A Pilot Study: Using the Health Belief Model to Understand Cannabidiol Use in One Amish Community

Abstract

Amish use of complementary and alternative medicine is common, but little is known about their opinion of cannabidiol. Hemp legalization has popularized cannabidiol, making it available to Amish whose traditions limit access to scientific information. The purpose of this pilot study is to gain an understanding of cannabidiol use in one Old Order Amish community. A researcher-developed questionnaire was mailed to 60 members of one Amish district. The Medicinal Cannabidiol Survey for an Amish Population was adapted from the Medicinal Cannabis Survey for General Practitioners to the specification of cannabidiol, Amish cultural relevance, and the six theoretical constructs of the health belief model. A content validity survey was completed with an overall item-level content validity index score of .92. Most respondents reported hearing discussions in the Amish community regarding cannabidiol [81.8% (n = 9)]. Slightly more agreement was found within the 10 benefit construct statements (40%) compared to six barrier statements (36.5%). Low agreement was observed among all nine questionnaire statements addressing Amish perceived threat to using cannabidiol. The barrier statement that cannabidiol cost prohibits its use had the highest agreement [90.9% (n = 10)] among all statements, which may be a stronger barrier when considering Amish culture. Higher agreement among the benefit construct compared to lower agreement among statements surrounding Amish perceived threat of cannabidiol suggests the likelihood of their cannabidiol use. A major limitation of this study was the sample size; therefore, the tool should be used in a large Amish sample to explore the findings of this pilot study.