The Relation between Substance Use and Medication Adherence among HIV Positive Substance Users in Residential Treatment

Poor medication adherence is problematic among HIV positive, low-income African-American substance users. Substance use has been shown to be associated with poor medication adherence, though we do not know the mechanism that underlies this relationship. Lack of positive environmental rewards and the propensity to discount delayed rewards may be possible mechanisms to explain this relationship. Using baseline data from a randomized controlled trial, we examined the relationships between substance use and medication adherence, testing both environmental rewards and delay discounting as independent mediators. There was a main effect of substance use on adherence, such that high frequency of substance use predicted poor adherence. There was also a main effect of environmental rewards on adherence, such that a lack of environmental reinforcement predicted poor adherence. This study shed light on the processes that contribute to low adherence, namely substance use and lack of environmental contingencies, and suggests important targets for intervention.

Too Busy to Be Fair? The Effect of Managers’ Perceived Workload on Their Core Technical Performance and Justice Rule Adherence

Despite the organizational benefits of treating employees fairly, both anecdotal and empirical evidence suggest that managers do not behave fairly towards their employees in a consistent manner. As treating employees fairly takes up personal resources such as time, effort, and attention, I argue that when managers face high workloads (i.e., high amounts of work and time pressure), they are unable to devote such personal resources to effectively meet both core technical task requirements and treat employees fairly. I propose that in general, managers tend to view their core technical task performance as more important than being fair in their dealings with employees; as a result, when faced with high workloads, they tend to prioritize the former at the expense of the latter. I also propose that managerial fairness will suffer more as a result of heightened workloads than will core technical task performance, unless managers perceive their organization to explicitly reward fair treatment of employees. I find support for my hypotheses across three studies: two experimental studies (with online participants and students respectively) and one field study of managers from a variety of organizations. I discuss the implications of studying fairness in the wider context of managers’ complex role in organizations to the fairness and managerial work demands literatures.