This document summarizes Julie Hynes' presentation on integrating problem gambling prevention into broader prevention efforts. It discusses why integration is important and efficient, identifies methods of integration, and provides practical tools. Risk and protective factors for problem gambling are similar to other issues like substance abuse. Integrating messaging across topics can increase reach and effectiveness. The document then provides specific examples of strategies that integrate problem gambling prevention, such as school curricula, social media campaigns, community coalitions, screening tools, and environmental policies. Evidence shows prevention is cost-effective and Oregon has seen success through these integrated approaches.

1. integrating
problem
gambling
in Prevention
Julie Hynes, MA, CPS
Focus on the Future Conference
Vancouver, WA | April 2014

2. Thanks! to…
• Oregon Problem Gambling Services
• Evergreen Council on Problem
Gambling
• Leaders in the field:
• Jeff Marotta
• Jim Wuelfing
Jeff Derevensky

3. www.preventionlane.org/
focusonthefuture
First Things First:

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. Let’s be real.

6. What are
some of the
Key Challenges
in your
work?

7. Some of mine…
Youthful subject
Perception
Stigma/shame
Industry
Proving results

8. prevention.

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. Prevention:
Behavioral Health
Public Health
ACA

14. 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?

15. Problem Behaviors
AND they are

16. • 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

17. factors.

18. ResiliencyTheory
ADVERSE CHILDHOOD EXPERIENCES (ACE)
40 DEVELOPMENTAL
ASSETS
SOCIAL DEVELOPMENT STRATEGY
PROMOTIVE FACTORS
Risk & Protective Factor
Theory

22. Risk Factors for Adolescent
Problem Behavior

23. 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

24. 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

26. check it out.

33. )

34. Effects of
Problem
Gambling
on Children

35. “Theearlierpeoplebegin
gambling,themorelikelythey
aretoexperienceproblemsfrom
gambling.”
-National Academyof Sciences

36. AVAILABILITY.

37. Acceptability.

38. Advertising.

39. age.

40. Amygdala
active
Risk-taking &
impulsive
behaviors
Source: Ramoski, S., Nystrom, R. (2007). Image source: simpsons.wikia.org
age…
Prefrontal
whaaa?

41. 2012 Oregon Student Wellness Survey, Lane County (“ESD”) and Oregon; available
at http://oregon.pridesurveys.com/esds.php?year=2012
Awareness (low).

42. 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

43. by the numbers.

44. 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

45. 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

46. 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

47. 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

48. 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

49. 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

50. 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

51. Delinquency
(physical Fight in Past Month)
41.80%
22.40%
Physical fight
Gambled Did not gamble

52. delinquency
sexual
behavior
depression
substance
use
gambling
Problem
Behaviors
Conclusion: Problem Gambling
is one component of
Problem Behaviors

53. 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

54. 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*

55. Protective Factors &
Gambling
60.60%
29%
65.90%
21.80%
Strong Positive Youth development Depression
Gambled Did not gamble

56. 43.80%
32.90%
53.70%
23.20%
Likes school absenteeism
Gambled Did not gamble
Protective Factors &
Gambling

57. Prevention in action.

58. Common Goals
“Denormalization”
Prevention
Protection
Harm Reduction

59.  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

60. 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

61. 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

62. SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
 Problem
Identification/
Referral
 Environmental/Policy
Approaches

65. Peer to Peer Campaign

66. 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

67. Social Media
• Websites, Blogs, Facebook, YouTube,
Twitter, etc.
• Fairly inexpensive & easy to
update!

68. SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
 Problem
Identification/
Referral
 Environmental/Policy
Approaches

69. 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

70. 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)

71. 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.

72. SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
 Problem
Identification/
Referral
 Environmental/Policy
Approaches

73. Casino night alternatives, art
projects, etc.

74. SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
 Problem
Identification/
Referral
 Environmental/Policy
Approaches

75. Coalitions:
Giving People
A Voice
• Youth coalitions
• Integrating in
your prevention
coalition
• Specific problem
gambling
coalitions
• Social media can

76. 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”

77. SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
 Problem
Identification/
Referral
 Environmental/Policy
Approaches

78. 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

79. Screening Techniques
• Add to SBIRT
• Community health centers
• Partner with AOD treatment providers

80. SPECIFIC
examples
 Information
Dissemination
 Prevention Education
 Alternative Activities
 Community-Based
Processes
 Problem
Identification/
Referral
 Environmental/Policy
Approaches

81. 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.

82. WHEW…OK.
BUT WHAT ARE
THE

83. right path

84. 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.

85. 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

86. 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

87. in Lane County.
And your examples.

88. 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

89. Community Health Benefit &
Health Reform
Community
Health
Community
Based
Prevention
Service
Integration
Clinical
Services

90. 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.

91. 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

92. Where can I find more info?
www.problemgamblingprevention.org
www.evergreencpg.org/

93. Where can I find more info?
www.addictionisagamble.com
www.preventionlane.org

98. 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