Rebecca Hofer|Hwajung Choi|Rebecca Mase|Angela Fagerlin|Michael S. Spencer|Michele Heisler
Mediators and Moderators of Improvements in Medication Adherence
University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|VA Ann Arbor Healthcare System|University of Michigan–Ann Arbor|Center for Practical Bioethics|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|VA Ann Arbor Healthcare System
objective randomized controlled trial compared two models community health workerled diabetes medication decision support lowincome latino african american adults diabetes outcomes improved community health workers used either interactive ehealth tool print materials article investigates mediators moderators improved medication adherence two models method programs significantly improved satisfaction medication information medication knowledge decisional conflict examined whether improvements outcomes turn associated improvements selfreported medication adherence whether improvements mediated improvements diabetes selfefficacy diabetes distress potential moderators improvement included gender raceethnicity age education insulin use health literacy baseline selfefficacy diabetes distress a1c results total 176 participants 94 completed assessments adjusting potential confounders increased satisfaction medication information correlated improved medication adherence p 024 improved selfefficacy diabetes distress associated improvements satisfaction medication information medication adherence however sobelgoodman mediation test support improvements selfefficacy mechanism improved satisfaction led better adherence none examined variables achieved statistical significance moderators conclusions improvements satisfaction medication information medication knowledge decision conflict associated improvements medication adherence interventions target lowincome ethnic racial minorities may need focus increasing participants satisfaction information provided diabetes medications improving knowledge medications future research explore depth possible mediators moderators improvements medication adherence lowincome minority populations