The Relationship Between Medical Cannabis Knowledge and Attitudes Among Nursing Home Administrators and Directors of Nursing

Andrew M. Peterson, PharmD, PhD
Saint Joseph’s University

Co-authors: Andrew M. Peterson¹, Rebecca Lucas¹, Ilene Warner-Maron², Allen Glicksman^3
1Saint Joseph’s University, ²Philadelphia College of Osteopathic Medicine, ³Eastern Pennsylvania Geriatrics Society

Background: As state medical cannabis programs expand, skilled nursing facilities (SNFs) face growing pressure to develop policies addressing resident access, storage, administration, and staff training. Implementation science emphasizes organizational readiness—including leadership knowledge and attitudes—as a prerequisite for successful policy adoption. However, little is known about how Nursing Home Administrators (NHAs and Directors of Nursing (DONs) perceive medical cannabis or how their knowledge relates to their attitudes toward its integration into facility care.

Objective(s): This study examined knowledge of and attitudes toward medical cannabis among NHAs and DONs in Pennsylvania SNFs. Specifically, it tested the hypothesis that greater cannabis-related knowledge is associated with more favorable attitudes toward medical cannabis in SNFs, while accounting for administrator role, years in current role, facility size, and multistate organizational status.

Methods: A cross-sectional online survey was administered to licensed NHAs and DONs in Pennsylvania. The final analytic sample comprised 124 respondents who completed all 44 survey items. Exploratory factor analysis was used to develop composite scores for knowledge and attitudes. Ordinary least squares regression tested the association between knowledge and attitudes in unadjusted and covariate-adjusted models.

Results: Respondents expressed moderately favorable attitudes toward medical cannabis (mean attitude score = 3.91, SD = 0.77).  Knowledge was more limited and variable across items. In the unadjusted regression model, greater knowledge was significantly associated with more favorable attitudes (b = 0.49, R² = .033, p = .044). After adjusting for administrator role, years in current role, facility size, and multistate organizational status, the knowledge coefficient was not statistically significant (b = 0.48, R² = .085, p = .055). However, the effect size (β =0.18) remained virtually unchanged, indicating that the knowledge-attitude association was not confounded by administrator or facility characteristics.

Conclusions: Among Pennsylvania NHAs and DONs, greater knowledge of medical cannabis is associated with more favorable attitudes toward its use in facility care. These findings suggest that knowledge represents a small but key component of organizational readiness. Targeted education for SNF leadership addressing state law, safety, and operational procedures may help build the capacity needed to support resident-centered policies. Future research should examined.