Prevention and education evidence review: Gambling-related harm

Abstract

This report supports an evidence-based approach to the prevention and education objective of the National Strategy to Reduce Harm from Gambling. Applying a public health policy lens, it considers three levels of measures: universal (for the benefit of the whole population), selective (for the benefit of at-risk groups), and indicated (for the benefit of at-risk individuals). Six measures are reviewed by drawing upon a range of evidence in the academic and grey literature. The universal level measures are “Regulatory restriction on how gambling is provided” and “Population-based safer gambling/responsible gambling efforts.” Selective measures focus on age cohorts in a chapter entitled, “Targeted safer gambling campaigns for children, youth, and older adults.” The indicated measures are “Brief internet delivered interventions for gambling,” “Systems and tools that produced actual (‘hard’) barriers and limit access to funds,” and “Self-exclusion.” Since the quantity and quality of the evidence base varied by measure, appropriate review methods were selected to assess publications using a systematic, scoping, or narrative approach. Some measures offered consistent findings regarding the effectiveness of interventions and initiatives, while others were less clear. Unintended consequences were noted since it is important to be aware of unanticipated, negative consequences resulting from prevention and education activities. After reviewing the evidence, authors identified knowledge gaps that require further research, and provided guidance for how the findings could be used to enhance the prevention and education objective. The research evidence is supplemented by consultations with third sector charity representatives who design and implement gambling harm prevention and education programmes. Their insights and experiences enhance, support, or challenge the academic evidence base, and are shared in a separate chapter. Overall, research evidence is limited for many of the measures. Quality assessments suggest that improvements are needed to support policy decisions more fully. Still, opportunities exist to advance evidence-based policy for an effective gambling harm prevention and education plan.

Towards a conceptual framework for the prevention of gambling-related harms: Findings from a scoping review

“…Hilbrecht [9] (see also Abbott et al [45,46]) Harms A conceptual framework of factors which contribute to or influence harmful gambling, as well as how they interact. It includes general factors such as cultural, social, biological and psychological factors.…”

“…These harms are wide-ranging, covering numerous dimensions (such as financial, emotional or cultural) and they are not restricted to the gambler, also affecting their families and social networks [5]. There is therefore a growing support for a public health (PH) approach to GRH [4,[6][7][8][9]. Thomas et al [7] highlight five key pillars of a PH approach to GRH [7]: the development and implementation of a comprehensive public health framework to prevent gambling harm; the elimination of industry influence from research policy and practice; the addressing of structural characteristics which impede gambling harm prevention; strong restrictions on gambling-related marketing; and an independent public health-based education programme.…”

“…Recent reports have identified that the targets and strategies of PH approaches to GRH must: recognise that the input of those with lived experience is integral [10]; understand product-based risks [11][12][13]; and include targeted advocacy and campaigning [14,15]. Other authors have suggested that initiatives should target affected others, wider communities [16] and entire populations [9,17] whilst also targeting specific at-risk communities [18][19][20].…”

“…These harms-focused frameworks generally agree upon the types of harms experienced, even if demarcations between categories vary. Finally, several harms frameworks recognise the importance of targeting different sections of society [5,9,17,26].…”

“…There are, however, two themes which appear consistently throughout the frameworks in Table 1: (1) a socio-ecological approach which recognises the need to focus on the relationship between harms and individual, community and societal determinants, and (2) the use of an established harms framework that is specific to the complex impacts of gambling [9]. Far less prominent are the range of goals and strategies that might make up a 'public health' approach to GRH.…”