Development and evaluation of self-help guidelines for reducing gambling-related harm for affected others

Abstract

Background: Gambling-related harm impacts not only the person with the problem but their family, whānau, and friends (i.e., affected others). Affected others cope with stressful gambling-related situations by enacting a range of self-help strategies. The full range of self-help strategies and the specifics of their implementation are not fully understood. Existing public health approaches provide some information on a limited number of self-help strategies (e.g., ways to talk to the gambler). However, there is a need for comprehensive self-help resources that provide information on the broader range of self-help strategies and their implementation. This thesis aims to develop a set of gambling harm reduction resources to inform public health interventions for affected others. Methods: This study encompassed three interconnected phases. The first phase aimed to systematically identify and classify self-help strategies used by affected others. Data mining techniques were used to construct a large dataset of 3536 extracts which were then analysed using pragmatic content analysis. The second phase reanalysed identified strategies using thematic analysis. From this, detailed, easy-to-understand, and engaging guidelines were developed. The third phase, used an online survey (n = 136) to evaluate the guidelines for acceptability in Aotearoa New Zealand. Results: Phase 1 revealed two taxonomies which were family-focused and gambler-focused. Each taxonomy indicated that self-help strategies were present across motivational (e.g., pros and cons of change) and volitional phases (e.g., behaviour substitution). Phase 2 translated the taxonomies into a family-focused set (70 pages) and a gambler-focused (58 pages) set of practical guidelines. Phase 3 evaluation indicated high levels of satisfaction, comprehension and perceived helpfulness. There were few quantitative differences on the rating scales by participants characteristics. Data triangulation indicated interactive activities and lived experience were valued, but a greater focus on culture and Te Reo Māori may be needed for population-level dissemination. Conclusion: This is the first large-scale systematic account of self-help strategies used by affected others to manage gambling harm. Self-help guidelines developed in this research are highly amendable to individual needs and could be integrated into numerous interventions as part of a novel population-level approach to reducing gambling harm at all levels of severity.