Abstract
There is an increased awareness that gambling is a meaningful public health issue that requires a robust response centred on prevention. However, unlike other problems such as substance use, gambling-related harm is generally poorly understood, and there is a meaningful lack of previsions to address it outside of responsible gambling strategies which have been shown to be inadequate.Study 1, 2 and 3 (Chapter 2) aimed to examine the current landscape of gambling-related harm using a multilevel approach that considered the perspectives of the general population, service providers and users. It was found that experience with gambling-related harm was prevalent, but the opportunities for support were limited. Many service providers did not possess adequate training and resources to identify and address the issue. They relied on self-disclosure and financial assessment as the only means of identification.
Study 4 (Chapter 3) carried out a systematic review of gambling screening tools. The review aimed to develop a detailed understanding of the wide range of tools employed across the literature and their merit as part of a public health framework for harm prevention. The review found a range of meaningful deficits in the literature. This included a lack of appropriate reference standard selection across most of the papers, methodological issues relating to design and sample selection and a lack of tools aimed at early identification. The key finding was that there was an absence of tools that could identify risk factors and, by extension, low-risk individuals, favouring instead to measure harm and higher-risk samples.
Study 5 (Chapter 4) was a systematic review of the literature examining the prevention and intervention approaches used in the field. The review employed strict inclusion criteria and required the studies to be methodologically robust and include a 12-month follow-up. The review concluded that there was a lack of prevention approaches discussed in the literature that employed a robust methodology and a 12-month follow-up. Additionally, there was little standardisation between the approaches used.
Study 6-7 (Chapter 5) took the previous chapters' findings and developed a screening tool to address the issues identified in previous studies. Study 6 consulted service providers on the barriers to routine gambling screening and their attitudes towards different gambling screening tools. This information was then used in study 7 to develop the Identifier of Potential Risk-factors of gambling harm (IDENT-Pro), a brief risk factor screening tool to support harm prevention.
This thesis has provided a robust examination of the landscape of gambling screening and intervention, identified various issues, and highlighted the need for approaches that target gambling risk factors that predict harm. The IDENT-Pro is a psychometrically robust tool that can identify low-risk gambling behaviour and allow service users to reflect on their scores to encourage behaviour change. This tool provides services with a means to deliver brief interventions without the need for training and increased resources.
| Date of Award | 2024 |
|---|---|
| Original language | English |
| Supervisor | Gareth Roderique-Davies (Supervisor) & Klara Price (Supervisor) |