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Objective: This study aimed to understand the factors that may influence how and why people with intellectual disability may engage in gambling. Method: Nineteen people with intellectual disability were recruited from a disability advocacy organization and participated in face to face, semi-structured qualitative interviews. Open ended questions were used to explore participants' gambling participation, recall of, and attitudes toward, different gambling products, understanding of gambling harm, and awareness of responsible gambling messages. Results: All participants could remember gambling in their lifetime and some participants had recently engaged in gambling. Many participants were aware of different gambling products, and a few participants could describe in detail the technical aspects of electronic gambling machines. Most participants did not specifically recall seeing gambling harm minimization messages, however some described engaging in individual responsibility measures, such as limits and control, as they perceived this reduced the risks of experiencing harm. Conclusions: People with intellectual disability are engaging with gambling products in a similar way to the general community. Therefore, it is important to understand the different pathways that may lead people with intellectual disability to initiate and continue gambling and to ensure that they are aware of and protected from the potential risk. Implications for Public Health: Policy makers and practitioners should seek to understand and implement a range of strategies to reduce and prevent the harms associated with particular gambling products and environments for this population sub-group., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Pitt, Thomas, Watson, Shuttleworth, Murfitt and Balandin.)

Objective: To understand how policies developed by Local Government Authorities (LGAs) to address electronic gambling machine (EGM) harm are developed and implemented., Methods: Semi-structured interviews were conducted with 16 participants from 15 LGAs in metropolitan Melbourne who worked in a role associated or aligned with gambling. An inductive thematic analysis was used to interpret the data., Results: Three key themes emerged. First, participants described a shift from addiction frameworks to public health policy responses to EGMs, which was driven by increasing EGM losses and the harms caused by EGMs to communities. Second, there was the role of stakeholder groups in the policy-making process, including the challenges associated with engaging the community. Finally, there were barriers and facilitators to policy development and implementation. Barriers included a lack of financial resources and legislative boundaries imposed by the State Government. Facilitators included whole-of-LGA approaches, supportive councillors and collaborative efforts. Conclusions and implications for public health: LGAs have made shifts towards public health responses to EGM harm. Initiatives to further support policy development and implementation could include imposing a levy on EGM losses to directly support public health prevention activities and implementing robust state-based regulatory frameworks that support LGA responses to EGM harm., (© 2020 The Authors.)

Background: Community gambling venues (pubs and clubs) are commonly associated with leisure and recreational options in Australian communities. While these venues offer a range of activities and facilities, including social opportunities, sporting facilities, live entertainment, they also contain gambling products that are known to cause significant harm to individuals, their families and communities. Although researchers have explored how adults and children engage with these venues, there is limited understanding about the potential risks and benefits of these venues for people with lifelong disability., Methods: Semi structured interviews were conducted with nineteen people aged 20-70 years with lifelong disability (includes in this context intellectual disability, autism spectrum disorder, ADHD, and learning disability), predominately intellectual disability. The interviews occurred in a large Australian city and explored interviewees' experiences and attitudes towards pubs and clubs. Using a range of visual prompts (if needed), participants were asked to describe their engagement in different activities offered within the venue. Interviews were audio-recorded and transcribed, with a thematic analysis used to identify themes across the group., Results: Most participants attended venues with family, friends, and supporters, with a few attending on their own. Participants described socialising in the venue, going for reduced price meals, and attended for a range of activities including recreational activities, live entertainment and sport. Some participants also valued being a member of venues, and the interactions with staff members. While participants were cautious about the consumption of alcohol, most had gambled, particularly on electronic gambling machines (EGMs, pokies, or slots). Some participants stated that they had experienced problems with gambling., Conclusions: While many people with lifelong disability have positive experiences in pubs and clubs, some are vulnerable to the harms associated with risky products such as gambling within the venue. While it is important to acknowledge the positives associated with recreational facilities and encourage engagement in leisure activities for people with lifelong disability, further consideration is needed to ensure people are informed and protected from the harms associated with gambling and other products that are provided within these spaces.

Objective: To develop a framework to guide the application of public health advocacy strategies aimed at preventing and reducing gambling-related harm., Methods: A narrative review of theories of change and public health advocacy literature., Results: An eight-step public health advocacy framework was created, which outlines the critical steps and considerations when developing and implementing successful change efforts. Implications for public health: To date, a clear public health advocacy approach to gambling harm prevention and reduction has not been well established. This study proposes a gambling-specific framework to guide future public health advocacy efforts to prevent and reduce gambling harm., (© 2019 The Authors.)

Issue Addressed: Community-based gambling venues provide a range of activities for children alongside adult products, such as gambling. However, there has been little examination of children's experiences with, and exposure to, a range of gambling and non-gambling activities within venues., Methods: Visual sociology methods were used to measure unprompted recall, prompted recall, current use and intended adult use of activities in community gambling venues in 44 children who attended venues. Qualitative data were also collected to gain further insight into children's perceptions of the venue and the activities within., Results: Children displayed high unprompted and prompted recall of gambling and nongambling activities within the venue. Children indicated positive perceptions of the venue overall. Just over half of the children (52.3%) reported current use of gambling activities in the venue. The large majority of the children indicated that they would attend community gambling venues as an adult (90.9%)., Conclusion: This research provides a starting point in understanding the extent to which children are exposed to gambling products in community gambling venues. SO WHAT?: This research will be important for researchers, policy makers and practitioners in developing health promotion initiatives to prevent children from being exposed to gambling products in community settings., (© 2018 Australian Health Promotion Association.)

Issue Addressed: Concerns have been raised about the expansion of sports betting marketing and the impact it may have on children's gambling attitudes and behaviours. This study aimed to investigate the content of Australian betting advertisements to identify if they contained specific attention strategies that have been identified by tobacco, alcohol and gambling researchers as having particular appeal to children., Methods: An interpretative content analysis of 91 advertisements from 11 corporate bookmakers was conducted. A search of specific attention strategies that may appeal to adults, but also have been demonstrated in the public health literature as having particular appeal for children was used to develop a coding framework. This framework was then applied to analyse the advertisements. Descriptive statistics were used to generate quantitative data and qualitative illustrations were used to provide examples of the strategies found within the advertisements., Results: On average there were 7.6 attention strategies found per advertisement. The most common attention strategies were music (n = 80), voiceovers (n = 79) and catchy slogans (n = 78). There were some attention strategies that related specifically to betting, such as technology, and risk-reducing promotions., Conclusion: This research has demonstrated that the content of betting advertisements contains attention strategies that, based on the research findings from other areas of public health, may have particular appeal for children. SO WHAT?: This research provides important evidence which could encourage researchers, regulators and policy makers to consider changes to current advertising regulations, to ensure children are protected from the potentially engaging and harmful attention strategies present in betting advertisements., (© 2017 Australian Health Promotion Association.)

Objective: To explore children's awareness of sports betting advertising and how this advertising may influence children's attitudes, product knowledge and desire to try sports betting., Methods: Semi-structured qualitative interviews were conducted with 48 children (8-16 years) from Melbourne, Victoria. The interview schedule explored children's recall and interpretations of sports betting advertising, strategies within advertisements that may appeal to children, children's product knowledge and understanding of betting terminology, and factors that may encourage gambling. Interviews were transcribed and thematic analysis was conducted., Results: Children recalled in detail sports betting advertisements that they had seen, with humour the most engaging appeal strategy. They were also able to describe other specific appeal strategies and link these strategies to betting brands. Many children described how advertisements demonstrated how someone would place a bet, with some children recalling the detailed technical language associated with betting., Conclusions: Children had detailed recall of sports betting advertisements and an extensive knowledge of sports betting products and terminology. Implications for public health: To protect children from the potential harms associated with sports betting, governments should consider changing regulations and implementing evidence-based education campaigns to counter the positive messages children receive from the sports betting industry., (© 2017 The Authors.)

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., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: To investigate how children and adults recall the content and promotional channels for sports wagering marketing., Methods: A mixed methods study of 152 parent/child (8-16 years) dyads was conducted at AFL (Australian Football League), NRL (National Rugby League), and soccer sporting sites in New South Wales and Victoria, Australia. Questions related to the frequency of viewing AFL and NRL matches, sports wagering promotions and perceptions of the normalisation of wagering in sport. Descriptive statistics and thematic analysis were used to analyse data., Results: Children recruited from NRL (n=75, 96.2%) and AFL (n=46, 92.0%) sites were significantly more likely to have recalled having ever seen a promotion for sports wagering as compared to children from Soccer sites (n=18, 75.0%) (p<0.05). Children and adults identified seeing sports wagering promotions in similar environments, most commonly on television, and at stadiums. Three-quarters of children (75.0%) and the majority of adults (90.0%) perceived that sports wagering was becoming a normal part of sport., Conclusion and Implications: This research shows that children engaged in particular sports have high awareness of wagering marketing, particularly as seen on television or at sporting matches. Regulation should comprehensively address the placement, quantity and content of wagering marketing aligned with sport to prevent current and/or future gambling harm., (© 2016 Public Health Association of Australia.)

Objective: To explore the attitudes and opinions of public health experts in gambling and related unhealthy commodity industries towards the tactics used by the gambling industry to prevent reform and the advocacy responses to these tactics., Methods: In-depth interviews (30-60 minutes) with a convenience sample of 15 public health experts and stakeholders with a public health approach to gambling (n=10), or other unhealthy commodity industries (food, alcohol, tobacco, n=5)., Results: Participants described the influences of political lobbying and donations on public policy, and industry framing of problem gambling as an issue of personal responsibility. Industry funding of, and influence over, academic research was considered to be one of the most effective industry tactics to resist reform. Participants felt there was a need to build stronger coalitions and collaborations between independent academics, and to improve the utilisation of media to more effectively shift perceptions of gambling harm away from the individual and towards the product., Conclusions and Implications: Gambling industry tactics are similar to the tactics of other unhealthy commodity industries. However, advocacy initiatives to counter these tactics in gambling are less developed than in other areas. The formation of national public health coalitions, as well as a strong evidence base regarding industry tactics, will help to strengthen advocacy initiatives., (© 2015 Public Health Association of Australia.)

The media play a key role in promoting the thin ideal. A qualitative study, in which we used in depth interviews and thematic analysis, was undertaken to explore the attitudes of 142 obese individuals toward media portrayals of the thin ideal. Participants discussed the thin ideal as a social norm that is also supported through the exclusion of positive media portrayals of obese people. They perceived the thin ideal as an 'unhealthy' mode of social control, reflecting on their personal experiences and their concerns for others. Participants' perceptions highlighted the intersections between the thin ideal and gender, grooming and consumerism. Participants' personal responses to the thin ideal were nuanced--some were in support of the thin ideal and some were able to critically reflect and reject the thin ideal. We consider how the thin ideal may act as a form of synoptical social control, working in tandem with wider public health panoptical surveillance of body weight., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: To examine Corporate Social Responsibility (CSR) tactics by identifying the key characteristics of CSR strategies as described in the corporate documents of selected 'Big Food' companies., Methods: A mixed methods content analysis was used to analyse the information contained on Australian Big Food company websites. Data sources included company CSR reports and web-based content that related to CSR initiatives employed in Australia., Results: A total of 256 CSR activities were identified across six organisations. Of these, the majority related to the categories of environment (30.5%), responsibility to consumers (25.0%) or community (19.5%)., Conclusions: Big Food companies appear to be using CSR activities to: 1) build brand image through initiatives associated with the environment and responsibility to consumers; 2) target parents and children through community activities; and 3) align themselves with respected organisations and events in an effort to transfer their positive image attributes to their own brands., Implications: Results highlight the type of CSR strategies Big Food companies are employing. These findings serve as a guide to mapping and monitoring CSR as a specific form of marketing., (© 2015 Public Health Association of Australia.)

Objectives: To investigate how gamblers interact with, and respond to, downstream social marketing campaigns that focus on the risks and harms of problem gambling and/or encourage help seeking., Methods: Qualitative study of 100 gamblers with a range of gambling behaviours (from non-problem to problem gambling). We used a Social Constructivist approach. Our constant comparative method of data interpretation focused on how participants' experiences and interactions with gambling influenced their opinions towards, and interactions with social marketing campaigns., Results: Three key themes emerged from the narratives. (i) Participants felt that campaigns were heavily skewed towards encouraging individuals to take personal responsibility for their gambling behaviours or were targeted towards those with severe gambling problems. (ii) Participants described the difficulty for campaigns to achieve 'cut through' because of the overwhelming volume of positive messages about the benefits of gambling that were given by the gambling industry. (iii) Some participants described that dominant discourses about personal responsibility prevented them from seeking help and reinforced perceptions of stigma., Conclusions and Implications: Social marketing campaigns have an important role to play in the prevention of gambling risk behaviours and the promotion of help seeking. Social marketers should explore how to more effectively target campaigns to different audience segments, understand the role of environmental factors in undermining the uptake of social marketing strategies and anticipate the potential unforeseen consequences of social marketing strategies., (© 2012 John Wiley & Sons Ltd.)

Objective: To inform public health approaches to problem gambling by examining how the news media covers problem gambling, with a particular focus on the causes, consequences and solutions to problem gambling, and the 'actors' and sources who influence media coverage., Methods: A qualitative content analysis guided by framing theory analysed coverage of problem gambling in Australian newspapers in the period 1 July 2011 to 30 June 2012., Results: Solutions to problem gambling were more frequently discussed than causes and consequences. A focus on the responsibility of individuals was preferred to reporting that focused on broader social, ecological, and industry determinants of problem gambling. Reporting was highly politicised, with politicians frequently quoted and political issues frequently discussed. In contrast, the community sector, health professionals and problem gamblers were rarely quoted., Conclusions and Implications: This analysis has revealed the need for a more proactive, coordinated approach to the media by both public health researchers and health groups. The establishment of a gambling-specific coalition to push for evidence-based reform is recommended., (© 2014 Public Health Association of Australia.)

Family interactions about weight and health take place against the backdrop of the wider social discourse relating to the obesity epidemic. Parents (and children) negotiate complex and often contradictory messages in constructing a set of beliefs and practices around obesity and weight management. Despite this, very little research attention has been given to the nature of family-unit discourse on the subject of body weight and it's potential influence on the weight-related behaviours of family members. This includes the broad influence that dominant socio-cultural discourses have on family conceptualisations of weight and health. Using in-depth qualitative interviews with 150 family 'groups' comprised of at least one parent and one child in Victoria and South Australia, we explored how parents and children conceptualise and discuss issues of weight- and health-related lifestyle behaviours. Data were analysed using Attride-Stirling's (2001) thematic network approach. Three thematic clusters emerged from the analysis. First, both parents and children perceived that weight was the primary indicator of health. However, parents focused on the negative physical implications of overweight while children focused on the negative social implications. Second, weight and lifestyle choices were highly moralised. Parents saw it as their responsibility to communicate to children the 'dangers' of fatness. Children reported that parents typically used negatively-framed messages and scare tactics rather than positively-framed messages to encourage healthy behaviours. Third was the perception among parents and children that if you were thin, then eating habits and exercise were less important, and that activity could provide an antidote to food choices. Results suggest that both parents and children are internalising messages relating to obesity and weight management that focus on personal responsibility and blame attribution. These views reflect the broader societal discourse, and their consolidation at the family level is likely to increase their potency and make them resistant to change., (Copyright © 2014. Published by Elsevier Ltd.)

Introduction: This study explores what types of information obese individuals search for on the Internet, their motivations for seeking information and how they apply it in their daily lives., Method: In-depth telephone interviews with an Australian community sample of 142 individuals with a BMI ≥ 30 were conducted. Theoretical, purposive and strategic samplings were employed. Data were analysed using a constant comparative method., Results: Of the 142 individuals who participated in the study, 111 (78%) searched for information about weight loss or obesity. Of these, about three quarters searched for weight loss solutions. The higher the individual's weight, the more they appeared to search for weight loss solutions. Participants also searched for information about health risks associated with obesity (n = 28), how to prevent poor health outcomes (n = 30) and for peer support forums with other obese individuals (n = 25). Whilst participants visited a range of websites, including government-sponsored sites, community groups and weight loss companies, they overwhelmingly acted upon the advice given on commercial diet websites. However, safe, non-judgemental spaces such as the Fatosphere (online fat acceptance community) provided much needed solidarity and support., Conclusions: The Internet provides a convenient source of support and information for obese individuals. However, many turn to the same unsuccessful solutions online (e.g. fad dieting) they turn to in the community. Government and community organisations could draw upon some lessons learned in other consumer-driven online spaces (e.g. the Fatosphere) to provide supportive environments for obese individuals that resonate with their health and social experiences, and address their needs., (© 2010 Blackwell Publishing Ltd.)

Obesity stigma exists within many institutions and cultural settings. Most studies suggest that stigmatising experiences have a negative impact on individuals' health and social behaviours and outcomes. However, some studies indicate that obesity stigma can motivate individuals to lose weight. Limited research has examined weight-based stigma from the perspective of obese individuals, including their perceptions of, and responses to, the different types of weight-based stigma they face in their daily lives. This study advances knowledge about weight-based stigma by documenting how obese adults (mostly female) described the different types of obesity stigma that they faced, how they responded to this stigma, and how different types of stigma impact on health and social wellbeing. Semi-structured, qualitative interviews were conducted between April 2008 and March 2009 with a diverse sample of 141 obese Australian adults. Guided by Link and Phelan's (2006) categorisation of different types of discrimination, participants' experiences could be grouped into three distinct types of stigma: 1) Direct (e.g. being abused when using public transport); 2) Environmental (e.g. not being able to fit into seats on planes); and 3) Indirect (e.g. people staring at the contents of their supermarket trolley). Participants described that more subtle forms of stigma had the most impact on their health and social wellbeing. However, it was the interaction between direct, environmental and indirect stigma that created a barrier to participation in health-promoting activities. Participants rarely challenged stigma and often blamed themselves for stigmatising experiences. They also avoided situations where they perceived they would be stigmatised and constantly thought about how they could find a solution to their obesity., (Copyright © 2011 Elsevier Ltd. All rights reserved.)