RESEARCH QUESTION
Is the “Stacked Deck” program (see below for description) an effective school-based program for the prevention of problem gambling?
PURPOSE
Although most people recognize that school-based prevention programs are an important component of problem gambling prevention, empirically effective programs are lacking. The purpose of the present study was to address this by reviewing a behaviourally effective school-based problem gambling prevention program, ‘Stacked Deck’.
HYPOTHESIS
None stated.
PARTICIPANTS
A total of 1240 grade 9–12 students (53% males; average age = 16 years) in schools across southern Alberta participated. Of these, 682 received the program, 267 received the program plus a booster session and 291 served as ‘controls’ (i.e., did not receive the program).
PROCEDURE
Schools were randomly assigned to condition (i.e., program, program plus booster, control) under the constraint that one quarter of the schools would not receive the program during the study. All control participants received the program following completion of the study. The standard ‘Stacked Deck’ program consisted of 5 interactive lessons that each lasted up to 100 minutes. Lesson 1 focused on what gambling is, the history and types of gambling available, the odds of traditional gambling games, and the insurmountable long-term advantage of the (“house edge.”) what is this? Casino profit. I would say “the insurmountable long-term gain for the casino.” Lesson 2 discussed the addictive potential of gambling, the signs and symptoms of problem gambling, causes and risk factors for problem gambling, and where to get help for gambling problems. Lesson 3 focused on making students more cognizant of and less susceptible to errors in thinking (i.e., gambling fallacies) that contribute to excessive gambling. The message of Lesson 4 was that everything you do is a gamble, and that the important thing is to approach life as a ‘‘smart gambler’’ by being a ‘‘problem solver’’ who routinely assesses the odds, the pay-off and potential loss. Lesson 5 focused on examining the reasons why people sometimes take ‘‘bad gambles’’ or make bad decisions, and it also addressed ways to overcome the barriers. The optional sixth session (booster session) consisted of a quiz game that was intended to consolidate the knowledge and skills learned in Lessons 1–5. The ‘Stacked Deck’ program was usually distributed over a 2-week period rather than on consecutive days. When the optional booster session was given, it was always scheduled 1-month after Lesson 5. At the beginning of the first lesson, students completed a questionnaire that collected information about demographics, gambling behaviour, and attitudes and knowledge about gambling. A follow-up questionnaire, containing the same items, was administered 3–7 months (4 months on average) after the program had ended.
MAIN OUTCOME MEASURES
Due to a lack of established measures, several variables were assessed via items designed for the present research: general attitude towards gambling (2 items); decision-making and problem-solving skills (8 items); involvement in high-risk activities in the past three months (9 items); and gambling behaviour in the past three months (4 items). Problem gambling in the past year was assessed via the 9-item DSM-IV-Multiple Response-Juvenile and a two-part self-report measure of problem gambling. The Gambling Knowledge scale assessed general knowledge of gambling and problem gambling. The Gambling Fallacies scale assessed awareness of and resistance to common gambling fallacies.
KEY RESULTS
Students who received the program demonstrated more negative attitudes toward gambling, greater knowledge of both gambling and problem gambling, and greater resistance to gambling fallacies at follow-up than those who did not receive the program. In addition, improvements in applied decision making and problem solving, a decrease in the percentage of gamblers, decreased overall gambling frequency, and some evidence of decreased rates of problem gambling were found at follow-up in students who received the program compared to those who did not. No differences based on age, gender, school or community were found.
LIMITATIONS
Students within the same school may be more similar to each other and there could be some increase in the possibility of Type I error (i.e., false positives in the findings). The long-term impact of the program (i.e., beyond 4 months) is uncertain. There is a need to replicate the findings in different jurisdictions with different students. It is unclear as to whether there are specific “active ingredients” that contributed to the effects and there may be value in conducting further research to dismantle the program so as to determine whether there are vital components.
CONCLUSIONS
The ‘Stacked Deck’ program appears to be a promising curriculum for the prevention of problem gambling. This school-based problem gambling prevention program is the first ever to have produced actual behaviour changes. Future research should work toward: examining the long-term impact of the program, replicating the results in different jurisdictions with different students, and determining whether there are ‘active ingredients’ that contributed to the present findings.
