Understanding the research capacity of alcohol and other drugs services in New South Wales, Australia.

INTRODUCTION: Enhancing health system research capacity can support improved quality care. This study assessed the research capacity of public local health district (LHD) and non-government organisation (NGO) alcohol and other drug (AOD) services, at the organisational, team and individual level. Research barriers and motivators were also examined. METHODS: Staff from LHD and NGO AOD treatment services in New South Wales completed an online survey using the Research Capacity and Culture (RCC) tool. Overall median research capacity scores are presented for the RCC subscales (organisational, team and individual). Comparisons were conducted by service type (LHD/NGO), geographical location (metropolitan/rural) and affiliation with a research network (yes/no). Qualitative questions explored barriers and motivators to research at individual and team levels. RESULTS: Of 242 participants, 55% were LHD-based and 45% NGO-based. Overall RCC scores indicated moderate research capacity at all levels. Organisational capacity (Med = 6.50, interquartile range [IQR] = 3.50) scored significantly higher than the team (Med = 5.00, IQR = 6.00) and individual level (Med = 5.00, IQR = 4.25). No differences in RCC scores existed between NGOs and LHDs. Metropolitan AOD services scored higher research capacity at the organisational level (Med = 7.00, IQR = 3.00) than rural services (Med = 5.00, IQR = 5.00). LHDs affiliated with a research network scored significantly higher at the organisational, team and individual level than non-affiliated LHD services. Key research barriers were inadequate time and funding. Motivators included skill development and problem-identification requiring change. DISCUSSIONS AND CONCLUSIONS: AOD services in New South Wales have moderate research capacity. Identified barriers and motivators can be used to target responses that enhance capacity and improve treatment outcomes.

A qualitative study exploring young offenders' perspectives on alcohol and other drug health promotion.

BACKGROUND: Drugs and alcohol can cause significant harm to individuals, families and communities. Young offenders represent an important population group, which often sport many characteristics that make them highly vulnerable to experiencing harm from drug use. For decades, research has shown the complexity of health behaviours and the need to consider consumer perspectives to respond and support different populations effectively. METHODS: This study utilised qualitative inquiry to explore young offenders' (aged 13 to 18 years) experiences with drug use. The study sought to discern the pathways to drug dependencies for young people and to understand how community organisations can better support young people involved with the justice system. RESULTS: Three themes were identified in the data. First, the clear lack of knowledge about how to reduce harm from drug use among young offenders. Second, the structural and environmental influences on drug use and the need to develop personal skills and knowledge, alongside advocating for supportive environments for good health. Third, the power and hope that a youth advocate with lived experience can bring to the harm prevention and health promotion field. CONCLUSIONS: Community services have an integral role in ensuring drug and alcohol education is accessible for different youth populations. Importantly, health promotion organisations should raise awareness about the environmental influences on drug use behaviours, and work deliberately to include consumer perspectives in the design and planning of prevention and harm reduction strategies.

Understanding the needs of local youth to inform drug and alcohol prevention and harm reduction services: A qualitative study.

ISSUE ADDRESSED: Reducing drug and alcohol harm is a public health priority and the Australian government has adopted a harm minimisation approach to policy. Understanding the needs of local youth is necessary for the design of relevant prevention and harm reduction services. METHODS: Using 5 unstructured focus groups and 10 interviews involving 30 participants recruited from different settings, this study explored youth perspectives around alcohol and other drugs and the psychosocial factors that influence their substance use. RESULTS: Three main themes were identified. First, young people perceived that drugs fell into a hierarchy related to the harm they cause and the stigma associated with use. Second, the importance of validating a young person's experience with using drugs (regardless of where they were placed on their substance-use trajectory) as a measure to increase the credibility of drug education programs. Third, the significant influence of peers on young people's drug attitudes and behaviours. CONCLUSIONS: Drug and alcohol education strategies must be more explicit regarding harm across all drug types, regardless of legal status or perceived social acceptability. Prevention services would benefit from including lived realities from young people's varied and changing experiences with using substances. Peer involvement in the design of preventive strategies (and involvement in participatory research to identify felt needs) is paramount to ensure teachings are grounded in a young person's social context and lived realities. SO WHAT?: This study provides information to guide the development of appropriate and authentic drug and alcohol prevention and harm reduction services for young people.

The influence of marketing on the sports betting attitudes and consumption behaviours of young men: implications for harm reduction and prevention strategies.

BACKGROUND: Gambling can cause significant health and social harms for individuals, their families, and communities. While many studies have explored the individual factors that may lead to and minimise harmful gambling, there is still limited knowledge about the broader range of factors that may contribute to gambling harm. There are significant regulations to prevent the marketing of some forms of gambling but comparatively limited regulations relating to the marketing of newer forms of online gambling such as sports betting. There is a need for better information about how marketing strategies may be shaping betting attitudes and behaviours and the range of policy and regulatory responses that may help to prevent the risky or harmful consumption of these products. METHODS: We conducted qualitative, semi-structured interviews with 50 Australian men (aged 20-37 years) who gambled on sports. We explored their attitudes and opinions regarding sports betting marketing, the embedding of marketing within sports and other non-gambling community environments, and the implications this had for the normalisation of betting. RESULTS: Our findings indicate that most of the environments in which participants reported seeing or hearing betting advertisements were not in environments specifically designed for betting. Participants described that the saturation of marketing for betting products, including through sports-based commentary and sports programming, normalised betting. Participants described that the inducements offered by the industry were effective marketing strategies in getting themselves and other young men to bet on sports. Inducements were also linked with feelings of greater control over betting outcomes and stimulated some individuals to sign up with more than one betting provider. CONCLUSIONS: This research suggests that marketing plays a strong role in the normalisation of gambling in sports. This has the potential to increase the risks and subsequent harms associated with these products. Legislators must begin to consider the cultural lag between an evolving gambling landscape, which supports sophisticated marketing strategies, and effective policies and practices which aim to reduce and prevent gambling harm.

"I can sit on the beach and punt through my mobile phone": The influence of physical and online environments on the gambling risk behaviours of young men.

Gambling is rapidly emerging as an important public health issue, with gambling products causing considerable health and social harms to individuals, families and communities. Whilst researchers have raised concerns about online wagering environments, few studies have sought to explore how factors within different gambling environments (both online and land-based) may be influencing the wagering, and more broadly the gambling risk behaviours of young men. Using semi-structured interviews with 50 Australian men (20-37 years) who gambled on sport, we explored the ways in which online and land-based environments may be risk-promoting settings for gambling. This included the appeal factors associated with gambling in these environments, factors that encouraged individuals to gamble, and factors that encouraged individuals to engage in different, and more harmful types of gambling. Interviews were conducted over the course of a year (April 2015 - April 2016). We identified a number of situational and structural factors that promoted risky gambling environments for young men. In the online environment, gambling products had become exceedingly easy to access through mobile technologies, with young men subscribing to multiple accounts to access industry promotions. The intangibility of money within online environments impacted upon risk perceptions. In land-based environments, the social rituals associated with peer group behaviour and sport influenced risky patterns of gambling. The presence of both gambling and alcohol in pub environments led individuals to gamble more than they normally would, and on products that they would not normally gamble on. Land-based venues also facilitated access to multiple forms of gambling under the one roof. We identified a number of factors in both land and online environments that when combined, created risk-promoting settings for gambling among young men. By exploring these contextual conditions that give rise to gambling harm, we are better able to advocate for effective public health responses in creating environments that prevent harmful gambling.

Microbiome and mental health in the modern environment.

A revolution in the understanding of the pathophysiology of mental illness combined with new knowledge about host/microbiome interactions and psychoneuroimmunology has opened an entirely new field of study, the "psychobiotics". The modern microbiome is quite changed compared to our ancestral one due to diet, antibiotic exposure, and other environmental factors, and these differences may well impact our brain health. The sheer complexity and scope of how diet, probiotics, prebiotics, and intertwined environmental variables could influence mental health are profound obstacles to an organized and useful study of the microbiome and psychiatric disease. However, the potential for positive anti-inflammatory effects and symptom amelioration with perhaps few side effects makes the goal of clarifying the role of the microbiota in mental health a vital one.

Creating symbolic cultures of consumption: an analysis of the content of sports wagering advertisements in Australia.

BACKGROUND: Since 2008, Australia has seen the rapid emergence of marketing for online and mobile sports wagering. Previous research from other areas of public health, such as tobacco and alcohol, has identified the range of appeal strategies these industries used to align their products with culturally valued symbols. However, there is very limited research that has investigated the tactics the sports wagering industry uses within marketing to influence the consumption of its products and services. METHOD: This study consisted of a mixed method interpretive content analysis of 85 sports wagering advertisements from 11 Australian and multinational wagering companies. Advertisements were identified via internet searches and industry websites. A coding framework was applied to investigate the extent and nature of symbolic appeal strategies within advertisements. RESULTS: Ten major appeal strategies emerged from this analysis. These included sports fan rituals and behaviours; mateship; gender stereotypes; winning; social status; adventure, thrill and risk; happiness; sexualised imagery; power and control; and patriotism. Symbols relating to sports fan rituals and behaviours, and mateship, were the most common strategies used within the advertisements. DISCUSSION/CONCLUSIONS: This research suggests that the appeal strategies used by the sports wagering industry are similar to those strategies adopted by other unhealthy commodity industries. With respect to gambling, analysis revealed that strategies are clearly targeted to young male sports fans. Researchers and public health practitioners should seek to better understand the impact of marketing on the normalisation of sports wagering for this audience segment, and implement strategies to prevent gambling harm.