2014 focus on the future conference: risk & protective factors for problem gambling

integratingproblemgambling

in PreventionJulie Hynes, MA, CPS

Focus on the Future ConferenceVancouver, WA | April 2014

Thanks! to…• Oregon Problem Gambling Services• Evergreen Council on ProblemGambling

• Jeff Marotta• Jim Wuelfing

www.preventionlane.org/focusonthefuture

First Things First:

Objectives:

• Understand why it is essential andefficient to integrate

• Identify and compare various methodsof integration

• Gain practical tools to bring back foruse with target population(s)

Let’s be real.

What aresome of theKey Challengesin yourwork?

Besidesfunding.

Besidestime.

Some of mine…Youthful subject

Perception

Stigma/shame

Industry

Proving results

prevention.

Pre-conception

Prenatal/Infancy

EarlyChildhood 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 byDevelopmental Phase and Domain

Prevention:

Behavioral Health

Public Health

ACA

Most focus

5.6% college age (18-24)

2½ % all adults (18+)

4-6% teens (13-17)

This is the first generation of widelyavailable electronic gambling.

We really don’t know the effects yet.

Why?Is it thegeneration?Technology?Or what?

Problem Behaviors

Problem Behaviors

• Tobacco, alcohol, andother drug use andabuse

• Delinquency and crime• Premature or unsafe

sex• Depression and

suicidality• School failure, dropout

Scientific consensus is that that we canprevent these problems

factors.

Resi

lien

cy T

heo

ry

ADVERSE CHILDHOOD EXPERIENCES (ACE)

40 DEVELOPMENTALASSETS

SOCIAL DEVELOPMENT STRATEGY

PROMOTIVE FACTORS

Risk & Protective FactorTheory

No onesize fits all

Risk Factors for AdolescentProblem Behavior

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/substanceabuse

Protective Factors

• Protective factor: a characteristicassociated with a lowerlikelihood of problem outcomesor that reduces the negativeimpact of a risk f actor onproblem outcomes

check it out.

)

Effects ofProblemGamblingon Children

“The earlier people begingambling, the more likely theyare to experience problems fromgambling.”- National Academy of Sciences

AVAILABILITY.

Acceptability.

Advertising.

age.

Amygdalaactive

Risk-taking &impulsivebehaviorsSource: Ramoski, S., Nystrom, R. (2007). Image source: simpsons.wikia.org

age…Prefrontalwhaaa?

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

Awareness (low).

ATTITUDESOregon parent/youth focus groups revealed:

All parents in their focus groups said theirkids didn’t gamble

All of their kids, who were in their own focusgroups, said they did gamble

Neither sees gambling as risky

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 at: www.preventionlane.org/sws.htm

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

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

Skipped School One or More Daysin 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

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

10.1%8.0%

21.0%18.6%

Grade 8 Grade 11

Did not bet/gamble more than wanted toBet/gambled more than wanted to

Attempted Suicide in the Past Year

Delinquency(physical Fight in Past Month)

41.80%

22.40%

Physical fight

Gambled Did not gamble

CONCLUSION?

Teens who gamble aresmoked up, toked up,

drunk emo delinquents.

CONCLUSION?

Teens who gamble aresmoked up, toked up,

drunk emo delinquents.

delinquency

sexualbehavior

depression

substanceuse

gambling

ProblemBehaviors

Conclusion: Problem Gamblingis one component ofProblem Behaviors

Protective Factors:Characteristics

• Individual Characteristics:– Gender– Resilient Temperament– Positive Social Orientation– Intelligence

• Protective Processes:– Opportunities for involvement– Social and cognitive skills– RecognitionDickson, Derevensky & Gupta, 2002

Skills, Opportunity, Recognition

0

20

40

60

80

100

6th7th8th

Teachers noticewhen I do a

good job

At least one teacheror other adult at

school really caresabout me

I get many chancesto join in sports,clubs, and otheractivities outside

class

At home, myparent or another

adult alwayswants me to do

my best*

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”PreventionProtectionHarm Reduction

The Right Support to the RightPeople

Ideally, we would havevarying levels of support tomeet the needs of diverseyouth and their families.

Size of population affected

More intensive for at-risk youth and families

~15%

Most intensiveinterventions for theyouth and families athighest risk

~10%

Universal supports forall youthand families

~75%

Evidence-based Prevention is aGood 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

in Lane County.And your examples.

Priority Drives Evidence-basedProgram Selection

3-5Early Childhood Education

prenatal-2Prenatal/Infancy Programs

6-14Family Therapy

prenatal-14Parent Training

Family ManagementProblems

Developmental PeriodProgram StrategyFactor Addressed

Community Health Benefit &Health Reform

CommunityHealth

CommunityBased

Prevention

ServiceIntegration

ClinicalServices

Using Federal & StateFundingPROGRAM ASSURANCES:

We:

• Support evidence-basedprevention practices

• Are Certified PreventionSpecialists

• 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, ProblemGambling AdvisoryCommittee, etc.

Leveraged Resources =Increased PreventionFEDERAL/STATE FUNDSALLOWS THE COUNTY TO:

• Employ preventionexperts

• Develop contentexpertise

• Engage the community

• Develop relationshipswith key stakeholders

• Fund limited preventionprograms

PARTNERSHIP WITHTRILLIUM ALLOWS:

• implementationprevention best practices

• ‘reach’ (geographically +discipline)

• FTE working inprevention

• Advocacy for policy &environmental change

Where can I find more info?

www.problemgamblingprevention.orgwww.evergreencpg.org/

Where can I find more info?

www.addictionisagamble.orgwww.preventionlane.org

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