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      Gambling harm prevention and harm reduction in online environments: a call for action

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          Abstract

          Background

          Gambling is increasingly offered and consumed in online and mobile environments. The digitalisation of the gambling industry poses new challenges on harm prevention and harm reduction. The digital environment differs from traditional, land-based gambling environments. It increases many risk-factors in gambling, including availability, ease-of-access, but also game characteristics such as speed and intensity. Furthermore, data collected on those gambling in digital environments makes gambling offer increasingly personalised and targeted.

          Main results

          This paper discusses how harm prevention and harm reduction efforts need to address gambling in online environments. We review existing literature on universal, selective, and indicated harm reduction and harm prevention efforts for online gambling and discuss ways forward. The discussion shows that there are several avenues forward for online gambling harm prevention and reduction at each of the universal, selective, and indicated levels. No measure is likely to be sufficient on its own and multi-modal as well as multi-level interventions are needed. Harm prevention and harm reduction measures online also differ from traditional land-based efforts. Online gambling providers utilise a variety of strategies to enable, market, and personalise their products using data and the wider online ecosystem.

          Conclusion

          We argue that these same tools and channels should also be used for preventive work to better prevent and reduce the public health harms caused by online gambling.

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          Most cited references74

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          Harnessing social media for health promotion and behavior change.

          Rapid and innovative advances in participative Internet communications, referred to as "social media," offer opportunities for modifying health behavior. Social media let users choose to be either anonymous or identified. People of all demographics are adopting these technologies whether on their computers or through mobile devices, and they are increasingly using these social media for health-related issues. Although social media have considerable potential as tools for health promotion and education, these media, like traditional health promotion media, require careful application and may not always achieve their desired outcomes. This article summarizes current evidence and understanding of using social media for health promotion. More important, it discusses the need for evaluating the effectiveness of various forms of social media and incorporating outcomes research and theory in the design of health promotion programs for social media.
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            A systematic review of online youth mental health promotion and prevention interventions.

            The rapid growth in the use of online technologies among youth provides an opportunity to increase access to evidence-based mental health resources. The aim of this systematic review is to provide a narrative synthesis of the evidence on the effectiveness of online mental health promotion and prevention interventions for youth aged 12-25 years. Searching a range of electronic databases, 28 studies conducted since 2000 were identified. Eight studies evaluating six mental health promotion interventions and 20 studies evaluating 15 prevention interventions were reviewed. The results from the mental health promotion interventions indicate that there is some evidence that skills-based interventions presented in a module-based format can have a significant impact on adolescent mental health, however, an insufficient number of studies limits this finding. The results from the online prevention interventions indicate the significant positive effect of computerized cognitive behavioral therapy on adolescents' and emerging adults' anxiety and depression symptoms. The rates of non-completion were moderate to high across a number of studies. Implementation findings provide some evidence that participant face-to-face and/or web-based support was an important feature in terms of program completion and outcomes. Additional research examining factors affecting exposure, adherence and outcomes is required. The quality of evidence across the studies varied significantly, thus highlighting the need for more rigorous, higher quality evaluations conducted with more diverse samples of youth. Although future research is warranted, this study highlights the potential of online mental health promotion and prevention interventions in promoting youth wellbeing and reducing mental health problems.
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              Randomized trial of internet-delivered self-help with telephone support for pathological gamblers.

              Although effective therapies for pathological gambling exist, their uptake is limited to 10% of the target population. To lower the barriers for help seeking, the authors tested an online alternative in a randomized trial (N = 66). The participants were pathological gamblers not presenting with severe comorbid depression. A wait-list control was compared with an 8-week Internet-based cognitive behavior therapy program with minimal therapist contact via e-mail and weekly telephone calls of less than 15 min. Average time spent on each participant, including phone conversations, e-mail, and administration, was 4 hr. The Internet-based intervention resulted in favorable changes in pathological gambling, anxiety, depression, and quality of life. Composite between-group effect size (Cohen's d) at posttreatment was 0.83. Follow-ups carried out in the treatment group at 6, 18, and 36 months indicated that treatment effects were sustained (ds = 2.58, 1.96, and 1.98). This evidence is in support of Internet-delivered treatment for pathological gamblers. However, it is not clear how effective the treatment is for more severely depressed individuals.
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                Author and article information

                Contributors
                virve.marionneau@helsinki.fi
                Journal
                Harm Reduct J
                Harm Reduct J
                Harm Reduction Journal
                BioMed Central (London )
                1477-7517
                22 July 2023
                22 July 2023
                2023
                : 20
                : 92
                Affiliations
                [1 ]GRID grid.7737.4, ISNI 0000 0004 0410 2071, Faculty of Social Sciences, Centre for Research on Addiction, Control, and Governance, , University of Helsinki, ; Unioninkatu 33, 00014 Helsinki, Finland
                [2 ]GRID grid.14758.3f, ISNI 0000 0001 1013 0499, Finnish Institute for Health and Welfare, ; Mannerheimintie 166, 00271 Helsinki, Finland
                Article
                828
                10.1186/s12954-023-00828-4
                10362766
                37481649
                c0938e79-5f7a-419e-a9ef-43479b04217f
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 26 April 2023
                : 16 July 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100008487, Sosiaali- ja Terveysministeriö;
                Award ID: Section 52 of the Finnish Lotteries Act
                Award ID: Section 52 of the Finnish Lotteries Act
                Award ID: Section 52 of the Finnish Lotteries Act
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100002341, Academy of Finland;
                Award ID: 349589
                Award Recipient :
                Funded by: University of Helsinki including Helsinki University Central Hospital
                Categories
                Perspective
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                Health & Social care
                gambling,online,ecosystem,harm prevention,harm reduction,public health
                Health & Social care
                gambling, online, ecosystem, harm prevention, harm reduction, public health

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