Medication adherence among rural, low-income hypertensive adults

A randomized trial of a multimedia community-based intervention

Michelle Martin, Young Il Kim, Polly Kratt, Mark S. Litaker, Connie L. Kohler, Yu Mei Schoenberger, Stephen J. Clarke, Heather Prayor-Patterson, Tung Sung Tseng, Maria Pisu, O. Dale Williams

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose. Examine the effectiveness of a community-based, multimedia intervention on medication adherence among hypertensive adults. Design. Randomized controlled trial. Setting. Rural south Alabama. Subjects. Low-income adults (N = 434) receiving medication at no charge from a public health department or a Federally Qualified Health Center. Intervention. Both interventions were home-based and delivered via computer by a community health advisor. The adherence promotion (AP) intervention focused on theoretical variables related to adherence (e.g., barriers, decisional balance, and role models). The cancer control condition received general cancer information. Measures. Adherence was assessed by pill count. Other adherence-related variables, including barriers, self-efficacy, depression, and sociodemographic variables, were collected via a telephone survey. Analysis. Chi-square analysis tested the hypothesis that a greater proportion of participants in the AP intervention are ≥80% adherent compared to the control group. General linear modeling examined adherence as a continuous variable. Results. Participants receiving the intervention did not differ from individuals in the control group (51% vs. 49% adherent, respectively; p = .67). Clinic type predicted adherence (p < .0001), as did forgetting to take medications (p = .01) and difficulty getting to the clinic to obtain medications (p < .001). Conclusions. Multilevel interventions that focus on individual behavior and community-level targets (e.g., how health care is accessed and delivered) may be needed to improve medication adherence among low-income rural residents.

Original languageEnglish (US)
Pages (from-to)372-378
Number of pages7
JournalAmerican Journal of Health Promotion
Volume25
Issue number6
DOIs
StatePublished - Jul 1 2011

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Multimedia
Medication Adherence
multimedia
medication
low income
community
Control Groups
Health
Self Efficacy
Telephone
Neoplasms
Randomized Controlled Trials
Public Health
Depression
cancer
promotion
Delivery of Health Care
general conditions
role model
health

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Public Health, Environmental and Occupational Health

Cite this

Medication adherence among rural, low-income hypertensive adults : A randomized trial of a multimedia community-based intervention. / Martin, Michelle; Kim, Young Il; Kratt, Polly; Litaker, Mark S.; Kohler, Connie L.; Schoenberger, Yu Mei; Clarke, Stephen J.; Prayor-Patterson, Heather; Tseng, Tung Sung; Pisu, Maria; Williams, O. Dale.

In: American Journal of Health Promotion, Vol. 25, No. 6, 01.07.2011, p. 372-378.

Research output: Contribution to journalArticle

Martin, M, Kim, YI, Kratt, P, Litaker, MS, Kohler, CL, Schoenberger, YM, Clarke, SJ, Prayor-Patterson, H, Tseng, TS, Pisu, M & Williams, OD 2011, 'Medication adherence among rural, low-income hypertensive adults: A randomized trial of a multimedia community-based intervention', American Journal of Health Promotion, vol. 25, no. 6, pp. 372-378. https://doi.org/10.4278/ajhp.090123-QUAN-26
Martin, Michelle ; Kim, Young Il ; Kratt, Polly ; Litaker, Mark S. ; Kohler, Connie L. ; Schoenberger, Yu Mei ; Clarke, Stephen J. ; Prayor-Patterson, Heather ; Tseng, Tung Sung ; Pisu, Maria ; Williams, O. Dale. / Medication adherence among rural, low-income hypertensive adults : A randomized trial of a multimedia community-based intervention. In: American Journal of Health Promotion. 2011 ; Vol. 25, No. 6. pp. 372-378.
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