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Transcript of Prevention of Problem Gambling: What Every Preventionist Needs to Know Jim Wuelfing Owner and...
Prevention of Problem Gambling: What Every
Preventionist Needs to Know
Jim WuelfingOwner and Principle Associate
The New England [email protected]
Prevention and Recovery ConferenceInspiration. Connection. Motivation.
Oklahoma City, OklahomaNovember, 2014
Never underestimate the Never underestimate the power of a few committed power of a few committed
people to change the world. people to change the world. Indeed, it is the only thing Indeed, it is the only thing
that ever has.that ever has.Margaret MeadeMargaret Meade
About the Meaning and Challenges of Prevention
PreventionNo progress has ever been
made against any epidemic by treating only the casualties. We simply replace them with more.
PreventionIs an active process of
changing conditions and fostering personal attributes that supports the well being of people.
Challenges and Principles of Challenges and Principles of Prevention PlanningPrevention Planning
Based prevention in tested theory, research and data
Use a proven prevention planning model Using multiple strategies over multiple domains Use evidenced-based strategies Reduce risk and enhance protective factors Utilizing best practices
Based on Tested Theory, Based on Tested Theory, Research and DataResearch and Data
What prevention models are you following?– Public health model– Environmental management– Youth empowerment and development– Social ecological theory
What do you know about your population?
Quality and Accuracy of DataQuality and Accuracy of Data Luxury Car –Valid and reliable measures that
allow you to observe outcomes over time (examples surveys)
Sedan – Proxy measure that may or may not be valid indicators of outcomes of interest
Compact Car – Qualitative data such as focus groups and people’s perception of the problem.
CSAP’s Strategic Planning CSAP’s Strategic Planning FrameworkFramework
AssessmentCapacity BuildingPlanningImplementationEvaluationAll under the umbrella of cultural
competence and sustainability
AssessmentAssessment
Assessment involves using data to access:– Problem gambling and related problems (i.e.
needs) which leads to recommendations for state and community priorities
– Capacities and resources in existence to address the problems and gaps in capacities
– Readiness of state and communities to act.
(Adapted from CSAP Strategic Planning Framework)
Capacity BuildingCapacity Building
Involves identifying types and levels of resources in the prevention system and enhancing those systems by:– Workforce development– Improving data-based systems– Increasing coordination– Building community resources.
(Adapted from CSAP Strategic Planning Framework)
PlanningPlanning
Includes developing a comprehensive, logical and data driven plan to:– Address priority problems and issues– Decrease risk factors– Increase protective factors– Minimizes gaps in resources and capacity– Selects complementary strategies (multiple strategies
over multiple domains.
(Adapted from CSAP Strategic Planning Framework)
ImplementationImplementation
Involves:– Infrastructure development– Implementing evidenced-based strategies.
(Adapted from CSAP Strategic Planning Framework)
EvaluationEvaluation
Involves:– Assessing technical assistance and training
efforts needed– Policies and procedures needed to foster
positive outcomes– Measuring positive change that occurred.
(Adapted from CSAP Strategic Planning Framework)
Six Prevention StrategiesSix Prevention Strategies[Center for Substance Abuse Prevention [Center for Substance Abuse Prevention
(CSAP)](CSAP)]
Information Dissemination
Prevention Education
Alternative Activities
Community-Based Processes
Environmental Approaches
Problem Identification and Referral
Information DisseminationInformation Dissemination
Complementary to more intensive / interactive approachesIncludes all types of passive education
– Posters– PSAs (print, radio, TV)– pamphlets
Choice air timesTarget audienceAvoid authority figures & exhortations
Prevention EducationPrevention Education
Combine information, skills, protective factors
Interactive, intense, with booster sessions
Peer-led components
Provide social skills training & practice
Involve parents individually & with students
AlternativesAlternatives
May be more effective with high-risk youthIntense programs with varietyComponent of integrated comprehensive
strategyCommunity service, mentoring, recreation,
cultural activities
Community-Based ProcessesCommunity-Based ProcessesUtilize multi-agency activities & interagency
coordinationClear purpose, appropriate planning,
commitment to resultsActive participation by meeting members’ needsLeadership essentialAppropriate roles for paid staff Implement proven effective strategies to achieve
outcome-based goalsEffectiveness based on strategies not structure
Environmental ApproachesEnvironmental ApproachesIndividualized environment
– Seek to socialize, instruct, guide, & counsel to increase their resistance to health risks
Shared environment– Support healthy behavior, prevent risky behavior
for all in the population
Environmental strategies– Price interventions, minimum -purchase-age,
deterrence, location & density, counter-ads
Problem Identification and Problem Identification and ReferralReferral
Estimate accurately people who justify intervention
Ensures appropriate referral to meet needs
Realize relationship between substance use, gambling and other health problems.
Risk of exposure to other risk behaviors
Brief interventions appear promising
PREVENTION DOMAINSPREVENTION DOMAINS
IndividualPeerFamilySchool/workCommunitySociety/environmental
MULTIPLE STRATEGIES MULTIPLE STRATEGIES OVER MULTIPLE DOMAINSOVER MULTIPLE DOMAINS
Questions to Consider in Selecting Strategies
Who is the strategy targeting ? Why are you targeting this population and what
data/information supports your targeting this group ? What factors is your strategy addressing ? Why do you feel this strategy will lead to a desired
change? Is their any evidence that indicates that this strategy is
effective ? What change due you want to occur in this group or
population?
Effective*Innovativeand/or Unproven Conditionally
Effective*Promising*Of
Interest*Insufficient Current
Support*
SAMHSA’s Emerging Evidence-Based SAMHSA’s Emerging Evidence-Based ContinuumContinuum
* SAMHSA/NREPP effectiveness levels
Little-to-NoEvidence of Effectiveness
Evidence of Effectiveness Based on Rigorous Evaluation
NewNewNREPPNREPP
2005+
Protective and Risk Factors
Protective and Risk Factors
Protective factors – Factors that decrease the chances of someone (or a community) developing health and behavioral problems are called protective factors. Having multiple protective factors can override risk factors.
Risk factors - Factors that increase the chances of someone developing health and behavior problems are called risk factors. Individuals, families and communities which possess these factors are considered at risk. Those that possess several are considered high risk.
PROTECTIVE FACTORS
A relationship with a caring adult role model
Having an opportunity to contribute and be seen as a resource
Effectiveness in work, play and relationships
Healthy expectations and a positive outlook
Self-esteem and an internal locus of control
Self-discipline Problem solving and
critical thinking skills A sense of humor Family cohesion School/community
connectedness
Protective Factors
Family connectednessDesigning school-based prevention
programs that seek to develop student’s attachment, trust, and identification with larger groups (e.g., school clubs and sports teams, Scouts or Guides).
YOUTH GAMBLING PROBLEMS: THE IDENTIFICATION OF RISK AND PROTECTIVE FACTORS:: Report to the Ontario Problem Gambling Research Centre: Laurie Dickson, M.A.Jeffrey L. Derevensky, Ph.D., Rina Gupta, Ph.D.
Risk Factors for Problem Gambling
At-risk for a substance abuse problem Having a parent, sibling, relative, friend, or
significant person with either a gambling problem or substance use problem
Having or knowing peers with substance use problems is a risk correlate of youth problem gambling
Anxiety High risk propensity Low perception of risk regarding problem gambling Early onset of gambling behaviour
YOUTH GAMBLING PROBLEMS: THE IDENTIFICATION OF RISK AND PROTECTIVE FACTORS::Report to the Ontario Problem Gambling Research Centre: Laurie Dickson, M.A.Jeffrey L. Derevensky, Ph.D., Rina Gupta, Ph.D.
High Risk Categories
Child of a compulsive gambler
Belief that skill is involved
An early big win Feeling that one must
chase gambling loss with more gambling
Early age of onset (8.5 years for pathological gamblers; 11.5 years for non-pathological gamblers)
Large first bets Otherwise addicted
Characteristics of Low Risk Gambling
For fun or recreation, never for financial gain
Knowledge that over time nearly everyone loses
Socially with family and friends, not alone
Limited time – frequency and duration
With predetermined limits for losses
Acknowledging that knowing a lot does not make you a better gambler
Minimizing Your Risk
Always bet with a predetermined amount of money to be lost
Never borrow money to gambleNever gamble illegallyKnow your personal risk factorsKnow where to get helpBe willing to help others
Three Consistent Messages
The choice to abstain from gambling as a lifelong practice is a legitimate choice that many people make.
We want you to be legally allowed to gamble before you do so and we do not want you to gamble illegally ever.
If you still choose to gamble, we want you to know enough about gambling so that you can lower your risk of gambling problems.
Best Practices in PreventionBest Practices in Prevention
Research and Conceptual Framework
Accuracy, Efficacy and Credibility of Approach
Needs Assessment Measurable Goals and
Objectives Outcome and Process
Evaluation
Comprehensive Approach Integrates Overall Health
Promotion Community Involvement
and Ownership Long-Term Commitment Replicability
The Connection Between Prevention and Recovery
Both are primarily concerned with wellnessBoth focus on both building personal
recovery capital as well as community recovery capital
There is much overlap in the skills used by preventionists and recovery support personnel
Both support a holistic approach
Prevention of Problem Gambling on the National Level
National Council on Problem Gambling NCPG) – Prevention Committee– Co-chairs: Julie Hynes (OR) [email protected]
Susan McLaughlin (CT) [email protected]
NCPG Annual Conference – July 10-11, 2014, Baltimore, MD
State Efforts
Oklahoma Association on Problem and Compulsive Gambling (www.oapcg.org)– Wiley Harwell, Executive Director
405-801-3330
Other State Affiliates of NCPG– Go to www.ncpgambling.org and click “About
Us” and then “State Affiliates”
Evidenced-based curriculum for the prevention of problem gambling among teens and young adults.
Created by Robert Williams, Ph.D., Alberta Gaming Research Institute and Robert Wood, Ph.D., University of Lethbridge, Alberta
Teaches young people to approach life as smart risk-takers, weighing the pros and cons of their actions to determine the odds of achieving positive results.
Stacked Deck
Thank you.Thank you.