• Gangjiao Zhu, Rahul Malhotra, Shangzhi Xiong, Xinyue Chen, Mingyang Zhang, You Wu, Enying Gong, Zhan Wang, Xiangyang Tian, Weixia Peng, Truls Østbye, and Lijing L Yan.
• School of Public Health, Wuhan University, Wuhan, People's Republic of China.
• Patient Prefer Adher. 2023 Jan 1; 17: 342134333421-3433.

PurposeWe assess whether the sequential mediating effects of self-efficacy and depressive symptoms on the relationship between community efficacy for non-communicable disease management (COEN) and medication adherence and whether these relationships differed by sex and age.Patients And MethodsOverall, 662 individuals from 12 communities in China were interviewed twice 1 year apart. Serial mediation analysis examined whether the relationship between COEN and medication adherence was mediated by self-efficacy and depressive symptoms. Model invariance across sex and age groups was assessed using multi-group analysis.ResultsSerial mediation analysis indicated that self-efficacy and depressive symptoms sequentially mediated relationship between COEN and medication adherence. Multi-group analysis by sex showed that the path from self-efficacy to medication adherence was significant only for females and from depressive symptoms to medication adherence was significant only for males.ConclusionInterventions that enhance individual self-efficacy may be beneficial in decreasing depressive symptoms and improving medication adherence.© 2023 Zhu et al.

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