Can Cultural Competency Speak to the Race Disparities in Methadone Dosage Levels?

Although national methadone treatment trends have improved substantially from 1988 to 2001, current research has found that African Americans still receive lower dosages of methadone treatment than their white and Hispanic counterparts, which has significant public health concerns. We sought to empirically examine whether the degree of cultural competency within an outpatient substance abuse treatment (OSAT) organization has influence on the methadone dosage levels received by African Americans in 1995 and in 2005. The 1995 and 2005 National Drug Abuse Treatment System Survey (NDATSS) provided a nationally-representative, stratified sample of 618 and 566 OSAT organizations, respectively, of which 121 and 140 affiliated methadone maintenance treatment programs, respectively, were analyzed. The organizations’ director and clinical supervisor were surveyed. Fixed-effects linear regression models were fitted with measures of cultural competency, client, and organizational characteristics to assess methadone dosage levels. Culturally-competent units have smaller numbers of methadone clients, greater percentages of clients who receive methadone dosages of less than 40 mg/d, smaller percentages of clients who receive methadone dosages of 80 mg/d or more, and provide a larger number of therapeutic and ancillary services during treatment than non-culturally-competent units. OSAT units with more African Americans are significantly more likely to have clients who receive dosages of less than 40 mg/d and are significantly less likely to have clients who receive dosages of 80 mg/d or more. There is no racial difference among culturally-competent unit clients who receive dosages of less than 40 mg/d, between 40 and 59 mg/d, between 60 and 79 mg/d, and 80 mg/d or more. However, among non-culturally-competent units, a racial difference exists among African Americans and other clients who receive these various dosage levels. Research indicating that African Americans receive lower dosages of methadone than their White and Hispanic counterparts may now be explained by whether these clients receive treatment in culturally competent organizations, rather than solely by arguments related to organizational differences in resources, experience and training of staff, staff bias and/or racism. Culturally competent organizations may seek a method of treatment that dissuades “replacing one drug for another,” while simultaneously treating the root cause of the addiction through the provision of comprehensive therapeutic and ancillary support services. Further research is needed to determine if cultural competency results in better substance abuse treatment outcomes for African Americans.     

The link between customer satisfaction and loyalty: the moderating role of customer characteristics

This research examines whether trust and commitment mediate the extent to which satisfaction influences loyalty, and whether such mediation is conditional on certain demographic or situational customer characteristics. The findings suggest that assuming homogeneity supports the general notion that trust and commitment partially mediate the extent to which satisfaction influences loyalty. FIMIX-PLS and PLS-MGA analyses substantiate that this mediation differs between two distinct customer segments. The two segments reveal heterogeneity in how trust and commitment partially mediate the link between satisfaction and loyalty. That is, the effect of satisfaction on loyalty is fully mediated by trust and commitment in the segment of customers with high education, whereas satisfaction is partially mediated by trust, but not by commitment, in the other segment of customers with less education.     

Stimulating innovation in large companies: Observations and recommendations for Belgium

This article summarizes the results of a large scale research which was conducted in 41 large Belgian companies. One hundred thirty-one innovation projects were studied in order to bring to light the factors encouraging or inhibiting the innovation process in large companies.
A stage-model of the innovation process is proposed, including the following phases: perception of the idea, conceptualization, development and operationalization. Favourable and unfavourable factors are emphasized at each stage. On the basis of these conclusions, recommendations are drawn which are aimed at managers, the public authorities, the universities and the trades unions. These recommendations concern three areas: increasing the technical-economic forecasting capacity of the companies and of the economic community at large; stimulating the research efforts inside and outside the firm; organizing the innovation development process within the firm.     

From organizational values to mobilization of human resources

This study examines the relationship of perceived organizational values to employee mobilization behaviours as mediated by perceived organizational support (POS) and affective organizational commitment. Firstly, a scale comprising three types of perceived organizational values (interpersonal values, formal values, and individual well‐being‐centered values) was developed and validated using a sample of 580 employees. Secondly, the relationships among variables were examined using structural equations modeling on an independent sample of 260 employees. POS mediated the relationship between employees' perceptions that their organization values the individual well‐being of its members and their affective organizational commitment, which in turn mediated the relationship between POS and individual mobilization behaviours. The contributions of these findings to advancing scholarship and practice are discussed. Copyright © 2010 ASAC. Published by John Wiley & Sons, Ltd.     

An analysis of pricing and basis risk for industry loss warranties

In recent years, industry loss warranties (ILWs) have become increasingly popular in the reinsurance market. The defining feature of ILW contracts is their dependence on an industry loss index. The use of an index reduces moral hazard and generally results in lower prices compared to traditional, purely indemnity-based reinsurance contracts. However, use of the index also introduces basis risk since the industry loss and the reinsured company’s loss are usually not fully correlated. The aim of this paper is to simultaneously examine basis risk and pricing of an indemnity-based industry loss warranty contract, which is done by comparing actuarial and financial pricing approaches for different measures of basis risk. Our numerical results show that modification of the contract parameters to reduce basis risk can either raise or lower prices, depending on the specific parameter choice. For instance, basis risk can be reduced by decreasing the industry loss trigger, which implies higher prices, or by increasing the reinsured company attachment, thus inducing lower prices.     

Managing longevity risk under adverse selection: the influence of policyholder age and contract duration

In recent years, the rising life expectancy in almost all industrialized countries has led to an increasing demand by life insurers for possibilities to hedge longevity risk. Two of the most prominent alternative risk management instruments in this regard are the transfer of longevity risk to the capital market, e.g. through the purchase of mortality contingent bonds, and natural hedging, i.e. hedging longevity risk through portfolio composition. In this paper, we study the effectiveness of these risk management instruments under adverse selection, which here refers to the difference between annuitant mortality and the mortality of the population as a whole. Special emphasis is thereby placed on analyzing the impact of policyholders’ age at contract inception and contract duration on the effectiveness of risk management.     

Betriebsunterbrechungsversicherung bei kleinen und mittleren Unternehmen

The business interruption caused by a property claim is an existential risk both for large industrial companies and for small to medium enterprises (SME). It is especially relevant for companies working on a more complex sales and production infrastructure. Statistics show that in case of a large property claim the cost of the accompanying business interruption claim frequently exceeds the property claim. In Germany, however, the share of companies opting for business interruption insurance is much smaller than those opting for property insurance. This is especially true for SME that can hardly cover the risk themselves. The goal of this paper is to analyze the insurance decision for a business interruption policy with a special focus on SME. As a database we use the results of a representative survey among 1802 German SME with up to 100 employees. Our results show that the decision for a business interruption policy is not only dependent on hard factors such as company size and industry, but also driven by the so-called “insurance mentality”, which includes risk aversion, insurance know-how and price-sensitivity.     

Price presentation and consumers’ choice

Currently, regulatory authorities and consumers ask for more cost transparency with respect to financial product components. In life insurance, for instance, the premium for products should be split in its components: A premium for death benefits, the savings premium, the cost of an investment guarantee, and the administration costs. In this regard, it is important for insurance companies and regulators to know to what extent the way of presenting the prices of an offer affects consumer evaluation of the product. Based on a paper by Huber et al. (How do price presentation effects influence consumer choice? The case of life insurance products. Working paper, 2011) as presented at the annual meeting of Deutscher Verein für Versicherungswissenschaft in 2011, this article presents the effects of different forms of presenting the price of life insurance contract components and especially of investment guarantees on consumer evaluation of this product. This is done by means of an experimental study using a representative panel for Switzerland and by focusing on unit-linked life insurance products. The findings reveal that, contrary to consumer products, there is no effect of price bundling and price optic on consumer evaluation and purchase intention for life insurance products. However, there is a significant moderating effect of consumer experience with insurance products on this relationship.     

An Attention‐Based View of Family Firm Adaptation to Discontinuous Technological Change: Exploring the Role of Family CEOs' Noneconomic Goals

Recent studies show that managerial attention is a particularly important precursor of established firms' responses to discontinuous technological change. However, little is known about the factors that shape managerial attention‐response patterns. Our qualitative study investigates how the attention of family firm chief executive officers (CEOs) to discontinuous technological shifts, the interpretation and decision‐making processes associated with these changes, and ultimately organizations' responses are affected by CEOs' noneconomic goals. Based on seven longitudinal case studies in the German consumer goods industry, the paper induces a process model that extends the findings of the literature on the attention‐based view and helps to explain heterogeneity in family firms' adaptation to discontinuous technological change. This study shows that the family CEO's specific noneconomic goals—such as power and control, transgenerational value, the maintenance of family reputation, the continuance of personal ties, or personal affect associated with the family business—determine whether the CEO assesses an emerging technology as relevant enough to warrant a reaction from the firm. Moreover, the family CEO's noneconomic goals constrain the set of considered responses. The outcome of this sensemaking process determines the organization's response. For instance, in the specific context of this study, the goal of “family power and control” entailed an immediate interpretation of the focal trend as important for maintaining influence, and resulted in an unconstrained set of responses and, ultimately, high innovation in the new domain. Over time, family CEOs might reevaluate the emerging trend based on their goals and adapt organizational moves accordingly. The paper identifies and discusses how ambiguities and dilemmas may arise during this process. Our findings contribute to the literature on adaptation to discontinuous technological change and to family firm research.