A Workplace Prevention Program for Problem Gambling

Abstract: Gambling is an activity that may involve harm for the gambler and others close to the gambler. Since workplaces may be negatively affected by employees who gamble during work or are at-risk problem gamblers, this setting has been proposed as a suitable arena for prevention. However, the potential effects of such initiatives have not been evaluated. This thesis explored the effects of a workplace prevention program for problem gambling. The program comprised gambling policy development and skill development training for managers.Study I used pre-intervention measures to explore gambling characteristics of employees (n=3629) in ten organizations, including both private and public sector organizations, and blue- and white-collar workers. About one in 20 employees knew someone who gambled during work, and this proportion was similar for both managers and subordinates. Another finding was that 3.5% of respondents were categorized as at-risk problem gamblers, with a higher prevalence among subordinates (3.8%) than managers (1.3%). A third finding was that 11.4% of employees stated that the organization had a gambling policy, and that this did not differ between managers and subordinates. Gambling policy knowledge was considerably lower than alcohol policy knowledge, as an alcohol policy was believed to exist by 94.3% of managers and 63.3% of subordinates. Lastly, in regression analyses, the two outcomes “knowing about a colleague who gambles during work” and “at-risk/problem gambling” were associated with each other, male gender, and young age. Taken together, the findings offer evidence that gambling may be an important topic to target in workplace settings, although more research is needed to pinpoint specific workplace harms and whether certain gambling types are associated with more workplace harms than others.Study II used a cluster-randomized design to investigate the effects of a prevention program. Ten organizations were randomized to an intervention group or a waitlist group. Individuals who were employed on any of three measurement occasions were eligible to participate. A total of n=490 (response rate 73%) managers and n = 4146 (response rate 43.3%) subordinates participated in the study by providing informed consent and responding to the survey at least once. The prevention program included two main components: policy development and skill development training for managers. The main outcome was managers’ inclination to act when worried about an employee regarding gambling or other harmful use (e.g., alcohol), together with a range of secondary outcome measures. The results showed that managers who participated in the skill development training significantly increased their inclination to act compared to the waitlist group, but this finding was not generalized to the whole intervention group. Thus, including managers in the intervention group who did not participate in the skill development training when calculating intervention effects resulted in non-significant effects. The results of secondary outcome measures showed that there were significant intervention effects regarding managers’ knowledge of a gambling policy, their confidence in how to act when concerned about an employee’s possible problem gambling or other harmful use, and the proportion of managers who had acted to provide support.   Study III included semi-structured interviews with skill development participants (n=23) to inquire about their experiences of the prevention program. Interviews were transcribed and analyzed using qualitative content analysis, which yielded six distinct themes related to the participants, namely: 1) their expectations, 2) aspects of the skill development training they appreciated, 3) their experiences of PG, 4) their proposed areas of improvement, 5) whether they felt they had  received a good basis for PG and other harmful use, and 6) their thoughts about the so-called “difficult conversation”. Taken together, the findings provide ideas for improving gambling-specific interventions for the workplace and corroborate earlier research findings on workplace interventions in general.To conclude, the thesis shows that a workplace preventive intervention for gambling can have positive effects on managers’ intended and performed actions to help an employee who they suspect has a problem with gambling or other harmful use. However, further program improvements and in-depth studies are needed to draw conclusions on explanations, robustness, and mechanisms of change.