Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia.
Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia.
Harm Reduct J. 2024 Jun 18;21(1):118. doi: 10.1186/s12954-024-01032-8.
Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level.
The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 - 2023 from all countries with gambling policy contexts and public health systems comparable to Australia's; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems.
One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective.
Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm.
赌博和与赌博相关的危害引起了研究人员和政策制定者的高度关注。在大多数西方国家，赌博的自由化与赌博活动的显著增加以及人口层面上与赌博相关的危害的增加密切相关。解决与赌博相关的危害的项目传统上侧重于表现出问题赌博行为的个人，尽管有明确的证据表明，针对赌博等高风险活动采取公共卫生方法是有效的。关于在人口层面解决与赌博相关的危害的项目的可用性或效果知之甚少。
维多利亚州负责任赌博基金会委托对旨在降低人口层面与赌博相关的危害的现有证据进行快速证据审查。该审查采用公共卫生和减少伤害的视角进行。系统地搜索了 MEDLINE、ProQuest Central 和 PsychInfo 数据库。纳入的研究发表于 2017 年至 2023 年期间，来自所有具有与澳大利亚可比的赌博政策背景和公共卫生系统的国家；纳入了原始数据；并侧重于预防与赌博相关的危害或问题的一级、二级和/或三级预防。
有 167 篇文章符合纳入标准。文献中确定的主题包括：风险和保护因素；一级预防；二级预防；三级预防；目标人群群体；以及公共卫生方法。证据审查揭示了在人口层面上减少与赌博相关的危害的有效干预措施方面存在实证证据的差距，特别是从公共卫生的角度来看。
解决与赌博相关的危害需要采取细致入微、多层次的方法，承认赌博和相关危害的复杂社会、环境和商业性质。此外，证据表明，旨在减少与赌博相关的危害的社区项目在基于良好的共同设计理论和解决导致危害的社会方面时，更有可能成功减少危害。
