Although it is seen by many as a form of leisure and recreation, gambling can have serious repercussions for individuals, families, and society as a whole. The harmful effects of gambling have been studied for decades in an attempt to understand individual differences in gambling engagement and the lifecourse of gambling-related problems. In this publication, we present a comprehensive, internationally relevant conceptual framework of "harmful gambling" that moves beyond a symptoms-based view of harm and addresses a broad set of factors related to population risk, community, and societal effects. Factors included in the framework represent major topics relating to gambling that range from specific (gambling environment, exposure, types, and resources) to general (cultural, social, psychological, and biological). The framework has been created by international, interdisciplinary experts in order to facilitate an understanding of harmful gambling. It reflects the state of knowledge related to factors influencing harmful gambling, and serves a secondary purpose as a guide for the development of future research programs and to educate policy makers on issues related to harmful gambling. Gambling Research Exchange Ontario (GREO) (formerly the Ontario Problem Gambling Research Centre (OPGRC) located in Guelph, Ontario, Canada) has facilitated the development of the Conceptual Framework of Harmful Gambling and retains responsibility for keeping it up-to-date.

Background and aims The Conceptual Framework of Harmful Gambling moves beyond a symptoms-based view of harm and addresses a broad set of factors related to the risks and effects of gambling harmfully at the individual, family, and community levels. Coauthored by international research experts and informed by multiple stakeholders, Gambling Research Exchange (GREO) facilitated the framework development in 2013 and retains responsibility for regular updates and mobilization. This review article presents information about the revised version of the Conceptual Framework of Harmful Gambling completed in late 2018. Methods We describe eight interrelated factors depicted in the framework that represent major themes in gambling ranging from the specific (gambling environment, exposure, gambling types, and treatment resources) to the general (cultural, social, psychological, and biological influences). After outlining the framework development and collaborative process, we highlight new topics for the recent update that reflect changes in the gambling landscape and prominent discourses in the scientific community. Some of these topics include social and economic impacts of gambling, and a new model of understanding gambling related harm. Discussion and conclusions We address the relevance of the CFHG to the gambling and behavioral addictions research community. Harm-based frameworks have been undertaken in other areas of addiction that can both inform and be informed by a model dedicated to harmful gambling. Further, the framework brings a multi-disciplinary perspective to bear on antecedents and factors that co-occur with harmful gambling.

The opioid crisis is disproportionately impacting Indigenous communities in Canada. There is a need to evaluate practical approaches to recovery that include community-based opioid agonist treatment (OAT) and integration of cultural treatment models. Naandwe Miikan, translated as The Healing Path, is an OAT program that blends clinical and Indigenous healing concepts and providers in a community-based setting. Aside from OAT pharmaceutical treatment, clients work with Indigenous counsellors that integrate culture with treatment, such as land-based activities, that reconnect the community to Indigenous teachings and harvesting. In this paper, we present a case study showcasing community advocacy in creating innovative funding models and engaging with clinicians to provide a shared care OAT model with traditional Indigenous counselling, cultural programs, and data sovereignty. Policy needs are identified.

Photovoice is a community-based participatory visual research method often described as accessible to vulnerable or marginalized groups and culturally appropriate for research with Indigenous peoples. Academic researchers report adapting the photovoice method to the sociocultural context of Indigenous participants and communities with whom they are working. However, detailed descriptions on cultural frameworks for transforming photovoice in order for it to better reflect Indigenous methodologies are lacking, and descriptions of outcomes that occur as a result of photovoice are rare. We address the paucity of published methodological details on the participant-directed Indigenization of photovoice. We conducted 13 visual research group sessions with participants from three First Nations communities in Northern Ontario, Canada. Our intent was to privilege the voice of participants in a mindful exploration aimed at cocreating a transformation of the photovoice method, in order to meet participants' cultural values. Gaataa'aabing is the Indigenized, culturally safe visual research method created through this process. Gaataa'aabing represents an Indigenous approach to visual research methods and a renewed commitment to engage Indigenous participants in meaningful and productive ways, from the design of research questions and the Indigenization of research methods, to knowledge translation and relevant policy change. Although Gaataa'aabing was developed in collaboration with Anishinaabek people in Ontario, Canada, its principles will, we hope, resonate with many Indigenous groups due to the method's focus on (1) integration of cultural values of the respective Indigenous community(ies) with whom researchers are collaborating and (2) placing focus on concrete community outcomes as a requirement of the research process.

The emergence of Alzheimer’s disease and related dementias (ADRD) in Indigenous populations across Canada is of rising concern, as prevalence rates continue to exceed those of non-Indigenous populations. The Intergenerativity Model, guided by Indigenous Ways of Knowing, nurtures a psychosocial approach to promoting healthy brain aging and quality of life. Community-based participatory action methods led by interviews, focus groups, and program observations aid in identifying the barriers to and facilitators of success for intergenerational social engagements in the Anishinaabe community of Wiikwemkoong in northwestern Ontario. A qualitative thematic analysis guides future recommendations for programming opportunities that foster traditional roles of older First Nation adults and support intergenerational relationships. The results of this project elicit culturally appropriate recommendations for community-driven supports that address healthy brain aging. These outcomes are relevant to other Indigenous communities as the framework for determining that culturally appropriate health supports can be adapted to the unique context of many communities.