Building Bridges Between Prevention and Research Ken Winters, Ph.D. University of Minnesota [email protected] for Prevention of Problem Gambling Conference

Building Bridges Between Prevention and Research

Ken Winters, Ph.D.University of Minnesota

[email protected]

Prevention of Problem Gambling ConferenceUniversity of Lethbridge

March 27, 2003

Top Ten Issues for Building a Prevention-Research Agenda

1. Engage the industry to participate in prevention and intervention research


2. Tackle the measurement and definitional issues of “pathological gambling”

Label Hodge-Podge

Problem Severity Continuum

No gambling

At-Risk

gambling

Social g

ambling

Problem gamblin

g

---------Level 1 to 4---------

Pathologica

l gamblin

g

Compulsive gamblin

g

Habitual g

ambling

?


3. What should we prevent?• underlying risk factors?


3. What should we prevent?• underlying risk factors?• development of the disorder?

• attitudes and perceptions?


3. What should we prevent?• underlying risk factors?• development of the disorder?• attitudes and perceptions?

• access and density?


3. What should we prevent?• underlying risk factors?• development of the disorder?• access and density?

• demographic considerations• youth• elderly


4. We are a small fish in a big pond

Playing the Grant Game in the U.S.

• Institute for Research on Pathological Gambling and Related Disorders (spin-off from the National Center for Responsible Gaming)

•21 grants funded since the mid-1990’s•$3.1 million allocated

Playing the Grant Game in the U.S.

• National Institutes of Health•10 grants funded since their “request for proposals” in the mid-1990’s

•$10.2 million allocated


5. The standards for rigorous prevention research are high• After 25 years of drug abuse research

in the U.S., the bar for methodological rigor is quite high.

• Controlled designs with prospective samples are the norm

Transportability

Efficacy Effectiveness

Dissemination

Diffusion

Prevention Intervention Research Model

Pre-intervention


6. Avoid reinventing the wheel; tap the vast knowledge from drug abuse and related behavioral prevention research.

Lessons Learned fromDrug Abuse Prevention

• Know the psychosocial determinants of the target population.

• (Youth): Start early.• Employ methods that engage the

target.• Be multi-systemic, multi-

dimensional

Multiple Spheres of Influence

Individual

Family

Social

Community

Effective Prevention =Use at Least TWO

• information dissemination• prevention education• alternative drug-free activities• problem identification and referral• community-based intervention• environmental approach


7. Harm reduction, risk reduction and pattern normalization strategies are worthy of consideration, despite their ideological controversies.

Spectrum of Intervention ResponsesAdapted from Broadening the Base of Alcohol Treatment (IOM)

Primary Prevention

Non-player Infrequent play Heavy play Subclinical Problem

HarmReduction

Harm Reduction/Abstinence

Thresholds for Action


8. Of the major models....

universaltargetedindicated

which should receive priority given limited $$?


9. The web has great potential; can it be harnessed for effective prevention?


10. Proceed with caution.

Avoid the DARE Phenomenon

Just because a prevention effort is popular, well-received, highly

integrated into the community, and affordable, it does not mean

that it WROKS!

Remember JFK’sWarning

“Twenty-five percent of the people are against

everything all the time.”

Thank You

Documents

Building Bridges Between Prevention and Research Ken Winters, Ph.D. University of Minnesota [email protected] for Prevention of Problem Gambling Conference