Evaluation of a city-region initiative to galvanise a community response to gambling-related harms

Abstract

Abstract Background Community interventions have an important role in public health strategy for gambling harms yet many interventions are shaped by stigmatising notions of individual responsibility. This presentation describes a process evaluation of an intervention for galvanising community-level innovation, administered by a city-region government. The intervention comprised 12 community projects, a Lived Experience Advisory Panel and a Community of Practice. Methods The process evaluation focused on refining a coproduced logic model. Data collection consisted of n-42 qualitative interviews and a short survey (n-21) with stakeholders, including commissioner-facilitators, project leads and people with Lived Experience, during intervention delivery. Thematic analysis and complex intervention modelling were carried out with the outputs of this refined through consensus discussion. Results The modelling exercise revealed a highly complex intervention that was suited to the poorly understood, hidden and stigmatised issue of gambling-related harms. The Community of Practice fostered group identity, collaboration and learning, with commissioner-facilitators expanding this to support the sustainability of the community projects. The Lived Experience Advisory Panel helped develop project outputs and non-stigmatising health messages although impact on the community projects varied. Stigma and commercially-driven gambling normalisation presented challenges to projects with the greatest impact evident on skill development among professionals and community actors. The city-region government adapted its gambling harms strategy based on learning generated. Conclusions The findings suggest the combination of a Community of Practice, Lived Experience and commissioner-facilitation effectively galvanised a community response to gambling harms, generating vital learning for the field. Public health actors should explore applying the approach for other emerging and contested public health issues.