Primary care patients reporting concerns about their gambling frequently have other co-occurring lifestyle and mental health issues

BACKGROUND: Problem gambling often goes undetected by family physicians but may be associated with stress-related medical problems as well as mental disorders and substance abuse. Family physicians are often first in line to identify these problems and to provide a proper referral. The aim of this study was to compare a group of primary care patients who identified concerns with their gambling behavior with the total population of screened patients in relation to co-morbidity of other lifestyle risk factors or mental health issues. METHODS: This is a cross sectional study comparing patients identified as worrying about their gambling behavior with the total screened patient population for co morbidity. The setting was 51 urban and rural New Zealand practices. Participants were consecutive adult patients per practice (N = 2,536) who completed a brief multi-item tool screening primary care patients for lifestyle risk factors and mental health problems (smoking, alcohol and drug misuse, problem gambling, depression, anxiety, abuse, anger). Data analysis used descriptive statistics and non-parametric binomial tests with adjusting for clustering by practitioner using STATA survey analysis. RESULTS: Approximately 3/100 (3%) answered yes to the gambling question. Those worried about gambling more likely to be male OR 1.85 (95% CI 1.1 to 3.1). Increasing age reduced likelihood of gambling concerns – logistic regression for complex survey data OR = 0.99 (CI 95% 0.97 to 0.99) p = 0.04 for each year older. Patients concerned about gambling were significantly more likely (all p < 0.0001) to have concerns about their smoking, use of recreational drugs, and alcohol. Similarly there were more likely to indicate problems with depression, anxiety and anger control. No significant relationship with gambling worries was found for abuse, physical inactivity or weight concerns. Patients expressing concerns about gambling were significantly more likely to want help with smoking, other drug use, depression and anxiety. CONCLUSION: Our questionnaire identifies patients who express a need for help with gambling and other lifestyle and mental health issues. Screening for gambling in primary care has the potential to identify individuals with multiple co-occurring disorders

How do you recruit and retain a prebirth cohort? Lessons learnt from growing up in New Zealand

Growing Up in New Zealand, a longitudinal study following nearly 7,000 children, has faced some unique challenges in identifying, enrolling, and retaining a large and diverse antenatal cohort. Identification of a study region with population demographics that enabled enrollment of an appropriately diverse sample was required as was intensive community and participant engagement in order to promote the study. Complementary methods used included direct engagement with prospective participants and the community and indirect engagement via media. Thus far, retention rates above 95% have been achieved by maintaining a multimethod approach that includes valuing participants and building trusting relationships, strong brand recognition, community engagement, maintenance of participant contact and location records, ensuring high-quality interactions between the participants and the study, pretesting measures and methods prior to the main cohort, and using participant feedback to inform the measures and methods used in future waves of data collection

Growing up in New Zealand: A longitudinal study of New Zealand children and their families. Report 2: Now we are born

Growing Up in New Zealand is a longitudinal study that provides an up-to-date, population-relevant picture of what it is like to be a child growing up in New Zealand in the 21st century. It recruited and collected information from both mothers and their partners from before their children were born, and it has undertaken several further data collection waves during the children’s first two years of life. It is unique in terms of its capacity to provide a comprehensive picture of contemporary child development across multiple domains of influence for children born in New Zealand, and for including significant numbers of Māori, Pacific and Asian children as well as New Zealand European and other New Zealanders.From its inception the Growing Up in New Zealand study has been explicitly designed to follow children from before birth until they are young adults, to understand ’what works’ for children and families (rather than primarily focusing on negative outcomes) and to consider pathways of development across multiple domains of influence. This will allow a much better understanding of the complex interplay of all the factors that lead to child outcomes including growth, health, behaviours and cognitive development. The model of child development shaping this study is child centred, but never forgets that children develop in dynamic interactions with their families, communities, environments and societal contexts over time. This conceptual approach to the study acknowledges the growth in our understanding of early child development in the last few decades, with an increasing recognition of the importance of the antenatal period and the first few years of life for shaping future developmental pathways for children.This first longitudinal report describes the children’s development from before their birth and through the critical first nine months of their lives. The report highlights the breadth of information that is available from the children and their families in these early months, but it is not the end of what is possible. There is much to be done yet to describe more fully the associations that exist between the diverse environments that these children are growing up in and their development to date, as well as into the future. These analyses will be undertaken over the next several months as the more detailed level data is fully prepared and more complex modelling is undertaken by the study team. In this report there are examples of what is possible, but these are only indicative of the evidence that is yet to emerge from this rich resource. This evidence will contribute important information about the development of our new generation of New Zealand children that will help to inform strategies to ensure that every child born in 21st century in New Zealand is enabled to thrive, belong and achieve (New Zealand Government, 2011