title: Using the theory of planned behavior to improve treatment adherence in Mexican Americans with schizophrenia.
abstract: OBJECTIVE
  Failure to adhere to treatment with antipsychotic medication is the most common cause of relapse among patients with schizophrenia. A novel multifamily group (MFG) intervention, informed by the Theory of Planned Behavior (TPB), demonstrated efficacy in increasing medication adherence and decreasing rehospitalizations in schizophrenia patients. This report explores the hypothesis that the improved outcomes obtained through the MFG approach were mediated by changes in the patients' attitudes toward medications, subjective norms-social influences, and perceived behavioral control of resources.
  
  
  METHODS
  Data from a recently completed, randomized controlled trial of MFG was used to test the hypothesis that the improvement in adherence was mediated by the 3 TPB factors. Subjects were 174 Mexican American adults with schizophrenia-spectrum disorder who had participated in a study of MFG focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months.
  
  
  RESULTS
  Path analysis revealed that the increased adherence associated with MFG was mediated by improvements in subjective norms but not attitudes toward medications nor perceived behavioral control.
  
  
  CONCLUSIONS
  An MFG treatment specifically tailored to increase medication adherence among Mexican Americans with schizophrenia achieved its benefits by leveraging social influences through teaching family members how to support medication adherence in their ill relatives.
authors.affiliation: David Geffen School of Medicine, University of California-Los Angeles.
authors.forename: Alex
authors.initials: A
authors.lastname: Kopelowicz
authors.affiliation: David Geffen School of Medicine, University of California-Los Angeles.
authors.forename: Roberto
authors.initials: R
authors.lastname: Zarate
authors.affiliation: David Geffen School of Medicine, University of California-Los Angeles.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Wallace
authors.affiliation: David Geffen School of Medicine, University of California-Los Angeles.
authors.forename: Robert Paul
authors.initials: RP
authors.lastname: Liberman
authors.affiliation: Department of Psychology, University of Southern California.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Lopez
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center at San Antonio.
authors.forename: Jim
authors.initials: J
authors.lastname: Mintz
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D065246:Culturally Competent Care / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D017058:Mexican Americans / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D012559:Schizophrenia / Q000188:drug therapy*; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D014150:Antipsychotic Agents