title: Associations Among Depressive Symptoms, Wellness, Patient Involvement, Provider Cultural Competency, and Treatment Nonadherence: A Pilot Study Among Community Patients Seen at a University Medical Center.
abstract: Treatment nonadherence is a pernicious problem associated with increasing rates of chronic diseases, escalating healthcare costs, and rising mortality in some patients. Although researchers have suggested numerous factors related to treatment nonadherence, several understudied aspects warrant attention, such as primary-care settings, provider cultural competence, and patient involvement. Adding to the research base, the present pilot study examined 88 primarily Black American and White American community patients from a large university medical center in the southern part of the United States. The study explored two research questions: (a) To what extent are there associations among depressive symptoms, wellness, patient involvement, cultural competency, and treatment nonadherence in a racially diverse community patient population? And (b) to what extent do the study exploratory variables and background characteristics predict treatment nonadherence, both separately and jointly? Depressive symptoms, the patient's perception of a provider's cultural competence, and marital/partnered status were found to be statistically significantly associated with treatment nonadherence, but not entirely in the directions expected.
authors.affiliation: Department of Counseling and Human Development, University of Louisville, 329 Woodford R. and Harriett B. Porter Building, Louisville, KY, 40292, USA. lisa.hooper@louisville.edu.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Hooper
authors.affiliation: Department of Clinical-Community Psychology, University of South Carolina, 1100 Pulaski St. Apt 107, Columbia, SC, 29201, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Huffman
authors.affiliation: Institute for Rural Health Research, Department of Community and Rural Medicine, College of Community Health Sciences, The University of Alabama, 850 5th Avenue East, Tuscaloosa, AL, 35401, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Higginbotham
authors.affiliation: Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, P.O. Box 870231, Tuscaloosa, AL, 35487, USA.
authors.forename: George C T
authors.initials: GCT
authors.lastname: Mugoya
authors.affiliation: Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, P.O. Box 870231, Tuscaloosa, AL, 35487, USA.
authors.forename: Annie K
authors.initials: AK
authors.lastname: Smith
authors.affiliation: The Graduate School, Clemson University, E-108 Martin Hall, Clemson, SC, 29634, USA.
authors.forename: Tia N
authors.initials: TN
authors.lastname: Dumas
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D003430:Cross-Sectional Studies; D054521:Cultural Competency / Q000523:psychology; D003863:Depression / Q000523:psychology*; D000066498:Emotional Adjustment / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D010349:Patient Compliance / Q000523:psychology*; D010358:Patient Participation / Q000523:psychology*; D010865:Pilot Projects
keywords: Community patients; Depressive symptoms; Patient involvement; Primary-care setting; Provider cultural competency; Treatment nonadherence; Well-being