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

Teachers College, Columbia University, New York, ams2125{at}columbia.edu

Gbenga Ogedegbe, MD, MS, MPH

College of Physicians and Surgeons, Columbia University, New York

John P. Allegrante, PhD

Teachers College, Columbia University, New York

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 (β = .013, p = .036) and low self-efficacy (β = —.008, p = .023). Self-efficacy is negatively associated with medication adherence at follow-up (β = —.612, p < .001). The relationship between depressive symptoms and medication adherence becomes nonsignificant when controlling for self-efficacy (β = .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.

Key Words: African American • depressive symptoms • hypertension • medication adherence • self-efficacy

This version was published on February 1, 2009

Health Education & Behavior, Vol. 36, No. 1, 127-137 (2009)
DOI: 10.1177/1090198107309459


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