Community Efficacy for Non-Communicable Disease Management and Medication Adherence: The Sequential Mediating Role of Self-Efficacy and Depressive Symptoms

• Published in: Patient preference and adherence Vol. 17; pp. 3421 - 3433
• Main Authors: Zhu, Gangjiao, Malhotra, Rahul, Xiong, Shangzhi, Chen, Xinyue, Zhang, Mingyang, Wu, You, Gong, Enying, Wang, Zhan, Tian, Xiangyang, Peng, Weixia, Østbye, Truls, Yan, Lijing L
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2023; Dove; Dove Medical Press
• Subjects: Analysis; Care and treatment; china; Chronic diseases; Communicable diseases; community; Community health services; Depression, Mental; depressive symptoms; Diagnosis; Health behavior; Mediation; medication adherence; Methods; neighborhood; non-communicable chronic diseases; Original Research; Patient compliance; self-efficacy; Self-efficacy (Psychology); social cognitive theory; Type 2 diabetes; China; non-communicable chronic diseases; China; social cognitive theory; self-efficacy; medication adherence; neighborhood; community; depressive symptoms
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/PPA.S436419

We assess whether the sequential mediating effects of self-efficacy and depressive symptoms on the relationship between community efficacy for non-communicable disease management (COEN) and medication adherence and whether these relationships differed by sex and age. Overall, 662 individuals from 12 communities in China were interviewed twice 1 year apart. Serial mediation analysis examined whether the relationship between COEN and medication adherence was mediated by self-efficacy and depressive symptoms. Model invariance across sex and age groups was assessed using multi-group analysis. Serial mediation analysis indicated that self-efficacy and depressive symptoms sequentially mediated relationship between COEN and medication adherence. Multi-group analysis by sex showed that the path from self-efficacy to medication adherence was significant only for females and from depressive symptoms to medication adherence was significant only for males. Interventions that enhance individual self-efficacy may be beneficial in decreasing depressive symptoms and improving medication adherence.