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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-BasedStrategies?
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*Innovativeand/or Unproven Conditionally
Effective*Promising*Of
Interest*Insufficient Current
Support*
SAMHSA’s Emerging Evidence-Based Continuum
* SAMHSA/NREPP effectiveness levels
Little-to-NoEvidence of Effectiveness
Evidence of Effectiveness Based on Rigorous Evaluation
NewNREPP
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: 508-523-3937E-mail: [email protected]
Massachusetts Council on Compulsive GamblingPhone: 617-426-4554
Connect with Us
You can connect with the Council through: