Self-efficacy mediates the relationship between depressive symptoms and medication adherence among hypertensive African Americans.
Many studies have documented the negative effects of depression on adherence to recommended treatment; however, little is known about the mechanism underlying this relationship. Using the Kenny and Baron analytic framework of mediation, the authors assessed whether self-efficacy mediated the relationship between depression and medication adherence in 167 hypertensive African Americans followed in a primary care practice. Depressive symptoms are associated with poor medication adherence (beta=.013, p=.036) and low self-efficacy (beta=-.008, p=.023). Self-efficacy is negatively associated with medication adherence at follow-up (beta=-.612, p<.001). The relationship between depressive symptoms and medication adherence becomes nonsignificant when controlling for self-efficacy (beta=.010, p=.087). Implications for further examination into the mediating role of self-efficacy and the deleterious effect of depression on medication adherence are discussed.
Schoenthaler
Antoinette
A
Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY 10027, USA. ams2125@columbia.edu
Ogedegbe
Gbenga
G
Allegrante
John P
JP
D001741:Black or African American / Q000523:psychology*; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003863:Depression / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D008297:Male; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology*; D008875:Middle Aged; D020377:Self Efficacy
D000959:Antihypertensive Agents