SPRinG—a digital health tool to support self-management of gambling harm reduction and
recovery: a pilot feasibility study
| Principal Investigator: Dr. Arthur McLuhan Problem gambling and gambling disorder (PDG) are serious public health issues that result in a range of harms, including financial losses, food and housing insecurity, and disruptions to relationships. Several barriers contribute to low rates of PG treatment-seeking and care, such as stigma, long wait times, transportation requirements, and treatment costs. Despite the growing interest in potential of smartphone-delivered interventions to make gambling harm reduction supports more accessible, there is a notable lack of research and dearth of data on their uptake and use. In this study, we are assessing the feasibility of SPRinG, a smartphone delivered digital health tool to support self-management of gambling harm reduction and recovery. Funded by greo |
Self-Management in the Age of Complexity: An e-Health Tool to Support People Experiencing Gambling, Poverty and Homelessness
| Principal Investigators: Dr. Flora Matheson and Dr. Alireza Sadeghian Problem gambling disproportionately affects people experiencing poverty, homelessness, and multimorbidity, including substance use, mental illness, trauma, chronic illness, and disability. Several barriers contribute to low rates of formal treatment-seeking and utilization for problem gambling. Self-management approaches and eHealth technologies—such as smartphone-delivered self-management interventions–may offer viable adjuncts or alternatives to current PG treatment options in Canada. Working with community partners and people with lived experience, we co-designed and -developed SPRinG, a smartphone-delivered intervention designed to support self-management of problem gambling. Funded by CIHR/NSERC Collaborative Health Research Projects grant |
Optimizing Support and Service Delivery for Problem Gambling Among People Living With Complex Needs
| Principal Investigators: Dr. Flora Matheson and Dr. Sara JT Guilcher Optimizing Support is a multi-deliverable study designed to give people experiencing problem gambling (PG) and other health and social needs an alternative treatment option. We engaged a range of healthcare providers to understand what knowledge, strategies and resources are needed to improve screening and treatment for PG. Working in collaboration with Dr. Sara Guilcher’s research team at the University of Toronto, and community partners such as the Good Shepherd Ministries, the Jean Tweed Centre, Fred Victor and the Biomedical Zone, Gambling Research Exchange Ontario, we also created a prototype of a smartphone-delivered intervention to support self-management among people experiencing problem gambling. with PG and other health and social concerns. Funded by the Ministry of Health and Long-Term Care |
A Process Evaluation of the Gambling Addiction Program in Partnership With Good Shepherd Ministries
| Principal Investigator: Dr. Flora Matheson The prevalence of problem gambling among people experiencing poverty and homelessness is up to 9 times higher than the general population and services for people experiencing these concerns and other health needs are scarce. The Good Shepherd Ministries partnered with us to implement and evaluate a novel Gambling Addiction Program situated in a multi-service shelter setting and tailored to the needs of people experiencing poverty and/or homelessness. We conducted a mixed-methods process evaluation of the Gambling Addiction Program to better understand program features, implementation processes, client experiences, and opportunities for enhancing program impact. Funded by the Ontario Trillium Foundation under the Local Poverty Reduction Fund. |
Betting on Housing: Women, Problem Gambling and Homelessness
| Principal Investigator: Dr. Flora Matheson Research on the association between problem gambling and homelessness among women is scarce. The Betting on Housing project was the first study of gambling concerns among women experiencing homelessness in Canada. We collected quantitative survey data to determine the prevalence of problematic gambling among women using shelter services in Toronto and Hamilton, Ontario and qualitative interview data to explore perspectives and experiences regarding the relationship between precarious social and financial situations (e.g., single parenthood, interpersonal violence, immigration, debts, and unemployment), marginalization, and vulnerability to problem gambling. Funded by Social Sciences and Humanities Research Council |
Raising Awareness: Multi-Sector Engagement to Enhance Understanding of Gambling and Poverty
| Principal Investigator: Dr. Flora Matheson Our team, including a Community Advisory Committee, and four talented students with backgrounds in film, journalism, graphic art and nursing, has co-created multimedia tools to communicate the link between problem gambling and homelessness. These knowledge translation products feature documentary film, visual art, storytelling and a workshop. We produced: 1. Problem gambling pamphlets for youth and women; 2. An animated whiteboard video developed for and informed by youth who have lived experience with trauma, poverty, and addiction; 3. A digital story about an adult male’s recovery from problem gambling; 4. A learning module for service providers to help them support clients experiencing problem gambling, poverty and homelessness 5. A written feature story about childhood trauma, substance abuse and problem gambling, and finding positivity in recovery. See them on gamblingandpoverty.ca. Funded by the Gambling Research Exchange Ontario (Greo) |
Seeking Solutions to Problem Gambling in a Primary Care Organization Focused on Health Equity
| Principal Investigators: Dr. Flora Matheson and Dr. Andrew Pinto In one of our previous studies, we found that many healthcare providers feel uncomfortable screening patients for problem gambling. In this project, we wanted to learn why. We surveyed healthcare providers at St. Michael’s Hospital to know how they document problem gambling in electronic medical records and how they approach the topic of gambling with their patients. Our questionnaire was also embedded with information about gambling and gambling-related harms to raise their awareness. We found that the problem gambling documentation rate is 1 per 1000 patients, however, the prevalence of problem gambling in Ontario is estimated to be between 1% to 2.2%. Chart reviews indicated that the embedded gambling screening tool was not used by the Family Health Team Physicians and Allied Health Professionals but health care providers said they would like to change their approach to PG and intended to use gambling screening tools. This project was funded by the Gambling Research Exchange of Ontario (GREO). |
Women Creating Community: Supporting Women to Manage Problem Gambling Through Arts-Based Programming
| Principal Investigators: Dr. Flora Matheson and Dr. Janet Parsons Creative activity is a beneficial approach to recovery that can foster personal and social renewal. It is a known need in service delivery for women experiencing concerns with gambling and isolation. Dr. Janet Parsons and Dr. Flora Matheson led the development of a free art program for women experiencing gambling concerns. Modeled after Isabel Fryszberg‘s art program for people experiencing mental health and substance use concerns, and Dr. Clara Juando-Prats’ art program for marginalized youth, the program was delivered by Dr. Clara Juando-Prats and Isabel Fryszberg, and informed by staff at the Jean Tweed Centre and Fred Victor, where the program was delivered. Women were invited to paint, draw, write songs, play music, journal, and create collages in a positive and communal space. The program aimed to reduce gambling-related harms, and promote a shift in identity from “person who gambles” to “artist.” A detailed final report can be found here. Funded by Gambling Research Exchange of Ontario (GREO). |
Problem Gambling and Housing Instability
| Principal Investigator: Dr. Flora Matheson This study explores: (a) pathways to housing instability and the experiences of unstable housing among people who have gambling problems; (b) barriers to treatment for problem gambling and to gaining stable housing; (c) opportunities to intervene along the pathway between problem gambling and housing instability; and, (d) personal and social consequences of problem gambling and housing. Using a qualitative approach we conducted 31 in-depth interviews with men who were clients of Good Shepherd Ministries in downtown Toronto. The majority of the men screened positive for past year problem gambling as assessed by the Canadian Problem Gambling Index (CPGI). Peer interviewers (those who have experienced housing instability, mental illness and/or addiction) were hired and trained by the Survey Research Unit. There is a web of critical social and health needs that these men face. These needs are situated within a landscape of poverty; for some, this relationship with poverty began in their youth and persisted into their adult lives. Men spoke of poor mental and physical health, disability, financial insecurity, substance use, and relationship loss and grief. For men who were underemployed gambling gave them hope or provided a way to escape reality for a short time. The majority of participants accessed government transfer payments, such as Ontario Works (OW) and the Ontario Disability Support Program (ODSP). Gambling provided a glimmer of hope, an alternative way to improve their financial situation, to pay for daily needs, or to purchase drugs and alcohol as a way to ease the pain. We identified several key intervention points to help men with gambling problems and who are using homeless services: a) interventions for youth experiencing unstable family environments to deter early entry into gambling and substance use; b) non-judgmental care for people seeking help with problem gambling and comorbid issues; c) remove systemic barriers such as lack of access to a family doctor who is familiar with and able to provide treatment and/or referrals for gambling addiction; and, d) publicly funded psychological support services. The men also spoke of a lack of availability of services, long wait-times, difficulty accessing services because of physical location, cost of transportation to access services, the lack of safe housing, and the lack of good quality and affordable housing. The intersection of social and health needs for people experiencing problem gambling presents itself as a considerable challenge to provision of services. Funded by Gambling Research Exchange of Ontario (GREO). |
J&E Lab 