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Ontario Problem Gambling Research Centre June 16, 2010.

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Presentation on theme: "Ontario Problem Gambling Research Centre June 16, 2010."— Presentation transcript:

1 Ontario Problem Gambling Research Centre June 16, 2010

2 Stage 1: What We Learned  MOHLTC performance indicators for research  current state of knowledge (bio-psycho-social risk factors)  Ontario gambling stakeholder relationships Stage 2: New Environmental Scans  publicly funded research trends  gambling, industry, political and regulatory trends  key stakeholder analysis: specific research interests  competitor (CMAH, RGC) analysis

3 Ministry of Health and Long-Term Care (MOHLTC) has developed new methods of evaluating grants and agencies in health services research. performance indicators for research

4 Involvement of End-Users in Question Formation and Other Stages of Research:  OLG – ATM Study  BME for Self-Exclusion  MOHLTC – Directed Research  Panels Development of Products Translating Research Findings for Different Audiences  Slots Animation  Synopses Summaries Up-to-Date Website  Information (research findings, etc.) more accessible  Better search engine  New application, review process performance indicators for research

5 Publically Accessible Repository of Research Articles Produced by the Centre  Online summaries recently updated  Bilingual summaries Information we are currently unable to provide the MOHLTC:  Number of full- and part-time core researcher / scientist positions paid for by OPGRC funding  Number and list of peer-reviewed publications stemming from funded research  Number of Knowledge Brokers (those with at least 50% of their work time devoted to conducting knowledge transfer activities) performance indicators for research

6 Number (and description) of researcher(s) that developed any products or processes that had a demonstrable impact on the health care system Number (and description) of researcher(s) that developed any products or processes that has been adopted by the health system Impact of ministry-funded research on improving equitable access or patients’ experiences with the health care system did you become aware during the Reporting Period of any commercial inventions – e.g. inventions announced publicly by independent private companies in press releases, public reports, etc (includes commercial publication of clinical measures, products or processes that have been developed through research or idea-generation) – that cite or reference ministry-funded research that your organization has undertaken or supported? no impact to report

7 scan of original research and literature review overview of which risk factors and risk populations have the strongest research evidence for contribution to problem gambling bio-psycho-social risk factors for problem gambling

8 Genetic dopamine genes show a significantly different occurrence in PGs serotonin and norepinephrine genes are also possible risk factors Neurobiological D2 receptors in PG’s have problems processing information from dopamine compared to non- PG’s PGs have higher dopamine release than non-PGs in specific brain regions (ventral striatum) Cognitions strong evidence that the illusion of control interacts with the development of PG PGs more likely to overestimate chance of winning, place riskier bets Other Addictions genetic/biological vulnerability to addictive behaviour is common to many (alcohol) the same risk factors may lead to co morbid addictions or other problems Mental Health Disorders mood disorders (anxiety, depression) impulse disorders (OCD, bulimia) and characteristics (impulsivity, ADHD, sensation seeking) Family higher risk of PG in children of PGs lower income, at-risk SES groups Culture and Peer Group evidence from international prevalence studies suggest members of ethno-cultural communities (ECC) have higher rates of PG peer group involvement in gambling is a significant risk factor of children and young adults Broader Environment speed of play & sound play an important role in development of PG stop button and near misses lead to longer play

9 demographic: young, male, Asian, immigrant or minority status in any society parental gambling proximity to gambling erroneous perceptions, illusion of control games: high frequency variable reinforcement addictions: alcohol, tobacco, drug abuse mood, impulse control & personality disorders delinquency, criminal history


11 key stakeholder analysis Dr. Srinivasan provided an interim response to Board Chair, Lynda Hessey’s request for the list of MOHLTC-directed priorities for FY 2010-2011 as quickly as possible:  MOHLTC accepted request to OPGRC from the Ministry of Health Promotion (MHP) to expand scope of existing funded project on ethno cultural services, at a cost of $25,000.  Ministry entitled to direct up to $1M to benefit Ontario health care system through priority areas established by the Inter-ministerial Problem Gambling Committee. The Committee will be meeting shortly to determine remaining priorities.  To support the new 10-year mental health and addictions strategy, remaining questions will relate to the prevention, rehabilitation and treatment of problem gambling.  Ministry emphasized importance of target populations, partnerships and leveraged or matching funds, de-emphasized “investigator-driven research that gets published and leads to tenure for the researcher, but doesn’t benefit the system.”  Staff will provide a bulleted list of topics for the Inter-ministerial Committee meeting. The list will be derived in part from the excel spreadsheet prepared by J. Major that summarized results of previous MOHLTC-Directed research and next steps recommended by researchers.

12 Ministry of Health Promotion (MHP) Ethno cultural communities  MHP a member of the Inter-ministerial Problem Gambling Committee establishing MOHLTC-directed priorities.  Program Coordinator approached OPGRC to request an expansion of Dr. Matthew Young’s, Gambling and problem gambling in ethno-cultural communities, to include the role of immigrant settlement organizations and their involvement in problem gambling outreach services to ethno-cultural communities. MOHLTC has accepted this and given OPGRC direction to expand the work. First Nations  MHP asked Acting CEO to attend a meeting in late June with Eight Aboriginal organizations funded under the Ontario Problem Gambling Prevention program by MHP.  They report having been discouraged from doing so by the Research Centre in the past and would like to discuss the development of a research proposal to develop Aboriginal assessment tools and conduct a prevalence study, respecting the National Aboriginal Health Organization (NAHO) principles of Ownership, Control, Access and Possession for research in First Nations.

13 Ontario Lottery and Gaming Corporation (OLG) In the past, OLG has responded to research ideas from OPGRC. For the first time, OLG has approached the Centre with a research agenda of their own and asked for collaboration. In addition OLG invited OPGRC to meet with the Interprovincial Lottery Corporation (ILC), Responsible Gaming Group on June 8 to discuss a national research agenda. ILC represents all of the provincial operators of gambling in Canada. Their respective research priorities are briefly outlined next slide.

14 Ontario Lottery and Gaming Corporation (OLG) OLG Projects:  Data analytics: Explore application of algorithms for player data to provide feedback to players, in real time and through a variety of channels. This would apply to the gaming environment and any potential internet gaming platform. OLG is planning to release an RFP this year.  RG education/communications through direct marketing channels: OLG is launching "It Pays to Know" education campaign in gaming sites, on lottery terminals, through direct mailings. It will cover all of the key areas of information that operators need to provide to players. OLG is undertaking a number of methods for measuring the impact of this.  Two policy issues (Sleep at sites, Monitoring players for excessive play): Explore how to create clearer guidelines for staff to interact with players. OLG will begin with internal consultations, and then solicit feedback from external partners.  Lottery play: Assess products and features for risk e.g., high frequency reinforcement schedules. Examine potential role of retailer interaction, informed consent, education, mass media.

15 Interprovincial Lottery Corporation (ILG) ILC Projects:  Follow-up Study to Effectiveness of brief intervention and ATM removal in reducing erroneous cognitions and over expenditure during slot play in problem and non-problems gamblers: Option 1: prevention focus targeted to all gamblers analyzing player card data from the London & Flamboro sites for one year prior to removal of ATMs from gaming floor and one year after, analysis by length of membership. Option 2: harm reduction focus targeted to at- risk and problem gamblers examining the dependent variable total $ amount spent, assessing for problem status, intention to use withdrawn funds, evaluate definition of “break in play” (duration distance, effort, ambiance).  New marketing techniques and technologies: As the industry responds to pressure to grow markets using new technology and direct marketing, assess when and for whom an inducement to spend more becomes an inducement to problem gamblers.  Link self exclusion to treatment: Brief motivational intervention to encourage treatment acceptance at point of self exclusion. Dependent variable: treatment uptake and compliance with self-exclusion. Consider adding assessment and intervention at point of reinstatement.  GamTALK: Assess objective and outcomes for problem gamblers of this peer support resource.  Risk/population profiles for education: segment players by risk factors and develop targeted resources and strategies to reduce risk  Socio-Economic Impact research: participate in the upcoming CCSA-led consultation with respect to its socio-economic impact study, including implementing a process to review and determine common priorities for operators.

16 Alcohol and Gaming Commission of Ontario (AGCO) Self exclusion consultation  AGCO Board considering adopting a policy and program that would require gaming operators to implement self-exclusion programs that meet certain minimum requirements.  On May 19, AGCO requested input from OPGRC on a discussion document.  In order to provide an objective research-based response, OPGRC conducted a literature search, commissioned a review of the published literature, and asked four of the researchers who have published in the area to provide expert advice.  Staff will combine the literature review and expert consultation and provide it to AGCO by the June 30 deadline.

17 Centre for Addiction and Mental Health (CAMH) Journal of Gambling Issues (JGI) partnership request  CAMH approached OPGRC to partner in and co-fund their on-line journal.  JGI is an on-line publication that combines peer reviewed articles with opinion pieces and first person accounts.  CAMH is already a partner in the Synopsis Project, contributing $21,000 per year for the next three years.

18 Responsible Gmabling Council (RGC) Research Partnership  RGC CEO Jon Kelly has expressed an interest in being included in or partnering in research with ethno-cultural agencies to explore using agencies dedicated to ethno cultural services in problem gambling education and prevention.  This is closely related to the research requested by Ministry of Health Promotion.

19 publicly funded research trends government research policy is moving increasingly towards applied research that results in patient experience and health system improvements and efficiencies  Increasingly, governments have prioritized outcome-focused research.  CIHR’s strategic plan calls for increasing funding towards “solutions- based research” and requires end-user input on research projects  Canadian Association of University Teachers announced “a central theme in [the 2009 budget] is a continuation of the government’s efforts to force universities and colleges into a closer embrace with the private sector.”  MOHLTC moving away from investigator-driven research that is published in an academic journal and results in tenure but has no health system or patient benefit. Proof of this can be seen in MOHLTC’s recent decision to move approval for funding removed from the Research Unit to a Ministry-approval process.  The move from basic research to applied represents a major sea-change in how research is done at the most basic level.

20 publicly funded research trends knowledge translation becoming important aspect of research process  Federal Government’s Science and Technology Strategy is explicit: “Canada must translate knowledge into commercial applications that generate wealth for Canadians and support the quality of life we all want.”  Ministry of Health and Long-Term Care’s Making Research Relevant report says, “While researchers may have information that could help in planning or delivering health services, that information doesn’t always get into the hands of the people who can use it. There are many barriers to research transfer, the process of putting research findings into action, or making evidence-based decisions.”  MOHLTC’s “vision for research” is to “improve the health care and outcomes of Ontarians by investing strategically in policy relevant and applied health services research.”

21 publicly funded research trends federal funding for research will likely be reduced  There has been rapid growth in research spending in Canada for more than 10 years. Canada is at the top of the Organization for Economic Co-operation and Development (OECD) in government support for Research and Development.  Research organizations will be hard-pressed to make resonant arguments against deep spending cuts, espcially in a climate focused on economic recovery.  National Council on Ethics in Human Research (NCEHR) had its funding terminated by Health Canada and CIHR. Unlike other nations, Canada now has no body that audits or oversees the research ethics boards across the country.  Canadian Foundation for Climate and Atmospheric Sciences said it was “acutely disappointed” in the latest budget as it pertained to research, calling the budget “the nightmare scenario.”

22 publicly funded research trends Agencies are increasingly requiring publicly funded research be made available to the public for free as a requirement of funding  Currently, if a member of the public wishes to view an research report in a peer- reviewed article, they must pay for the report. The cost ranges from $40-75 per report.  The National Institute of Health Public Access Policy (United States) ensures that the public has access to the published results of NIH funded research. It requires scientists to submit final peer-reviewed journal manuscripts that arise from NIH funds to the digital archive PubMed Central (the U.S. NIH free digital archive of biomedical and life sciences journal literature) upon acceptance for publication.  In the United States, an expert panel of librarians, library scientists, publishers, and university academic leaders called on federal agencies that fund research in January, 2010 to develop and implement policies that ensure free public access to the results of the research they fund "as soon as possible after those results have been published in a peer-reviewed journal.“  MOHLTC is looking into a policy of requiring researchers make their research publicly available. The MOHLTC is researching the financial, etc. cost to researchers of such a policy.

23 gambling, political, industrial and regulatory trends Expansion Expansion will ride the back of the economic downturn  The recent economic downturn has meant lower revenue numbers for gaming in general, including venerable locations such as Las Vegas, it has also encouraged cash-strapped jurisdictions and governments to seriously look at alternate sources of revenue-generation, including gaming. This trend should continue throughout 2010, with several Canadian provinces set to venture into Internet Gaming. Expansion is a hot topic in the US  Several states are either allowing more gambling (table games, VLTs, etc.) or opening the door for new gambling. New Hampshire, Deleware, Texas, Alabama and Ohio are just some of the states grappling with the expansion or regulation of gambling.

24 gambling, political, industrial and regulatory trends Internet Internet Gaming (iGaming) playing field will be changing dramatically in Canada as some provinces are set to offer casino-style gaming online  In February, OLG Chair Paul Godfrey said “When you see what's going on in British Columbia, Quebec and the Atlantic provinces... it's something I would explore. Money is going out of this province to other provinces as well as offshore sites." iGaming continues to be a subject of much debate in the United States, with a few states indicating a strong desire to offer some form of regulated iGaming.  On May 6, 2009, Rep. Barney Frank (D-MA), re-introduced the Internet Gambling Regulation, Consumer Protection, and Enforcement Act (H.R. 2267). The legislation would establish a framework to permit licensed gambling operators to accept wagers from individuals in the U.S. and mandates a number of significant consumer protections.

25 gambling, political, industrial and regulatory trends Technology Regulators will struggle to provide appropriate regulatory oversight over the massive changes in technologies used by gaming venues  Several casinos are considering adopting new technologies, such as allowing visitors to bet with their iPhones, networked games that allow players to compete against each other and games that allow players to bank their wins for later play.  These changes include not only new features on VLTs and slot machines like touch screens, etc., but also new networks, allowing machines in disparate locations to communicate, perform software updates, etc.

26 gambling, political, industrial and regulatory trends Regulation Regulation will be a hot topic in the coming months, with iGaming ramping up throughout Canada  Provinces that choose to offer iGaming will implement regulations that attempt to provide regulatory oversight and responsible gaming provisions.

27 opportunities for collaboration OPGRC has been approached by several organizations to partner on various projects OPGRC has the opportunity to become a source for applied research to stakeholders in Ontario’s gambling industry Usually, directed research has come to OPGRC in one of two ways:  from the MOHLTC or from staff  OPGRC would then approach potential partners with research ideas  The current process for directed research is not designed to be responsive to external requests for partnerships because of issues such as timing, flexibility, etc. RGC and CAMH have worked closely with the OLG and other provincial operators on far more collaborative projects than OPGRC

28 potential partners in operation and regulation Ontario Lottery and Gaming Corporation  data analytics (explore application of algorithms for player data)  Responsible gaming education/communication through direct marketing channels  Policy issues: sleep at sites, monitoring players for excessive play)  Lottery play (assess products and features for risks) Interprovincial Lottery Corporation  Follow up to the ATM study  New marketing techniques and technologies (assessing when and for whom a marketing inducement to spend more becomes an inducement to problem gamblers).  Linking self-exclusion to treatment (using the BMI)  Assessing objective and outcomes for problem gamblers of GamTALK  Risk/population profiles for education  Socio-Economic impact research

29 potential partners in operation and regulation Alcohol and Gaming Commission of Ontario (AGCO)  data analytics (explore application of algorithms for player data)  AGCO has requested input on a discussion document regarding self exclusion  OPGRC is currently developing three prevention animations in partnership with AGCO. There are plans to create five additional animations.

30 potential competitors Centre for Addiction and Mental Health (CAMH)  Problem Gambling Institute of Ontario (PGIO) formally integrates the work of Centre for Addiction and Mental Health (CAMH)’s researchers, clinicians and staff responsible for education, community resources and research  OLG contracts CAMH to train gaming staff in responsible gambling across Canada  Approximately 50 per cent of OPGRC’s funding goes to CAMH researchers  CAMH offers a variety of knowledge translation resources, including Fundamental Concepts of Problem Gambling, Problem Gambling: Education and Treatment in a Residential Setting, as well as printable handouts for operators and staff, problem gambling resource lists, problem gambling screening tools and lists of problem gambling treatment services in Ontario.

31 potential competitors Responsible Gambling Council (RGC)  Responsible Gaming Resource Centres are located on-site at OLG gaming venues across Ontario, provides patrons with information on safer gambling practices as well as assistance and local referrals for help with gambling-related problems  introduced the Responsible Gambling Index (RGI) and the Responsible Gambling Check Accreditation. The RGI is a system to ‘provide responsible gaming standards to industry leaders (operators).’ This national and soon-to-be international program consists of eight standards, 46 criteria and 68 indicators to help operators become ‘accredited.’ It includes topics such as self-exclusion, employee training, responsible gambling policies and advertising and promotion  maintains a research branch that includes a collection of more than 8,000 articles, reports and documents  runs the The Centre for The Advancement of Best Practices, which promotes the identification and adoption of best practices to reduce the incidence of problem gambling.

32 potential partnerships with competitors CAMH has requested that OPGRC help fund its Journal of Gambling Issues (JGI). JGI is an online publication consisting of peer-reviewed articles (gambling-related research, treatment and policy) and offers a forum (opinions, first person accounts and letters to the editor) to “help make sense of how gambling affects us all.” RGC has requested an expansion to the Gambling and problem gambling in ethno-cultural communities study.

33  state of knowledge - provide stakeholders with a starting point for research planning, heads up on research findings  expert consultation - provide and/or coordinate advice from international research community  co-fund and monitor arms-length, credible research

34 benefits of partnerships By engaging in partnerships with problem gambling industry and health system stakeholders, OPGRC could:  maximize the collective impact of knowledge creation and its application to affect the health system change  continue to strengthen its relationships with government partners and other gambling stakeholders to support evidence-informed policy making  build linkages with researchers  promote the creation of research needed by stakeholders  funds leveraged for greater efficiences and effects  increase value of OPGRC to MOHLTC

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