Adolescent Gambling Problems: Public Health Intervention Using the Internet
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1 Adolescent Gambling Problems: Public Health Intervention Using the Internet David Korn MD Charlotte Lombardo Martha Murray Department of Public Health Sciences University of Toronto
2 Acknowledgements! Dave Haans! Dan Rootman! Sherry Biscope! Oonagh Maley! Harvey Skinner
3 About Us! University of Toronto! Faculty of Medicine! Public Health Sciences Department! TeenNet! Gambling Research Project
4 Presentation! Establish a public health context for addressing youth gambling! Describe TeenNet within Public Health Sciences, University of Toronto! Report progress on our Gambling Research Project
5
6 The way you define a problem will determine what you do about it. Dr. Jonathan Mann GLOBAL AIDS Program World Health Organization
7 Frame Youth Gambling as A Public Health Matter
8 The enduring value of a public health perspective is that it applies different lenses for understanding gambling behavior, analyzing its benefits and costs, as well as identifying strategies for action. Harvey Skinner, Chair Department of Public Health Sciences University of Toronto
9 Public Health & Gambling Definition Study of the distribution & determinants of gambling problems in a defined population and the organized measures to prevent, minimize or control its occurrence and spread
10 Value of a Public Health Framework for Youth Gambling! Upstream emphasis! Strategic orientation! Commitment to partnerships! Youth engagement! Multiple interventions! Asset rather than deficits approach
11 Perceived Positives for Youth! Can learn competencies! Numeracy & literacy! Risk assessment! Decision making! Coping with disappointment, loss & winning! Can promote self efficacy & informed choice! Leisure & lifestyle! Health behaviors! Consequences of actions
12 Determinants of Problem Gambling Gambler Money Environment Game
13 Youth Gambling Strategic Goals! Promote: informed, balanced attitudes & behaviors towards gambling & gamblers! Prevent: youth gambling related health problems! Protect: vulnerable & at risks youth David Korn MD, International Think Tank on Youth Gambling, McGill University, Montreal, May 2001
14 Public Health Integrated Intervention Model Public Health Framework For Youth Spectrum of Gambling Behaviors & Risk Non- Gambling none health promotion At-risk Gambling Problem Continuum m ild moderate severe Unhealthy Gambling brief intensive treatment harm reduction primary prevention secondary prevention Range of Interventions tertiary prevention
15 Youth & Technology
16 Internet Access by Youth Canada: 99% United States: 65% England: 75%! Access & Fun! home, work, school, libraries, community centres! Web, ICQ, Phone
17 TECHNOLOGY, HEALTH, AND HEALTH CARE
18 e n c o u r a g e d $ Tertiary Secondary Primary Professional Care d i s c o u r a g e d Industrial Age Medicine Self-Care
19 e n c o u r a g e d Information Age Healthcare Individual self-care Friends and family d i s c o u r a g e d $ Self-help networks Professional as facilitators Professionals as partners Professionals as authorities
20 TeenNet Department of Public Health Sciences University of Toronto
21 TeenNet PURPOSE To generate new knowledge on engaging youth in health promotion using interactive technology
22 TeenNet AIM To develop Websites with teens and for teens, that are highly graphical, interactive, fun, autonomy supporting, accessible,and contains information that is relevant for teens.
23 TeenNet! Established 1995; Website launch dates:! CyberIsle 1997! Smoking Zine 1999! Teen Clinic On-Line 2000! PractitionerNet 2001! Gambling 2002
24 CyberIsle s Smokin Zine
25 Teen Clinic Online
26 TeenNet APROACH! Youth Driven! Action Research Model! Commitment to Partnerships
27 TeenNet YOUTH DRIVEN Takes a youth in action approach that involves young people from diverse backgrounds in all stages of program development and dissemination
28 TeenNet Youth In Action
29 TeenNet Youth in Action
30 TeenNet Youth in Action
31 TeenNet ACTION RESEARCH MODEL! Project Development Cycles! Community Involvement! Technology Options
32 A c t D i s s e m i n a t io n S t u d y O w nership U tiliz a tio n R a p id Prototyping D o C o m m u n i t y C a p a c i t y E n g a g e m e n t P la n F e a sib ility R e le v a n c e L i s t e n / D ia l o g u e T echnology O p t i o n s D e v e l o p m C y c l e s e n t C o m m u n i t y In volvem en t TeenN et A ction R esearch M odel
33 TeenNet ACADEMIC-COMMUNITY PARTNERSHIP When only community members have the experience, & only academics have the theories, both forms of knowledge are weakened.
34 TEENNET GAMBLING RESEARCH PROJECT
35 Ontario Government-University of Toronto Partnership! Funded by the Ontario Ministry of Health and Long-Term Care! 3 year project! Special Population Initiative
36 Project Target Group! Youth aged 10-19! Emphasis on youth of diverse cultural and socio-economic backgrounds! Ontario wide
37 Research Challenges! Engage youth using interactive webbased technology! Develop a range of public health interventions! Demonstrate a community collaboration model
38 Products I. Interactive multimedia youth & gambling website II. Evaluation on effectiveness of public health interventions
39 Project Phases! Phase I (Feb 2000 Jan 2001)! Phase II (Feb 2001 April 2002)! Phase III (May 2002 May 2003)
40 Community Partnerships Community Partners! YMCA of Toronto! Davenport-Perth Neighbourhood Centre! St. Stephen s Community House! Substance Abuse Program for African- Canadian and Caribbean Youth! Responsible Gambling Council of Ontario
41 YOUTH INVOLVEMENT! Focus groups! Roundtable event! Website working group
42 FOCUS GROUPS
43 Focus Groups Overview! Carried out Oct./Dec. 2000! Diverse demographic profile! Data used to help develop website design, content & messaging
44 Focus Groups Demographics! 12 focus groups! 103 youth! 57% female, 43% male! Diversity of cultural identification! Age range: years old! 13 & 16 concentrations
45 ROUNDTABLE EVENT
46 Roundtable Overview! Weekend event in April 2001! Held on University of Toronto campus! Involved 30 diverse youth from across Ontario, aged 13-19! All recruited by community partners! Facilitated by YMCA staff partners
47 Roundtable Goals 1. Refine focus group results 2. Create the gambling website concept 3. Recruit members for Website Working Group
48 Website Development
49 Website Development! Youth Working Group! Website Concept! Website Content! Technical Design
50 Web Site Working Group! Recruited from roundtable! 7 core youth members! 5 female, 2 male! aged 14-18! Development of website
51 Website Concept A NEIGHBOURHOOD SCENE
52 Website Gambling Home Page
53 Website Concept Neighbourhood scene with 6 locations! Gaming areas:! A school yard! A back alley! A corner store! A casino! Information areas:! A library! A community centre
54 Corner Store
55 Back Alley
56 Schoolyard
57 Casino
58 Library
59 Community Centre
60 Website Content! Public Health Intervention Tool Kit! Developed with the youth! Multiple interventions! Based on public health principles
61 Public Health Principles 1. Prevention 2. Harm reduction 3. Self-efficacy 4. Health promotion
62 Public Health Intervention Toolkit 1. Money Management 2. Time Management 3. Decision Balance Strategy 4. Self Assessment Tool 5. Risk Perception 6. Randomness, Odds & Probability 7. Minimizing Negative Consequences
63 Public Health Tool 1. Money Management! Choices about how to spend money! Gambling in a safe environment! Choices and consequences
64 Money Management
65 Public Health Tool 2. Time Management! How youth spend their time! Time management strategies! Time management and gambling
66 Time Management
67 Public Health Tool 3. To Bet or Not to Bet! Gambling scenario presented! Choose to bet or not! Random outcome! Consequences related to:! Money! Relationships! Personal feelings
68 To Bet or Not To Bet
69 Public Health Tool 4. Self-Assessment Tool! Gambling continuum! SOGS-RA
70
71 Public Health Tool 5. Risk Perception! Youth perception of risk! Comparison to other youth! Opportunity for discussion
72 Risk Perception
73 Items Embedded In Each Location! Bulletin board! Link to chat room! Telephone! Link to helpline and other resources
74 Website Launch! Wednesday, May 15 th! 4:00-7:00 pm! East Common Room, Hart House! University of Toronto! VISIT THE SITE THROUGH:!
75 Evaluation! Utilization evaluation! Changes in Gambling Knowledge, Awareness, Attitudes and Behavioural intentions
76 Marketing! Community Partners! YMCA Youth Gambling Project! Web-based! Gambling and health community
77 Your Involvement is Welcome! David Korn (Project Director)! ! Martha Murray (Project Coordinator)! !
78 ! One more item..
79 Youth Gambling Research Listserv! Purpose:! To provide a forum to share and discuss information, questions and resources related to youth gambling research! Developed & managed by:! Gambling Project, Department of Public Health Sciences, University of Toronto! To join contact:! Martha Murray, Listserv Manager
80 THE END
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