Predictors of adherence to controller medication in urban African American emerging adults with uncontrolled persistent asthma

Abstract

Background African American emerging adults tend to have low adherence to asthma controller medication, as well as a disproportionate burden of asthma morbidity and mortality. This study explored constructs from the Information-Motivation-Behavioral Skills model as predictors of controller medication adherence in urban African Americans ages 18–29 (N=152) with uncontrolled asthma using multiple measures of self-reported adherence. Methods Structural equation modeling (SEM) was employed to test the hypothesized mediation model that specified the relationship among psychological distress, substance use, asthma knowledge, motivation, self-efficacy, and adherence. Results Results suggested that motivation is an important predictor of adherence to medication; moreover, higher self-efficacy was associated with higher motivation. Results also highlighted psychological distress as an important intervention target to improve medication adherence in emerging adults. Conclusions The model tested in this study may offer a feasible framework for beginning to understand adherence to controller medication in this population.