Development of the Saini-Hodgins Addiction Risk Potential of Games (SHARP-G) Scale: An International Delphi study.

Background and Objectives: As the gaming industry experiences exponential growth, concerns about gaming disorder (GD) also grow. It is crucial to understand the structural features of games that can interact with individual characteristics of gamers to promote GD. This research consolidates the views of an international body of panelists to create an assessment tool for gauging the addictive potential of distinct games. Methods: Utilizing the iterative and structured Delphi method, an international panel of researchers, clinicians, and people with lived experience were recruited to offer a multifaceted viewpoint on the addictive risk associated with specific structural elements in games. Two rounds of surveys facilitated consensus. Results: The panel initially included 40 members-ten from research, eight from clinical settings, and 22 with lived experiences. The second round included 27 panelists-seven from research, eight from clinical settings, and 11 with lived experiences. The study identified 25 structural features that contribute to potentially addictive gaming patterns. Discussion and Conclusions: Consensus was found for 25 features, which were distilled into a 23-item evaluation tool. The Saini-Hodgins Addiction Risk Potential of Games Scale (SHARP-G) consists of five overarching categories: 'Social,' 'Gambling-Like Features,' 'Personal Investment,' 'Accessibility,' and 'World Design.' SHARP-G yields a total score indicating level of addiction risk. A case study applying the scale to three games of differing perceived risk levels demonstrated that that score corresponded to game risk as expected. While the SHARP-G scale requires further validation, it provides significant promise for evaluating gaming experiences and products.

Factorial structure of the Internet Gaming Disorder questionnaire in the Italian setting: a single-factored ailment or a multifaceted condition?

INTRODUCTION: Internet Gaming Disorder (IGD) according to DSM-5 is a behavioral addiction needing additional study. IGD in youth is correlated with anxiety, depression, attention problems, interpersonal problems, social phobia, behavior problems and low academic achievement. The aim of the present research is to contribute to the understanding of the disorder, by providing preliminary data on the factorial structure of the IGD Questionnaire in the Italian version. PARTICIPANTS: 612 Italian students (323 females), mean of age = 13.94 (SD = 2.44). Instruments: a survey comprising IGD Questionnaire, Internet Addiction Test (IAT), Children's Coping Strategies Checklist (CCSC-R1), Assessment of Interpersonal Relations (AIR), and Child Behavior Checklist (CBCL). RESULTS: 15.2% of participants showed a sub-clinical IGD and 2.1% met the full diagnostic criteria. Participants with IGD showed lower scores in interpersonal relationships, worse coping strategies and higher scores in externalization. The factorial structure of the IGD Questionnaire highlights 4 factors ("addiction", "gaming as coping", "impaired control" and "negative outcomes") that explain 52.14% of the variance. A single-factor solution was also tested and results seem to be coherent with the four-factor solution, explaining less variance. CONCLUSIONS: IGD is a complex clinical condition that can be thought both as a single-factored and as a multi-faceted condition.

Developmental Changes in the Relation between Youth Disclosure and Parenting Behavior: A Cohort-sequential Analysis.

To address a gap in the literature regarding the development of youth disclosure across the transition to adolescence, the current research uses a cohort-sequential approach to study youth disclosure from middle childhood through adolescence. Longitudinal data from three cohorts of parents were utilized (N = 1359; children at T1 were in grades 2 [M = 8.00 years, SD = 0.57 years, 45% female], 4 [M = 10.12 years, SD = 0.60 years, 45% female], and 9 [M = 15.19 years, SD = 0.57 years, 48% female]). Parents were assessed annually over a 3-year time period. The focal analyses explored contemporaneous associations between characteristics of the parent-youth relationship (specifically, parental rejection and parental consistent discipline) and youth disclosure after accounting for person-specific trajectories of disclosure. Associations of gender, age, and socioeconomic status with disclosure were also assessed. Regarding trajectories of youth disclosure, results indicate that youth disclose less information to their parents about their daily lives as they get older; this trend was consistent across gender and socioeconomic status. In terms of associations with youth disclosure, when parents provided more consistent discipline or engaged in less rejection of their child, youth disclosure increased, even after accounting for their own trajectory of disclosure across time. In addition, the association of consistent discipline with youth disclosure became stronger with increased youth age. Results are discussed in terms of implications for understanding youth autonomy development, and the dyadic and developmental impact of parenting behaviors over time.

Silencing screaming with screens: The longitudinal relationship between media emotion regulation processes and children's emotional reactivity, emotional knowledge, and empathy.

Many parents use screens to regulate their young children's emotions. We know very little, however, about how this parenting practice is related to the development of emotional competencies (i.e., emotional reactivity, emotion knowledge, and empathy) over time. The current longitudinal study examined bidirectional associations between media emotion regulation and various emotional competencies across a 1-year period during early childhood (between ages 3.5 and 4.5 on average). Participants included 269 child/parent dyads who completed a number of in-home tasks and questionnaires. Results revealed that higher levels of media emotion regulation were associated with worse emotional knowledge and empathy and higher emotional reactivity at the cross-sectional level. However, early media emotion regulation was associated with higher levels of child empathy 1 year later. We discuss these results in the context of general parenting practices and encourage future research on the topic with a focus on how these processes develop over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Within-Person Bidirectional Associations Over Time Between Parenting and Youths' Callousness.

OBJECTIVE: Callousness has been identified as a key driver of aggressive and violent behavior from childhood into early adulthood. Although previous research has underscored the importance of the parenting environment in contributing to the development of youth callousness, findings have generally been confined to the between-individual level and have not examined bidirectionality. In the current study, we test whether aspects of parenting are associated with callousness from childhood to adolescence both between and within individuals, examine the temporal ordering of associations, and test whether these relations are moderated by gender or developmental stage. METHOD: Data came from a longitudinal study in which parents of 1,421 youth (52% girls; 62% White and 22% Black) from the second, fourth, and ninth grades were interviewed three times, with one year between consecutive interviews. RESULTS: A random-intercept cross-lagged panel model indicated that elevated youth callousness predicts subsequent increases in parental rejection and decreases in consistency of discipline. Findings were largely similar for boys and girls, but within-individual associations were generally stronger for 4th graders compared to the 2nd and 9th graders. CONCLUSIONS: Callousness and parenting practices and attitudes were related both at the between-individual and within-individual level. These results have implications for the etiology and treatment of children and adolescents who exhibit callousness.

Are mindful people less aggressive? The role of emotion regulation in the relations between mindfulness and aggression.

Inducing mindfulness has shown a promising effect on reducing aggression in both clinical and nonclinical populations, possibly because mindfulness can improve emotion regulation. The present study examined the association between mindfulness and aggression through potential mediating effects of several emotion regulation strategies. University and community samples of U.S. adults completed questionnaires on mindfulness, emotion regulation strategies, and trait aggression. Results indicate that mindfulness was associated with rumination and expressive suppression, which mediated the mindfulness-aggression relationship. Most facets of mindfulness were unrelated to the use of reflection and cognitive reappraisal. The nonjudging of experience facet of mindfulness was negatively related to hostility through rumination and expressive suppression. In contrast, the observing mindfulness facet was positively related to verbal aggression and hostility; these relations were mediated by rumination and expressive suppression.

Tantrums, toddlers and technology: Temperament, media emotion regulation, and problematic media use in early childhood.

Parents regularly use media to help regulate their child's difficult emotions, particularly for those with a more difficult temperament. However, no research has examined how this may be related to the development of problematic (or addictive-like) media use in early childhood. The purpose of the study was to examine associations between temperament, parental media emotion regulation, and problematic media use in young children, using both questionnaires and observational data. Participants included 269 toddlers (2-3 years old) and their parents, who completed several observational tasks and questionnaires. Analyses revealed that higher levels of media emotion regulation was associated with more problematic media use and more extreme emotions when media was removed in toddlers. Additionally, temperament (specifically negative affect and surgency) was related to problematic media and extreme emotions and was mediated by media emotion regulation. Parents should avoid using media as a primary way of regulating their children's emotions as this may be related to the development of problematic media strategies during infancy.

The Role of Peer Support in the Growth Trajectory of Pathological Internet Use Among Youth: A Protective Factor.

Despite the escalating public concern about pathological use of the Internet among youth, little research has investigated the longitudinal trajectory of the problem and the role of peer support in it. This study aimed to determine the growth trajectory of pathological Internet use (PIU), identify latent subgroups presenting heterogeneous growth trajectories of PIU, and examine the initial status of and the rate of change in peer support as predictors of the growth trajectory of PIU among children and adolescents. Using four-wave longitudinal data from 3,079 Singaporean youth at ages 7-19, we performed Latent Growth Curve Modeling, Latent Class Growth Analysis and Latent Growth Mixture Modeling. Results revealed a downward trajectory of PIU among youth. We identified six latent subgroups, three of which were in pathological status for at least a year. The more rapid improvement in peer support, but not the initial level of peer support, predicted the faster reduction of PIU symptoms during the 3-year period. Findings suggest that although the symptoms of PIU among children and adolescents would decline over time, improving peer support could further alleviate youth PIU. We recommended that intervention programs include a peer support component to mitigate PIU among youth.

Evaluating the implementation of the SWITCH® school wellness intervention and capacity-building process through multiple methods.

BACKGROUND: School wellness programming is important for promoting healthy lifestyles and academic achievement in youth; however, research is needed on methods that can help schools implement and sustain such programs on their own. The purpose of this study was to investigate factors within and outside the school environment that influenced school capacity for implementation and potential sustainability of wellness programming. METHODS: As part of the School Wellness Integration Targeting Child Health (SWITCH®) intervention, elementary school wellness teams (N = 30) were guided through a capacity-building process focused on promoting the adoption of healthy lifestyle behaviors in students. Data on implementation were collected through three standardized surveys and interviews (pre-mid-post) and a post-implementation interview. Indicators of organizational capacity were assessed using the School Wellness Readiness Assessment (SWRA). Paired t-tests were run to assess changes in implementation (classroom, physical education, and lunchroom settings), capacity, and stakeholder engagement over time. One-way analysis of variance (ANOVA) tests were run to examine how implementation of best practices (low, moderate, high) explained differences in capacity gains. Qualitative data were analyzed through inductive and deductive analysis, following the Consolidated Framework for Implementation Research (CFIR). RESULTS: Paired t-tests showed non-significant increases in school and setting-specific capacity and implementation of SWITCH best practices over time, in addition to a consistent level of engagement from key stakeholders. ANOVA results revealed non-significant associations between implementation group and gains in school capacity (F [2, 24] = 1.63; p = .21), class capacity (F [2, 24]=0.20 p = .82), lunchroom capacity (F [2, 24]=0.29; p = .78), and physical education (F [2, 24]=1.45; p = .25). Qualitative data demonstrated that factors within the outer setting (i.e., engaging community partners) facilitated programming. Inner-setting factors (i.e., relationships with administration and staff) influenced implementation. Implementation process themes (e.g., planning, adaptation of resources to meet school capacity/needs, and engaging students as leaders) were cited as key facilitators. Schools discussed factors affecting sustainability, such as school culture and knowledge of school wellness policy. CONCLUSIONS: The results from this implementation study document the importance of allowing schools to adapt programming to meet their local needs, and highlight the strengths of measuring multiple implementation outcomes. Increased support is needed for schools regarding the formation and improvement of wellness policies as a means to enhance sustainability over time.

Evaluating the Implementation and Effectiveness of the SWITCH-MS: An Ecological, Multi-Component Adolescent Obesity Prevention Intervention.

Background: The purpose of this study was to evaluate the implementation and effectiveness of an ecological, multi-component adolescent obesity prevention intervention called School Wellness Integration Targeting Child Health-Middle School (SWITCH-MS). Methods: Following the effectiveness-implementation hybrid type 3 quasi-experimental design, seven middle schools (377 students) in Iowa, United States, were stratified into "experienced" (n = 3; 110 students) or "inexperienced" (n = 4; 267 students) groups to receive the 12-week SWITCH-MS intervention. To evaluate implementation, school informants (n = 10) responded to a survey and students completed behavioral tracking in the classroom on a website. For effectiveness evaluation, students in 6th, 7th, and 8th grades completed a validated questionnaire before and after intervention, to measure behaviors of physical activity (PA; "Do"), screen-based activity ("View"), and fruits and vegetable consumption ("Chew"). Results: The two groups of schools showed similar levels of implementation for best practices, awareness, and engagement. Behavioral tracking rate favored the experienced schools early on (47.5% vs. 11.7%), but differences leveled off in weeks 3-12 (sustained at 30.1-44.3%). Linear mixed models demonstrated significant time effects for "Do" (at school and out of school; p < 0.01) and "View" behaviors (p = 0.02), after controlling for student- and school-level covariates. Conclusions: This study demonstrates that prior experience with SWITCH-MS may not be a prominent factor for implementation and effectiveness, although greater experience is associated with favorable behavioral tracking when the intervention is first launched.

Pathological video game symptoms from adolescence to emerging adulthood: A 6-year longitudinal study of trajectories, predictors, and outcomes.

The aim of this study was to examine trajectories of pathological video game symptoms over a 6-year period from adolescence to emerging adulthood. We also examined a number of predictors and outcomes for different trajectories. Participants included 385 adolescents (M age = 15.01 at the initial time point) who completed multiple questionnaires once a year over a 6-year period. Analyses showed there were 3 distinct trajectories. Approximately 10% of adolescents (called "increasing symptoms") showed moderate levels of pathological gaming symptoms at the initial time point and then increases in symptoms over time. Conversely, 18% of adolescents (called "moderate symptoms") started with moderate symptoms that did not change over time. Finally, 72% of adolescents (called "nonpathological") were relatively low in symptoms across the 6 years of data collection. Being male predicted both the increasing and moderate groups. The increasing group tended to show the worst outcomes over time, with higher levels of depression, aggression, shyness, problematic cell phone use, and anxiety than the nonpathological group, even when controlling for initial levels of many of these variables. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Gaming patterns and related symptoms in adolescents using cluster analysis: Baseline results from the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study.

PURPOSE: The risk and protective factors of Internet gaming disorder (IGD) could vary by individual. The identification of more homogeneous subgroups may lead to better understanding of gaming behaviors and their consequences in adolescents. The purpose of this study was to investigate the prevalence of IGD among the subgroups defined by cluster analysis in adolescents. METHODS: A total of 2319 adolescents were enrolled in the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study at baseline. Self-reported IGD was assessed with a DMS-5 adapted measurement. Smartphone addiction, musculoskeletal discomfort, and dry eye symptoms were evaluated by self-administered questionnaires. Cluster analysis was performed using risk and protective factors of IGD after considering multicollinearity. RESULTS: Three different clusters were identified. Cluster 1 (19.2%) was users with combined potential psychological and social issues. Cluster 2 (32.3%) was users with potential social but no psychological issues. Cluster 3 (45.6%) was users with no potential issues of either a social or psychological nature. Adolescents from both clusters 1 and 2 showed higher degrees of IGD, smartphone addiction, musculoskeletal discomfort, and dry eye symptoms than did those from cluster 3. Also compared with adolescents in cluster 3, those in cluster 1 showed statistically higher risks of IGD (aOR:11.9, 95%CI:7.5-19.9), smartphone addiction (aOR:5.4, 95%CI:4.0-7.2), musculoskeletal discomfort (aOR:2.6, 95%CI:2.1-7.4), and dry eye symptoms (aOR:3.8, 95%CI:3.0-4.9). Those in cluster 2 also showed statistically higher risk of IGD, smartphone addiction, musculoskeletal discomfort, and dry eye symptoms compared with cluster 3 (aOR:4.5, 95%CI:2.8-7.6; aOR:2.8, 95%CI:2.1-3.7; aOR:1.6, 95%CI:1.3-1.9; and aOR:1.9, 95%CI:1.6-2.4, respectively). CONCLUSIONS: Clustering based on the risk and preventive factors of IGD may be suitable for determination of high risk of IGD in adolescents. However, we need to confirm the usefulness and clinical application of the classifications by observing their longitudinal changes.

Beer advertisements and adolescent drinking knowledge, expectancies, and behavior.

OBJECTIVE: (1) To examine the degree to which overall beer advertising expenditure is related to youth brand awareness, preferences, and drinking behavior, and (2) to use multiple methods, including individual brand awareness and expectancies, to gain a broader understanding of the effects of alcohol advertising on youth alcohol-related expectancies and behavior. METHOD: Mixed psychological and advertising methods were used to examine how beer advertising is related to adolescents' beer brand awareness, expectancies, and behavior. 1588 7-12th graders were surveyed in two U.S. states. RESULTS: The amount of money spent advertising beer brands was positively correlated with adolescents' brand awareness, preference, use, and loyalty behavior (all correlations above 0.65). Moreover, beer advertising-related variables predicted adolescents' intention to drink and actual alcohol consumption, independent of peer and parent alcohol-related behavior and attitudes. CONCLUSIONS: The results show that overall levels of advertising expenditures were strong predictors of adolescents' beer brand awareness, preferences, use, and brand loyalty. Moreover, advertising-related variables were substantial predictors of adolescents' intention to drink as an adult and current underage drinking behavior. Together, the present findings suggest that previous work may have underestimated the relationship between alcohol advertising and adolescents' drinking behavior.

The Importance of Self-Monitoring for Behavior Change in Youth: Findings from the SWITCH® School Wellness Feasibility Study.

School Wellness Integration Targeting Child Health (SWITCH®) is a school wellness implementation initiative focused on building capacity for schools to plan and coordinate wellness programming. Grounded in Social Cognitive Theory (SCT), the purpose of this study was to evaluate the utility of the web-based, self-regulation system on physical activity (PA) behavior outcomes. At pre-test and post-test, students in SWITCH® schools (n = 8) completed the online Youth Activity Profile (YAP) to assess PA and sedentary behavior (SB). Students (n = 513) were categorized into high or low self-monitoring groups (using a median split) based on their use of the web-based self-regulation platform. Linear mixed models were used to assess differences in moderate-to-vigorous PA (MVPA) and sedentary behavior, with school, classroom, student, time-by-school, and time-by-classroom random effects and main and interaction fixed effects for student self-monitoring, gender, and time. Significant self-monitoring-by-time interactions were observed for estimates of PA F(1, 477) = 5.55, p = 0.02 and SB F(1, 477) = 4.90, p = 0.03. Students in the high self-monitoring group had larger gains in PA per day and larger declines in hours per day of sedentary screen time behavior compared to students in the low self-monitoring group. These findings support the utility of web-based self-regulation for facilitating PA change in youth.

The relationship between perceived stress and problematic social networking site use among Chinese college students.

BACKGROUND AND AIMS: Perceived stress has been regarded as a risk factor for problematic social networking site (SNS) use, yet little is known about the underlying processes whereby confounding variables may mediate or moderate this relationship. To answer this question, this study examined whether depression and anxiety mediated the relationship between perceived stress and problematic SNS use, and whether these mediating processes were moderated by psychological resilience and social support. METHODS: Participants were 641 Chinese college students who completed anonymous questionnaires measuring perceived stress, depression/anxiety, psychological resilience, social support, and problematic SNS use. RESULTS: The results showed that (a) depression/anxiety mediated the relationship between perceived stress and problematic SNS use; (b) the mediating effects of depression/anxiety on the association between perceived stress and problematic SNS use were moderated by psychological resilience. Specifically, the mediating effects of depression/anxiety were stronger for individuals with lower levels of psychological resilience, compared with those with higher levels of psychological resilience; and (c) the mediating effects of depression/anxiety were not moderated by social support, although social support was negatively related to depression/anxiety. DISCUSSION AND CONCLUSION: This study can contribute to a better understanding of how and when perceived stress increases the risk of problematic SNS use, and implies the importance of enhancing psychological resilience in preventing problematic SNS use.

Development and Validation of the Problematic Media Use Measure: A Parent Report Measure of Screen Media "Addiction" in Children.

Although problematic media use among adolescents is of wide interest, less is known regarding problematic media use among younger children. The current study reports on the development and validation of a parent-report measure of one potential aspect of children's problematic use-screen media addiction-via the Problematic Media Use Measure (PMUM). Items were based on the nine criteria for Internet Gaming Disorder in the DSM-5. The first study describes the development and preliminary validation of the PMUM in a sample of 291 mothers. Mothers (80.8% identified as White) of children 4 through 11 years of age completed the PMUM and measures of child screen time and child psychosocial functioning. EFA indicated a unidimensional construct of screen media addiction. The final versions of the PMUM (27 items) and PMUM Short Form (PMUM-SF, 9 items) evidenced high internal consistency (Cronbach α = .97 and α = .93, respectively). Regression analyses were conducted to examine convergent validity of the PMUM with indicators of child psychosocial functioning. Convergent validity was supported and the PMUM scales also independently predicted children's total difficulties in functioning, over and above hours of screen time, indicating incremental validity. The second study sought to confirm the factor structure of the PMUM-SF and test for measurement invariance across gender. In a sample of 632 parents, we confirmed the factor structure of the PMUM-SF and found measurement invariance for boys and girls. These studies support the use of the PMUM-SF as a measure of screen media addiction in children ages 4 through 11 years old.

Electronic Gaming Characteristics Associated with Class 3 Severe Obesity in Youth Who Attend the Pediatric Weight Management Programs of the COMPASS Network.

BACKGROUND: The prevalence of severe obesity and electronic game use among youth has increased over time. METHODS: We administered a survey assessing gaming and psycho-demographic characteristics to youth aged 11-17 attending five weight management programs. We conducted chi-square and logistic regression analyses to describe the association between class 3 severe obesity and gaming characteristics. RESULTS: Four hundred twelve youth (51% female, 26% Black, 25% Hispanic, 43% White, and 44% with class 3 severe obesity) completed the survey. There was a stepwise relationship between time spent gaming and class 3 severe obesity, with 28% of those playing 2 to <4 hours a day, 48% of those playing 4 to <6 hours a day, and 56% of those playing ≥6 hours a day having class 3 severe obesity (p = 0.002). Compared to youth without class 3 severe obesity, youth with class 3 severe obesity were more likely to have a TV in the bedroom (76% vs. 63%, p = 0.004) and play games on a console (39% vs. 27%, p = 0.03) and were less likely to report parental limit setting on type of games played (7% vs. 16%, p = 0.006). Youth who played games ≥4 hours a day were 1.94 times (95% confidence interval 1.27-3.00) more likely to have class 3 severe obesity than those who played <4 hours a day, after adjustment for demographic, behavioral, and academic variables. CONCLUSIONS: Our study demonstrates a clear association between gaming characteristics, especially time spent gaming, and severe obesity in youth. Further research testing family-based interventions that target gaming behaviors in youth are needed.

Feasibility study of the SWITCH implementation process for enhancing school wellness.

BACKGROUND: There is a need to identify strategies that enhance the implementation of evidence-based school wellness intervention programs in real-world settings. The present study evaluates the feasibility of empowering school wellness leaders to deliver an evidence-based, childhood obesity-prevention program called Switch ™. We specifically evaluated the feasibility of a new implementation framework, based on the robust Healthy Youth Places framework, to increase capacity of school leaders to lead school wellness programming. METHODS: The SWITCH (School Wellness Integration Targeting Child Health) implementation process was evaluated in a convenience sample of eight Iowa elementary schools. Teams of three leaders from each school attended an in-person school wellness conference followed by five online webinar sessions delivered by two SWITCH team members. The capacity-building and quality improvement process was designed to empower schools to lead wellness change using methods and concepts from the original 16-week Switch ™ program. School wellness leaders completed checklists on two occasions to assess overall school-level implementation as well as setting-level changes in physical education, classrooms, and the lunchroom. Student acceptability of SWITCH was evaluated by the degree of behavior tracking using an online SWITCH Tracker system that promoted self-monitoring. School acceptability and practicality were assessed through an exit survey completed by school leaders. RESULTS: All school staff reported satisfaction with the SWITCH implementation process. Reports of school- and setting-level implementation were relatively high (2.0 to 2.8 on a 3-point scale) but student engagement, based on use of the online tracking system, varied greatly over time and across schools. Three high implementation schools had average tracking rates exceeding 70% (range: 72-90%) while three low implementation schools had rates lower than 30% (range = 0-23%). CONCLUSIONS: This feasibility study supports the utility of the new implementation framework for promoting school and student engagement with SWITCH. Further testing regarding effectiveness and scale-up of this evidence-based school wellness intervention program is warranted.

Thinking more broadly about policy responses to problematic video game use: A response to Király et al. (2018).

Király et al. (2018) did an excellent job of reviewing policies that are undertaken to prevent and respond to problematic video game use. I argue that there has been a failure of imagination when considering public policy - generally, we only think of governmental or legislative policies. This paper identifies several other ways we could consider public policy, providing examples of some that have already been enacted and suggesting others that could be, all without governmental intervention. These types of policies may not only be more practical, but also be more effective.