Our Voices Matter: Using Lived Experience to Promote Equity in Problem Gambling Prevention

Abstract

Purpose of Review The field of problem gambling has been historically disconnected from the community experience of gambling and people of color, leading to a lack of integration of those with lived experience into programming. The aim of this article is to describe community-centered efforts to prevent and mitigate harm from problem gambling in Massachusetts—including a pilot program, the Massachusetts Ambassador Project, which is grounded within public health and lived experience frameworks. Recent Findings To engage Massachusetts communities in problem gambling prevention, planning processes were conducted to develop culturally appropriate prevention strategies. One of the recurrent themes was the desire of men in the substance misuse recovery community to share their knowledge with others, specifically, men of color who experience racism and health disparities. This finding informed the development of the Ambassador Project, a novel, peer-based, community-centered, and culturally responsive approach for men of color who have a history of substance misuse to engage other men of color in problem gambling prevention. Two organizations pilot tested the project and reached 4388 individuals. The pilot led to several findings in the design and implementation of related projects. Lessons are shared in three categories: structure, support, and implementation. Summary This article demonstrates an innovative approach to connect the field of problem gambling prevention to the community experience, using a public health and social justice lens. Others in the field should acknowledge the disconnect between problem gambling and the lived experience of those disproportionately impacted by creating opportunities for community voice to be at the center of programming.

Predicting online problem gambling treatment discontinuation: New evidence from cross-validated models.

“…Should the clients think their social relations are scarce and not supportive, which may undermine treatment commitment, the program could be adjusted to support them in other ways. In addition to motivating the clients to strengthen their social relations with family members or friends, they could be encouraged to contact people with lived experience from gambling problems (Nilsson et al, 2021; Ortiz et al, 2021). The clients’ significant others can also be invited to be involved in the treatment (Nilsson et al, 2018).…”

How do academics, regulators, and treatment providers think that safer gambling messages can be improved?

“…Participants were all from Australia, and so these findings may be less relevant to gamblers in other jurisdictions. Although some participants did have a lived experience of gambling harm, including a dedicated sample from within this group would have provided additional perspectives (Ortiz et al, 2021), as would the recruitment of recreational gamblers (Davies, Collard, McNair, & Leak-Smith, 2022). Industry could also provide alternative reflections on safer gambling messages (Behavioural Insights Team, 2021).…”

Involving lived experience in regional efforts to address gambling-related harms: going beyond ‘window dressing’ and ‘tick box exercises’

“…Lived Experience (LE), or “knowing from experience”, refers to people’s direct or indirect experiential knowledge of an issue or service [ 1 ]. LE involvement in mental health services and research is longstanding [ 2 , 3 ] and recognised as important in public health [ 4 – 7 ], where it echoes established approaches to public involvement and asset-based community development [ 8 ].…”

“…The emphasis on knowledge in LE distinguishes it from Patient and Public Involvement and Engagement (PPIE), although PPIE can be an engagement route for involving ‘experts by Lived Experience’, or ‘people with Lived Experience’ (PLE). The developing research base on LE involvement in public health intervention design and delivery highlights its importance for ensuring relevance and practical impact [ 9 , 10 ], and for reducing the risk that an intervention may unintentionally exacerbate harms [ 1 , 9 ].…”

“…However, the lack of evidence-based frameworks for appropriately engaging PLE in GRH reduction activities, which can be attributed to the sensitivity and stigma surrounding gambling, has only recently begun to be addressed [ 38 ]. As online gambling continues to be a target area for growth and precision marketing, it is imperative that public health researchers and practitioners engage with communities to raise awareness of GRH [ 1 ] and develop their own and others’ critical health literacy [ 39 ] specific to gambling.…”