Medication adherence among rural, low-income hypertensive adults: a randomized trial of a multimedia community-based intervention.
Medication adherence among rural, low-income hypertensive adults: a randomized trial of a multimedia community-based intervention.
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农村，低收入高血压成年人的药物依从性：基于社区的多媒体干预的随机试验。
DOI：
10.4278/ajhp.090123-quan-26
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发表时间：
2011-07
期刊：
影响因子：
--
通讯作者：
Williams OD
中科院分区：
文献类型：
--
作者：
Martin MY;Kim YI;Kratt P;Litaker MS;Kohler CL;Schoenberger YM;Clarke SJ;Prayor-Patterson H;Tseng TS;Pisu M;Williams OD
检验基于社区的多媒体干预措施对高血压成年人服药依从性的效果。
随机对照试验。
阿拉巴马州南部农村地区。
434名从公共卫生部门或联邦合格健康中心免费领取药物的低收入成年人。
两种干预措施均以家庭为基础，由社区健康顾问通过计算机实施。依从性促进（AP）干预侧重于与依从性相关的理论变量（例如，障碍、决策平衡和榜样）。癌症控制条件组接受一般的癌症信息。
通过药丸计数评估依从性。其他与依从性相关的变量，包括障碍、自我效能、抑郁和社会人口统计学变量，通过电话调查收集。
卡方分析检验了AP干预组中依从性≥80%的参与者比例高于对照组这一假设。一般线性模型将依从性作为连续变量进行检验。
接受干预的参与者与对照组个体无差异（依从性分别为51%和49%；p = 0.67）。诊所类型可预测依从性（p < 0.0001），忘记服药（p = 0.01）以及前往诊所取药困难（p < 0.001）也可预测依从性。
可能需要关注个体行为和社区层面目标（例如，如何获得和提供医疗保健）的多层次干预措施，以提高低收入农村居民的服药依从性。（《美国健康促进杂志》2011年；25[6]：372 - 378页）
Examine the effectiveness of a community-based, multimedia intervention on medication adherence among hypertensive adults. Randomized controlled trial. Rural south Alabama. Low-income adults (N = 434) receiving medication at no charge from a public health department or a Federally Qualified Health Center. 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. Adherence was assessed by pill count. Other adherence-related variables, including barriers, self-efficacy, depression, and sociodemographic variables, were collected via a telephone survey. 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. 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). 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. (Am J Health Promot 2011;25 [6]:372–378.)