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Community Efficacy for Non-Communicable Disease Management and Medication Adherence: The Sequential Mediating Role of
Gangjiao Zhu1,2, Rahul Malhotra3,4,5, Shangzhi Xiong6
1School of Public Health, Wuhan University, Wuhan, People's Republic of China.
Purpose:
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.
Patients And Methods:
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.
Results:
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.
Conclusion:
Interventions that enhance individual self-efficacy may be beneficial in decreasing depressive symptoms and improving medication adherence.
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