en Community Health Community Health Original Research Original Research <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><b>&nbsp;&nbsp;</b><b><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp; Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">Medication adherence in stroke patients remains a significant challenge, impacting treatment efficacy and patient outcomes. This study aimed to model the structural relationships predicting medication adherence based on social support and social health in stroke patients, focusing on the mediating roles of self-esteem and leisure time in Tehran.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> This correlational study used structural equation modeling. The statistical population included all stroke patients referred to the Neurology Clinic of Firoozgar Hospital in Tehran in 2021. A sample of 255 participants was selected through a convenience sampling method. Participants completed questionnaires on medication adherence (Lin & et al, 2018), social support (Wax and Reader, 1986), self-esteem(Rosenberg, 1965), social health (Keyes, C. L., & Shapiro, A. D, 2004), and leisure time (Wang, 2019 ). Data were analyzed using Pearson correlation and structural equation modeling methods.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> The results indicate that SEM analysis demonstrated excellent model fit (&chi;&sup2;/df=2.91, CFI=0.97, RMSEA=0.062). Significant direct effects were found: social support &rarr; self-esteem (&beta;=0.34, *</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">*<0.001), social health &rarr; medication adherence (&beta;=0.45, *</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">*<0.001). Key indirect effects via mediators: social health &rarr; leisure time &rarr; adherence (&beta;=0.15, *</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">*=0.001) and social support &rarr; self-esteem &rarr; adherence (&beta;=0.15, *</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">*=0.001). All standardized coefficients (*</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">*<0.05) confirmed the hypothesized pathways</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; Conclusion:</span></span></b><span style="font-size:9.0pt"><span style="font-style:normal"> The findings demonstrate that psychological factors significantly influence medication adherence and, ultimately, patient recovery. Strengthening social support, self-esteem, social health, and leisure time can enhance treatment outcomes and facilitate better management of stroke patients.</span></span></span></span></span></span></span></span><br> &nbsp; Medication Adherence, Social Support, Social Health, Stroke, Self-Esteem, Leisure Time 971 978 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-9506-1&slc_lang=en&sid=1 Younes Doostian y.doostian@edu.ui.ac.ir 200319475328460093455 200319475328460093455 No Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Iran Aliakbar Godini drgodini@cfu.ac.ir 200319475328460093456 200319475328460093456 No Psychology and Counseling Department, Farhangian University, Tehran, Iran Seyedeh Fahimeh Shojaei Shojaee.fahimeh@yahoo.com 200319475328460093457 200319475328460093457 Yes Firoozgar Clinical Research and Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran