related to pressure to use cigarettes
at parties and at respondent's home and
accounted for 24.3% of the variance. Items
with the strongest loadings on factor 3
related to pressure to use alcohol in party
and home settings and accounted for
24.2% of the variance. Four cigarette
items and 2 alcohol items, however, had
close to equal loadings on more than 1
factor.
A cross-loading item was considered
an item that loaded at .32 or higher on 2
or more factors.^' In this analysis, several
items cross-loaded (> .32) on 2 or more
factors. Overall, however, most items
clearly tapped one factor (loading greater
than 0.7). Results provided some evidence
of drug-specific factors.
To examine whether DURSE items cap-
tured different aspects of RSE beliefs
among young adolescents, compared to
related measures, the DURSE items, 5 RS
items, and 4 DRS items were included in
a joint factor analysis that was computed
using PCA (Table 4). A 5-factor solution
appeared to be adequate based on the
variance accounted for (81%) cind eigen-
values greater than one, though, the fifth
factor, eigenvalue (1.05) only accounted
for 3.2% of the variance. As in the initial
factor analysis, a Varimax rotation method
was interpreted. When factor analyzed
with the other measures, the DURSE
Am J Health Behav.™ 2009;33(2):147-157
Carpenter & Howard
% of Variance Range of
Explained Factor Loadings
55.482 • 0.809-0.874
10.191 0.509-0.815
7.816 0.504-0.711
4.371 0.836-0.902
3.175 0.613-0.821
81.04
items formed 3 drug-specific dimensions
(Table 4), and the related subscales formed
separate dimensions. Results provide pre-
liminary evidence that the DURSE items
measure a unique but related dimension
of drug use RSE when compared with
existing scales.
Reliability
Reliability was extremely high for the
DURSE subscales and total scale, indicat-
ing potentially redundant items (Table 5).
All 3 subscales and the total scale exhib-
ited strong negative skews. Internal con-
sistency reliability for the DURSE total
scale score for females was 0.98 and for
males, 0.97.
Subscale Structure
DURSE subscales had high correlations
with each other and even higher correla-
tions with the total scale, suggesting that
these scales were not tapping different
dimensions. Item-to-total correlations and
item-to-subscale correlations failed to fit
an acceptable p a t t e r n for s e p a r a t e
subscales. That is, most items were close
to or as highly correlated with the total
scale as with their own subscale. EFA
provided preliminary evidence that the
DURSE scale may adequately tap drug-
specific dimensions. However, further
evaluation of subscales did not warrant a
strong justification for dividing items into
discrete subscales for use in testing the
scale validity; thus, the subscales were
combined in favor of a single overall score.
Construct Validity
DURSE scores were moderately corre-
lated with DRS scale (a = 0.47, P < .01) and
the RS scale (a = 0.40, P < .01) scores.
153
Self-efficacy (DURSE) Scale
Table 5
Reliability of DURSE Total Scale and Subscales
Number Cronbach's
Subscale Items a (SD)
Alcohol 8 .95
Cigarette 8 .97
Marijuana 8 .98
Total Score 24 .98
(15.29)
A l t h o u g h DURSE i t e m s a r e r e l a t e d t o
m e a s u r e s of similar c o n s t r u c t s , prelimi-
n a r y evaluation shows t h a t t h e DURSE
scale is a distinct m e a s u r e of d r u g u s e
r e s i s t a n c e self-efficacy. DURSE s c o r e s
were significantly correlated (a = 0.16, P <
.05) with reported academic grades, indi-
cating that participants who reported
higher RSE beliefs also reported higher
academic grades. Higher RSE beliefs were
significantly associated (a = - 0.24, P < .01)
with lower self-reported intentions to use
alcohol, marijuana, and cigarettes in the
next 12 months. Higher RSE beliefs were
negatively associated (a = -0.05, ns) with
reported family drug use though the rela-
tionship was not significant. The DURSE
scale was significantly correlated with
the social desirability scale (a = 0.15, P <
.05), indicating that students may have
responded to DURSE items in a socially
desirable way.
DISCUSSION
Study findings suggested that the
DURSE scale may be a multidimensional
scale composed of drug-specific RSE di-
mensions that generalize across some
certain situations. Drug-specific dimen-
sions of RSE were consistent with theo-
retical underpinning of the construct of
self-efficacy, which posits that behavior
is determined largely by self-efficacy be-
liefs that represent context-specific judg-
ments of an individual's competence to
perform a specific task.^^ Despite speci-
ficity, however, self-efficacy across re-
lated domains may be correlated.^^ That
is, if development of refusal skills and
enhancement of efficacy beliefs related
154
Mean Range
(min, max) Skewness Median
28.61 8,32 -2.09 32
(5.89)
29.59 8,32 -2.66 32
(5.27)
30.06 8,32 -3.16 32
(5.31)
88.26 24,96 -2.64 96
to one drug are similar and generalized to
other drugs, separate drug-specific self-
efficacy beliefs would be correlated. Sup-
port for this was demonstrated in the
present study.
Several DURSE items probed beliefs in
one's ability to resist drug offers from
friends as well as nonadult (sibling/
cousin) family members and influential
adults (parent, aunt/uncle or neighbor).
In this regard, the DURSE scale repre-
sents a substaintive refinement over ex-
isting scales as the person making the
offer is specified, rather than couched in
broader terms such as "someone," "best
friend," or "girl/boy friend." Focus group
respondents felt that drug offers would not
come from their "true friends." Thus,
students may not associate offers from
best friends with peer pressure, whereas
offers from peer acquaintances (ie,
friends), older peers including siblings, or
other adults, including parents, may rep-
resent a more realistic pressure situa-
tion. This issue may be particularly im-
portant considering recent studies that
highlight the importance of familial in-
fluences on adolescent substance use.^^"^®
There is evidence that siblings, in par-
ticular, play an important role in influ-
encing adolescent drug use.^^"^^ It is left
for future research to investigate the
influence of adults other than parents on
adolescent drug use.
Assessing RSE beliefs in different set-
tings, as accomplished by the DURSE
scale, may enable a more textured under-
standing of the contexts and dynamics
that create social pressures on youth to
use drugs. Based on the present findings.

it is possible that younger adolescents
considered "offers at home" to be more
realistic than other offers (ie, outside or
school settings) because they have less
freedom in middle school than in high
school to hang out in those settings. In-
deed, it has been reported that younger
adolescents were more likely to use alco-
hol in their homes than in other homes or
in open fields.^^ With maturity and age,
adolescents typically gain more indepen-
dence; thus, "outside" and "school" situa-
tions may be considered more realistic
settings for drug offers for older adoles-
cents.
The DURSE scale demonstrated pre-
dictive and construct validity, though sig-
nificant correlations were relatively low.
RSE beliefs were correlated with other
variables (academic grades, future drug
intentions, family drug use). These find-
ings support past research showing that
RSE is associated with academic achieve-
ment and drug u s e . ' " Although previous
studies suggest that parental and family
substance-use behaviors have a signifi-
cant impact on the risk of adolescent drug
^gg 23-26 j ^ ^gg possible that this study
lacked adequate statistical power to iden-
tify a significant relationship. Low to mod-
erate correlations between DURSE scores
and other study variables, however, indi-
cate that other risk and protective factors
(eg, cognitive, familial, school, social, peer,
and community) that may vary across
individual demographics such as age,
gender, ethnicity, and psychosocial de-
velopmental factors^^"^° may have ac-
counted for differences between these
factors.
The DURSE scale appears to tap a dis-
tinct, but related measure of drug use
RSE when compared with extant mea-
sures. Items cover a wider range of pres-
sure situations, settings, and drugs and
include a qualifying statement that may
reduce potentially confounding notions of
"desire" or "willingness" to accept drug
offers with "likelihood of refusing" offers.
Furthermore, the DURSE scale represents
a unique and specific measure of resis-
tance self-efficacy that demonstrates com-
parable or improved content, construct,
and predictive validities when compared
with other measures.
Several study limitations should be
noted. First, due to the cross-sectional
nature of the design, levels of RSE beliefs
were measured at only one point in time.
Am J Health Behav.™ 2009;33(2):147-157
Carpenter & Howard
and changes related to age and experi-
ence were not determined. Longitudinal
studies that measure RSE beliefs and
related variables over time would provide
an index of whether and to what extent
relationships between these variables
change as young adolescents enter later
stages of adolescent development. Fur-
ther, all MCPS sixth graders receive a
drug prevention curriculum; thus, the
infiuence of this program on survey re-
sponses is not known.
Second, there are several limits on the
extent to which these findings can be
generalized to all seventh graders. Due to
the convenience nature of the sampling
method, several groups of students may
have been underrepresented, including
those (1) who were absent on the day of
data collection, (2) who were not enrolled
in school, (3) who did not return active
parental consent forms, and (4) who were
not able to read or spoke English as their
second language. The sample itself was
limited in variability in that most stu-
dents reported low intentions to use drugs
in the future and high levels of DURSE.
Thus, it was not possible to generalize the
psychometric properties of the DURSE
scale to all seventh-grade students,
younger and/or older students, or stu-
dents living in different socioeconomic
levels and geographic areas. Indeed, stu-
dents not enrolled in school or not in class
the day of the survey administration may
represent students at higher risk for drug
use and low self-efficacy.
Third, self-report data can result in
several biases. Results showed a signifi-
cant relationship between the social de-
sirability scale and DURSE scores, indi-
cating that some students may not have
shared their honest answers because
they believed that resisting drug offers
was a socially desirable behavior. Despite
the use of anonymous measures, assur-
ance of confidentiality, and requests for
honesty, a number of students may have
been inclined to give misleading answers,
either overestimating or underestimat-
ing their beliefs and intentions. Adoles-
cent beliefs related to health risk behav-
iors such as drug use could plausibly be
considered socially undesirable.^' Inex-
perience and unfamiliarity with drug pres-
sure or drug use, as well as leading state-
ments about refusing drug offers, may
have led students to overestimate compe-
tence and efficacy judgments,^ which may
155
Self-efficacy (DURSE) Scale
be reflected in the extremely high DURSE
scores. In addition, misunderstanding of
items and response style could have led to
inaccurate findings. Finally, self-report
measures of behavioral intentions were
used as a proxy for future behavior and
might not be an accurate measure of
actual behavior.
Future Research Directions
This study followed a well-established,
multistep process to develop and provide
psychometric evidence of the DURSE
scale. Each step contributed important
information and could be replicated. This
process must continue beyond the initial
development of the scale as items and
normative data are further refined. Al-
though the scale's validity and reliability
have not been fully established, the re-
sults offer a promising first step in the
development process and present an op-
portunity to refine the scale and test its
usefulness in different population groups.
Additional refinement and testing of
the DURSE instrument could yield a prac-
tical tool to measure drug use RSE among
adolescents. Although it remains un-
known whether the psychometric proper-
ties established in this study would per-
sist among samples who report more vari-
ability in terms of DURSE levels, mea-
surement of self-efficacy, even among
youth who report high levels of self-effi-
cacy, is requisite for evaluation of pri-
mary prevention programs. The original
24 items should be tested across larger,
more diverse populations of seventh grad-
ers and older adolescents to assess
whether the factor structure found in the
present study is robust for different groups
of respondents, as well as whether the
structure changes over developmental
time. In the future, more conservative
testing criteria should be used in a confir-
matory analysis. Upon further testing and
refinement, the DURSE scale could be
administered longitudinally to determine
the effects of school-based interventions
aimed at preventing drug use among ado-
lescents.
CONCLUSION
Given the evidence supporting preven-
tion programs that incorporate strategies
for increasing drug use RSE, a well-tested
measurement tool to assess this con-
struct is critical. Current scales are
limited in scope and consist of items that
156
may not be appropriate for younger ado-
lescents. As indicated by these findings,
the DURSE scale may be useful to practi-
tioners as well as researchers by contrib-
uting to the current need for a more
thorough assessment of RSE among young
adolescents. •
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