Analyzing Consumer Protection for Gamblers Across Different Online Gambling Operators: A Replication Study

Online gambling is a growing business with many stakeholders. Due to the fact that a small proportion of gamblers develop problems, responsible gambling (RG), player protection, and harm minimization have become core areas for gambling regulators. The present study replicated a previous one carried out by Bonello and Griffiths in 2017 to determine whether there had been any significant changes by leading gambling operators due to increased regulatory pressures over the past few years. Fifty leading online gambling operators were audited in relation to their RG practices as well as engaging with their customer services by posing as a problem gambler. Results indicated that overall RG practices appeared to have improved in the past 3 years based on the information in dedicated RG webpages, the increase in RG tool availability, and the communication with customer services. Despite the fact that RG practices appear to have improved, there were still areas for improvement.

Gambling-Related Harms for Affected Others: A Finnish Population-Based Survey

Aims This study explores the prevalence of being a past-year affected other (AO) of a problem gambler by gender. The aims were to study the amount and type of gambling-related harms (GRHs) for subgroups of AOs and to distinguish GRH profiles for AO subgroups. Methods A total of 7186 adults aged 18 years and over participated in the Gambling Harms Survey evaluating year 2016. The data were analyzed using descriptive statistics and binary logistic regression. Results Of all respondents, 12.9% were defined as past-year AOs (women 13.7%; men 12.1%). The proportion of affected non-family members (ANFs) was 8.4%, and 5.6% were affected family members (AFMs). AFMs were usually women, and ANFs were usually men. Emotional, relationship, and financial harms were the most common types of harm. The odds of experiencing financial harm were highest for the 18- to 34-year-olds (OR 1.82) and for those whose partner/ex-partner had a gambling problem (OR 3.91). Having a parent/step-parent (OR 1.93) and child/stepchild (OR 3.64) increased the odds of experiencing emotional harm, whereas male gender (OR 0.50) and being an ANF (OR 0.58) decreased emotional harm. Relationship harm was evident for partners/ex-partners (OR 1.97–5.07). Conclusions GRH profiles for AO subgroups varied, which emphasizes the need for effective harm minimization strategies for those in need.

Window dressing: possibilities and limitations of incremental changes in solitary confinement

Background In light of mounting evidence of the physical and psychological harms associated with solitary confinement, many correctional systems, state legislators, courts, and even international human rights bodies are increasingly recommending and implementing reforms to mitigate the harms of solitary confinement, if not abolish the practice entirely. In this piece, we examine three specific infrastructural changes to solitary confinement conditions and practices implemented in Washington state prisons with such harm minimization goals in mind: (1) building so-called “nature imagery rooms” to play videos of outdoor spaces, (2) eliminating punishments for self-harm, and (3) conducting daily cell-front wellness checks. Results Drawing on 183 in-depth qualitative interviews with both staff working in and people imprisoned in solitary confinement units conducted in Washington state restrictive housing units in 2017, we find that these three reforms not only resulted in limited successes but also generated new conflicts. Institutional logics such as deprivation, risk-management, and responsibilization ultimately impeded even the most modest attempts to mitigate the inherently harsh practice of solitary confinement. The limits of these reforms are due in part to individual choices made by people imprisoned in solitary confinement and staff working in these units, as well as the larger cultural norms that shape life in restrictive housing units. Conclusions Incrementalist reforms aimed at softening the environment of solitary confinement may actually serve to increase the strain and stress experienced by people confined to and working within them. Even the most well-intentioned reforms, like those attempted by the Washington DOC, should be scrutinized in order to determine if they are producing the desired outcomes, or instead, reproducing a different, but nonetheless damaging set of harms to people imprisoned in solitary confinement. Further, even well-intentioned reforms are often stymied by the underlying institutional logics of restrictive housing spaces.

Accuracy of self-reported gambling frequency and outcomes: Comparisons with account data

Objectives: The ability to accurately recall past gambling behavior and outcomes is essential for making informed decisions about future gambling. We aimed to determine whether online gambling customers can accurately recall their recent gambling outcomes and betting frequency. Methods: An online survey was distributed to 40,000 customers of an Australian sports and race wagering website which asked participants to recall their past 30-day net outcome and number of bets. We compared responses to these questions with participants’ actual outcomes as provided by the online site. Results: Among the 514 participants who reported their net outcome, only 21 (4.09%) were accurate within a 10% margin of their actual outcome. Participants were most likely to underestimate their losses (N = 333, 64.79%). Lower actual net losses were associated with greater under- and over-estimation of losses. Of the 652 participants who reported their gambling frequency, 48 (7.36%) were accurate within a 10% margin of their actual frequency. Most participants underestimated their number of bets (N = 454, 69.63%). Higher actual betting frequencies were associated with underestimating betting and lower actual frequencies with overestimating betting. Conclusions: The poor recall accuracy we observed suggests public health approaches to gambling harm minimization that assume people make informed decisions about their future bets based on past outcomes and available funds should be reconsidered. Findings also question the reliability of research outcomes predicated on self-reported gambling behavior. Research is needed to determine the best methods of increasing people’s awareness of their actual expenditure and outcomes.

The Effectiveness of Low-Investment Pachinko/Pachislot in Reducing Gambling-Related Harms: A Cross Sectional Study

BackgroundPachinko and pachislot are popular types of gambling activities in Japan. Prior studies in Japan have reported a concerning prevalence of problem gambling among adult players. While these studies have identified various gambling-related harms, Japanese research on harm-minimization strategies is scarce. Therefore, the present study aimed to analyze the effectiveness of low-investment pachinko and pachislot as a harm-reduction strategy. MethodsWe considered gamblers who played games that cost the typical amount of money to be “normal-pachi players.” Those who played low-investment games were categorized as “half-pachi players” and “quarter-pachi players,” reflecting those who played games at half or one quarter the cost of a typical machine, respectively. To assess the harm-reduction effect, a one-way ANCOVA was conducted to compare the impact of the groups (normal-pachi players [n= 101], half-pachi players [n= 104], and quarter-pachi players [n= 100]) on dependent variables, namely the number of days players had gambled during the prior month; total time and amount of money spent on gambling; debts caused by gambling; gambling severity; cognitive distortion; depressive symptoms; and problems in work, family, and social life. ResultsWe demonstrated that the amount of money spent by quarter-pachi players on gambling during the past month was lower than that of normal-pachi players. However, we did not find significant differences with respect to any other gambling-related harms among normal-, half-, and quarter-pachi players. ConclusionLow-investment pachinko and pachislot can reduce the amount of money spent on gambling. It can thus partly act as a harm-minimization strategy. Moreover, the results of the present study indicate that the problems at work affect various outcomes for gamblers. Given that 90% of the participants in this study were employed, the results of this study may have important implications for employed gamblers.

Recorded Mental Health Recovery Narratives as a Resource for People Affected by Mental Health Problems: Development of the Narrative Experiences Online (NEON) Intervention

Background The internet enables sharing of narratives about health concerns on a substantial scale, and some digital health narratives have been integrated into digital health interventions. Narratives describing recovery from health problems are a focus of research, including those presented in recorded (eg, invariant) form. No clinical trial has been conducted on a web-based intervention providing access to a collection of Recorded Recovery Narratives (RRNs). Objective This study presents knowledge produced through the development of the Narrative Experiences Online (NEON) Intervention, a web-based intervention incorporating the algorithmic recommendation of RRNs. Methods Knowledge was gathered through knowledge integration (KI) activities. KI1 synthesized previous studies to produce the NEON Impact Model describing how accessing RRNs produces health-related outcomes. KI2 developed curation principles for the NEON Collection of RRNs through consultation with the NEON Lived Experience Advisory Panel and the curation of a preliminary collection. KI3 identified harm minimization strategies for the NEON Intervention through consultation with the NEON International Advisory Board and Lived Experience Advisory Panel. The NEON Intervention was finalized through 2 research studies (RS). In RS1, mental health service users (N=40) rated the immediate impact of randomly presented narratives to validate narrative feedback questions used to inform the recommendation algorithm. In RS2, mental health service users (n=25) were interviewed about their immediate response to a prototype of the NEON Intervention and trial procedures and then were interviewed again after 1 month of use. The usability and acceptability of the prototype and trial procedures were evaluated and refinements were made. Results KI1 produced the NEON Impact Model, which identifies moderators (recipient and context), mechanisms of connection (reflection, comparison, learning, and empathy), processes (identification of change from narrative structure or content and internalization of observed change), and outcomes (helpful and unhelpful). KI2 identified 22 curation principles, including a mission to build a large, heterogeneous collection to maximize opportunities for connection. KI3 identified seven harm minimization strategies, including content warnings, proactive and reactive blocking of narratives, and providing resources for the self-management of emotional distress. RS1 found variation in the impact of narratives on different participants, indicating that participant-level feedback on individual narratives is needed to inform a recommender system. The order of presentation did not predict narrative feedback. RS2 identified amendments to web-based trial procedures and the NEON Intervention. Participants accessed some narratives multiple times, use reduced over the 4-week period, and narrative feedback was provided for 31.8% (105/330) of narrative accesses. Conclusions RRNs can be integrated into web-based interventions. Evaluating the NEON Intervention in a clinical trial is feasible. The mixed methods design for developing the NEON Intervention can guide its extension to other clinical populations, the design of other web-based mental health interventions, and the development of narrative-based interventions in mental health.

The Effectiveness of Low-investment Pachinko/pachislot in Reducing Gambling-related Harms: A Cross Sectional Study

Background: Pachinko and pachislot are popular types of gambling activities in Japan. Prior studies in Japan have reported a concerning prevalence of gambling disorder among university students and adult players. While these studies have identified various gambling-related harms, Japanese research on harm-minimization strategies is scarce. Therefore, the present study aimed to analyze the effectiveness of low-investment pachinko and pachislot as a harm-reduction strategy. Methods: We also called gamblers who played for the normal amount as “normal-pachi players,” those who played pachinko and pachislot for half of the normal amount were called “half-pachi players,” and those who played for a quarter of the normal amount were called “quarter-pachi players.” To assess the effect of harm reduction, a one-way ANCOVA was conducted to compare the impact of the groups (normal-pachi players [n= 101], half-pachi players [n= 104], and quarter-pachi players [n= 100]) on dependent variables, namely the number of days players had gambled during the prior month, the total time and amount of money spent on gambling, debts caused by gambling, gambling severity, cognitive distortion, depressive symptoms, and disability. Results: We demonstrated that the amount of money spent by quarter-pachi players on gambling during the past month was lower than that of normal-pachi players. However, we did not find significant differences with respect to any other gambling-related harms among normal-, half-, and quarter-pachi players. Conclusion: Low-investment pachinko and pachislot can reduce the amount of money spent on gambling. It can thus partly act as a harm-minimization strategy. Moreover, the results of present study indicate that the level of disability at work affects various outcomes for gamblers. Given that 90% of the participants in this study were employed, the results of this study may have important implications for employed gamblers. Interventions should be devised to reduce work-related disabilities among employed adults with a gambling disorder.

Sustainable Harm Reduction Needle and Syringe Programs for People Who Inject Drugs: A Scoping Review of Their Implementation Qualities

While substance use disorders (SUD) continue to be a global concern, harm reduction approaches can provide sustainable harm minimization to people who inject drugs (PWID) without requiring abstinence. Yet, the evidence for the sustainable implementation of harm reduction approaches is newly emerging. This scoping review sought to map the evidence on implementation qualities of sustainable harm reduction needle and syringe programs (NSPs). We searched the Cochrane Database of Systematic Reviews, PubMed, ProQuest Central, and Directory of Open Access Journals for empirical studies (a) with an explicit focus on harm minimization NSPs, (b) with a clearly identified study population, (c) that described the specific NSP implementation protocol, (d) that provided information on accessibility, affordability, and feasibility, and (e) were published in English between 2000–2020. Following narrative qualitative synthesis, the evidence suggests individual implementer characteristics directly influenced sustainable availability and scope of NSP provision while implementation processes explained the predictability and continuity of service provision across services. External factors including community perceptions of NSPs and policing activity influenced the sustainability of NSP implementation. The emerging evidence suggests that sustainable NSP programs for PWID require provider, consumer, and community engagement, supported by enabling health policies.

How Do People With Intellectual Disability Engage With and Understand Gambling? A Qualitative Study of Adults in Victoria, Australia

Objective: This study aimed to understand the factors that may influence how and why people with intellectual disability may engage in gambling.Method: Nineteen people with intellectual disability were recruited from a disability advocacy organization and participated in face to face, semi-structured qualitative interviews. Open ended questions were used to explore participants' gambling participation, recall of, and attitudes toward, different gambling products, understanding of gambling harm, and awareness of responsible gambling messages.Results: All participants could remember gambling in their lifetime and some participants had recently engaged in gambling. Many participants were aware of different gambling products, and a few participants could describe in detail the technical aspects of electronic gambling machines. Most participants did not specifically recall seeing gambling harm minimization messages, however some described engaging in individual responsibility measures, such as limits and control, as they perceived this reduced the risks of experiencing harm.Conclusions: People with intellectual disability are engaging with gambling products in a similar way to the general community. Therefore, it is important to understand the different pathways that may lead people with intellectual disability to initiate and continue gambling and to ensure that they are aware of and protected from the potential risk.Implications for Public Health: Policy makers and practitioners should seek to understand and implement a range of strategies to reduce and prevent the harms associated with particular gambling products and environments for this population sub-group.

Reducing Internet Gambling Harms Using Behavioral Science: A Stakeholder Framework

Internet gambling provides a unique environment with design mechanics and data-driven opportunities that can impact gambling-related harms. Some elements of Internet gambling including isolation, lack of interruption, and constant, easy access have been argued to pose specific risks. However, identifiable player accounts enable identification of behavioral risk markers and personalized private interfaces to push customized messages and interventions. The structural design of the Internet gambling environment (website or app) can have a strong influence on individual behavior. However, unlike land-based venues, Internet gambling has few specific policies outlining acceptable and unacceptable design practices. Harm minimization including responsible gambling frameworks typically include roles and responsibilities for multiple stakeholders including individual users, industry operators, government regulators, and community organizations. This paper presents a framework for how behavioral science principles can inform appropriate stakeholder actions to minimize Internet gambling-related harms. A customer journey through internet gambling demonstrates how a multidisciplinary nexus of collaborative effort may facilitate a reduction in harms associated with Internet gambling for consumers at all stages of risk. Collaborative efforts between stakeholders could result in the implementation of appropriate design strategies to assist individuals to make decisions and engage in healthy, sustainable behaviors.