Suzanne Lischer

Background: This study reports the results of a project evaluation (2021–2024) that aimed to integrate self-help friendliness within the Swiss healthcare system and foster collaboration between hospitals, self-help centers, and self-help groups (SHGs). Methods: A mixed-methods design was used, comprising document analysis, standardized online surveys of hospital staff involved in 56 cooperative projects at two time points with repeated group comparisons (T0: n = 530, T1: n = 281), and in-depth case studies at four cooperation sites. Results: The descriptive findings indicate that the implemented measures contributed to achieving project objectives. Hospital staff increasingly perceived SHGs as complementary to professional care and reported more frequent provision of information to patients and their relatives. In addition, SHGs became more visible within hospitals. Conclusions: This study provides descriptive insights into the implementation of self-help friendliness in practice and suggests that introducing self-help friendliness in hospitals is both feasible and beneficial. Long-term, sustainable collaboration requires clear roles and responsibilities, organizational support, and recognition of the experiential expertise of SHGs.

Zusammenfassung: Zielsetzung: In den letzten Jahren haben Mikrotransaktionen, insbesondere Lootboxen (LB), in Videospielen an Bedeutung gewonnen. Übersichtsarbeiten mit überwiegend erwachsenen Teilnehmenden zeigen einen Zusammenhang zwischen LB-Nutzung und problematischer Videospiel- bzw. Glücksspielnutzung. Ziel unserer Arbeit war, diesen Zusammenhang im Kanton Zürich bei einer Stichprobe von Jugendlichen im Alter von durchschnittlich knapp 14 Jahren zu untersuchen (Min. = 12, Max. = 17, M = 13.7, SD = 1.0). Methodik: Die vorliegende Querschnittsstudie ist eine Sekundärdatenanalyse von 1005 befragten Schülerinnen und Schülern der Sekundarstufe. Die Datenerhebung erfolgte an fünf Schulen zwischen Februar 2022 und Oktober 2023. Mittels statistischer Regressionsanalysen (linear bzw. binär-logistisch) wurden Zusammenhänge untersucht zwischen dem Risky-Lootbox-Index (RLBI) und einer problematischen Videospielnutzung, erfasst anhand der „Game Addiction Scale for Adolescents“, sowie zwischen RLBI und Online-Glücksspielteilnahme. Zudem wurden Prävalenzdaten ermittelt. Ergebnisse: In der Subgruppe der 638 mindestens wöchentlich videospielenden Teilnehmenden lag die LB-Nutzungsprävalenz bei rund 30 %. Rund 9 % zeigten eine problematische Videospielnutzung und 8.5 % haben schon an Online-Glücksspielaktivitäten teilgenommen. Der Zusammenhang zwischen Lootbox-Nutzung und problematischer Videospielnutzung ist recht stark (standardisierter β-Koeffizient = .31). Derjenige zwischen der Lootbox-Nutzung und einer allfälligen Online-Glücksspielteilnahme ist ebenfalls signifikant, aber nur sehr schwach (OR = 1.07; 95 % KI [1.01–1.14]). Der Einfluss eines sozialen Gradienten ist bereits in der 7. bis 9. Klasse erkennbar, was bei Präventionsmaßnahmen berücksichtigt werden sollte. Schlussfolgerungen: Die Nutzung von Lootboxen ist bei Jugendlichen stark verbreitet und mit einem erhöhten Risiko für eine Videospiel-Nutzungsstörung assoziiert. Trotz des Verbots von Online-Glücksspielen für Jugendliche ist der Zugang nachweislich möglich, was auf Lücken im Jugendschutz hinweist. Eine Regulierung von LB könnte aus Public-Health-Sicht zur Prävention psychischer Belastungen bei Jugendlichen beitragen.

This study involves a comprehensive analysis of an anonymized dataset provided by a Swiss online casino that adds to the identification of reliable early indicators for problematic online gambling. Targeting gambling addiction prevention, our objective was to model and evaluate behavioral characteristics that signal early stages of problem gambling. We scrutinized player behaviors against a list of gamblers previously excluded for problematic gambling, using this as our target variable. Our approach combined traditional gambling risk indicators, as outlined in the existing literature, with innovative exploratory feature engineering and feature selection. This involved computing moving aggregates over specific periods to capture nuanced gambling patterns. All features were evaluated by assessing mutual information with the target variable as well as the collinearity of each pairwise combination of features. Based on our data analysis, we found that the total losses in the previous seven days, total deposits in the previous 15 days, total duration played in the previous seven days, stakes (amount bet per game) over the previous seven days, andmaking a deposit 12 h after a loss (chasing) were the most informative and independent risk indicators. To assess the accuracy of these indicators for early detection of problematic gambling and accordingly for responsible gambling interventions, we combined them in a linear regression model and compared its performance with the casino’s currently used model. We found that a binary decision model based on a linear combination of these indicators provided better recall, greater precision, andmore timely decisions than the benchmark.

Gamblers enrolled in the Swiss Multi-Venue Exclusion Program completed a written questionnaire three times, at six-month intervals. In addition to sociodemographic information, they provided details of their gambling behavior, and completed the South Oaks Gambling Screen-Revised (SOGS-R). The excluded gamblers were compared to a control group of non-excluded gamblers who also completed the questionnaire. The baseline survey demonstrated that there was a significant association between gamblers status (excluded n = 87 and non-excluded n = 259) and income (p = .039), as well as debt situation (p < .001) and SOGS-R score classification (p < .001). Over the course of three surveys, 242 gamblers participated. Of these, 133 respondents were not excluded from casinos at any time, 33 were excluded at the time of the first survey wave and remained so, while the exclusion status of 76 respondents changed over time, thus they were excluded for a minimum of one wave. Overall, 12.1% of excluded individuals stopped gambling altogether. Although exclusion is circumvented by some gamblers, it is associated with significant reductions in frequency, duration, and expenditure, as well as severity of problem gambling. The effects were more significant among gamblers who were excluded from casinos during the entire survey period. The results suggest that the duration of an exclusion should be at least six months instead of the current three months. 62.6% of the excluded gamblers had at least one exclusion lifted during the survey period. Further research is needed to investigate the implications of repeated exclusions for gambling-specific problems.

Corrigendum: Motivating factors and barriers to help-seeking for casino gamblers: results from a survey in Swiss casinos

Introduction: Gambling can have serious consequences for many aspects of a person’s life. Yet relatively few people with gambling problems seek help. This study examines the extent to which exclusion from casino venues among other factors may act as a motivator for further help-seeking among casino gamblers (both landbased and remote) with at-risk or disordered gambling behavior. In addition, the barriers that prevent gamblers from accepting help are examined.Methods: Gamblers from Swiss casinos completed a written questionnaire twice, at 6-month intervals. The questions included whether they had sought help in the past 6 months.Results: For those with a SOGS-R rating of 1 or over (n = 173) at the second survey point, a difference in help-seeking was found between the excluded and non-excluded gamblers (p < .001), suggesting that exclusion may be a motivator for help-seeking. Reported differences in levels of debt (p = .006), recognition of gambling problems (p = .010) and severity of gambling-related problems (p = .004) can be taken to suggest that other motivating factors may also influence help-seeking behavior. With regard to the support sought, the most frequently used forms of support were specialized addiction counseling centers (39.5%), followed by self-help groups (21.1%) and remote counseling centers (10.5%). In terms of barriers, reasons relating to attitude, such as denial, appear to pose greater barriers than treatment-related concerns.Discussion: From a public health perspective, an overarching strategy is required to increase the share of help-seekers among casino gamblers through targeted measures.

The Swiss Youth and Media Act, which is about to enter into force, is an attempt to provide a legislative framework for video game use. Among other inclusions, the law intends to make providers more accountable by taking measures to protect minors from harm that can be caused by improper use of video games. However, it is a challenge to create a legal framework that can adequately regulate the evolving features of video games. Legislators must find a suitable regulatory approach which takes into account the fact that there is an increasing convergence between video games and gambling, particularly with the introduction of loot boxes. Moreover, there is a need for regulation, including the prohibition of misleading designs, the introduction of additional protection for minors, and the assurance of transparency of transactions. Appropriate policy legislation and consumer-protection measures are needed to protect people using these types of products, particularly children and adolescents. Further work should focus on assessing game characteristics to refine regulatory models to promote safe gaming. Based on experiences from the field of psychoactive substances as well as that of gambling, it is now a matter of developing a matrix of harm with elaborated categories: a tool that makes it possible to evaluate the potential harms of certain game design in an evidence-based manner.

The COVID-19 pandemic has had an extensive impact on the global higher education sector. In a written survey, staff and students at the Lucerne School of Social Work reported how they had coped with the challenges to their teaching or respective learning situation. The initial survey was conducted during the lockdown in spring 2020, and the follow-up survey was performed in the period of relaxed sanitary measures in summer 2020. During the first wave of the survey, 51 employees and 225 students participated. In the follow-up survey, 28 employees and 117 students partook. Findings indicate that the increased workload created by the transition was stressful for both staff and students but overall was handled well. Staff and students who felt supported by the university management experienced less psychological distress. Since the outbreak of the pandemic, there has been an effort to develop hybrid forms of teaching. Because the social work curriculum contains building blocks that are difficult to implement in the form of distance learning, the transition posed challenges for both staff and students. During times of transition, university management must carefully assess the support needs of staff and students and take appropriate action.

The coronavirus pandemic (COVID-19) has had a major impact on most societies worldwide, including the closure of non-essential businesses in spring 2020. The present study considers its impact upon gambling behavior. Particularly, changes in self-reported gambling by Swiss, land-based casino players are examined. The main characteristics of respondents who played or did not play during lockdown are also investigated. This study is embedded in an ongoing longitudinal study that examines the gambling behavior of casino players at three points in time. All respondents who had participated in the first wave of the longitudinal study by the cut-off date (15th March 2020) were asked about their gambling behavior during lockdown in a supplementary online survey three weeks after the end of lockdown. A total of 55% of the 110 respondents reported having played during lockdown. Gambling intensity significantly decreased (p < 0.001) in our sample. Considering only those respondents (n = 66) who reported having gambled during lockdown, gambling intensity also decreased (p < 0.001), but online gambling significantly increased (p < 0.002). Those players who have increased their gambling activity require particular attention. It is important that casinos respond with appropriate player protection measures to those who have increased their gambling activity during the pandemic.