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Forsström, D., Sundqvist, K., Samuelsson, E. & Spångberg, J. (2024). Feasibility and results of a pilot online survey to examine prevalence of gambling and problem gambling among Swedish substance abuse inpatients in compulsory care. Cogent Psychology, 11(1), Article ID 2305543.
Open this publication in new window or tab >>Feasibility and results of a pilot online survey to examine prevalence of gambling and problem gambling among Swedish substance abuse inpatients in compulsory care
2024 (English)In: Cogent Psychology, E-ISSN 2331-1908, Vol. 11, no 1, article id 2305543Article in journal (Refereed) Published
Abstract [en]

The comorbidity between problem gambling and substance use/abuse is high in many populations previously studied. However, the occurrence of problem gambling among individuals with substance abuse has not been thoroughly studied, which is especially true for individuals in inpatient or compulsory care. The present early-stage study explored the presence of gambling and problem gambling among inpatients in compulsory care in Sweden who has been court-ordered to treatment for their substance abuse (alcohol and/or drugs). The study furthermore investigates the use of preventive measures and treatment seeking. The most effective strategy to recruit participants (no incentive, incentive and incentive and face-to-face recruitment) was also explored. Twenty-one participants were recruited and seven of them had at-risk or problem gambling and none of them had accessed treatment. The best way of recruiting was to offer a gift certificate and inform about the study face-to-face. The implications are that individuals in compulsory care for substance abuse need to be screened for problem gambling, that recruitment for studies in this population is best carried out by offering incentives and educational efforts and that it might be beneficial for the clients in compulsory care to be offered gambling treatment. 

Keywords
Substance abuse, compulsory care, comorbidity, problem gambling, confirmed cases
National Category
Public Health, Global Health, Social Medicine and Epidemiology Substance Abuse
Identifiers
urn:nbn:se:su:diva-226147 (URN)10.1080/23311908.2024.2305543 (DOI)001154202700001 ()2-s2.0-85183859985 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfarePublic Health Agency of Sweden
Available from: 2024-02-01 Created: 2024-02-01 Last updated: 2024-02-19Bibliographically approved
Elling, D. L., Brännström Almquist, Y., Wennberg, P. & Sundqvist, K. (2023). Effects of a multi-component alcohol prevention program in the workplace on hazardous alcohol use among employees. BMC Public Health, 23, Article ID 1420.
Open this publication in new window or tab >>Effects of a multi-component alcohol prevention program in the workplace on hazardous alcohol use among employees
2023 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, article id 1420Article in journal (Refereed) Published
Abstract [en]

Background: The workplace can be affected negatively by hazardous alcohol use, and intervening at an early stage remains a challenge. Recently, a multi-component alcohol prevention program, Alcohol Policy and Managers’ skills Training (hereafter, ‘APMaT’), was delivered at the organizational level. In a previous outcome evaluation, APMaT appeared to be effective at the managerial level. The current study takes a step further by aiming to evaluate the effectiveness of APMaT in decreasing the alcohol risk level among employees.

Methods: Data from 853 employees (control: n = 586; intervention: n = 267) were gathered through a cluster-randomized study. To analyze changes in the odds of hazardous alcohol use among employees, multilevel logistic regression was applied using group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group × time) as the main predictors. The intervention effect was further adjusted for sociodemographic characteristics and policy awareness.

Results: No statistically significant difference was observed in the odds of hazardous alcohol use, although employees in the intervention group showed a larger decrease compared to the control group. This remained even after adjusting for several factors, including the sociodemographic factors and policy awareness.

Conclusions: The findings are insufficient to determine the effectiveness of APMaT at the employee level at the current stage of the evaluation. Future studies should strive to identify issues with implementation processes in workplace-based alcohol interventions.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
workplace intervention, alcohol prevention, hazardous alcohol use, policy awareness
National Category
Substance Abuse Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-220995 (URN)10.1186/s12889-023-16150-4 (DOI)001035797200004 ()37488547 (PubMedID)2-s2.0-85165709677 (Scopus ID)
Note

Open access funding provided by Stockholm University. The funding for this project was provided by the Public Health Agency of Sweden (grant no: 02781 − 2017; 03333 − 2018; 03843 − 2019).

Available from: 2023-09-12 Created: 2023-09-12 Last updated: 2024-01-11Bibliographically approved
Sundström, C., Forsström, D., Berman, A. H., Khadjesari, Z. & Sundqvist, K. (2023). What do we know about alcohol internet interventions aimed at employees?: A scoping review. Frontiers In Public Health, 11, Article ID 929782.
Open this publication in new window or tab >>What do we know about alcohol internet interventions aimed at employees?: A scoping review
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2023 (English)In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 929782Article, review/survey (Refereed) Published
Abstract [en]

Background: Internet interventions are a promising avenue for delivering alcohol prevention to employees. The objective of this scoping review was to map all research on alcohol internet interventions aimed at employees regardless of design, to gain an overview of current evidence and identify potential knowledge gaps.

Methods: We conducted a literature search in three data bases (PsycInfo, PubMed, and Web of Science). Eligibility criteria were that (1) the study targeted employees age ≥18 years; (2) the intervention was delivered predominantly online; (3) the study focused specifically or in part on alcohol use; and (4) the study was published in English in a peer-reviewed academic journal. Two reviewers independently screened, reviewed, and extracted data.

Results: Twenty studies were included, of which 10 were randomized controlled trials, five were secondary analyses, three were feasibility trials, one was a cohort study and one described the rationale and development of an intervention. No qualitative studies were found. Randomized trials tended to show effects when interventions were compared to waitlists but not when more intensive interventions were compared to less intensive ones. We identified two design-related aspects where studies differed; (1) whether all applicants were included regardless of alcohol use level and (2) whether the intervention was explicitly framed as alcohol-focused or not. Significant recruitment problems were noted in several studies.

Conclusions: Alcohol internet interventions hold promise in delivering alcohol prevention to employees, but heterogeneity in study design and difficulties in recruitment complicate interpretation of findings.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
alcohol, digital intervention, internet intervention, workplace, employee, scoping review
National Category
Substance Abuse
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-215442 (URN)10.3389/fpubh.2023.929782 (DOI)000935009400001 ()36778564 (PubMedID)2-s2.0-85147753208 (Scopus ID)
Note

This work was funded by AFA Försäkring.

Available from: 2023-03-16 Created: 2023-03-16 Last updated: 2024-01-30Bibliographically approved
Forsström, D., Rozental, A. & Sundqvist, K. (2022). Alcohol Use and Gambling Associated with Impulsivity among a Swedish University Sample. International Journal of Environmental Research and Public Health, 19(4), Article ID 2436.
Open this publication in new window or tab >>Alcohol Use and Gambling Associated with Impulsivity among a Swedish University Sample
2022 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 4, article id 2436Article in journal (Refereed) Published
Abstract [en]

Excessive alcohol use and gambling can have negative consequences. Across countries, the risk of excessive alcohol use is more common in university populations than in the general population. However, few studies have investigated the prevalence of both alcohol use and gambling in this group. This study explores these behaviours in a Swedish university setting. In addition, this study investigates how impulsivity affects alcohol use and gambling. In total, 794 Swedish students answered an online survey. Data were analysed using descriptive statistics to determine prevalence, and multinomial logistic regression was used to determine the contribution of impulsivity, age, and sex to alcohol use and gambling. Compared to the Swedish national prevalence, the prevalence was higher for excessive alcohol use, but the prevalence of gambling was at the same level or lower. High levels of impulsivity and male sex increased the risk of excessive alcohol use, while older age lowered the risk of excessive alcohol use and gambling. The results indicate that primarily young men could benefit from primary prevention in a university setting. Also, screening for impulsivity in men might be one way to identify risk groups in a university population.

Keywords
alcohol use, gambling, risk, impulsivity, Swedish university sample
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-203006 (URN)10.3390/ijerph19042436 (DOI)000778185400001 ()35206624 (PubMedID)2-s2.0-85124904594 (Scopus ID)
Note

The REGAPS programme is supported by the Swedish Research Council for Health, Working life and Welfare (Forte) under grant 2016-07091.

Available from: 2022-03-21 Created: 2022-03-21 Last updated: 2022-06-30Bibliographically approved
Elling, D. L., Brännström Almquist, Y., Wennberg, P. & Sundqvist, K. (2022). Evaluation of a workplace alcohol prevention program targeted on managers’ inclination to initiate early alcohol interventions. Work: A journal of Prevention, Assessment and rehabilitation, 73(2), 517-526
Open this publication in new window or tab >>Evaluation of a workplace alcohol prevention program targeted on managers’ inclination to initiate early alcohol interventions
2022 (English)In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 73, no 2, p. 517-526Article in journal (Refereed) Published
Abstract [en]

Background: Alcohol interventions targeting the adult population are often conducted in healthcare settings, while preventive interventions often target adolescents or young adults. The general working population is often overlooked. A workplace-based intervention, consisting of development and implementation of an organizational alcohol policy, and skills development training for managers (APMaT) was carried out in order to prevent and reduce alcohol-related harms by identifying hazardous consumers at an early stage. 

Objective: This study aims to evaluate APMaT by focusing on managers’ inclination to initiate early alcohol intervention.

Methods: In a cluster randomized design, data were obtained from 187 managers (control: n = 70; intervention: n = 117). Inclination to initiate early alcohol intervention was measured using three items on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Changes in managers’ inclination to intervene were analyzed by applying multilevel ordered logistic regression. Predictors included in the model were group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group × time).

Results: Significant increase in inclination to intervene against hazardous alcohol consumption among managers in the intervention group compared to managers in the control group was observed. Specifically, a 50% increase of confidence to initiate an intervention was observed among managers in the intervention group.

Conclusions: APMaT seems effective to increase managers’ inclination to intervene early against hazardous consumption in the workplace. The effectiveness of APMaT at the employee level should be explored in prospective studies.

Keywords
workplace interventions, APMaT, alcohol prevention, hazardous alcohol consumption, inclination to intervene
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-203817 (URN)10.3233/WOR-210943 (DOI)000885837700003 ()35938276 (PubMedID)2-s2.0-85140351170 (Scopus ID)
Available from: 2022-04-12 Created: 2022-04-12 Last updated: 2023-01-02Bibliographically approved
Elling, D. L., Martinez, M. W. & Sundqvist, K. (2022). Perceived barriers in the dissemination of an organisational alcohol policy as part of implementing an alcohol prevention programme among managers. Drugs, Habits and Social Policy, 23(2), 128-139
Open this publication in new window or tab >>Perceived barriers in the dissemination of an organisational alcohol policy as part of implementing an alcohol prevention programme among managers
2022 (English)In: Drugs, Habits and Social Policy, ISSN 2752-6739, Vol. 23, no 2, p. 128-139Article in journal (Refereed) Published
Abstract [en]

Purpose - An alcohol prevention programme, consisting of the implementation of an organisational alcohol policy and skills development training for managers, was delivered in Swedish workplaces. Previous findings revealed challenges in policy implementation because of the lack of dissemination amongst managers. This study aims to describe perceived dissemination barriers of the organisational alcohol policy by managers. Design/methodology/approach - A cross-sectional survey (n = 193 managers) was performed to identify common dissemination barriers in the workplace and complementary case illustrations derived from semi-structured interviews (n = 18 managers) were used to understand the dissemination barriers of the organisational alcohol policy. Frequency distributions were presented to describe common perceived barriers. Findings - Sixty-five per cent of managers reported that their workplace had not changed their approach to addressing alcohol-related issues compared to their usual practice before programme delivery. Various organisational factors, such as deprioritisation of programme dissemination, lack of communication and inadequate strategies were some of the common barriers perceived by managers. Moreover, managers reported uncertainties regarding any changes concerning the workplace's approach for addressing alcohol-related issues. Increased efforts in disseminating the organisational alcohol policy can reduce uncertainties among managers. Practical implications - A thorough process evaluation to understand processes in programme delivery and implementation is necessary to ensure the uptake of the intervention. Originality/value - This study highlighted the complexity of disseminating an alcohol policy in a dynamic setting, such as the workplace, and provided the importance of addressing organisational obstacles.

Keywords
Dissemination barrier, Organisational alcohol policy, Alcohol prevention programme, Organisational factors, Workplace intervention, Programme implementation
National Category
Health Sciences
Identifiers
urn:nbn:se:su:diva-215823 (URN)10.1108/DHS-03-2022-0013 (DOI)000941162900004 ()2-s2.0-85144143684 (Scopus ID)
Available from: 2023-03-30 Created: 2023-03-30 Last updated: 2023-03-30Bibliographically approved
Sundqvist, K. & Wennberg, P. (2022). Problem gambling and anxiety disorders in the general swedish population: a case control study. Journal of Gambling Studies, 38, 1257-1268
Open this publication in new window or tab >>Problem gambling and anxiety disorders in the general swedish population: a case control study
2022 (English)In: Journal of Gambling Studies, ISSN 1050-5350, E-ISSN 1573-3602, Vol. 38, p. 1257-1268Article in journal (Refereed) Published
Abstract [en]

Co-occurring psychiatric comorbidity is high among problem gamblers, and anxiety disorders has repeatedly been linked to problem gambling. Less conclusive, however, is the association between problem gambling and specific anxiety disorders. The aim of this study is to examine the association between problem gambling and specific anxiety disorders in subgroups of gender, age and socio-economic status (SES) in the general Swedish population. A case-control design was employed - nested in the Swedish longitudinal gambling study cohort. All anxiety disorders studied - Panic Disorder, Social Phobia, Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD), were significantly associated with problem gambling, however the pattern differed across subgroups. Social Phobia was the anxiety disorder most commonly associated with problem gambling across subgroups. The strongest associations between problem gambling and various anxiety disorders were found in participants under the age of 25, among females, and in the group with middle SES. In those groups three of the four anxiety disorders studied were significantly associated with problem gambling, with different patterns. Quite remarkably, participants under the age of 25 had three times higher risk of having had GAD compared to their controls. Efforts to prevent an escalation of either gambling or anxiety could target the presented vulnerable groups specifically.

Keywords
problem gambling, anxiety disorders, specific anxiety disorders, gender, age, socio-economic status, Panic Disorder, Social Phobia, Generalized Anxiety Disorder (GAD), Post-Traumatic Stress Disorder (PTSD)
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Sciences; Psychiatry; Psychology
Identifiers
urn:nbn:se:su:diva-204063 (URN)10.1007/s10899-022-10117-7 (DOI)000779703300001 ()35380396 (PubMedID)2-s2.0-85127566072 (Scopus ID)
Available from: 2022-04-19 Created: 2022-04-19 Last updated: 2023-01-19Bibliographically approved
Wilson Martinez, M., Berglund, K., Hensing, G. & Sundqvist, K. (2022). Swedish Managers’ and HR-Officers’ Experiences and Perceptions of Participating in Alcohol Prevention Skills Training: A Qualitative Study. Frontiers in Psychology, 13, Article ID 756343.
Open this publication in new window or tab >>Swedish Managers’ and HR-Officers’ Experiences and Perceptions of Participating in Alcohol Prevention Skills Training: A Qualitative Study
2022 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 13, article id 756343Article in journal (Refereed) Published
Abstract [en]

Objective: The objective of this study was to explore Swedish managers’ and HR-officers’ experiences and perceptions of skills training including a development and implementation of an alcohol policy.

Methods: Semi-structured interviews were conducted with Swedish managers (n = 44) and HR-officers (n = 9) from nine different organizations whom had received skills training and an organizational policy implementation. The interviews were analyzed using thematic analyses.

Results: In total, nine themes were identified as: The prevalence of alcohol problems: a wake-up call; a reminder to intervene immediately; an altered view of the responsibility of the employer; initiating conversations about alcohol: a useful toolbox; an imprecise, yet positive, memory; increased awareness of issues related to alcohol culture; I have not heard a word about a new alcohol policy; the alcohol policy: a mere piece of paper; and alcohol problem prevention: hardly a low-hanging fruit. Participants’ experiences of the skills training were positive overall.

Conclusion: Various aspects of the skills training were appreciated by managers and HR-officers, including insight of prevalence statistics and employer responsibilities. Participants emphasized the value of repeated skills training occasions for retaining knowledge. Future research may investigate further in what way skills training may affect managers’ willingness to engage in workplace alcohol prevention. Since the implementation of any policy had gone unnoticed to participants, a reason for which could be related to the notion of the existing policy as “good enough” in its current condition, implementation and organizational issues, or a reluctance to address alcohol-related matters unless necessary; future research may focus on investigating in what manner alcohol policies are in fact utilized within organizations.

Keywords
health promotion, workplace intervention, thematic analysis, alcohol policy, alcohol problem prevention, skills training experiences
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Sciences
Identifiers
urn:nbn:se:su:diva-203007 (URN)10.3389/fpsyg.2022.756343 (DOI)000773223300001 ()2-s2.0-85127183146 (Scopus ID)
Projects
Alkoholpreventiva insatser i arbetslivet
Funder
Public Health Agency of Sweden , 03333 2018
Available from: 2022-03-21 Created: 2022-03-21 Last updated: 2023-01-04Bibliographically approved
Sundqvist, K. & Wennberg, P. (2022). The Association Between Problem Gambling and Suicidal Ideations and Attempts: A Case Control Study in the General Swedish Population. Journal of Gambling Studies, 38(2), 319-331
Open this publication in new window or tab >>The Association Between Problem Gambling and Suicidal Ideations and Attempts: A Case Control Study in the General Swedish Population
2022 (English)In: Journal of Gambling Studies, ISSN 1050-5350, E-ISSN 1573-3602, Vol. 38, no 2, p. 319-331Article in journal (Refereed) Published
Abstract [en]

The association between problem gambling and suicidal behaviours is well established in treatment seeking populations, but less explored among sub-clinical problem gamblers in the general population. The aim of this study was to examine the association between problem gambling (including moderate risk gambling) and suicidal ideations/suicide attempts, in the general Swedish population. Another aim was to compare problem gamblers with and without suicide ideation/attempts. A case-control study nested in the Swelogs cohort was used. Both ideations and attempts were about twice as frequent among the cases compared to the controls. After controlling for socio-economic status and life-time mental health problems, suicidal ideation, but not attempts, remained significantly higher among the cases compared to the controls. The largest difference between attempters and non-attempters were on payment defaults and illicit drug abuse, whereas depression yielded the largest difference between ideators and non-ideators. Problem gambling severity (PGSI 8+) resulted in the smallest difference, compared to the other variables, between attempters and non-attempters. Even though no conclusion regarding the casual relationship can be drawn in this type of study, it seems like sub-clinical levels of problem gambling might have an impact on suicidal ideations whereas for suicide attempts to occur, other factors need to be present. In addition to mental health issues, financial difficulties may be such factors.

Keywords
problem gambling, suicidal behaviours
National Category
Psychology Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Psychology; Public Health Sciences
Identifiers
urn:nbn:se:su:diva-203005 (URN)10.1007/s10899-020-09996-5 (DOI)2-s2.0-85099864434 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07091
Note

This work was conducted within the research programme REGAPS (Responding to and Reducing Gambling Problem Studies). The REGAPS programme is supported by the Swedish Research Council for Health, Working life and Welfare (Forte) under grant 2016–07091. The study was also funded by the Svenska Spel independent research council under grant FO2016-0017. Open Access funding provided by Stockholm University.

Available from: 2022-03-21 Created: 2022-03-21 Last updated: 2023-01-04Bibliographically approved
Molander, O., Volberg, R., Månsson, V., Sundqvist, K., Wennberg, P. & Berman, A. H. (2021). Development of the Gambling Disorder Identification Test: Results from an international Delphi and consensus process. International Journal of Methods in Psychiatric Research, 30(2), Article ID e1865.
Open this publication in new window or tab >>Development of the Gambling Disorder Identification Test: Results from an international Delphi and consensus process
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2021 (English)In: International Journal of Methods in Psychiatric Research, ISSN 1049-8931, E-ISSN 1557-0657, Vol. 30, no 2, article id e1865Article in journal (Refereed) Published
Abstract [en]

Objectives: Diverse instruments are used to measure problem gambling and Gambling Disorder intervention outcomes. The 2004 Banff consensus agreement proposed necessary features for reporting gambling treatment efficacy. To address the challenge of including these features in a single instrument, a process was initiated to develop the Gambling Disorder Identification Test (GDIT), as an instrument analogous to the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test.

Methods: Gambling experts from 10 countries participated in an international two-round Delphi (n = 61; n = 30), rating 30 items proposed for inclusion in the GDIT. Gambling researchers and clinicians from several countries participated in three consensus meetings (n = 10; n = 4; n = 3). User feedback was obtained from individuals with experience of problem gambling (n = 12) and from treatment-seekers with Gambling Disorder (n = 8).

Results: Ten items fulfilled Delphi consensus criteria for inclusion in the GDIT (M >= 7 on a scale of 1-9 in the second round). Item-related issues were addressed, and four more items were added to conform to the Banff agreement recommendations, yielding a final draft version of the GDIT with 14 items in three domains: gambling behavior, gambling symptoms and negative consequences.

Conclusions: This study established preliminary construct and face validity for the GDIT.

Keywords
Delphi, gambling disorder, Gambling Disorder Identification Test (GDIT), problem gambling, psychometric development
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychology
Research subject
Psychology; Public Health Sciences
Identifiers
urn:nbn:se:su:diva-187453 (URN)10.1002/mpr.1865 (DOI)000591057900001 ()33220163 (PubMedID)
Available from: 2020-12-11 Created: 2020-12-11 Last updated: 2022-06-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5923-0092

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