Using the Theory of Planned Behavior to Improve Treatment Adherence in Mexican Americans With Schizophrenia

• Published in: Journal of consulting and clinical psychology Vol. 83; no. 5; pp. 985 - 993
• Main Authors: Kopelowicz, Alex, Zarate, Roberto, Wallace, Charles J, Liberman, Robert Paul, Lopez, Steven R, Mintz, Jim
• Format: Journal Article
• Language: English
• Published: United States American Psychological Association 01-10-2015
• Subjects: Adolescent; Adult; Antipsychotic Agents - therapeutic use; Attitudes; Clinical outcomes; Clinical psychology; Clinical trials; Culturally Competent Care - statistics & numerical data; Drug Therapy; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Human; Humans; Male; Medical treatment; Medication Adherence - psychology; Medication Adherence - statistics & numerical data; Mexican Americans; Mexican Americans - psychology; Mexican Americans - statistics & numerical data; Middle Aged; Neuroleptic Drugs; Planned Behavior; Psychoeducation; Reasoned Action; Schizophrenia; Schizophrenia - drug therapy; Treatment Compliance; Young Adult; United States > US; schizophrenia; treatment adherence; family psychoeducation; antipsychotic medication
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/a0039346

Objective: Failure to adhere to treatment with antipsychotic medication is the most common cause of relapse among patients with schizophrenia. A novel multifamily group (MFG) intervention, informed by the Theory of Planned Behavior (TPB), demonstrated efficacy in increasing medication adherence and decreasing rehospitalizations in schizophrenia patients. This report explores the hypothesis that the improved outcomes obtained through the MFG approach were mediated by changes in the patients' attitudes toward medications, subjective norms-social influences, and perceived behavioral control of resources. Method: Data from a recently completed, randomized controlled trial of MFG was used to test the hypothesis that the improvement in adherence was mediated by the 3 TPB factors. Subjects were 174 Mexican American adults with schizophrenia-spectrum disorder who had participated in a study of MFG focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months. Results: Path analysis revealed that the increased adherence associated with MFG was mediated by improvements in subjective norms but not attitudes toward medications nor perceived behavioral control. Conclusion: An MFG treatment specifically tailored to increase medication adherence among Mexican Americans with schizophrenia achieved its benefits by leveraging social influences through teaching family members how to support medication adherence in their ill relatives.
This study demonstrated that a culturally informed family intervention improved treatment outcomes for Mexican Americans with schizophrenia by teaching family members how to support medication adherence in their ill relatives