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First published on December 12, 2007
Health Education & Behavior 2007, doi:10.1177/1090198107309459

Article

Self-Efficacy Mediates the Relationship Between Depressive Symptoms and Medication Adherence Among Hypertensive African Americans

Antoinette Schoenthaler, EdD1*, Gbenga Ogedegbe, MD, MS, MPH2, and John P. Allegrante, PhD1

1 Teachers College, Columbia University, New York
2 College of Physicians and Surgeons, Columbia University, New York

* To whom correspondence should be addressed. E-mail: ams2125{at}columbia.edu.


  Abstract
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.


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