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Dr. Julio Ángel Brizuela President of The Specialty Area on Pathological Gambling and other Behavioural Addictions of the Argentinean Psychiatrists Association (APSA) Coordinator of the Section on Pathological Gambling and other Behavioural Addictions of the Latin American Psychiatric Association (APAL) BUENOS AIRES ARGENTINA 2
METHODOLOGICAL GROUNDS TO DEVELOP INTEGRAL PUBLIC HEALTH PROGRAMMES ABOUT PATHOLOGICAL GAMBLING Dr. Julio Ángel Brizuela 3
METHODOLOGICAL GROUNDS This paper highlights the importance of Mental Health programs that respond to key questions on planning: what to do and how to outline integral plans on Public Health. 4
KINDS OF GAMBLERS Brizuela y Cía, 2007 Practiced by the vast majority of the population (96%) HEALTHY RECREATIONAL, SOCIAL OR MODERATE GAMBLING Sufficient Information RESPONSIBLE GAMBLING CONTROL In a vulnerable minority (4%) LACK OF CONTROL PROBLEM GAMBLING IMMODERATE, UNCONTROLLED OR COMPULSIVE GAMBLING PATHOLOGICAL GAMBLING 5
Integral Public Health Programs referred to Pathological Gambling Aimed at avoiding the disordered participation in gambling, and at developing principles and practices intended for preventing and mitigating the harmful effects of immoderate and pathological gambling, including the implementation of multi-pronged measures to protect vulnerable groups. 6
Objectives a) Preventing and reducing the dangers of Immoderate and Pathological Gambling. b) Instructing about how to gamble in a safe and healthy way. c) Detecting ways of immoderate and/or pathological gambling. d) Referring those who already suffer from this disorder for their proper treatment. Dr. Julio Ángel Brizuela 7
Objectives e) Facilitating illustrative consultations for relatives and close friends of immoderate and pathological gamblers. f) Fostering research on the incidence and prevalence of problem gambling and pathological gambling in the general population. g) Planning intra and inter institutional measures for prevention and assistance. h) Promoting professionals training in the art of healing to assist those suffering from these disorders. Dr. Julio Ángel Brizuela 8
The programs that are more likely to achieve success are based on a clear understanding of the health behaviors expected to reach and their environmental context. Through them we can understand the dynamics of behavior, the processes to change it, and the effects of external circumstances. Promoting health has adapted the ideas of social sciences and behavior to adjust them to the concerns of public health workers. Dr. Julio Ángel Brizuela 9
Health communication models and theories, which allow the preparation of programs Individual or intrapersonal-level models Individual level is essential in health promotion. Not only should interpersonal factors be considered, but also individual interpersonal characteristics, as well as their knowledge, skills, attitudes, motivations, beliefs, history of development and behavior. Dr. Julio Ángel Brizuela 10
Theories at this level 1) Theory of change stages 2) Health Belief Model 3) Theory of data processing Dr. Julio Ángel Brizuela 11
Theory of change stages Willingness to change towards healthy behaviors. The most important thing is to understand that behavior change is a PROCESS and is not an act, and that individuals are in several levels of motivation or willingness to change. 12
Health Belief Model Consists of perceiving the threat of a certain health problem that people have, and of the evaluation of a recommended behavior to prevent and manage said problems. 13
Theory of data processing Studies the processes through which the subject receives and uses information to make decisions. It is important to clarify that the information is necessary but not sufficient to cause behavioral changes. 14
Theory of Interpersonal Health Behavior This theory assumes that a person acts in contexts where other people feelings, examples, advice, emotional help and support influence their own feelings and behaviors, i.e. people are influenced by their social context and, at the same time, have influence on it. Dr. Julio Ángel Brizuela 15
Think about Social learning or cognitive theory The basic premise of this theory is that individuals learn not only through their own experience, but also by observing the actions of others and the results of those actions. 1) RECIPROCAL DETERMINISM 2) BEHAVIORAL CAPABILITY (Albert Bandura s Social Cognitive Theory) Dr. Julio Ángel Brizuela 16
1. Reciprocal Determinism Individual behavior and its environment are reciprocal systems, that is, influence takes place in both directions. Dr. Julio Ángel Brizuela 17
2) Behavioral Capability People need to know what to do and how to do it; therefore, clear and accurate rules or special training will be necessary. Dr. Julio Ángel Brizuela 18
Community-level models The collective well-being of communities can be fostered by creating structures and policies that support a healthy lifestyle besides reducing or eliminating hazards in social and physical environments. Dr. Julio Ángel Brizuela 19
Three conceptual frameworks 1) COMMUNITY ORGANIZATION 2) DIFFUSION OF INNOVATIONS THEORY 3) ORGANIZATIONAL CHANGE THEORIES Dr. Julio Ángel Brizuela 20
1) Community Organization A process whereby community groups are helped to identify common problems and goals by mobilizing resources and developing strategies to achieve a certain purpose. The objective is to stimulate problem solving by making community members act. Dr. Julio Ángel Brizuela 21
2) Diffusion of innovations theory Studies how new ideas, products and social practices spread within a society. It involves paying attention to innovation as well as communication channels and social systems. The most relevant characteristics of innovations are: their relative advantages, compatibility, complexity, trial ability, and results observability Dr. Julio Ángel Brizuela 22
3) Organizational Change a) Stage Theory Theories based on the idea that organizations go through a series of stages as they change, and by recognizing them, strategies can be adjusted to various points in the change process b) Organizational Development Theory based on organizational structures and processes which influence people behavior and motivation. Dr. Julio Ángel Brizuela 23
In this way, Integral Public Health Programs referred to Pathological Gambling become essential tools for preventing and detecting Immoderate and Pathological Gambling, as well as valuable alternatives for referring and assisting this problem, thus emerging as innovative options in Public Health, covering not only primary but also secondary and tertiary prevention. Dr. Julio Ángel Brizuela 24
Email julioangelb@gmail.com 25
THANK YOU FOR YOUR ATTENTION!!! Dr. Julio Ángel Brizuela 26