Transcript Building Bridges Between Prevention and Research

Building Bridges Between
Prevention and Research
Ken Winters, Ph.D.
University of Minnesota
[email protected]
for
Prevention of Problem Gambling Conference
University of Lethbridge
March 27, 2003
Top Ten Issues for Building a
Prevention-Research Agenda
1. Engage the industry to
participate in prevention and
intervention research
Top Ten Issues for Building a
Prevention-Research Agenda
2. Tackle the measurement and
definitional issues of
“pathological gambling”
Label Hodge-Podge
Problem Severity Continuum
?
---------Level 1 to 4---------
Top Ten Issues for Building a
Prevention-Research Agenda
3. What should we prevent?
• underlying risk factors?
Top Ten Issues for Building a
Prevention-Research Agenda
3. What should we prevent?
• underlying risk factors?
• development of the disorder?
• attitudes and perceptions?
Top Ten Issues for Building a
Prevention-Research Agenda
3. What should we prevent?
• underlying risk factors?
• development of the disorder?
• attitudes and perceptions?
• access and density?
Top Ten Issues for Building a
Prevention-Research Agenda
3. What should we prevent?
• underlying risk factors?
• development of the disorder?
• access and density?
• demographic considerations
• youth
• elderly
Top Ten Issues for Building a
Prevention-Research Agenda
4. We are a small fish in a big
pond
Playing the Grant Game in
the U.S.
•
Institute for Research on
Pathological Gambling and
Related Disorders (spin-off from the
National Center for Responsible
Gaming)
• 21 grants funded since the mid-1990’s
• $3.1 million allocated
Playing the Grant Game in
the U.S.
•
National Institutes of Health
• 10 grants funded since their “request
for proposals” in the mid-1990’s
• $10.2 million allocated
Top Ten Issues for Building a
Prevention-Research Agenda
5. The standards for rigorous
prevention research are high
• After 25 years of drug abuse research
in the U.S., the bar for methodological
rigor is quite high.
• Controlled designs with prospective
samples are the norm
Prevention Intervention Research Model
Transportability
Pre-intervention
Efficacy
Effectiveness
Dissemination
Diffusion
Top Ten Issues for Building a
Prevention-Research Agenda
6. Avoid reinventing the wheel;
tap the vast knowledge from
drug abuse and related
behavioral prevention research.
Lessons Learned from
Drug Abuse Prevention
•
•
•
•
Know the psychosocial determinants of
the target population.
(Youth): Start early.
Employ methods that engage the
target.
Be multi-systemic, multi-dimensional
Multiple Spheres of Influence
Community
Social
Family
Individual
Effective Prevention =
Use at Least TWO
•
•
•
•
•
•
information dissemination
prevention education
alternative drug-free activities
problem identification and referral
community-based intervention
environmental approach
Top Ten Issues for Building a
Prevention-Research Agenda
7. Harm reduction, risk reduction
and pattern normalization
strategies are worthy of
consideration, despite their
ideological controversies.
Spectrum of Intervention Responses
Adapted from Broadening the Base of Alcohol Treatment (IOM)
Primary Prevention
Harm
Reduction
Thresholds
for Action
Harm Reduction/
Abstinence
Top Ten Issues for Building a
Prevention-Research Agenda
8. Of the major models....
universal
targeted
indicated
which should receive priority given
limited $$?
Top Ten Issues for Building a
Prevention-Research Agenda
9. The web has great potential;
can it be harnessed for effective
prevention?
Top Ten Issues for Building a
Prevention-Research Agenda
10. Proceed with caution.
Avoid the DARE
Phenomenon
Just because a prevention
effort is popular, well-received,
highly integrated into the
community, and affordable, it
does not mean that it WROKS!
Remember JFK’s
Warning
“Twenty-five percent of
the people are against
everything all the time.”
Thank You