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integrating
problem
gambling
in Prevention
Julie Hynes, MA, CPS
Focus on the Future Conference
Vancouver, WA | April 2014
Thanks! to…
• Oregon Problem Gambling Services
• Evergreen Council on Problem
Gambling
• Leaders in the field:
• Jeff Maro...
www.preventionlane.org/
focusonthefuture
First Things First:
Objectives:
• Understand why it is essential and
efficient to integrate
• Identify and compare various methods
of integrat...
Let’s be real.
What are
some of the
Key Challenges
in your
work?
Some of mine…
Youthful subject
Perception
Stigma/shame
Industry
Proving results
prevention.
Pre‐
conception
Prenatal/ 
Infancy
Early 
Childhood
Childhood
Early 
Adolescence
Adolescence
Family
• Prenatal care
• Home...
Prevention:
Behavioral Health
Public Health
ACA
5.6% college age (18‐24)
2½ % all adults (18+)
4‐6% teens (13‐17)
This is the first generation of widely 
available electr...
Problem Behaviors
AND they are
• Tobacco, alcohol, and
other drug use and
abuse
• Delinquency and crime
• Premature or unsafe
sex
• Depression and
suicid...
factors.
ResiliencyTheory
ADVERSE CHILDHOOD EXPERIENCES (ACE)
40 DEVELOPMENTAL
ASSETS
SOCIAL DEVELOPMENT STRATEGY
PROMOTIVE FACTORS...
Risk Factors for Adolescent
Problem Behavior
Recognized Problem Behaviors
• Substance abuse
• Violence
• Delinquency
• Teenage pregnancy
• School dropout
• Depression ...
Protective Factors
• Protective factor: a characteristic
associated with a lower
likelihood of problem outcomes
or that re...
check it out.
)
Effects of
Problem
Gambling
on Children
“Theearlierpeoplebegin
gambling,themorelikelythey
aretoexperienceproblemsfrom
gambling.”
-National Academyof Sciences
AVAILABILITY.
Acceptability.
Advertising.
age.
Amygdala
active
Risk-taking &
impulsive
behaviors
Source: Ramoski, S., Nystrom, R. (2007). Image source: simpsons.wikia.or...
2012 Oregon Student Wellness Survey, Lane County (“ESD”) and Oregon; available
at http://oregon.pridesurveys.com/esds.php?...
ATTITUDES
Oregon parent/youth focus groups revealed:
All parents in their focus groups said their 
kids didn’t gamble
All ...
by the numbers.
Used alcohol in the past month
3.1%
14.6%
29.5%
14.9%
30.9%
46.9%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Binge drank in the last 30 days
0.5%
5.6%
16.4%
4.3%
12.7%
28.7%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Available...
Smoked cigarettes in the past month
1.1%
6.2%
12.5%
5.1%
10.8%
18.7%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Avail...
Used Marijuana in the Past Month
0.7%
8.3%
19.3%
4.3%
15.8%
28.4%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Availabl...
Skipped School One or More Days
in the Past Month
5.7%
12.8%
22.5%
15.4%
23.0%
35.4%
Grade 6 Grade 8 Grade 11
Did not gamb...
7.2%
5.0%
11.3%
9.0%
Grade 8 Grade 11
Did not gamble Gambled
Available at: www.preventionlane.org/sws.htm
Attempted Suicid...
10.1%
8.0%
21.0%
18.6%
Grade 8 Grade 11
Did not bet/gamble more than wanted to
Bet/gambled more than wanted to
Attempted S...
Delinquency
(physical Fight in Past Month)
41.80%
22.40%
Physical fight
Gambled Did not gamble
delinquency
sexual
behavior
depression
substance
use
gambling
Problem
Behaviors
Conclusion: Problem Gambling
is one compon...
Protective Factors:
Characteristics
• Individual Characteristics:
– Gender
– Resilient Temperament
– Positive Social Orien...
Skills, Opportunity, Recognition
0
20
40
60
80
100
6th
7th
8th
Teachers notice
when I do a
good job
At least one teacher
o...
Protective Factors &
Gambling
60.60%
29%
65.90%
21.80%
Strong Positive Youth development Depression
Gambled Did not gamble
43.80%
32.90%
53.70%
23.20%
Likes school absenteeism
Gambled Did not gamble
Protective Factors &
Gambling
Prevention in action.
Common Goals
“Denormalization”
Prevention
Protection
Harm Reduction
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
 Problem
Identifi...
Prevention Efforts:
Shared Environments
• Information Dissemination:
moving readiness… first step is
to acknowledge there’...
Prevention Efforts:
Individualized Environments
• Identification & referral
• Problem gambling - LIE-BET (see
www.preventi...
SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
...
Peer to Peer Campaign
Video Contest & Art Search
• Cheap
• Great for integration in schools where
health curriculum not a possibility
• Ask medi...
Social Media
• Websites, Blogs, Facebook, YouTube,
Twitter, etc.
• Fairly inexpensive & easy to
update!
SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
...
Department of Education
• Exhibiting and presenting at
school teacher trainings
• ODE health education standards
now inclu...
Partnering with schools
• Casino night alternatives
• Parenting programs (e.g., Strengthening
Families)
• Selective preven...
Use Your Area’s Existing Best
Practice Curricula…add in
language!• Project Northland
• Life Skills
• Project Alert
• Stren...
SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
...
Casino night alternatives, art
projects, etc.
SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
...
Coalitions:
Giving People
A Voice
• Youth coalitions
• Integrating in
your prevention
coalition
• Specific problem
gamblin...
Josephine County Focus Teen
Council
“Working to make a positive impact
in our community and in the lives
of other youth by...
SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
...
Screening & Assessment 
Tools
• Lie/Bet  
• South Oaks Gambling Screen (SOGS)
• DSM‐V criteria
• National Opinion Diagnost...
Screening Techniques
• Add to SBIRT
• Community health centers
• Partner with AOD treatment providers
SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
...
RewardandReminders
Lottery Scratch Tickets
Thanks to Shawn Martinez of Josephine County, Oregon
Evidence‐Based Strategy ef...
WHEW…OK.
BUT WHAT ARE
THE
right path
System Evaluation Results
Prevention and outreach are working:
• Evaluation report in Oregon shows
many successes; see
htt...
Evidence-based prevention programs
save money
• On average, for every dollar
invested in these evidence-based
prevention p...
Evidence-based Prevention is a
Good Investment
$61  $120  $880 
$1,200 
$15 
$30,828 
$79,935  $94,900 
$50
$5,050
$10,050...
in Lane County.
And your examples.
Priority Drives Evidence-based
Program Selection
3‐5Early Childhood Education
prenatal‐2Prenatal/Infancy Programs
6‐14Fami...
Community Health Benefit &
Health Reform
Community
Health
Community
Based
Prevention
Service
Integration
Clinical
Services
Using Federal & State
Funding
PROGRAM ASSURANCES:
We:
• Support evidence-based
prevention practices
• Are Certified Preven...
Leveraged Resources =
Increased Prevention
FEDERAL/STATE FUNDS
ALLOWS THE COUNTY TO:
• Employ prevention
experts
• Develop...
Where can I find more info?
www.problemgamblingprevention.org
www.evergreencpg.org/
Where can I find more info?
www.addictionisagamble.com
www.preventionlane.org
www.preventionlane.org
Thank You! More info…
Connect :Connect :
Julie.Hynes@co.lane.or.us | 541.682.3928
Lane County Publi...
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling
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2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling

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Presented by Julie Hynes.
APril 24, 2014

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2014 Focus on the Future Conference: Risk & Protective Factors for Problem Gambling

  1. 1. integrating problem gambling in Prevention Julie Hynes, MA, CPS Focus on the Future Conference Vancouver, WA | April 2014
  2. 2. Thanks! to… • Oregon Problem Gambling Services • Evergreen Council on Problem Gambling • Leaders in the field: • Jeff Marotta • Jim Wuelfing Jeff Derevensky
  3. 3. www.preventionlane.org/ focusonthefuture First Things First:
  4. 4. Objectives: • Understand why it is essential and efficient to integrate • Identify and compare various methods of integration • Gain practical tools to bring back for use with target population(s)
  5. 5. Let’s be real.
  6. 6. What are some of the Key Challenges in your work?
  7. 7. Some of mine… Youthful subject Perception Stigma/shame Industry Proving results
  8. 8. prevention.
  9. 9. Pre‐ conception Prenatal/  Infancy Early  Childhood Childhood Early  Adolescence Adolescence Family • Prenatal care • Home visiting • Evidence‐based parenting programs • Evidence‐based kernels Schools • High‐quality preschool and daycare • Classroom‐based prevention curricula • Evidence‐based kernels • Afterschool programs Community • Community organizing to improve neighborhood environments • Support for evidence‐based strategies • Support for out‐of‐school activities • Evidence‐based kernels Policy • Community members have ensured access to services to meet basic needs • Promotion and support of healthy lifestyles • Policy to promote and support evidence‐based strategies Prevention Strategies by Developmental Phase and Domain
  10. 10. Prevention: Behavioral Health Public Health ACA
  11. 11. 5.6% college age (18‐24) 2½ % all adults (18+) 4‐6% teens (13‐17) This is the first generation of widely  available electronic gambling.  We really don’t know the effects yet. Why? Is it the generation? Technology? Or what?
  12. 12. Problem Behaviors AND they are
  13. 13. • Tobacco, alcohol, and other drug use and abuse • Delinquency and crime • Premature or unsafe sex • Depression and suicidality • School failure, dropout Scientific consensus is that that we can preventthese problems
  14. 14. factors.
  15. 15. ResiliencyTheory ADVERSE CHILDHOOD EXPERIENCES (ACE) 40 DEVELOPMENTAL ASSETS SOCIAL DEVELOPMENT STRATEGY PROMOTIVE FACTORS Risk & Protective Factor Theory
  16. 16. Risk Factors for Adolescent Problem Behavior
  17. 17. Recognized Problem Behaviors • Substance abuse • Violence • Delinquency • Teenage pregnancy • School dropout • Depression & Anxiety  Problem gambling?? – Apparently similar risk factors – Very high co-occurrence between problem gambling & other problem behaviors, especially alcohol/substance
  18. 18. Protective Factors • Protective factor: a characteristic associated with a lower likelihood of problem outcomes or that reduces the negative impact of a risk f actor on problem outcomes
  19. 19. check it out.
  20. 20. )
  21. 21. Effects of Problem Gambling on Children
  22. 22. “Theearlierpeoplebegin gambling,themorelikelythey aretoexperienceproblemsfrom gambling.” -National Academyof Sciences
  23. 23. AVAILABILITY.
  24. 24. Acceptability.
  25. 25. Advertising.
  26. 26. age.
  27. 27. Amygdala active Risk-taking & impulsive behaviors Source: Ramoski, S., Nystrom, R. (2007). Image source: simpsons.wikia.org  age… Prefrontal whaaa?
  28. 28. 2012 Oregon Student Wellness Survey, Lane County (“ESD”) and Oregon; available at http://oregon.pridesurveys.com/esds.php?year=2012 Awareness (low).
  29. 29. ATTITUDES Oregon parent/youth focus groups revealed: All parents in their focus groups said their  kids didn’t gamble All of their kids, who were in their own focus  groups, said they did gamble Neither sees gambling as risky
  30. 30. by the numbers.
  31. 31. Used alcohol in the past month 3.1% 14.6% 29.5% 14.9% 30.9% 46.9% Grade 6 Grade 8 Grade 11 Did not gamble Gambled
  32. 32. Binge drank in the last 30 days 0.5% 5.6% 16.4% 4.3% 12.7% 28.7% Grade 6 Grade 8 Grade 11 Did not gamble Gambled Available at: www.preventionlane.org/sws.htm
  33. 33. Smoked cigarettes in the past month 1.1% 6.2% 12.5% 5.1% 10.8% 18.7% Grade 6 Grade 8 Grade 11 Did not gamble Gambled Available at: www.preventionlane.org/sws.htm
  34. 34. Used Marijuana in the Past Month 0.7% 8.3% 19.3% 4.3% 15.8% 28.4% Grade 6 Grade 8 Grade 11 Did not gamble Gambled Available at: www.preventionlane.org/sws.htm
  35. 35. Skipped School One or More Days in the Past Month 5.7% 12.8% 22.5% 15.4% 23.0% 35.4% Grade 6 Grade 8 Grade 11 Did not gamble Gambled Available at: www.preventionlane.org/sws.htm
  36. 36. 7.2% 5.0% 11.3% 9.0% Grade 8 Grade 11 Did not gamble Gambled Available at: www.preventionlane.org/sws.htm Attempted Suicide in the Past Year
  37. 37. 10.1% 8.0% 21.0% 18.6% Grade 8 Grade 11 Did not bet/gamble more than wanted to Bet/gambled more than wanted to Attempted Suicide in the Past Year
  38. 38. Delinquency (physical Fight in Past Month) 41.80% 22.40% Physical fight Gambled Did not gamble
  39. 39. delinquency sexual behavior depression substance use gambling Problem Behaviors Conclusion: Problem Gambling is one component of Problem Behaviors
  40. 40. Protective Factors: Characteristics • Individual Characteristics: – Gender – Resilient Temperament – Positive Social Orientation – Intelligence • Protective Processes: – Opportunities for involvement – Social and cognitive skills – Recognition Dickson, Derevensky & Gupta, 2002
  41. 41. Skills, Opportunity, Recognition 0 20 40 60 80 100 6th 7th 8th Teachers notice when I do a good job At least one teacher or other adult at school really cares about me I get many chances to join in sports, clubs, and other activities outside class At home, my parent or another adult always wants me to do my best*
  42. 42. Protective Factors & Gambling 60.60% 29% 65.90% 21.80% Strong Positive Youth development Depression Gambled Did not gamble
  43. 43. 43.80% 32.90% 53.70% 23.20% Likes school absenteeism Gambled Did not gamble Protective Factors & Gambling
  44. 44. Prevention in action.
  45. 45. Common Goals “Denormalization” Prevention Protection Harm Reduction
  46. 46.  Information Dissemination  Prevention Education  Alternative Activities  Community-Based Processes  Problem Identification/ Referral  Environmental/Policy Approaches A Common Approach: Uses the Center  for Substance  Abuse Prevention  Strategies for  Effective  Prevention
  47. 47. Prevention Efforts: Shared Environments • Information Dissemination: moving readiness… first step is to acknowledge there’s an issue! • Community-based prevention coalitions – Communities that Care • Norms, Policies & Law – Social Host Ordinance – Gambling
  48. 48. Prevention Efforts: Individualized Environments • Identification & referral • Problem gambling - LIE-BET (see www.preventionlane.org/lie-bet) • School-based prevention • Reconnecting Youth • RESPONSE (H.S. suicide prevention) • Problem gambling integration with ATOD curricula • Family support
  49. 49. SPECIFIC examples  Information Dissemination  Prevention Education  Alternative Activities  Community-Based Processes  Problem Identification/ Referral  Environmental/Policy Approaches
  50. 50. Peer to Peer Campaign
  51. 51. Video Contest & Art Search • Cheap • Great for integration in schools where health curriculum not a possibility • Ask media, A/V, drama teachers about participating • See http://preventionlane.org/videos.htm and http://preventionlane.org/gambling/art- search.htm for more information
  52. 52. Social Media • Websites, Blogs, Facebook, YouTube, Twitter, etc. • Fairly inexpensive & easy to update!
  53. 53. SPECIFIC examples  Information Dissemination  Prevention Education  Alternative Activities  Community-Based Processes  Problem Identification/ Referral  Environmental/Policy Approaches
  54. 54. Department of Education • Exhibiting and presenting at school teacher trainings • ODE health education standards now includes problem gambling at 6-8th grade level Above: see http://preventionlane.org/gambling/about-us.htm for complete chart & information CSAP: Policy
  55. 55. Partnering with schools • Casino night alternatives • Parenting programs (e.g., Strengthening Families) • Selective prevention programs (e.g., Reconnecting Youth) • Adding language about gambling into any drug or alcohol curriculum • In-class presentations that can fold in with problem gambling • Sample policies (see student handbooks) CSAP: Info dissemination, policy, community process,  education, ID & referral (possibly alternative activities)
  56. 56. Use Your Area’s Existing Best Practice Curricula…add in language!• Project Northland • Life Skills • Project Alert • Strengthening Families 10-14 • Etc… again, add in the language or tools here.
  57. 57. SPECIFIC examples  Information Dissemination  Prevention Education  Alternative Activities  Community-Based Processes  Problem Identification/ Referral  Environmental/Policy Approaches
  58. 58. Casino night alternatives, art projects, etc.
  59. 59. SPECIFIC examples  Information Dissemination  Prevention Education  Alternative Activities  Community-Based Processes  Problem Identification/ Referral  Environmental/Policy Approaches
  60. 60. Coalitions: Giving People A Voice • Youth coalitions • Integrating in your prevention coalition • Specific problem gambling coalitions • Social media can
  61. 61. Josephine County Focus Teen Council “Working to make a positive impact in our community and in the lives of other youth by supporting a healthy, Drug Free lifestyle”
  62. 62. SPECIFIC examples  Information Dissemination  Prevention Education  Alternative Activities  Community-Based Processes  Problem Identification/ Referral  Environmental/Policy Approaches
  63. 63. Screening & Assessment  Tools • Lie/Bet   • South Oaks Gambling Screen (SOGS) • DSM‐V criteria • National Opinion Diagnostic Summary  (NODS) • GA/Gam‐Anon 20 Questions The above tools are available online at  http://npgaw.org/tools/screeningtools.asp
  64. 64. Screening Techniques • Add to SBIRT • Community health centers • Partner with AOD treatment providers
  65. 65. SPECIFIC examples  Information Dissemination  Prevention Education  Alternative Activities  Community-Based Processes  Problem Identification/ Referral  Environmental/Policy Approaches
  66. 66. RewardandReminders Lottery Scratch Tickets Thanks to Shawn Martinez of Josephine County, Oregon Evidence‐Based Strategy effectively  used for Alcohol and Tobacco  retailers, many of whom are lottery  retailers as well.  
  67. 67. WHEW…OK. BUT WHAT ARE THE
  68. 68. right path
  69. 69. System Evaluation Results Prevention and outreach are working: • Evaluation report in Oregon shows many successes; see http://problemgamblingprevention.org/reports/08-09- AD80-Annual-Reports-Summary.pdf for more complete report • Oregon is one of the few states that appears to have averted a significant increase in problem gambling prevalence while expanding legalized gambling (National Center For the Study of Gambling, 2006) 1. Moore & Marotta, in press 2. National Center For the Study of Gambling, 2006.
  70. 70. Evidence-based prevention programs save money • On average, for every dollar invested in these evidence-based prevention programs nationwide… – $6 was saved with Project Alert – $8 was saved with Adolescent Transitions Program – $11 was saved with Strengthening Families 10-14 – $35 was saved with Good Behavior Game
  71. 71. Evidence-based Prevention is a Good Investment $61  $120  $880  $1,200  $15  $30,828  $79,935  $94,900  $50 $5,050 $10,050 $15,050 $20,050 Annual cost per person per family
  72. 72. in Lane County. And your examples.
  73. 73. Priority Drives Evidence-based Program Selection 3‐5Early Childhood Education prenatal‐2Prenatal/Infancy Programs 6‐14Family Therapy prenatal‐14Parent Training Family Management  Problems Developmental PeriodProgram StrategyFactor Addressed
  74. 74. Community Health Benefit & Health Reform Community Health Community Based Prevention Service Integration Clinical Services
  75. 75. Using Federal & State Funding PROGRAM ASSURANCES: We: • Support evidence-based prevention practices • Are Certified Prevention Specialists • Engage the community • Value & use data EXAMPLES: • Good Behavior Game • Family Check-up • Policy work • MH First Aid • Question, Persuade, Refer • MH Promotion Steering Committee, Problem Gambling Advisory Committee, etc.
  76. 76. Leveraged Resources = Increased Prevention FEDERAL/STATE FUNDS ALLOWS THE COUNTY TO: • Employ prevention experts • Develop content expertise • Engage the community • Develop relationships with key stakeholders • Fund limited prevention programs PARTNERSHIP WITH TRILLIUM ALLOWS: •  implementation prevention best practices •  ‘reach’ (geographically + discipline) •  FTE working in prevention • Advocacy for policy & environmental change
  77. 77. Where can I find more info? www.problemgamblingprevention.org www.evergreencpg.org/
  78. 78. Where can I find more info? www.addictionisagamble.com www.preventionlane.org
  79. 79. www.preventionlane.org Thank You! More info… Connect :Connect : Julie.Hynes@co.lane.or.us | 541.682.3928 Lane County Public Health hynes@uoregon.edu University of Oregon preventionlane

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