canadian consortium for gambling research to Discovery Conference 2012 Judith Glynn April 4, 2012
members are research, regulatory and treatment organizations from across Canada with a mandate to fund gambling research coordinate national priorities, pool resources to achieve efficiencies and broaden opportunities for major research initiatives that serve the interests of all Canadian jurisdictions fund foundational research (since 2001) and educational workshops (added in 2011) all research is publicly available at www.ccgr.ca
Social and Economic Impact of Gambling Framework (SEIG) Canadian Adolescent Gambling Inventory (CAGI) Canadian Problem Gambling Index (CPGI)
2008 SEIG Framework 1 provides a map of indicators, based on six themes, upon which to assess the gambling s impact consistently, objectively and from multiple perspectives 2011 review 2 examined nearly 500 studies on the impact of gambling and simplified the SEIG Framework by recommending principles for meaningful socioeconomic impact analyses 1 Anielski & Braaten. (2008). The Socio-Economic Impact of Gambling (SEIG) Framework. Retrieved from www.ccgr.ca/seig.php. 2 Williams, Rehm & Stevens. (2010). The Social and Economic Impacts of Gambling. Retrieved from www.ccgr.ca/seig.php.
Launched in 2010 to measure gambling-related harm and consequences in adolescent populations First instrument designed specifically for use with adolescent populations Developed simultaneously in English and French, rather than being developed in one language and translated 3 Tremblay, Stinchfield, Weibe & Wynne. (2010). Canadian Adolescent Gambling Inventory. Retrieved from www.ccgr.ca/seig.php.
launched 2001 to measure gambling involvement, correlates and problem gambling prevalence in general adult populations first screen validated with a general population sample Problem Gambling Severity Index (PGSI) nine items to classify respondents into four gambler subtypes: 0 non-problem gambler 1-2 low-risk gambler 3-7 moderate-risk gambler 8-27 problem gambler (0=never; 1=sometimes; 2=most of the time; 3=almost always) used in all Canadian provinces, by Statistics Canada, and in Australia, Norway, Great Britain and Iceland 4 Ferris & Wynne. (2001). The Canadian Problem Gambling Index: Final Report. Retrieved from www.ccgr.ca/cpgi.php.
Two reports identify potential improvements to both CPGI and PGSI: 2006 report 5 on interviews with investigators who had used CPGI since its inception 2007 review 6 of critical comments on CPGI in the published literature, coupled with above findings, to formulate recommendations on projects to improve utility & utilization of CPGI 5 McCready & Adlaf. (2006) Performance and Enhancement of the Canadian Problem Gambling Index (CPGI): Report and Recommendations. Retrieved from www.ccgr.ca/cpgi.php. 6 Brown & Seraganian. (2007). Review of Canadian Problem Gambling Index (CPGI)
project 1 improve psychometric properties of PGSI (2010) project 2 broaden assessment of harm to population level (2012) project 3 develop common administration protocol (2012) project 4 develop common assessment of gambling participation (RFA 2012)
Objectives included: o Assess the validity of the PGSI classification cut-off scores o Assess the impact of recalibrating the PGSI scoring rules (e.g., new cut-off scores, dichotomous items, weighting) on the reliability and external validity of the PGSI classifications Used three large population datasets: o CPGI integrated dataset (2001-2005) o Canadian Community Health Survey (2002) o Leisure, Lifestyle, Lifecycle Project (2006-present) Methods include exploratory and confirmatory factor analysis; rasch modeling, differential item functioning analysis, regression modeling and an expert opinion survey 5 Currie, Casey & Hodgins. (2010). Improving the Psychometric Properties of the Problem Gambling Severity Index. Retrieved from www.ccgr.ca/cpgi.php.
PGSI in its present form demonstrates strong internal validity and reliability Among the four gambler subtypes: o Non-problem gambler and problem gambler subtypes are the most distinct, with the greatest external validity o Low-risk and moderate-risk subtypes are not meaningfully distinct There are gaps in the coverage of problem gambling severity There is no evidence to justify weighting the PGSI items
Modify the PGSI scoring rules: o 0 non-problem gambler o 1-4 low-risk gambler o 5-7 moderate-risk gambler o 8-27 problem gambler Do not combine! Change to a three-point Likert response scale Add new items to increase the range of scores for gamblers in the low-risk and moderate-risk subtypes Modify the PGSI items based on forthcoming changes to DSM-V
original instrument assesses harm at individual level but does not adequately assess harm at the family, community, and other environmental levels provide high public health utility - fully capture harm that occurs beyond the individual gambler objective: develop new, unscored items to assess population harm
Method: initial pool of items generated from systematic review of empirical literature and clinical instrumentation across the domains of gaming, gambling, impulse control, addiction and public health The psychometric properties of these items were evaluated in a large sample of 317 individuals with varying levels of gambling behaviour
The CPGI-Population Harm finally included 10 of the original 39 items gambling-related harm to family members, romantic partners, friends, the workplace, and the community comparable to the PGSI in scale length (10 versus 9 items) and item format (4-point Likert); however item anchors reflect degree of agreement rather than frequency as a proportion of items refer to difficulties that are not discrete events and therefore relatively difficult to judge in terms of frequency Future examination using different samples and methodologies (e.g., multi-trait multi-method designs and item response theory analysis) is encouraged
A standardized administration protocol would be important to consolidate data from different studies and to reduce administration bias.(due early 2012) Method: analysis of 183 papers/reports that used CPGI or PGSI, and interviews with authors to determine population characteristics collected, administration format and protocol
most did not use a protocol to introduce/explain the instrument demographic variables were collected in a variety of ways with few using the original CPGI demographic questions (described as too complex) preliminary recommendations: Provide a brief introduction (administration protocol) Use brief socio-demographic questions from Stats Can CCHS (sex, age, education, income, employment status, ethnicity) Include basic information on gambling participation (frequency, expenditure)
develop and validate a gambling participation instrument for use in general population surveys many studies hinge on correlating a variety of gambling attitudes and outcome measures to respondents intensity of gambling involvement problem: lack consistent metrics (time spent, frequency, expenditures etc.), measures (question wording, response options, timeframe), and method of administration RFA to be issued soon
review the DSM-V when it is released to assess implications for changes that might be required to the CPGI, and the PGSI in particular DSM-V is expected to be released in May 2013
The following agencies are standing members of the Canadian Consortium for Gambling Research: Alberta Gambling Research Institute British Columbia Gaming Policy and Enforcement Branch Gambling Awareness Nova Scotia (formerly the Nova Scotia Gaming Foundation) Manitoba Gaming Control Commission Ontario Problem Gambling Research Centre Québec, Ministère de la Santé et des Services sociaux http://www.ccgr.ca