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

Andrew Reid, Nick McGhie, Thi Huyen Linh Nguyen, Uday Yadav, Patricia Cullen, Leon Booth, Amy Bestman
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Abstract

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.

在费尔菲尔德的全科医生和社区服务机构探索赌博危害筛查模式的可行性:一项试点研究。
背景:在澳大利亚,赌博是一个日益严重的公共健康问题。然而,在澳大利亚,对初级卫生保健和社会服务在常规赌博危害筛查中的作用的研究十分有限。本研究旨在探讨在新南威尔士州费尔菲尔德市--一个赌博支出较高的地区--实施共同设计的赌博筛查模式的促进因素和障碍:2020年,在费尔菲尔德实施了为全科医生和社区组织共同设计的赌博筛查和转介模式。对九名医护人员进行了后续访谈,他们对130名患者实施了筛查。通过主题分析,得出了实施该模式的主要障碍和有利因素:结果:筛查模式实施的主要推动因素包括结构因素(筛查模式与当前工作的一致性)、流程因素和人员因素(员工授权)。然而,我们也注意到过程因素是实施的障碍,特别是筛查后的转诊途径。其他障碍包括社会和结构因素,如赌博危害的复杂性和项目资金:在初级和社区医疗机构中开展常规筛查,可以在治疗、减少和预防与赌博相关的伤害方面发挥作用,并减少费尔菲尔德及其他地区的污名化现象。此外,像这样的筛查模式还能为医疗系统提供明确的证据,说明其所在社区的赌博危害程度(对于在研究中代表性不足的文化和语言多元化社区尤为重要)。这些证据对于解决系统层面的危害驱动因素和倡导政治改革以减少赌博对社区的影响非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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