Massachusetts Council on Compulsive Gambling We understand the problem. We can help. Designing Effective Prevention of Problem Gambling Programs

Background on the Mass. Council on Compulsive Gambling  Founded in 1983 by Tom Cummings.  Private, non-profit health agency dedicated to providing leadership to reduce the social, financial, and emotional costs of problem gambling.  Promote a continuum of prevention, intervention, and recovery support strategies.

Never underestimate the power of a few committed people to change the world. Indeed, it is the only thing that ever has. Margaret Meade

Challenges and Principles of Prevention Planning Have your prevention work based in tested theory, research and data Use a tested 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, Research 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 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 Framework Assessment Capacity Building Planning Implementation Evaluation All under the umbrella of cultural competence and sustainability

Assessment 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 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)

Planning 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)

Implementation Involves: Infrastructure development Implementing evidenced-based strategies. (Adapted from CSAP Strategic Planning Framework)

Evaluation 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 Strategies [Center for Substance Abuse Prevention (CSAP)] Information Dissemination Prevention Education Alternative Activities Community-Based Processes Environmental Approaches Problem Identification and Referral

Information Dissemination Complementary to more intensive / interactive approaches Includes all types of passive education Posters PSAs (print, radio, TV) pamphlets Choice air times Target audience Avoid authority figures & exhortations

Prevention Education Combine information, skills, protective factors Interactive, intense, with booster sessions Peer-led components Provide social skills training & practice Involve parents individually & with students

Alternatives May be more effective with high-risk youth Intense programs with variety Component of integrated comprehensive strategy Community service, mentoring, recreation, cultural activities

Community-Based Processes Utilize multi-agency activities & interagency coordination Clear purpose, appropriate planning, commitment to results Active participation by meeting members’ needs Leadership essential Appropriate roles for paid staff Implement proven effective strategies to achieve outcome-based goals Effectiveness based on strategies not structure

Environmental Approaches Individualized 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 Referral 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 DOMAINS Individual Peer Family School/work Community Society/environmental

MULTIPLE STRATEGIES OVER MULTIPLE DOMAINS

What are Evidence-Based Strategies? 1)Included on Federal lists or registries of evidence-based interventions 2)Reported (with positive effects) in peer- reviewed journals, or 3)Documented evidence of effectiveness based on guidelines developed by SAMHSA/CSAP

Effective* Innovative and/or Unproven Conditionally Effective* Promising* Of Interest* Insufficient Current Support* SAMHSA’s Emerging Evidence-Based Continuum * SAMHSA/NREPP effectiveness levels Little-to-No Evidence of Effectiveness Evidence of Effectiveness Based on Rigorous Evaluation New NREPP 2005+

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.

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 behavior 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.

Protective Factors Family connectedness Designing 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.

Best 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

Some Examples

Older Adult Project Found local peer expert, built capacity Researched what we knew about older adults Researched access to the population Planned program Materials development Training interventions Empowerment model program development Multiple strategies/multiple domains Risk and protective factors Implementation and Evaluation

Thank you! Any further questions or comments?

Contact Information Jim Wuelfing Director of Prevention and Recovery Phone: Massachusetts Council on Compulsive Gambling Phone:

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