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Clune S, Ratnaike D, White V, Donaldson A, Randle E, O'Halloran P, Lewis V. What is known about population level programs designed to address gambling-related harm: rapid review of the evidence. Harm Reduct J 2024; 21:118. [PMID: 38890632 PMCID: PMC11184756 DOI: 10.1186/s12954-024-01032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/02/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level. METHODS The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 - 2023 from all countries with gambling policy contexts and public health systems comparable to Australia's; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems. RESULTS One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective. CONCLUSIONS Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm.
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Affiliation(s)
- Samantha Clune
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia.
| | - Deepika Ratnaike
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Vanessa White
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Alex Donaldson
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Erica Randle
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Paul O'Halloran
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Virginia Lewis
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
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Vigna-Taglianti FD, Martorana M, Viola E, Renna M, Vadrucci S, Sciutto A, Andrà C, Mehanović E, Ginechesi M, Vullo C, Ceccano A, Casella P, Faggiano F. Evaluation of Effectiveness of the Unplugged Program on Gambling Behaviours among Adolescents: Study Protocol of the Experimental Controlled Study "GAPUnplugged". JOURNAL OF PREVENTION (2022) 2024; 45:405-429. [PMID: 38416313 DOI: 10.1007/s10935-024-00772-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 02/29/2024]
Abstract
Gambling risk behaviour is an emerging problem among adolescents. "Unplugged" is an effective Social Influence curriculum for preventing substance use among students. This study aims to develop and test a new component focused on gambling added to the Unplugged program. Schools of Piedmont region and Rome city were invited to participate in the study. A self-completed anonymous questionnaire including questions on socio-demographic characteristics, addictive behaviours, beliefs, attitudes and risk perceptions about gambling, normative perceptions, parental practices, school climate, refusal skills, impulsiveness, self-esteem, antisocial behaviours and sensation seeking was prepared for baseline and follow-up surveys. The protocol of the study was submitted and approved by the Novara Ethical Committee and registered in ClinicalTrials.gov (NCT05630157, Protocol ID: 080.742, 11/17/2022). Twenty-nine schools accepted to participate in the study. Sixty-three classes (1325 students) satisfied the eligibility criteria for intervention and were allocated to the intervention arm, and the other 61 (1269 students) were allocated to the control arm. Because of drop-out, absentees, refusals, and invalid questionnaires, data on 1874 students (998 in the intervention and 876 in the control arm), were available for the analysis at baseline. Data management of follow-up questionnaires is in progress. Results of the present study will be useful to clarify the effectiveness of prevention interventions in reducing gambling behaviours among adolescents. Moreover, this will be the first experience of evaluating a new component focused on a different risk behaviour, added to a curriculum previously shown as effective on other risk behaviours.
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Affiliation(s)
- Federica D Vigna-Taglianti
- Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy.
| | - Marco Martorana
- Epidemiology Unit, ASL Vercelli, Vercelli, Italy
- Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, Vercelli, Italy
- Department of Statistics, Computer Science, and Applications "Giuseppe Parenti" (DiSIA), University of Florence, Firenze, Italy
| | - Erica Viola
- Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, Vercelli, Italy
| | - Mariaelisa Renna
- Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy
| | - Serena Vadrucci
- Department of Prevention, Hygiene and Public Health Unit, ASL Città di Torino, Torino, Italy
| | - Alberto Sciutto
- Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, Vercelli, Italy
| | - Chiara Andrà
- Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, Vercelli, Italy
| | - Emina Mehanović
- Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy
| | - Maria Ginechesi
- Department of Mental Health, Addiction Unit, ASL Roma1, Roma, Italy
| | - Claudia Vullo
- Department of Mental Health, Addiction Unit, ASL Roma1, Roma, Italy
| | - Adalgisa Ceccano
- Department of Mental Health, Addiction Unit, ASL Roma1, Roma, Italy
| | - Pietro Casella
- Department of Mental Health, Addiction Unit, ASL Roma1, Roma, Italy
| | - Fabrizio Faggiano
- Epidemiology Unit, ASL Vercelli, Vercelli, Italy
- Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, Vercelli, Italy
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Monreal-Bartolomé A, Barceló-Soler A, García-Campayo J, Bartolomé-Moreno C, Cortés-Montávez P, Acon E, Huertes M, Lacasa V, Crespo S, Lloret-Irles D, Sordo L, Clotas Bote C, Puigcorbé S, López-Del-Hoyo Y. Preventive Gambling Programs for Adolescents and Young Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4691. [PMID: 36981602 PMCID: PMC10048743 DOI: 10.3390/ijerph20064691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Gambling disorder in youth is an emerging public health problem, with adolescents and young adults constituting a vulnerable age group for the development of gambling-related problems. Although research has been conducted on the risk factors for gambling disorder, very few rigorous studies can be found on the efficacy of preventive interventions in young people. The aim of this study was to provide best practice recommendations for the prevention of disordered gambling in adolescents and young adults. We reviewed and synthesized the results of existing RCTs and quasi-experimental studies covering nonpharmacological prevention programs for gambling disorder in young adults and adolescents. We applied the PRISMA 2020 statement and guidelines to identify 1483 studies, of which 32 were included in the systematic review. All studies targeted the educational setting, i.e., high school and university students. Most studies followed a universal prevention strategy, that particularly targeted adolescents, and an indicated prevention strategy for university students. The reviewed gambling prevention programs generally showed good results in terms of reducing the frequency and severity of gambling, and also regarding cognitive variables, such as misconceptions, fallacies, knowledge, and attitudes towards gambling. Finally, we highlight the need to develop more comprehensive prevention programs that incorporate rigorous methodological and assessment procedures before they are widely implemented and disseminated.
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Affiliation(s)
- Alicia Monreal-Bartolomé
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Chronicity, Primary Care, and Health Promotion Research Network (RICAPPS), 50015 Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Chronicity, Primary Care, and Health Promotion Research Network (RICAPPS), 50015 Zaragoza, Spain
- Department of Psychiatry, Hospital Miguel Servet, University of Zaragoza, 50009 Zaragoza, Spain
| | - Cruz Bartolomé-Moreno
- Primary Care Teaching Unit for Zaragoza Healthcare District 1, 50018 Zaragoza, Spain
| | - Paula Cortés-Montávez
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Esther Acon
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - María Huertes
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Víctor Lacasa
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Sofía Crespo
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Daniel Lloret-Irles
- Department of Health Psychology, Miguel Hernández University, 03202 Elche, Spain
| | - Luis Sordo
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | | | | | - Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Chronicity, Primary Care, and Health Promotion Research Network (RICAPPS), 50015 Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
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Systematic Review: Preventive Intervention to Curb the Youth Online Gambling Problem. SUSTAINABILITY 2022. [DOI: 10.3390/su14116402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This systematic review focuses on all the gambling addiction prevention programs carried out in schools, with the intention of making their effectiveness known and encouraging the creation of more such programs. During the third quarter of 2021, an exhaustive search was conducted using the databases of Scopus, Medline (via Pubmed), WOS, and PsycINFO. The search strategy was based on a combination of specific search terms: “Gambling Disorder [Mesh]”, “Online Gambling Disorder [Mesh]”, and “Prevention Programs [Mesh]”. A total of 15 articles were chosen for systematic review. All the programs analyzed show effective results, although there are several methodological shortcomings in the way they are conducted. Effective programs need to focus more on long-term results and the emotional aspects of gambling. We need professionals who can convey the causal nature of the problem the youth are facing.
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Ludens: A Gambling Addiction Prevention Program Based on the Principles of Ethical Gambling. J Gambl Stud 2021; 38:993-1008. [PMID: 34424447 PMCID: PMC8381860 DOI: 10.1007/s10899-021-10066-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/12/2022]
Abstract
Gambling is legal in most countries. However, despite having some economic benefits, certain characteristics of gambling can have health consequences, rendering it a public health issue. The effects can be summarized according to the following three "laws" of ethical gambling: "Gambling Dynamics Law": companies' economic gains come directly from players' losses; "Expected Loss Law": the more one gambles, the greater the probability of losing; and "Addiction Law": the more one gambles, the greater the need to play again, leading to further losses. Ludens is a gambling addiction prevention program that has four goals: inform participants about gambling and gambling addiction; sensitize participants to the risk of gambling for health, especially addiction; promote a change in attitudes toward gambling; and alert participants to risky behaviors that can lead to addiction. The prevention program was implemented during 2017 to 2019. Fourteen psychologists presented it to 2372 adolescents (48.8% females, 51.2% males) aged 14-19 years, none of whom were university students, recruited from 42 Spanish high schools in 132 groups taking different courses. The main dependent variables analyzed were the monthly frequencies of gambling, at-risk gambling, and gambling addiction (as measured by the National Opinion Research Center DSM-IV Screen for Gambling Problems, adapted to diagnose gambling disorder according to DSM-5, in which pathological gambling is considered an addictive disorder). Given that all of the gamblers were adolescents (most were minors), fulfilment of 1-3 the DSM-5 diagnostic criteria was considered to indicate a risk of problem gambling. After the administration of Ludens, statistically significant reductions were observed in the three variables of interest: monthly frequency of gambling, percentage of adolescents with risky gambling, and percentage of adolescents with gambling disorder. The results were analyzed according to sex and age (minors vs. adolescents between 18 and 19 years old). The results obtained after applying the prevention program indicate that Ludens is effective as a universal prevention program for gambling addiction.
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