risk & protective factor framework: application to problem gambling

Risk Factors

& Protective

Julie Hynes, MA, CPS

Midwest Conference on Problem Gambling & Substance Abuse

June 26, 2013 | Kansas City, MO

in Prevention and where problem gambling fits in

These slides are online at

www.preventionlane.org/mcpgsa

promote the wellbeing

beforechange the factors

that contribute to it.

PROBLEM BEHAVIORS

Promotion & Prevention And prevention is finally REALLY on

the national agenda (!)

Kernels

Resiliency T

heory

ADVERSE CHILDHOOD

EXPERIENCES (ACE)

40 DEVELOPMENTAL

ASSETS

SOCIAL DEVELOPMENT

STRATEGY

PROMOTIVE FACTORS

Risk & Protective Factor Theory

Problem behaviors share common risk

factors

Exposure to risk factors a

young person’s risk

exponentially

Protective factors buffer exposure

to risk & build on strengths

The Risk & Protective Factor Theory:

Risk-Focused Prevention • Decades of research: Hawkins, Catalano

& other researchers (Biglan, Embry, etc.)

• PREVENT problem behavior from

happening:

– Identify factors that increase risk of

problem and then find ways to reduce those

risks

– Enhance protective/resiliency factors

• Four Domains:

– Community -- Family

– School -- Individual/Peer

Risk Factor A characteristic at the

biological, psychological,

family, community, or

cultural level that

precedes and is associated

with a higher likelihood of

problem outcomes

Source: CAPT http://captus.samhsa.gov

Risk Factor

(In other words, a factor

that increases risk.)

My Analogy

“Recognized” Problem Behaviors

• Substance abuse

• Violence

• Delinquency

• Teenage pregnancy

• School dropout

• Depression

Problem gambling?? (not yet)

Risk Factors for Adolescent

Problem Behavior

Risk Factors for Adolescent

Problem Behavior

(There will be a test on your vision, &

memorization of this, later.

Otherwise it’s online.)

Protective Factors:

Individual Characteristics:

– Gender (go, girls!)

– Resilient Temperament

– Positive Social Orientation

– Intelligence (!?)

Protective Processes:

– Opportunities for involvement

– Social and cognitive skills

– Recognition

Dickson, Derevensky & Gupta, 2002

Image source: Greater Old Town Communities that Care, Maine

when

We give

Opportunity,

Skills and

Recognition.

Combined w/

some of those

Individual Characteristics.

Quick

Risk or Protective? Individual, family, community?

Young people who feel school is

important.

Young people who live in

communities with norms tolerant

of use.

Young people who believe drug use

is dangerous.

Young people who have friends

who use alcohol or marijuana.

Young people who have an

opportunity to contribute to their

schools.

Young people who begin ______ at

an early age.

Risk or Protective? Individual, family, community ?

but where does

Back at the office, Click to go

http://www.problemgamblingprevention.org/resources/prevention-

resource-guide03.pdf

Back at the office, Click to go

http://youthgambling.mcgill.ca/en/PDF/Publications/2008/Dickson%20article.pdf

School:

– Anti-Social behavior

Individual/Peer:

– Peer Involvement

– Favorable Attitudes

– Early Initiation

– Constitutional

Source: Dickson, Derevensky & Gupta, 2002; Marotta & Hynes, 2003

“Probable” SHARED Risk Factors for

Community:

– Availability

– Community Laws & Norms

Family:

– Family History

– Family Conflict (competition)

– Parental Attitudes/Involvement

“Probable” SHARED Risk Factors for

Source: Dickson, Derevensky & Gupta, 2002; Marotta & Hynes, 2003

• Single-parent

household

• Gambling on

cards/sports

• Being male, older teen

• Lower household

income

• Competitive

• Having lost more than

$50 in a single month

• Started gambling

before 8th grade (early

initiation)

• Parents who gamble--

youth twice as likely

to be at-risk gamblers

& four times as likely

to be problem gamblers

Source: Volberg, et al (2008.

Specifics: Risk Factors for youth

“A” Unique Set of Risks

Gambling

is

decades

behind

ATOD!

A

A

A

A

“The earlier people begin

gambling, the more likely

they are to experience

problems from gambling.”

- National Academy of Sciences

A

A•Amygdala active

•Fight or flight,

emotion

•Decision-making

altered

•More vulnerable to

risk-taking &

impulsive behaviors

Source: Ramoski, S., Nystrom, R. (2007).

“The adolescent brain is

especially sensitive to the

effects of dopamine.

2012 Oregon Student Wellness Survey, Lane County (“ESD”) and Oregon; available at http://oregon.pridesurveys.com/esds.php?year=2011

AWARENESS (low)

AWARENESS

Oregon parent/youth focus groups :

Source: Oregon Health Authority

ATTITUDES

Most parents &

communities believe: Youth gambling is harmless

Youth who gamble are

unlikely to have

problems in school

Youth gambling is not

associated with

alcohol or drug use

…and those beliefs are

part of the problem!

GETTING REAL By the

2012 OREGON

STUDENT WELLNESS SURVEY (SWS)

2012 Gambling, Substance Use and Mental Health

among Oregon Youth

0%

10%

20%

30%

40%

50%

Gambling Alcohol Binge

Alcohol

Marijuana Cigarettes Depression Psych

distress

Per

cent

ag

e

6th 8th

11th

Source: Oregon Health Authority, 2012. All SWS data is available online at http://www.oregon.gov/oha/amh/pages/student-wellness/index.aspx n=55,611 students (18,885 6th grade; 21,368 8th grade; 15,358 11th grade)

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

Source: Oregon Health Authority, 2012. Regression analysis conducted by state epidemiologist Rusha Grinstead, MPH. All SWS data is available online at http://www.oregon.gov/oha/amh/pages/student-wellness/index.aspx

Binge drank in the past month

0.5%

5.6%

16.4%

4.3%

12.7%

28.7%

Grade 6 Grade 8 Grade 11

Did not gamble Gambled

Source: Oregon Health Authority (ibid)

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

Source: Oregon Health Authority (ibid)

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

Source: Oregon Health Authority (ibid)

5.7%

12.8%

22.5%

15.4%

23.0%

35.4%

Grade 6 Grade 8 Grade 11

Did not gamble Gambled

Skipped school one or more days in the past month

Source: Oregon Health Authority (ibid)

7.2%

5.0%

11.3%

9.0%

Grade 8 Grade 11

Did not gamble Gambled

Attempted suicide in the past year

Source: Oregon Health Authority (ibid)

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 to

Bet/gambled more than wanted to

Delinquency (physical fight in last month)

41.80%

22.40%

Physical fight

Gambled Did not gamble

Source: Oregon Health Authority (ibid)

CONCLUSION?

Teens who gamble are

smoked up, toked up,

drunk emo delinquents.

CONCLUSION?

Teens who gamble are

smoked up, toked up,

drunk emo delinquents.

delinquency

sexual

behavior

depression

substance

use

gambling

Problem

Behaviors

Conclusion: Problem Gambling is

One Component of Problem Behaviors

Adapted from: Jeffrey Derevensky

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

Protective Factors & Gambling

Lussier et al (2007):

Social bonding &

personal competence

related to lower

gambling severity.

SO NOW WHAT? PREVENTION in action

• Tobacco, alcohol, and

other drug use and abuse

• Delinquency and crime

• Premature or unsafe sex

• Depression and suicidality

• School failure, dropout

Scientific consensus is that that we can prevent these problems

Source: Project WEAVE, 2011

By creating nurturing environments using EVIDENCE-BASED

PREVENTION PRACTICES

Pre-

conceptio

n

Prenatal/

Infancy

Early

Childhood 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 by developmental phase and domain

Source: Project WEAVE, 2011

The right support to the right people

Ideally, we would have varying levels

of support to meet the needs of

diverse youth and their families. Size of population affected

More intensive for at-

risk youth and families

~15%

Most intensive

interventions for the

youth and families at

highest risk

~10%

Universal supports for

all youth

and families

~75%

Source: Project WEAVE, 2011

Evidence-based prevention is

a good 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

Source: Project WEAVE, 2011

Evidence-based prevention programs save money

• On average, for every dollar invested

in these evidence-based prevention

programs nationwide…

– $6 was saved with Project Alert

– $8 was saved with Adolescent Transitions

Program

– $11 was saved with Strengthening

Families 10-14

– $35 was saved with Good Behavior Game

Hey! We can expect all of these to work with problem gambling!

Data source: Project WEAVE, 2011

It’s ALL of us. NOT JUST programs

OR those prevention people.

Excellent links:

Consider doing one of your assignments on a vulnerable population group we didn’t get to

explore.

National Registry of Effective

Prevention Practices (NREPP)

(SAMHSA)

“Best Intentions Aren’t Enough:

Techniques for Using Research &

Data to Develop New Evidence-

Informed Prevention Programs”

(U.S. Dept of H&HS, 2013)

Consider doing one of your assignments on a vulnerable population group we didn’t get to

explore.

National Prevention Strategy

(U.S. Surgeon General, 2011)

Nurturing Environments

(Blog – renowned prevention experts

Tony Biglan & Dennis Embry)

Excellent links:

preventionlane

For more info & resources, visit

preventionlane preventionlane

Thank

Connect: