Theoretically informed gender analysis for gambling harm reduction: a New Zealand study

Background Gambling harm affects men and women relatively equally, and gender influences the social determinants of gambling harm. Responses to preventing and minimising women’s gambling harm have been shaped and constrained by population research identifying male gender as a key risk factor for gambling problems. Gender analysis in gambling studies is rare and has lacked theoretical underpinning and coherence, limiting possibilities for gender-responsive and gender-aware harm prevention and reduction activities. Methods Two influential qualitative studies of gambling harm in New Zealand (involving total n = 165 people who gambled, affected others, community leaders, gambling and community support service providers, policy makers and academics) neglected to explore the role of gender. This study revisited data collected in these studies, using thematic analysis informed by feminist social constructionist theory. The overarching research questions were: How do gender-related issues, notions and practices influence women’s gambling related harm? What are the implications for women’s gambling harm reduction? Results Women’s socio-cultural positioning as primary caregivers for families and children constrained their ability to access a range of recreational and support options and increased the attractiveness of local gambling opportunities as accessible and ‘safe’ outlets for stress reduction. Patriarchal practices of power and control within family contexts operated to maintain gambling behaviour, shut down alternative recreational opportunities, and limit women’s autonomy. Consideration of these themes in relation to current health promotion practice in New Zealand revealed that national programmes and strategies appear to be operating without cognisance of these gender dynamics and therefore have the potential to exacerbate or cause some women harm. Conclusions This study demonstrates the value of theoretically informed gender analysis for gambling harm reduction research, policy and practice. International guidelines for gender-aware and gender-responsive health research and practice should be engaged as a foundation for strategic and effective gambling harm reduction programmes, projects, research and policy, and as an essential part of developing and implementing interventions for gambling harm.

18-Item Version of the Short Gambling Harm Screen (SGHS-18): Validation of Screen for Assessing Gambling-Related Harm among Finnish Population

Background and aims: It is common for gambling research to focus on problem and disordered gambling. Less is known about the prevalence of gambling-related harms among people in the general population. This study aimed to develop and validate the 18-item version of the Short Gambling Harms Screen (SGHS-18). Methods: Population-representative web-based and postal surveys were conducted in the three geographical areas of Finland (n = 7186, aged 18 or older). Reliability and internal structure of SGHS-18 was assessed using coefficient omega and via confirmatory factor analysis (CFA). Four measurement models of SGHS-18 were compared: one-factor, six-factor, a second-ordered factor model and a bifactor model (M4). Results: The analysis revealed that only the bifactor model had adequate fit for SGHS-18 (CFI = 0.953, TLI = 0.930, GFI = 0.974, RMSEA = 0.047, SRMR = 0.027). The general factor explained most of the common variance compared to specific factors. Coefficient omega hierarchical value for global gambling harm factor (0.80) was high, which suggested that SGHS-18 assessed the combination of general harm constructs sufficiently. The correlation with the Problem and Pathological Gambling Measures (PPGM) was 0.44, potentially reflecting that gambling harms are closely—although not perfectly—aligned with the mental health issue of problem gambling. SGHS-18 scores were substantially higher for participants who gambled more often, who spent more money or who had gambling problems, demonstrating convergent validity for the screen. Discussion: The SGHS-18 comprehensively measures the domains of gambling harm, while demonstrating desirable properties of internal consistency, and criterion and convergent validity.

What are the odds? Lower compliance with Western loot box probability disclosure industry self-regulation than Chinese legal regulation

Loot boxes are purchased to obtain randomised rewards in video games. These mechanics are frequently implemented, including in children’s games, and are psychologically akin to gambling. Emulating gambling harm reduction measures, disclosing the probabilities of obtaining loot box rewards is a consumer protection measure that may reduce overspending. Presently, this has been adopted as law only in China, where a 95.6% disclosure rate was previously observed. In other countries, the industry has generally adopted this measure as self-regulation. This study assessed the compliance rate of self-regulation amongst the 100 highest-grossing UK iPhone games to be 64.0%, significantly lower than that of Chinese legal regulation. Additionally, only 6.7% of games containing first-party implemented loot boxes made reasonably prominent disclosures. Non-enforced Western self-regulation needs substantial improvements before it can be as effective as legal regulation: until then, uniform and prominent disclosures should be required by law to maximise their consumer protection benefits.

“This is not about gambling, it’s about our lives”

In this interview, Darrel Manitowabi speaks to Sheila Wahsquonaikezhik, Director of Indige-Spheres to Empowerment, a non-profit organization addressing Indigenous health and wellness. This interview explores Sheila Wahsquonaikezhik’s Indigenous gambling experience including work in an Indigenous casino in Ontario, gambling harm reduction outreach in northwestern Ontario First Nations, and gambling research collaborations. An outcome of this interview is a revelation that the practice of Indigenous gambling is connected to the wider context of colonialism and Indigenous gambling research requires greater inclusion of Indigenous peoples.

Benchmarking gambling screens to health-state utility: The PGSI and the SGHS estimate similar levels of population gambling-harm

Background and aims: Both the Problem Gambling Severity Index (PGSI) and the Short Gambling Harms Screen (SGHS) purport to identify individuals harmed by gambling. However, there is dispute as to how much individuals are harmed, conditional on their scores from these instruments. We used an experienced utility framework to estimate the magnitude of implied impacts on health and wellbeing.Methods: We measured health utility using the Short Form Six-Dimension (SF-6D), and used this as a benchmark. All 2603 cases were propensity score weighted, to balance the affected group (i.e., SGHS 1+ or PGSI 1+ vs 0) with a reference group of gamblers with respect to risk factors for gambling harm. Weighted regression models estimated decrements to health utility scores attributable to gambling, whilst controlling for key comorbidities.Results: We found significant attributable decrements to health utility for all non-zero SGHS scores, as well as moderate-risk and problem gamblers, but not for PGSI low-risk gamblers. Applying these coefficients to population data, we find a similar total burden for both instruments, although the SGHS more specifically identified the subpopulation of harmed individuals. For both screens, outcomes on the SF-6D implies that about two-thirds of the ‘burden of harm’ is attributable to gamblers outside of the most severe categories.Discussion and Conclusions: Gambling screens have hitherto provided nominal category membership, and population surveys typically focus on problem gambling prevalence. These results quantify the health utility decrement for each category, allowing for tracking of the aggregate population impact based on all affected gamblers.

Prevention and education evidence review: Gambling-related harm

This report supports an evidence-based approach to the prevention and education objective of the National Strategy to Reduce Harm from Gambling. Applying a public health policy lens, it considers three levels of measures: universal (for the benefit of the whole population), selective (for the benefit of at-risk groups), and indicated (for the benefit of at-risk individuals). Six measures are reviewed by drawing upon a range of evidence in the academic and grey literature. The universal level measures are “Regulatory restriction on how gambling is provided” and “Population-based safer gambling/responsible gambling efforts.” Selective measures focus on age cohorts in a chapter entitled, “Targeted safer gambling campaigns for children, youth, and older adults.” The indicated measures are “Brief internet delivered interventions for gambling,” “Systems and tools that produced actual (‘hard’) barriers and limit access to funds,” and “Self-exclusion.” Since the quantity and quality of the evidence base varied by measure, appropriate review methods were selected to assess publications using a systematic, scoping, or narrative approach. Some measures offered consistent findings regarding the effectiveness of interventions and initiatives, while others were less clear. Unintended consequences were noted since it is important to be aware of unanticipated, negative consequences resulting from prevention and education activities. After reviewing the evidence, authors identified knowledge gaps that require further research, and provided guidance for how the findings could be used to enhance the prevention and education objective. The research evidence is supplemented by consultations with third sector charity representatives who design and implement gambling harm prevention and education programmes. Their insights and experiences enhance, support, or challenge the academic evidence base, and are shared in a separate chapter. Overall, research evidence is limited for many of the measures. Quality assessments suggest that improvements are needed to support policy decisions more fully. Still, opportunities exist to advance evidence-based policy for an effective gambling harm prevention and education plan.

A Critical Analysis of Interventions for Women Harmed by Others’ Gambling

At present, gambling studies literature has multiple understandings of family and others affected (FAOs) by gambling harm and their support needs in play, each with different possibilities and constraints for harm reduction engagement with women. Individual psychological approaches have been privileged, eschewing the social and relational situation of gambling and harm in women’s lives. In Australasia, the majority of those seeking support in relation to a significant others’ gambling are women. Gender has been posited as a shaping force in the social stratification system, distribution of resources, and gambling and harm within society. There has been minimal engagement with the lived experiences of FAOs, which limits gambling harm reduction service development and planning. This research critically engaged with gambling harm reduction studies for FAOs, alongside interviews with eight women FAOs who presented to community services from a social constructionist perspective. The aim was to provide insight into how women FAOs position themselves and their support needs in relation to gambling harm and recovery. Data was analysed using thematic analysis informed by feminist poststructuralist theories of language. Results suggested that this small group of women were subject to intersecting patriarchal constraints and economic determinants of gambling harm. Powerful normative and moral constructions of ‘good/bad’ mothers operated to individualise some women’s responsibility for addressing harm in families and to alienate these women from gambling support services. These findings suggest that gambling services must support women and families in ways that go beyond personal functioning, extending into the social and political conditions of possibility for harm and recovery. Critical psychology and coherent gender analysis may offer opportunities to expand the role of gambling support to include advocacy, community development, and more client-led and gender-aware practice with women affected by gambling harm.