Interventions that address interpersonal violence experienced by adolescents globally: a systematic review of reviews.

Globally, adolescents experience a significant burden of interpersonal violence, impacting their health, well-being and life trajectory. To address this, decision-makers need reliable evidence on effective interventions across various contexts. OBJECTIVES: Synthesise the evidence for interventions addressing interpersonal violence experienced by adolescents aged 10-25 years. METHODS: Six electronic databases were systematically searched. Systematic reviews and meta-analyses published globally between 2010 and 2022 were included if they reported interventions addressing interpersonal violence experienced by adolescents. Results were synthesised narratively. RESULTS: 35 systematic reviews were included, of which 16 were also meta-analyses. Majority of reviews included interventions set in high income countries (71%) and implemented in educational settings (91%). Effectiveness was reported in majority of interventions measuring victimisation and/or perpetration of intimate partner violence, sexual violence, bullying and/or cyberbullying (90%), majority of interventions measuring improvements in knowledge and attitudes towards violence (94%) and all interventions measuring bystander behaviour and improvements in well-being and quality of life. However, the quality of included reviews as per Assessment of Multiple Systematic Reviews 2 and National Health and Medical Research Council was low, and equity as per PROGRESS-PLUS was seldom considered. There was also a paucity of interventions addressing interpersonal violence in low-middle income countries (12%) and none of the included interventions specifically addressed interpersonal violence perpetrated in the home such as family violence. CONCLUSION: There is some evidence of promising interventions to address interpersonal violence experienced by adolescents, however there are gaps in scope and implementation. There is a need for equity-oriented public health approaches to comprehensively address the disproportionate burden of interpersonal violence experienced by adolescents globally, including those at the highest risk of harm. PROSPERO REGISTRATION NUMBER: CRD42020218969.

Exploring the feasibility of a gambling harm screening model in general practice and community service settings in Fairfield: a pilot study.

BACKGROUND: Gambling is a growing public health issue in Australia. However, limited research has examined the role of primary health care and social services in routine screening for gambling harm in Australia. This research aimed to explore the enablers and barriers to implementing a co-designed gambling screening model in Fairfield, New South Wales - an area with high gambling expenditure. METHODS: A co-designed gambling screening and referral model for GP and community-based organisations was implemented in Fairfield in 2020. Follow-up interviews were conducted with nine health care professionals who implemented the screening in 130 patients. Thematic analysis generated key barriers and enablers for implementation of this model. RESULTS: Key enablers for the screening model implementation included structural factors (alignment of the screening model with current work), process factors and staffing factors (staff empowerment). However, we also noted process factors as a barrier to implementation, particularly the referral pathway following screening. Other barriers included social and structural factors, such as the complexity of gambling harm and project funding. CONCLUSIONS: Embedding routine screening in primary and community care settings can play a role in treating, reducing and preventing gambling-related harm, and reducing stigma in Fairfield and beyond. Additionally, screening models such as this provide health systems with clear evidence on the level of gambling harm in their community (particularly important in culturally and linguistically diverse communities who are underrepresented in research). This evidence is important for addressing system-level drivers of harm and advocating for political reform to reduce the impact of gambling on communities.

Exploring the Potential of a Behavior Theory-Informed Digital Intervention for Infant Fall Prevention: Mixed Methods Longitudinal Study.

BACKGROUND: Falls are the most common hospitalized injury mechanism in children aged ≤1 years, and currently, there are no targeted prevention interventions. The prevention of falls in children of this age requires changes in the behavior of their caregivers, and theoretically informed digital behavior change interventions (DBCIs) may provide a unique mechanism for achieving effective intervention. However, user acceptance and the ability of DBCIs to effect the required changes in behavior are critical to their likelihood of success. OBJECTIVE: This study aims to evaluate a behavior theory-informed digital intervention developed following a user-centered approach for user experience, the potential for this intervention to prevent infant falls, and its impact on behavioral drivers underpinning fall risk in young children. METHODS: Parents of infants aged <1 year were recruited and asked to use the intervention for 3 months. A pre-post longitudinal design was used to examine the change in the potential to reduce the risk of falls after a 3-month exposure to the intervention. Postintervention data on behavioral drivers for fall prevention, user acceptability, and engagement with the app were also collected. Interviews were conducted to explore user experiences and identify areas for further improvement of the intervention. RESULTS: A total of 62 parents participated in the study. A statistically significant effect on the potential to reduce falls was observed after the intervention. This effect was higher for new parents. Parents agreed that the intervention targeted most of the target behavior drivers. The impact of behavior drivers and intervention on the potential for fall prevention had a positive correlation. The intervention demonstrated good levels of acceptability. Feedback from participants was mostly positive, and the primary area identified for further improvement was widening the scope of the intervention. CONCLUSIONS: This study demonstrated the promise of a newly developed digital intervention to reduce the risk of infant falls, particularly among new parents. It also showed a positive influence of the DBCI on the drivers of parental behaviors that are important for fall reduction among infants. The acceptability of the app was high, and important insights were gained from users about how to further improve the app.

How to do (or not to do) how to embed equity in the conduct of health research: lessons from piloting the 8Quity tool.

Global health research reflects and can either perpetuate or challenge the complex power hierarchies and inequities that characterize our health systems and the societies in which they are situated. The imperative to embed equity in health research aligns with broader efforts globally to promote equitable partnerships among researchers, and between researchers and the communities potentially impacted by their research, or with whom knowledge is co-produced. We describe lessons learnt from piloting a heuristic and diagnostic tool for researchers to assess integration of equity considerations into their research practices. The '8Quity' tool comprises eight domains of equity we developed which roughly correspond to the typical stages in the research process-from team formation to capacity strengthening, research ethics and governance to relationships with research partners, participants and stakeholders beyond the project period. Resources that detail how this can be done on a practical level are also shared, corresponding to each of the eight domains. We acknowledge that tools like 8Quity may be helpful, even necessary, but are insufficient for the broader societal changes required to ensure equity in the research enterprise. However, by firmly setting intentions and accountabilities within our research practices, we (as researchers) can play a role, however modest, in turning the tide of the injustices that leave some communities behind.

What Are Healthy Societies? A Thematic Analysis of Relevant Conceptual Frameworks.

BACKGROUND: While support for the idea of fostering healthy societies is longstanding, there is a gap in the literature on what they are, how to beget them, and how experience might inform future efforts. This paper explores developments since Alma Ata (1978) to understand how a range of related concepts and fields inform approaches to healthy societies and to develop a model to help conceptualize future research and policy initiatives. METHODS: Drawing on 68 purposively selected documents, including political declarations, commission and agency reports, peer-reviewed papers and guidance notes, we undertook qualitative thematic analysis. Three independent researchers compiled and categorised themes describing the domains of a potential healthy societies approach. RESULTS: The literature provides numerous frameworks. Some of these frameworks promote alternative endpoints to development, eschewing short-term economic growth in favour of health, equity, well-being and sustainability. They also identify values, such as gender equality, collaboration, human rights and empowerment that provide the pathways to, or underpin, such endpoints. We categorize the literature into four "components": people; places; products; and planet. People refers to social positions, interactions and networks creating well-being. Places are physical environments-built and natural-and the interests and policies shaping them. Products are commodities and commercial practices impacting population health. Planet places human health in the context of the 'Anthropocene.' These components interact in complex ways across global, regional, country and community levels as outlined in our heuristic. CONCLUSION: The literature offers little critical reflection on why greater progress has not been made, or on the need to organise and resist the prevailing systems which perpetuate ill-health.

How to Build Healthy Societies: A Thematic Analysis of Relevant Conceptual Frameworks.

BACKGROUND: As the Sustainable Development Goals deadline of 2030 draws near, greater attention is being given to health beyond the health sector, in other words, to the creation of healthy societies. However, action and reform in this area has not kept pace, in part due to a focus on narrower interventions and the lack of upstream action on health inequity. With an aim to guide action and political engagement for reform, we conducted a thematic analysis of concepts seeking to arrive at healthy societies. METHODS: This paper drew on a qualitative thematic analysis of a purposive sample of 68 documents including political declarations, reports, peer reviewed literature and guidance published since 1974. Three independent reviewers extracted data to identify, discuss and critique public policy levers and 'enablers' of healthy societies, the "how." RESULTS: The first lever concerned regulatory and fiscal measures. The second was intersectoral action. The final lever a shift in the global consensus around what signifies societal transformation and outcomes. The three enablers covered political leadership and accountability, popular mobilization and the generation and use of knowledge. CONCLUSION: Documents focused largely on technical rather than political solutions. Even as the importance of political leadership was recognized, analysis of power was limited. Rights-based approaches were generally neglected as was assessing what worked or did not work to pull the levers or invest in the enablers. Frameworks typically failed to acknowledge or challenge prevailing ideologies, and did not seek to identify ways to hold or governments or corporations accountable for failures. Finally, ideas and approaches seem to recur again over the decades, without adding further nuance or analysis. This suggests a need for more upstream, critical and radical approaches to achieve healthy societies.

Exploring the beliefs and experiences with regard to COVID-19 vaccine hesitancy and acceptance in a slum of Karachi, Pakistan.

The COVID-19-related misinformation and vaccine hesitancy is a widespread global concern and a recognized public health problem in Pakistan. The current research sought to explore the beliefs and experiences with regard to COVID-19, including vaccine hesitancy and acceptance, in a slum of Karachi, Pakistan. This study used an interpretivist epistemological approach for data collection and employed in-depth interviews (IDIs) and focus group discussions (FGDs) to explore the themes of interest. IDIs and FDGs were conducted in the local language (Pashtu) and Urdu, using semi-structured interview guides. A hybrid thematic analysis approach (use of both inductive and deductive coding) was used to analyze the data. We identified two key themes: the first related to vaccine hesitancy and refusal and included the role of personal belief systems, vaccine mistrust and public perceptions in hesitancy; the second related to vaccine acceptance and included knowledge and awareness about the vaccine and trusted sources of information. Religious beliefs and cultural norms influenced attitudes toward COVID-19 and vaccination. This study also found that awareness about the COVID-19 vaccine in this sample was influenced by sex, educational status and socioeconomic status. Participants with good health literacy and those from healthcare backgrounds were more likely to share views that indicated vaccine acceptance. The findings of this study are being used to co-design a comprehensive intervention to dispel COVID-19 misinformation and vaccine hesitancy across a range of stakeholders such as youths, community leaders, family members, faith leaders, schools and community-based local organizations in Pakistan.

This study explored the beliefs and experiences of the COVID-19 vaccine, including hesitancy and acceptance toward vaccinations, in a slum of Karachi, Pakistan. The findings of this study highlight that hesitancy was linked to personal belief systems, vaccine mistrust and public perceptions. In contrast, vaccine acceptance was linked to knowledge and awareness about the vaccine and trusted sources of information. This research identifies a clear need for co-designed health communication for vaccines to design and deliver people-centered interventions to dispel the COVID-19 misconceptions and vaccine hesitancy.

Difficulties faced by older Rohingya (forcibly displaced Myanmar nationals) adults in accessing medical services amid the COVID-19 pandemic in Bangladesh.

BACKGROUND: COVID-19 has seriously disrupted health services in many countries including Bangladesh. This research aimed to explore whether Rohingya (forcefully displaced Myanmar nationals) older adults in Bangladesh faced difficulties accessing medicines and routine medical care services amid this pandemic. METHODS: This cross-sectional study was conducted among 416 Rohingya older adults aged 60 years and above residing in Rohingya refugee camps situated in the Cox's Bazar district of Bangladesh and was conducted in October 2020. A purposive sampling technique was followed, and participants' perceived difficulties in accessing medicines and routine medical care were noted through face-to-face interviews. Binary logistic regression models determined the association between outcome and explanatory variables. RESULTS: Overall, one-third of the participants reported difficulties in accessing medicines and routine medical care. Significant factors associated with facing difficulties accessing medicine included feelings of loneliness (adjusted OR (AOR) 3.54, 95% CI 1.93 to 6.48), perceptions that older adults were at the highest risk of COVID-19 (AOR 3.35, 95% CI 1.61 to 6.97) and required additional care during COVID-19 (AOR 6.89, 95% CI 3.62 to 13.13). Also, the notable factors associated with difficulties in receiving routine medical care included living more than 30 min walking distance from the health centre (AOR 3.57, 95% CI 1.95 to 6.56), feelings of loneliness (AOR 2.20, 95% CI 1.25 to 3.87), perception that older adults were at the highest risk of COVID-19 (AOR 2.85, 95% CI 1.36 to 5.99) and perception that they required additional care during the pandemic (AOR 4.55, 95% CI 2.48 to 8.35). CONCLUSION: Many Rohingya older adults faced difficulties in accessing medicines and routine medical care during this pandemic. This call for policy-makers and relevant stakeholders to re-assess emergency preparedness plans including strategies to provide continuing care.

A qualitative study to understand drivers of psychoactive substance use among Nepalese youth.

BACKGROUND: Psychoactive substance use among youth is an emerging public health issue in Nepal. This exploratory study aimed to better understand the drivers of psychoactive substance use among Nepalese youth in Rupandehi district of Nepal. MATERIALS AND METHODS: This study used a qualitative approach for data collection. Both in-depth interviews (IDI, seven participants) and focus group discussions (FGD, 13 participants) were conducted among study participants who self-reported as psychoactive substance users or had history of psychoactive substance use. Participants for IDI were aged between 11 and 24 years and between 18 and 35 years old for FGDs. Semi-structured interview guides were prepared separately for IDIs and FDGs. Interviews were conducted in Nepali language and were audio recorded, which were there transcribed and translated into English for coding and analyses. In addition, interviews notes were taken by two research assistants. An inductive thematic analysis was used to analyze the data. RESULTS: This study identified a range of drivers of psychoactive substances use among Nepalese youths. Themes included (i) socio-cultural factors, (ii) individual factors, (iii) academic environment, (iv) physical environment and the (v) influence of media. The socio-cultural factors were categorized into sub-themes of family relationships, ethnic identity and psychoactive substance use and lack of social acceptance. Individual factors included peer pressure, stress relief and coping with financial challenges. Accessibility and availability of psychoactive substances in the surrounding environment and lack of monitoring and reinforcement of rules/ law and regulations were other drivers to psychoactive substance use among this Nepalese youth cohort. CONCLUSION: Our study identified several important drivers of psychoactive substance use among youth in the Rupandehi district of Nepal. Future works are anticipated to further explore youth initiation and use of psychoactive substances and support the design of interventions that address these risk factors to reduce and prevent subsequent harms.

Use of Psychoactive Substance and its Associated Factors among School Adolescents in Rupandehi District of Nepal.

BACKGROUND: Psychoactive substance use among adolescents has been identified as an important health issue in Nepal. Therefore, this study examined the psychoactive substance use and factors associated with its use among adolescent students in the Rupandehi district of Nepal. METHODS: A school-based cross-sectional study was conducted from December 2017 to July 2018 with 460 school students aged between 15 to 19 years across sampled public and private schools in the Rupandehi district of Nepal. Structured interview schedule was used to collect information on psychoactive substance use. The generalized estimating equation was used to identify the factors associated with the use of psychoactive substances. RESULTS: Over a quarter (27.4%) of school-going adolescents used at least one type of psychoactive substance. Commonly used psychoactive substance included tobacco products (59.3%) followed by cannabis (55.6%), marijuana (35.8%), hashish (23.5%), alcohol (22.2%), heroin (18.5%), nitrogen tablets (14.8%), sulfa (13.6%) and opium (13.6%), respectively. Being male (AOR=2.0, 95% CI: 1.19-3.36), having peers (AOR=1.8, 95% CI: 1.13-3.03) or family members (AOR=2.2, 95% CI: 1.40-3.54) that used psychoactive substances and father's education level (AOR=2.5, 95% CI: 1.05-5.78) were significantly associated with the psychoactive substance use. CONCLUSIONS: This study identified that over a quarter of school-going adolescents reported the use of at least one illegal psychoactive substance. This study provided details on the extent of behaviours, and can be used to develop a comprehensive prevention and control program. Such programs should address the socio-cultural factors that enable substance use and address gaps in knowledge to prevent and control of psychoactive substance use.

The Rohingya Little Local: exploring innovative models of refugee engagement in Sydney, Australia.

The Rohingya community living in the City of Canterbury-Bankstown in Sydney have been identified as a priority population with complex health needs. As part of ongoing work, AU$10000 was provided to the community to address important, self-determined, health priorities through the Can Get Health in Canterbury program. Program staff worked with community members to support the planning and implementation of two community-led events: a soccer (football) tournament and a picnic day. This paper explores the potential for this funding model and the effect of the project on both the community and health services. Data were qualitatively analysed using a range of data sources within the project. These included, attendance sheets, meeting minutes, qualitative field notes, staff reflections and transcripts of focus group and individual discussions. This analysis identified that the project: (1) enabled community empowerment and collective control over funding decisions relating to their health; (2) supported social connection among the Australian Rohingya community; (3) built capacity in the community welfare organisation -Burmese Rohingya Community Australia; and (4) enabled reflective practice and learnings. This paper presents an innovative model for engaging with refugee communities. Although this project was a pilot in the Canterbury community, it provides knowledge and learnings on the engagement of refugee communities with the health system in Australia.

Overloaded and Unrestrained: A Qualitative Study with Local Experts Exploring Factors Affecting Child Car Restraint Use in Cape Town, South Africa.

(1) Background: Children in South Africa experience significant impacts from road injury due to the high frequency of road crashes and the low uptake of road safety measures (including the use of appropriate child restraints). The current study aimed to assess the feasibility of a child restraint program and to describe factors influencing child restraint use from the perspectives of clinicians, representatives of non-government agencies, and academics in Cape Town, South Africa. (2) Methods: Qualitative interviews were conducted with 13 experts from government, academic and clinical backgrounds. Findings were analyzed using the COM-B component of the Behaviour Change Wheel and were grouped by the layers of the social-ecological model (individual, relational, community and societal). (COM-B is a framework to explain behaviour change which has three key components; capability, opportunity and motivation), (3) Results: Experts believed that there was a need for a child restraint program that should be staged and multifactorial. Participants described knowledge gaps, perceptions of risk, mixed motivations and limited enforcement of child restraint legislation as key influences of restraint use. (4) Conclusions: The results demonstrate potential areas on which to focus interventions to increase child restraint use in Cape Town, South Africa. However, this will require a coordinated and consistent response across stakeholder groups.

'Everyone knows grandma'. Pathways to gambling venues in regional Australia.

In regional Australia, families (including children), attend community venues that contain gambling products, such as electronic gambling machines (EGMs), for a range of non-gambling reasons. However, there is a gap in research that seeks to understand how these venues may become embedded into family social practices. Drawing on Bourdieu's concepts of habitus and cultural capital, this paper aimed to explore factors that influence family decisions to attend venues and perceptions of risk associated with children's exposure to gambling products. Face-to-face qualitative interviews were conducted with 31 parents who attended community gambling venues with their children, in New South Wales, Australia. Families attended venues for three key reasons, first because of the influence of others in their social networks, second for regular social activities and third because of structural factors such as a lack of alternative, affordable, family friendly environments in their local area. Despite recognizing the harm associated with EGMs, parents distanced themselves from EGM harm with all parents perceiving venues to be an appropriate space for families. Research in this study indicates that family social practices within venues affect perceptions of risk associated with community gambling venues. The impact of these practices on longer-term health requires more investigation by public health and health promotion researchers and practitioners. Health promotion initiatives should consider identifying alternative sources of support and/or developing alternative social spaces for families in regional communities that do not contain gambling products.

Exploring children's experiences in community gambling venues: A qualitative study with children aged 6-16 in regional New South Wales.

ISSUE ADDRESSED: Community-based gambling venues provide a range of activities for children alongside adult products, such as gambling. However, there has been little examination of children's experiences with, and exposure to, a range of gambling and non-gambling activities within venues. METHODS: Visual sociology methods were used to measure unprompted recall, prompted recall, current use and intended adult use of activities in community gambling venues in 44 children who attended venues. Qualitative data were also collected to gain further insight into children's perceptions of the venue and the activities within. RESULTS: Children displayed high unprompted and prompted recall of gambling and nongambling activities within the venue. Children indicated positive perceptions of the venue overall. Just over half of the children (52.3%) reported current use of gambling activities in the venue. The large majority of the children indicated that they would attend community gambling venues as an adult (90.9%). CONCLUSION: This research provides a starting point in understanding the extent to which children are exposed to gambling products in community gambling venues. SO WHAT?: This research will be important for researchers, policy makers and practitioners in developing health promotion initiatives to prevent children from being exposed to gambling products in community settings.

Do betting advertisements contain attention strategies that may appeal to children? An interpretative content analysis.

ISSUE ADDRESSED: Concerns have been raised about the expansion of sports betting marketing and the impact it may have on children's gambling attitudes and behaviours. This study aimed to investigate the content of Australian betting advertisements to identify if they contained specific attention strategies that have been identified by tobacco, alcohol and gambling researchers as having particular appeal to children. METHODS: An interpretative content analysis of 91 advertisements from 11 corporate bookmakers was conducted. A search of specific attention strategies that may appeal to adults, but also have been demonstrated in the public health literature as having particular appeal for children was used to develop a coding framework. This framework was then applied to analyse the advertisements. Descriptive statistics were used to generate quantitative data and qualitative illustrations were used to provide examples of the strategies found within the advertisements. RESULTS: On average there were 7.6 attention strategies found per advertisement. The most common attention strategies were music (n = 80), voiceovers (n = 79) and catchy slogans (n = 78). There were some attention strategies that related specifically to betting, such as technology, and risk-reducing promotions. CONCLUSION: This research has demonstrated that the content of betting advertisements contains attention strategies that, based on the research findings from other areas of public health, may have particular appeal for children. SO WHAT?: This research provides important evidence which could encourage researchers, regulators and policy makers to consider changes to current advertising regulations, to ensure children are protected from the potentially engaging and harmful attention strategies present in betting advertisements.

Young people's recall and perceptions of gambling advertising and intentions to gamble on sport.

BACKGROUND: There has been an increased international policy focus on the factors that may contribute to, and prevent, the normalization of gambling for young people. However, there is still limited research, which investigates the role of advertising in shaping young people's gambling attitudes and consumption intentions. METHODS: Mixed methods study of 111 young people aged 11-16 years recruited from community basketball stadiums in Victoria, Australia, between May and July 2018. Interviewer-assisted surveys investigated recall and awareness of sports betting brands, perceptions of promotional strategies, intention to gamble, and reasons for betting on particular sports. Quantitative data were analyzed using descriptive statistics and χ2 tests. Thematic analyses were used to interpret qualitative responses. RESULTS: Young people had high recall and awareness of advertising, with most able to name at least one betting brand (n = 90, 81.1%), and many demonstrating a high awareness of the distinct characteristics (such as colors and appeal strategies) of different brands. A fifth of young people (n = 25, 22.5%) expressed intentions to gamble at 18 years, with boys significantly more likely than girls to state they would gamble (χ2 = 10.90, p = .001). Young people perceived that advertising strategies associated with inducement promotions would be the most influential in encouraging individuals to gamble. While many young people took promotions at face value, there was evidence that some were able to critically engage with and challenge the messages within marketing. DISCUSSION AND CONCLUSIONS: Current regulatory structures appear to be ineffective in limiting young people's recall and awareness of gambling advertising. Lessons from tobacco control support the application of precautionary approaches as a more effective way to limit young people's development of positive gambling attitudes and behaviors.

Young people's awareness of the timing and placement of gambling advertising on traditional and social media platforms: a study of 11-16-year-olds in Australia.

BACKGROUND: Research has demonstrated that the promotion of gambling, particularly within sport, may have a significant impact on positively shaping young people's attitudes towards gambling. While some governments have implemented restrictions to limit young people's exposure to gambling advertising, few studies have investigated where young people recall seeing gambling advertising, and whether they perceive that advertising restrictions have gone far enough in reducing exposure to these promotions. METHOD: Mixed methods, interviewer-assisted surveys were conducted with n = 111 young people aged 11-16 years, who were self-reported fans of basketball in Victoria, Australia. Interviews were conducted at basketball stadiums between May and July 2018. The study assessed media viewing patterns; recall and awareness of the timing, placement, and content of gambling advertising; the impact of gambling advertising restrictions; and attitudes towards sporting organisations' roles in the promotion of gambling. RESULTS: The majority of young people recalled seeing gambling advertising on television (n = 101, 91.0%), with most recalling advertising within sporting matches or games (n = 79, 71.2%). Most young people recalled seeing gambling advertising in the early evening before 8:30 pm (n = 75, 67.6%). Just over half of young people described seeing gambling advertisements on social media (n = 61, 55.0%), and over a third (n = 40, 36.0%) recalled gambling advertising on YouTube, predominantly before watching sporting or gaming videos. The majority stated that they continued to watch sport after 8:30 pm (n = 93, 83.7%), which is when restrictions on advertising in live sport in Australia end. The majority (n = 88, 79.3%) stated that there were too many gambling advertisements in sport. Three quarters believed that sporting codes should do more to prevent young people from being exposed to advertising for gambling in sport (n = 84, 75.7%). CONCLUSIONS: There is now a clear body evidence that current regulatory systems for gambling advertising are ineffective, with further restrictions urgently needed across a range of media channels to prevent exposure to promotions that may encourage young people's interest and involvement in gambling.

Attitudes towards community gambling venues and support for regulatory reform: an online panel study of residents in New South Wales, Australia.

BACKGROUND: Harmful gambling has been identified as an important public health issue that affects individuals, families and the broader community. One gambling product, electronic gambling machines (EGMs), has been associated with significant gambling harm in Australia. There has been limited research that has explored community perceptions of EGMs and attitudes towards reform. This study, conducted in NSW, Australia, aimed to explore community use of EGM venues (clubs and hotels containing EGMs), attitudes towards EGMs and whether the use of these venues influenced attitudes towards EGM reform. METHODS: An online survey was conducted with 500 adults aged 16 years and over, representative of the population for age and gender. Discrete choice and open-ended questions were used to gather data on gambling behaviours, use of and attitudes towards EGMs and EGM venues and support for gambling harm reduction measures. RESULTS: Three quarters of participants had visited an EGM venue in the previous year. Participants who had attended such venues were significantly more likely to use EGMs at least once per month. Participants attended EGM venues for a range of reasons including use of non-gambling facilities such as restaurants, the social aspects of the venue and ease of access to the venue. Some participants also attended EGM venues specifically for the gambling facilities. Most participants identified some negative impacts of EGMs for local communities and were supportive of measures to reduce the number of EGMs and prevent children's exposure to EGMs in such venues. CONCLUSIONS: This study shows a high level of support for EGM reform amongst both individuals who attend EGM venues and also those who do not. There is potential for government to further regulate EGMs and the environments where they are located.

Women's gambling behaviour, product preferences, and perceptions of product harm: differences by age and gambling risk status.

BACKGROUND: Women's participation in, and harm from gambling, is steadily increasing. There has been very limited research to investigate how gambling behaviour, product preferences, and perceptions of gambling harm may vary across subgroups of women. METHODS: This study surveyed a convenience sample of 509 women from Victoria and New South Wales, Australia. Women were asked a range of questions about their socio-demographic characteristics and gambling behaviour. Focusing on four gambling products in Australia-casino gambling, electronic gambling machines (EGMs), horse betting, and sports betting-women were asked about their frequency of participation, their product preferences, and perceptions of product harms. The sample was segmented a priori according to age and gambling risk status, and differences between groups were identified using Chi-square tests and ANOVAs. Thematic analysis was used to interpret qualitative data. RESULTS: Almost two thirds (n = 324, 63.7%) of women had engaged with one of the four products in the previous 12 months. Compared to other age groups, younger women aged 16-34 years exhibited a higher proportion of problem gambling, gambled more frequently, and across more products. While EGMs were the product gambled on most frequently by women overall, younger women were significantly more likely to bet on sports and gamble at casinos relative to older women. Qualitative data indicated that younger women engaged with gambling products as part of a "night out", "with friends", due to their "ease of access" and perceived "chance of winning big". There were significant differences in the perceptions of the harms associated with horse and sports betting according to age and gambling risk status, with younger women and gamblers perceiving these products as less harmful. CONCLUSIONS: This study highlights that there are clear differences in the gambling behaviour, product preferences, and perceptions of product harms between subgroups of women. A gendered approach will enable public health researchers and policymakers to ensure that the unique factors associated with women's gambling are taken into consideration in a comprehensive public health approach to reducing and preventing gambling harm.

What do children observe and learn from televised sports betting advertisements? A qualitative study among Australian children.

OBJECTIVE: To explore children's awareness of sports betting advertising and how this advertising may influence children's attitudes, product knowledge and desire to try sports betting. METHODS: Semi-structured qualitative interviews were conducted with 48 children (8-16 years) from Melbourne, Victoria. The interview schedule explored children's recall and interpretations of sports betting advertising, strategies within advertisements that may appeal to children, children's product knowledge and understanding of betting terminology, and factors that may encourage gambling. Interviews were transcribed and thematic analysis was conducted. RESULTS: Children recalled in detail sports betting advertisements that they had seen, with humour the most engaging appeal strategy. They were also able to describe other specific appeal strategies and link these strategies to betting brands. Many children described how advertisements demonstrated how someone would place a bet, with some children recalling the detailed technical language associated with betting. CONCLUSIONS: Children had detailed recall of sports betting advertisements and an extensive knowledge of sports betting products and terminology. Implications for public health: To protect children from the potential harms associated with sports betting, governments should consider changing regulations and implementing evidence-based education campaigns to counter the positive messages children receive from the sports betting industry.