The Lincy Institute
E-Health Summit
November 10, 2011
Technology, Youth, Gambling, and
Addiction
Jeffrey L. Derevensky, Ph.D.
Professor, School/Applied Child Psychology
Professor, Psychiatry
McGill University
www.youthgambling.com
E-Health Summit
University 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. LaPlante
Division 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 & Society
Much 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 & Society
History 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 System
Image courtesy of the National Institute on Drug Abuse
Shaffer et al., 2004; Brieter et al., 2001
A 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
good
Things like drugs, sex,
and gambling can
stimulate the reward
system
People who have a
propensity for excessive
Internet gaming show
Emerging
Evidence
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-Health
Clinician 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 technology
New 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
Influenza
Annually, 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