Gambling and Addictions Research Centre, School of Public Health & Psychological Studies, Faculty of Health & Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
Eur J Public Health. 2018 Apr 1;28(2):369-376. doi: 10.1093/eurpub/ckx120.
The Gambling Act 2003 mandated a public health strategy for preventing and minimising gambling harm in New Zealand. Aware Communities and Supportive Communities are two public health programmes subsequently implemented nationwide. These programmes differed from common health promotion initiatives such as media or education campaigns as they were community-action based (requiring community involvement in programme planning and delivery). We carried out a process evaluation to determine their implementation effectiveness and inform improvement and future programme planning.
Our qualitative dominant mixed methods design comprised analysis of over a hundred implementer progress reports (submitted July 2010 - June 2013), a staff survey and a staff focus group interview.
The programmes demonstrated capacity to not only achieve expected outcomes (e.g. enhanced community awareness about harmful gambling), but also to enhance social sustainability at the community level (e.g. established trustful relationships) and achieve some programme sustainability (e.g. community ownership over ongoing programme delivery).
The evaluation noted the potential for a sustainable gambling harm-minimisation model. Community-action based harm-minimisation programmes offer programme sustainability potential which in turn offers funding cost-effectiveness when there are continual public health outcomes beyond initial funding. Although resource intensive, the community-action based approach enables culturally appropriate public health programmes suitable for societies where specific ethnic groups have higher gambling risk. Recognition of such harm-minimisation programmes' contribution to social sustainability is important considering the potential for broader public health outcomes (e.g. better life quality, lesser social problems) within socially sustainable societies.
2003 年《赌博法》要求在新西兰制定一项预防和减少赌博危害的公共卫生战略。随后，全国范围内实施了“意识社区”和“支持性社区”这两个公共卫生计划。这些计划与常见的健康促进举措（如媒体或教育活动）不同，因为它们是基于社区行动的（需要社区参与规划和实施）。我们进行了一项过程评估，以确定其实施效果，并为改进和未来的方案规划提供信息。
我们的定性主导混合方法设计包括对一百多份实施者进展报告（2010 年 7 月至 2013 年 6 月提交）、员工调查和员工焦点小组访谈的分析。
该计划不仅展示了实现预期结果的能力（例如，提高了社区对有害赌博的认识），而且还增强了社区一级的社会可持续性（例如，建立了值得信赖的关系），并实现了一些方案的可持续性（例如，社区对持续方案交付的所有权）。
评估注意到可持续的减少赌博危害模式的潜力。基于社区行动的减少危害方案具有方案可持续性的潜力，当最初的资金投入之外还有持续的公共卫生成果时，这提供了资金的成本效益。虽然资源密集，但基于社区行动的方法能够实现适合那些特定族裔群体赌博风险较高的社会的文化上适当的公共卫生方案。考虑到在社会可持续性社会中可能产生更广泛的公共卫生成果（例如，更高的生活质量、更少的社会问题），认识到这些减少危害方案对社会可持续性的贡献是很重要的。
