Group 2 Research Proposal
Group 2 Research Proposal
Group 2 Research Proposal
HAWASSA, ETHIOPIA
Feb, 2016. EC.
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Acknowledgment
We would like to thank Hawassa University College of Medicine and Health Sciences for giving
us the opportunity to develop this research proposal. We would like also to thank our instructor
for giving us suggestions in the development of this proposal. Also, we would like to express our
special thanks to our beloved friend who has given us a computer access wisely. We would also
express our thanks to all persons who helped and encouraged us in one way or another in
connection with our all work.
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Contents
Acknowledgment........................................................................................................................................i
List of Abbreviations and Acronyms.......................................................................................................iv
Summary...................................................................................................................................................vi
1. Introduction.......................................................................................................................................1
1.1 Background......................................................................................................................................1
1.2 Statement of the problem................................................................................................................1
1.3. Significance of the study.................................................................................................................2
2. Literature Review..............................................................................................................................3
2.1 Prevalence of substance abuse in the University student..............................................................3
2.2 Prevalence of substance abuse globally in the University student...............................................3
2.3 Prevalence of substance abuse in Africa in the University student..............................................3
2.4 Prevalence of substance abuse in Ethiopia in the University student..........................................4
2.5 Factors affecting substance abuse..................................................................................................4
2.5.1 Personal factors.........................................................................................................................5
2.5.2 Family factors...........................................................................................................................5
2.5.3 Social factors.............................................................................................................................6
2.5.4 Environmental factors..............................................................................................................6
3. Objectives...............................................................................................................................................6
3.1 General objectives: -........................................................................................................................6
3.2 Specific objectives:...........................................................................................................................6
4. Methodology..........................................................................................................................................7
4.1. Study area.......................................................................................................................................7
4.1.2 Study period..............................................................................................................................7
4.2 Study design.....................................................................................................................................7
4.3 Population........................................................................................................................................7
4.3.1 Source population.....................................................................................................................7
4.3.2 Target population.....................................................................................................................7
4.4. Sample population..........................................................................................................................7
4.5 inclusion and exclusion criteria......................................................................................................7
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4.5.1 Inclusion Criteria......................................................................................................................7
4.5.2 Exclusion Criteria.....................................................................................................................7
4.6. Sample size......................................................................................................................................7
4.7 Sampling method/ procedure..........................................................................................................8
4.8 Study Variables................................................................................................................................8
4.8.1. Dependent Variable.................................................................................................................8
4.8.2 Independent Variables.............................................................................................................8
4.9 Operational Definition.....................................................................................................................8
4.10 Data Collection...............................................................................................................................9
4.10.1. Data Collection Tools and Measurements............................................................................9
4.10.2 Data analysis, Interpretation and Presentation....................................................................9
4.11 Data Quality Management..........................................................................................................10
4.12 Ethical consideration...................................................................................................................10
4.13 Dissemination plan.....................................................................................................................10
6. Budget Breakdown..............................................................................................................................12
6.1 Stationary cost...............................................................................................................................12
6.2 Miscellaneous cost..........................................................................................................................12
6.2 Budget Summery...........................................................................................................................12
References................................................................................................................................................13
Annex I: Consent Form...........................................................................................................................15
Annex II: Annex ΙΙ: Questionnaire (English)........................................................................................15
Part I Socio-demographic Information..............................................................................................15
Part II Questions related to experience of substance use..................................................................17
Part III Cause of substance use by students......................................................................................20
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Lists of Tables
iv
List of Abbreviations and Acronyms
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Summary
Background
Substance abuse is a harmful practice that exposes young people to social and health issues and
is a global burden on youth. It's critical to understand the prevalence and risk factors for
substance use among college students in order to plan recurring, locally relevant treatments. The
purpose of this study is to evaluate the prevalence and risk factors for substance use among
students at Hawassa University.
Objective: to determine the prevalence of substance abuse and the risk factors linked with it
among undergraduate students at Hawassa University in the Ethiopian calendar year 2016.
Work plan: This study will be conducted from February to June with a total budget of 10,940
ETB
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1. Introduction
1.1 Background
Substance abuse is a global problem that affects young people, often leading to unhealthy habits
that cause social and health problems for young people. Teenagers and young adults are
susceptible to a range of harmful sexual, physical, psychological, and social activities. Among
the issues facing the younger population group today is substance consumption, both legal and
illicit, and the multifaceted effects of this behavior. Many young people today are found in
higher education institutions, where they are exposed to a variety of novel and dangerous
activities. (1)
In addition to biological and psychological susceptibility, university students may be more likely
to participate in risky behaviors like substance abuse due to peer pressure, social pressure,
environmental factors, academic expectations, and lack of parental influence.
College and University students, who make up a younger demographic in Ethiopia, are
particularly vulnerable to issues like alcohol, khat, and tobacco usage. Among University
students at Axum, the lifetime prevalence of alcohol consumption, khat chewing, and cigarette
smoking were 34.5%, 28.7%, and 9.5%, respectively. In a similar vein, the current rates of
alcohol consumption, cigarette smoking, and khat chewing were 27.9%, 32.8%, and 9.3%,
respectively. The most popular justifications for smoking cigarettes, drinking wine, and
consuming khat were to relieve stress, unwind, and stay awake while reading, respectively.
Substance usage was highly correlated with having family members who drink alcohol and peer
friends who chew khat. (2)
It's critical to understand the prevalence and risk factors for substance use among college
students in order to plan recurring, locally relevant treatments. The purpose of this study is to
evaluate the prevalence and risk factors for substance use among students at Hawassa University.
One of the main health problems for undergraduate students is substance use, including
substance use disorders and related illnesses. Substance abuse, including the use of alcohol, khat,
and tobacco, is one of the world's most pressing public health and socioeconomic issues. The
usage of these substances has detrimental effects on one's health, finances, and the environment.
Because of their near contact to drugs, health practitioners have historically been associated with
the problem of substance use. The primary risk factor for chronic illnesses like cancer, chronic
lung disease, diabetes, and other cardiovascular disorders has been substance abuse, much like
tobacco smoking. Ethiopians, including university students, use these drugs and deal with the
fallout. (3)
In Ethiopia, the most often used drugs are khat, alcohol, and tobacco (cigarettes). Yemenis,
Somalis, Ethiopians, and other East African communities chew khat leaves as a social pastime,
both in their home countries and in the diaspora. This habit has "amphetamine like" effects. In
Ethiopia, drinking alcohol, chewing khat, and smoking cigarettes have all become widespread
habits among high school, college, and university students. These young people's usage of
cigarettes, khat, and alcohol can be detrimental.
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It result in poorer academic performance, a higher chance of getting HIV and other STDs, or
other mental illnesses like psychosis, sadness, and anxiety. Substance abuse has emerged as a
significant global public health and socioeconomic issue, with Ethiopia being no exception.
It is having a significant impact on the "young generations," who make up the majority of the
population and are anticipated to govern the nation in the near future. University students are
particularly susceptible to these issues, which could be brought on by their unfamiliar
surroundings and inadequate parental supervision, their youth and the yearning to experience
life, peer pressure, and the lack of preventive initiatives. (4)
The World Health Organization's estimates for 2024 state that approximately 275 million people
(or 5.8% of the world's population between the ages of 15 and 64) used psychoactive drugs in the
year prior, and an estimated 37 million people are estimated to be afflicted by drug use disorders,
which include harmful patterns of drug use or drug dependence. (5)
Overall, the research mentioned above showed that different colleges had diverse drug usage
patterns and risk factors. The local community's production and modification of drugs,
particularly Khat, may have a significant impact on how often kids use drugs. The majority of
study conducted in Ethiopian colleges focused on alcohol, khat, and cigarettes, with little
attention paid to illegal substances like cocaine and cannabis.
Despite the fact that Ethiopia has seen a great deal of research, our study areas have not seen any
comparable studies.
Additionally, there will occasionally be an increase in the prevalence of substance use among
college students, which will have a negative impact on academic performance. At light of the
aforementioned reports of substance use at several Ethiopian universities and colleges, the
primary goal of this study is to investigate the prevalence of substance use among undergraduate
students at Hawassa University and any relationships that may exist between these behaviors and
related variables.
There are various reasons why the incidence of substance use and related factors among
undergraduate university students are important to examine. It tackles a public health issue by
offering data to create focused interventions. Substance abuse has a detrimental impact on one's
health and well-being, increasing the risk of addiction, cognitive decline, mental health
problems, and poor academic performance, among other problems. To enhance academic
performance, it is helpful to identify susceptible groups and establish support networks by
comprehending the aspects linked to substance use. In order to inform preventative interventions,
it also analyzes risk and protective factors, such as psychological, social, environmental, and
individual factors.
The results of the study support evidence-based preventive and intervention programs that are
customized to the requirements of students. They also support legislative reforms, peer support,
counseling services, and educational campaigns aimed at lowering drug use and encouraging
healthier lifestyles. Furthermore, for HU undergraduate students who do not use substances, the
study will provide insight or raise awareness of the severity of substance use and related issues.
It also acts as a resource to encourage more research in this field for scholars and students who
are interested in the subject.
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2. Literature Review
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alcohol. Sudan, on the other hand, has the lowest rate of alcohol usage among college students,
at 2.7 percent, according to research. Sudan is a largely Muslim country that follows strict
Sharia law.
The introduction of prescription drugs in Africa has dramatically expanded the availability and
use of PAS. However, alcohol, and khat are hashish still the most common addictive materials
in Africa. In Zambia, 20% of college and high school students have been substance user. (11)
A study done in South Africa to assess substance users of university student using cross
sectional study design by Dr Alem in 2014, the study showed that Substance abuse casts a long
shadow across African universities, with varying intensities depending on the country. Alcohol
reigns supreme, with prevalence ranging from 28.7% in Ghana to a staggering 64.8% in South
Africa. Cannabis trails closely, particularly in South Africa (19.7%) and Kenya (8.2%).
Tobacco use shows similar geographic diversity, with South Africa again leading the pack
(38.4%) and Ghana boasting the lowest rate (8.3%). Khat, primarily consumed in East Africa,
finds its highest users in Ethiopia (9.2%). Other illicit drugs are less prevalent, though South
Africa still reports the highest usage (5.2%). (12)
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Hazaa Al Hinaai et al. conducted a cross-sectional survey in 2021 with 375 students in Asia.Use
of tobacco products was significantly correlated with alcohol abuse and misuse of other
substances. The majority of the negative consequences linked to substance abuse that research
participants described were social problems (27.7%) and health-related issues (25.8%).
Substance misuse also had a significant effect on their performance (23.8%). In addition, 4.7% of
respondents struggled with legal matters, while 15.4% of respondents faced money difficulties.
Remarkably, just 49.1% of respondents thought that substance abuse was a significant issue. (6)
According to a study conducted in Cameroon on 650 university students, 91.7% of substance
users said that they used drugs to decompress or unwind. The two most common negative
outcomes mentioned were financial loss (16.7%) and disagreements or quarrels (18%). The
primary source of substance usage was peers (66.9%). The main predictor of substance use on
multivariate analysis was male sex (95% CI): 0.801 (1.128, 4.398). (9)
In 2019, Gebremariam conducted a cross-sectional study design in Ethiopia to evaluate
university substance use. The study found that several factors, including being male, eating at the
university cafe, attending a private preparatory school, having a higher monthly income, and
having friends and family who use drugs, were significantly linked to students' substance use
behaviors. (13)
According to a study done at Haramaya University, there was a comparatively high prevalence
of substance use issues overall. The growth of appropriate recreational activities and educating
first-year students about improved stress coping strategies are the main causes of substance
usage. The likelihood of ever using drugs was found to be substantially correlated with factors
such as sex, monthly income, sexual risk behavior, and family history of substance abuse. (17)
Family support and solid emotional interactions have been demonstrated in studies to help
youngsters avoid high-risk behaviors, norm-breaking, and ultimately substance use. Families
nowadays encounter a variety of obstacles, including marital strife, poverty, the absence of one
parent, and poor parent-child communication, all of which can negatively impact children. As a
result, these problems have the potential to disrupt and impair family support.
A study in Turkey also found that individuals living away from their parents were also more
likely to be influenced by others and to engage in high-risk activities, according to a Turkish
study. According to a study conducted at Ambo University, parents have a 9.8% influence on
their children's substance use.
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2.5.3 Social factors
According to different studies, students of university who have substance using parents,
relatives, acquaintances, peer groups, or lovers are more likely to use substances, and many
students use substances because they are afraid of not being accepted in social circles with
substance-abusing peers. Furthermore, when young people are lonely, they are more likely to
put their substance abstinence on hold in order to make friends. According to a survey
conducted among Ambo University students, the most common cause for drug usage among
substance users is peer pressure 66.4 percent, and 37.8 percent of substances users’ uses drug
to be social with their friends. In addition, 27.6% of users use substances in order to be
accepted by their peers.
2.5.4 Environmental factors
According to a study conducted at Ambo University, the impact of the media accounts for 18.2
percent of substance usage, while the availability of the substance accounts for 30.1 percent.
Furthermore, a shortage of recreational areas on campus accounts for 52 percent of the reasons
for substance abuse among university students.
3. Objectives
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4. Methodology
4.1. Study area
Four sites of Hawassa University—the Main Campus, the Referral Campus, the Agricultural
Campus, and the Wondogenet Forestry College—will host the study. The first three are in the
Sidama Region's Hawassa City, which is 278 kilometers south of Addis Ababa via Batu.The
village is located at 7°3' latitude northward and 38°28' longitude eastward in terms of astronomy.
The settlement is situated at an elevation of roughly 1708 meters above sea level. The fourth
campus, Wondogenet Forestry College, is located in Wondogenet town. There are around 59
academic departments in the University.
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4.7 Sampling method/ procedure
These students will be selected using a two-stage stratified sampling process among several
departments. The entire sample size will be allocated proportionately to the colleges to which the
students are first classified according to their particular institutions. A lottery will be used to
choose one or more departments from each institution, depending on the sample size in each
college.
Each academic year will get a portion of the college's overall sample size, which will be assigned
to the department or departments of choice. Ultimately, the questionnaires will be handed out to
the students in the classroom using the systematic sampling technique, beginning in the right
front corner and proceeding one chair at a time until the section's required sample size is reached.
Socio demographic characteristics: (Age, sex, education status (year of study), religion
and ethnicity)
Family factors: (lack of family supervision, -Family conflict, marital status of family, -
Family drug utilization and Family education level).
Socio-cultural status :( Availability of substance and Peer pressure).
Economic factors :( Monthly pocket money, Family occupation and Family income).
Substance: Any drug that induces changes in mood, thinking, feeling, or behavior that might
lead to dependency, such as alcohol, cocaine, cigarettes, cannabis, and shisha is considered an
addictive stimulant.
Substance Use. In this study, it was defined as an individual's lifetime use of at least one of the
substances (alcohol, khat, cigarettes, and illicit drugs) to change their behavior or mood.
Current use: Students who, within 30 days of the data collecting period, used two or more
substances at least once.
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Life time substance use: Students who have used two or more drugs at least once in their lives
Associated factor: The term "associated factors" in this study refers to factors that influence or
contribute to substance use among undergraduate students at HU.
Ever Use: defined as the use of any substance by a person at least once in their lifetime.
Illicit Drugs: It is characterized as the use of drugs that are illegal to produce, sell, or consume,
such as heroin, hashish, and cannabis.
Items from the World Health Organization (WHO) Model Students' Substance Use Core
Questionnaire (18) will be used to evaluate substance use. Sections on socio-demographics,
alcohol, tobacco smoking, cannabis, heroin, other drug usage and cause of substance used by
students are included in this core questionnaire.
We only evaluate substances (alcohol, khat, tobacco, cannabis, cocaine, and heroin) that are
widely recognized in Ethiopia. The survey will not include other substances that are included in
the WHO core module, such as injectable medicines, opium, sedatives and hypnotics,
amphetamines or other stimulants, volatile inhalants, opiate medications, and tranquillizers.
Students who are scheduled to attend class on the distribution day will get questionnaires from
certified data collectors. The researchers will give a succinct overview of the project, outlining
the methodology for gathering data and advising the students not to write their names on the
surveys. Teachers won't be present when the study is conducted.
First, the data was manually cleansed, and questionnaires that did not meet the minimal
requirements for completeness were not allowed to be entered. The data collected was cleaned,
coded, and entered using EPI-INFO version 3.5.1. Using the Statistical Package for Social
Sciences (SPSS) version 21 software, descriptive statistics, bivariate analysis, and multivariate
analysis were performed on the data.
There was bivariate and univariate analysis performed. Odds ratios were used to calculate
associations, with a significance level of p < 0.05 and a 95% confidence interval.
For a subsequent multivariate study, the factors from the bivariate analysis that proved to be
significant were kept. Next, in order to forecast independent parameters linked to substance use
and control confounding variables, logistic regression analysis will be performed.
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4.11 Data Quality Management
The Institutional Review Board of the College of Medicine and Health Sciences, HU's ethical
review committee will authorize the study, and formal authorization in the form of a letter should
be provided. The goals and intentions of the research are communicated to the participants. The
willingness and cooperation of study participants will be the foundation for all we accomplish.
At every stage, information confidentiality will be guaranteed.
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5 .Work plan
4 Proposal Investigators
Presentation
5 Select and train Advisor’s
collector’s
6 Data collection Investigators
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6. Budget Breakdown
6.1 Stationary cost
No Item description Quantity Unit cost Total Cost(ETB)
.
1 Paper A4 size 5 packet 500 2500
2 Pen 25 20 500
3 Paper binder 30 100 3000
4 Pencil 10 15 150
5 Eraser 10 10 100
Subtotal cost 6250
Table 2 Stationary cost
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References
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October ; 10: 3033.
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No
Date
IINSTRUCTIONS
This is not a test: there are no right or wrong answers, but please answer carefully. For each
question pick the answer that fits you the best and choose one possible answer and circle it.Pick
only one answer for each question. Look at the example below:
The answer chosen was "D", indicating that the person who answered the question had drunk
water on 20 or more days during the previous 30 days. If you do not know the answer to a
question, or if you feel that you cannot answer honestly, leave the question blank.
Complete as many questions as possible.
a) Female
b) male
2. What is your age? _____Years
a) Orthodox
b) Muslim
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c) Protestant
d) Others (specify………….
4. What is your educational Status?
a) Year one
b) Year two
c) Year three
d) Year four
e) Year five
f) Year six
g) Year seven
a) 1 Urban
b) 2 Rural
a) Married
b) Divorced
c) widowed
a) SNNPR
b) 2 Amhara
c) Oromo
d) Others (specify)__________
9. Your Mother’s educational level
a) Illiterate
b) Elementary to Grade 12
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c) College or University
a) Illiterate
b) Elementary to Grade 12
c) College or University
Alcohol
1. Have you ever drunk any alcoholic beverage (including beer, wine, and spirits)?
a) No
b) Yes
a) No
b) Yes
3. Have you drunk any alcoholic beverage during the past 30 days?
a) No
b) Yes, on 1-5 days
c) Yes, on 6-19 days
d) Yes, on 20 or m o r e days
4. How old were you when you first had a drink of beer, wine, or spirit s — m o r e than j u s t a
sip?
Smoking
1. Have you ever smoked, chewed, or sniffed any tobacco product (such as cigarettes, cigars,
pipe tobacco, chewing tobacco)?
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a) N o
b) Yes
2. Have you smoked, chewed, or sniffed a tobacco product in the past 12 months?
a) N o
b) Yes
3. Have you smoked, chewed, or sniffed a tobacco products during the past 30 days?
a) N o
b) Yes
4. How old were you when you first smoked, chewed, or sniffed a
Tobacco product?
a) Have never smoked, chewed, or sniffed tobacco products
b) Below years old, or less
c) 11-12 years old
d) 13-14 years old
e) 15-16 years old
f) 17-18 years old
g) 19 years old, or more
Cannabis
1. H a v e you ever taken any cannabis (marijuana, pot, hashish, grass, ganja)?
a) N o
b) Yes
a) N o
b) Yes
a) No
b) Yes, on 1-5 days
c) Yes, on 6-19 days
d) Yes, on 20 or more days
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c) 11-12 years old
d) 13-14 years old
e) 15-16 years old
f) 17-18 years old
g) 19 years old, or more
Heroin
a) N o
b) Yes
a) N o
b) Yes
3. Have you taken any heroin during the past 30 days?
a) No
b) Yes, on 1-5 days
c) Yes, on 6-19 days
d) Yes, on 20 or more days
4. How old were you when you first took heroin?
Cocaine
a) No
b) Yes
2. Have you taken any cocaine in the past 12 months?
a) No
b) Yes
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a) No
b) Yes, on 1-5 days
c) Yes, on 6-19 days
d) Yes, on 20 or more days
a) No
b) Yes
a) No
b) Yes
4. Are substances easy to get in your community/village?
c) No
d) Yes
a) Family
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b) Friends
c) My income
a) No
b) Yes
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