Objective-This study was part of the Primary Care Research in Substance Abuse and Mental Health for the Elderly study (PRISM-E) and determined the relative effectiveness of two different models of care for reducing at-risk alcohol use among primary care patients aged 65 and older.Methods-This multisite study was a randomized clinical trial comparing integrated care with enhanced specialty referral for older primary care patients screened and identified to have at-risk drinking.Results-Before the study, the 560 participants consumed a mean of 17.9 drinks per week and had a mean of 21.1 binge episodes in the prior three months. At six months, both treatment groups reported lower levels of average weekly drinking (p<.001) and binge drinking (p<.001), despite low levels of treatment engagement. However, the declines did not differ significantly between treatment groups.Conclusions-These results suggest that older persons with at-risk drinking can substantially modify their drinking over time. Although no evidence suggested that the model of care was important in achieving this result, the magnitude of reduction in alcohol use was comparable with other intervention studies.Alcohol dependence is one of the leading causes of disability worldwide. However, an alcohol use disorder is often not appreciated as relevant to the care of older adults (1). The public health impact of alcohol misuse will increase over the next several decades, as the absolute number of elderly increase and with a three-fold increase in the prevalence of alcohol use disorder in the past ten years (2). Estimates suggest that the one-year prevalence rate for alcohol use disorder is 2.75 percent for elderly men and .51 percent for elderly women (2). At-risk drinking is a concept developed as having relevance for preventing further development of alcohol-related problems and as a target for reducing disability (3). At-risk drinking is a target for early intervention, much like treating hypertension is a target for preventing more severe illnesses. For older adults in primary care settings, at-risk drinking has been estimated to occur in 5 to 15 percent of the population (4-7). The purpose of the Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E) study was to test the effectiveness of two models of organized care for older adults screened in primary care who met criteria for depression, anxiety, or at-risk drinking. The research goal was to determine whether, and to what extent, the two care models improved access, outcome, and costs. The purpose of this study was to compare the clinical outcomes for at-risk drinking among older primary care patients who received integrated care (brief alcohol intervention sessions at a primary care clinic) with the outcomes of those receiving enhanced specialty referral (referral to specialty mental health or substance abuse clinics). The design and hypotheses for the study were based on a twoway comparison of the models that made no a priori assumption about which model woul...
PurposeThe purpose of this paper is to discover what corporate social responsibility (CSR) message themes are being communicated in selective pharmaceutical companies' mission and core values statements and their relevance to internal and external audiences.Design/methodology/approachA content analysis of five pharmaceutical companies mission and value statement web pages are analyzed. A panel developed a list of key words that are then analyzed and assigned to a level of Lerbinger's pyramid of CSR schema in order to determine if the web site is primarily communicating with internal or external stakeholders.FindingsKeywords communicating the organizations' mission focus on activities that support societal issues relevant to external stakeholders. Keywords communicating the organizations' values support minimizing social costs including employee safety and therefore are of more interest and importance to internal stakeholders. The analysis indicates that the content provided by these five pharmaceutical companies use message frames within specific sections of the web site to communicate with both internal and external stakeholders.Originality/valueThere has been much emphasis on the need for, and benefit of communicating an organization's CSR strategies to stakeholders. This paper evaluates what CSR initiatives are being communicated on pharmaceutical companies' web sites. The results show a strong propensity to communicate with both external and internal stakeholders indicating that some organizations are messaging to both groups.
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