The Lincy Institute E-Health Summit

November 10, 2011

Technology, Youth, Gambling, and Addiction

Jeffrey L. Derevensky, Ph.D.Professor, School/Applied Child

PsychologyProfessor, Psychiatry

McGill Universitywww.youthgambling.com

E-Health SummitUniversity of Nevada, Las Vegas

November, 2011

Slots for kids Slots for adults

Adolescent problem gambling prevalence studies

Canada Derevensky & Gupta (2001) Lussier, Derevensky, & Gupta (2007) Hardoon, Derevensky & Gupta (2002) Poulin (2000)

3.4%3.2%4.9%6.4%

U.S. National Research Council (1999) Welte et al. (2008)

3.5-5.0%2.1%

U.K. Fisher (1999) Wood et al. (2006)

5.6%3.5%

Scotland Moodie & Finnigan (2006) 9.0%

What are the most popular Facebook fan

sites?

10

Does Technology Hurt or Help Public Health?

Debi A. LaPlanteDivision on Addictions, Cambridge Health Alliance

Harvard Medical School

November 10, 2011

Technology & Society

Historians note that, with each advance, society has been “haunted by the effects of technology on the individual and society as a whole” (Ellerman,

2007)

A primary concern over time has included whether the new technology will be overwhelmingly

attractive to the people who are exposed to it

Technology & Society

Medieval society had an “ambivalent”

relationship with the development of

mechanical clocks because of their

ability to redirect individuals’

attention from eternity (and

spirituality) to the present (Ellerman, 2007)

Technology & SocietyMuch later, electronic communication advances

(e.g., the radio and television) stimulated concerns that these devices would absorb

individuals’ time excessively or cause addiction or other scandalous behavior (Silver,

1979; Stern, 1999)

Technology & SocietyHistory suggests the effects are temporary,

but…Most recently, people have expressed the same

or similar concerns about the potential for unhealthy excessive involvement with

personal computers, the Internet, and mobile devices, such as smart phones

The Brain’s Reward SystemA key component of the

development of addictive behavior, therefore, is the activation of the

brain’s reward system The reward system of the brain teaches us to do things that make us

feel goodThings like drugs, sex,

and gambling can stimulate the reward

systemImage courtesy of the National Institute on Drug Abuse

Shaffer et al., 2004; Brieter et al., 2001

Emerging Evidence

People who have a propensity for

excessive Internet gaming show similar

brain activation to that of individuals who

suffered from substance dependence or

pathological gambling when they viewed

relevant addiction-related cues (Han, Hwang,

& Renshaw, 2010)

Technology &

Society

Society’s recurring concerns, with every

technological advance, only reflect one side

of the story of technology and

addiction Technology also might play an important role

in preventing or curtailing risky

behavior

Toward e-HealthClinician researchers have suggested that the ability to use the computer to treat behavior

disorders might “…prove to be a small revolution for the delivery of mental health care” (Carroll &

Rounsaville, 2010)

What is e-health?New treatment approaches informed by or

delivered by new technologyNew delivery approaches for established

treatment by new technology

Health-E Gambling: Apps for a New World

From Cathedrals of Consumption…

Our view… There are a number of new and exciting e-tools for

health purposes generally, and for addiction-related problems in particular.

For example, studies seem to suggest that these technologies show promise by improving self-monitoring (which makes sense, given that you’ve always got this ‘tool’ on you, and can instantaneously enter data on consumption – food, smoking, gambling).

People can also, of course, instantaneously access data (information – specifically, educational and awareness information that might help with prevention).

Given these successes, we decided to create a problem gambling “e-health” program.

Based upon the literature review…

Our research team decided to focus “Health-E Gambling” development in four major areas:

1) Educational messaging: 20th century messages, 21st century media

2) Resource finder: helpline, using GPS to locate nearest/next GA meeting, treatment clinics

3) Community finder: connecting with others who “get it” – via bulletin boards, chat rooms, and other online communication tools

4) Virtual sponsor: urge-focused, and provides instant urge management strategies, stories of recovery, and resource information.

Down the road: algorithms, based upon direct or indirect play measurement?

The “Health-E Gambling” product

Focus Group Research• After the first version of the Health-E Gambling

website was complete, we put it to the empirical test!

• Focus groups in Las Vegas, Nevada, Medford, MA (urban Boston), and North Brookfield, MA (rural Massachusetts).

• Findings:• Prefer simple, easy-to-use interface• “Tools” effective but make them more fun and

interactive• Need to make the text “less academic”• Enhance individual customization features• Make it multi-lingual!

Social Media and Health Surveillance

Phil Polgreen, MD

University of Iowa

InfluenzaAnnually, an estimated 36,000 deaths and 120,000

hospitalizations occur in the U.S. as a result of influenza

Influenza is associated with other health related problems (acute myocardial infarctions, respiratory disorders, ear infections)

Influenza increases utilization of healthcare resources (inappropriate use of antibiotics)

The Historical Public Health Response to Efforts to Forecast Influenza:

Efforts to apply standard statistical methodology have not been successful

“. . . epidemic activity was unpredictable, and in a biological sense, exceptional.” Stroup, Thacker and Herndon, Statistics in Medicine, 1988.

But those efforts were based on old and relatively poor data

Benefits of an influenza forecast include allowing extra time for:

Administering prophylactic medications to persons in high-risk groups

Vaccinating high-risk individuals and healthcare workers

Preparing for an increased number of patients admitted for influenza complication

Social distancing (school closures)

Information about influenza activity is available but it is:

Disparate

Expensive to collect

Found in various forms/formats

Private/not in the public domain

• Ideas? Questions? Answers?

• Email me!

•bo.bernhard@unlv.edu