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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Christine G. Unson, PhD, Patricia Mahoney Trella, MA, and Karen Prestwood, MD. Claude Pepper Older Americans Independent Center, Center on Aging, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06030-6147, (860) 679-2239, Delapaz@nso1.uchc.edu
HYPOTHESES: Minority status, low education/income increase perceptions of poor mental (MCS) and physical (PCS) health (SF-36), and increase symptoms associated with ERT. In turn, both decrease adherence to drug treatment in a clinical trial. METHOD: Women, 65 years or older and not on ERT, were randomly assigned to groups receiving placebo, 0.25 mg, 0.5 mg and 1.0 mg (17b-Estradiol) for 12 weeks in a six-month dose response trial. Adherence was measured by pill count. Direct and indirect causal relationships were analyzed with AMOS (Smallwaters Corp.) RESULTS: 94 women (61% white, 25% African-American and 15% Hispanic) enrolled. The average participant was 75 years old; had some years or completed college and household incomes between $20K to $50K. SF-36 mental (51.44 ± 10.54) and physical component scores (41.02 ± 11.52) were above norm. 95% of white women (Mean=95.92±7.9), 59% of African-Americans (Mean 79.77±19.5) and 54% of Hispanics (Mean=75.38±23.5) were 80% adherent (overall adherence rate is 89%). In the causal model, African-American race (b=-.35, p=.00) and symptoms (b=-.44, p=.00) had significant direct paths to adherence. Hispanic origin (b=.49, p=.00) and MCS (b=-.38, p=.00) had direct paths to symptoms (R2=.28; ×2 (32)=34.67, p=.20). Other measures of fit such as TLI=.99, RMCSEA .03) show excellent fit. In analysis without Hispanics, education had a direct link to symptoms. Hispanics were excluded to reduce minority status-education/income confound. CONCLUSION: Research participants with little education reporting above average baseline symptoms are likely to be poor adherers. They should be the focus of special measures that encourage adherence.
Learning Objectives:
Keywords: Adherence, Minority Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.