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Table of Contents Acknowledgements

3

Executive summary

4

Literature review

5

Project goals and rationale

5

Methods

5

Project outcomes

7

Involvement in gambling

Gambling habits and attitudes

Gambling support services

Education and awareness opportunities

Demographics o Gender, sexuality, age, education, marital status, location, health

geographic

Final comments (selected)

Recommendations and lessons learned

12

Bibliography

13

Appendices Appendix A – Literature review

14

Appendix B – Advertising and media (selected)

16

Gambling in the Rainbow Community was designed and supported as an initial smallscale needs assessment employing survey tools to investigate whether further research into gambling within the LGBT (lesbian, gay, bisexual, and transgendered) community was warranted. While limited in its ability to minimize bias in the selection of survey recipients, care was taken to use established survey instruments with previous application within Nova Scotia. Nevertheless, the non-random nature of the data collection means we cannot necessarily generalize the results to the larger LGBT community in Nova Scotia. Gambling in the Rainbow Community – Final report 09-11

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Acknowledgements Out! Alive would like to acknowledge Gambling Awareness Nova Scotia* for providing the funds that made this project a reality. We would also like to thank the members of the Out! Alive Steering Committee, whose support and responses were helpful throughout the length of the project. Thank you also to project members Rick Anderson, Angus Campbell, Norval Collins, Patrick Daigle, Sheena Jamieson, Anita Keeping, and Liz McQuaid for participating and providing direction throughout the project. We would also like to sincerely thank Dr. Stan Kutcher MD, FRCPC, Sun Life Chair in Adolescent Mental Health, and Katherine Radchuck for the development of a literature review prior to the review in December 2010. Thanks also to those individuals who reviewed the survey in draft form: members of the Out! Alive steering committee, Kerry Chambers (Gambling Awareness Nova Scotia), Tracy Schrans (Focal Research Consultants Ltd.), Patryk Simon (Addiction Prevention and Treatment Services), Jayne MacCarthy (Pictou County Health Authority), and Patricia Auchnie (Problem Gambling Help Line). This community-based needs assessment could not have succeeded without the strong support of many community members. Out! Alive would like to acknowledge the following project partners: Addiction Prevention and Treatment Services (Capital Health), the Halifax Sexual Health Centre, prideHealth, the Youth Project, Halifax Pride Society, and The Nova Scotia Rainbow Action Project. We would also like to thank those that helped to distribute the survey in person and through online formats, including Ned MacInnis (AIDS Coalition of Nova Scotia), Norma Kennedy (Nova Scotia Advisory Commission on AIDS), Angie MacIntyre (Colchester East Hants Healthy Authority), and Caroline Ploem (Health Promotion Clearinghouse). Provincial Prevention colleagues from Addiction Services throughout the province were invaluable in getting the word out as well as staff at Addiction Services, Department of Health and Wellness, including Linda Brown and Sadie Watson who were also a great help. Angela Sarty and Dan Steeves (Addiction Prevention and Treatment Services), Beth Currie (Cape Breton District Health Authority), Suzanne Bailley, and Diane Grant assisted in supporting events at Pride this summer. We would also like to acknowledge the contributions of Jim Bain and Dan MacKay from Wayves and to thank Lee Bent for his design skills. *Gambling Awareness Nova Scotia (GANS) is a not-for-profit, arms-length government organization that encourages and supports an independent response to gambling harm in Nova Scotia. GANS provides funding to community groups, Community Health Boards, and researchers to help address and raise awareness of gambling harm.

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Gambling in the Rainbow Community Highlights of Out! Alive’s Needs Assessment Survey Final Report 2009-2011

Demographics  Gender and sexuality – Slightly more females answered the survey than males; 2% of respondents identified as transgender; 43% responded as gay.  Age - 50% of respondents listed their age between 25-44 years.  Education - 74% of respondents indicated they had some form of post-secondary education.  Location - 73% of respondents came from Halifax Regional Municipality (HRM) or Cape Breton Regional Municipality (CBRM), and 72% said they lived in a community of more than 10,000 residents.  Health - 85% of respondents reported that their health was ‘excellent’ or ‘good.’ Involvement in Gambling  Just over half of respondents (56%) infrequently purchased charity raffle tickets and 50/50 draws, and 43% bought scratch tickets every few months. On a weekly basis, 16.3% participated in lottery draws, 6% played scratch tickets, and 5% participated in 50/50 draws. Gambling Habits and Attitudes  25% of respondents scored at some level of risk for problem gambling, and 73% scored at non-gambling or non-problem gambling levels. This contrasts with the results of Nova Scotia’s 2007 Adult Gambling Prevalence Study, which indicated that 6% of the general population scored at some level of risk for problem gambling and 94% of the population scored at no risk of problem gambling. Gambling in the Rainbow Community was designed to provide comparison to the Province’s latest study.  21% of respondents had used a bank machine/ATM card to obtain more money while gambling, 14% of respondents had gambled with money intended for another purpose, and 15% had lent money to someone else so that person could continue gambling. Gambling Support Services  61% of respondents answered ‘yes’ or ‘unsure’ to knowing someone in the LGBT who has been affected by problem gambling; 30% know someone who is still affected by problem gambling. The most common products cited were VLTs, casino slots, and scratch tickets. Education and awareness opportunities  More than 80% of study participants indicated interest in more information on problem gambling, greater awareness campaigns on problem gambling for the LGBT community, more research on the subject, and more opportunities to discuss the impact of problem gambling in the LGBT community.

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Literature Review Prior to the grant application, Dr. Stan Kutcher and Katherine Radchuck undertook a comprehensive literature review. Literature on the subject of LGBT communities and gambling is limited, and three studies were included in their review. The three selected studies did not address general prevalence rates of gambling or help- seeking behaviour. The listed studies did discuss sexual orientation of men with pathological gambling (Grant and Potenza, 2006), male and female sexual orientation differences in gambling and self injury (Hershberger and Bogaert, 2005), or substance use and associated risk factors in a multi-campus probability sample of college students (Serras, Saules, Cranford and Eisenberg, 2010). A full description of the literature review can be found in appendix A.

Project Goals and Rationale Out! Alive proposed a study to investigate gambling habits and attitudes in the Rainbow community across Nova Scotia. A researcher with previous experience in delivery of similar surveys was contracted as a Project Coordinator to survey participants at Pride events in Halifax and Sydney in the summer of 2011. An online Survey was also offered to survey participants. Data were gathered from May 22 through August 31, 2011. After an analysis was conducted, this report of findings was produced and released on September 30, 2011. The target groups for this project were members of the Rainbow Community in Nova Scotia which includes Gay, Lesbian, Bisexual, and Transgender- identifying individuals. This project focused on individuals 16 years of age and older and did not identify them by nationality or race.

Methods The data collection instrument was a user-friendly survey that could be administered inperson at Pride events in Nova Scotia or online through Select Survey, a secure and confidential survey-gathering program. After the Project Coordinator was hired, potential survey instruments were reviewed. For this project, the 2007 Adult Gambling Prevalence Study (NS Health and Wellness, 2007) was used as a template for data collection because a number of its questions were relevant to the topic. A draft of the survey was presented to the Steering Committee in late May 2011, and drafts were then circulated to researchers and staff at the Department of Health and Wellness (Nova Scotia), Addiction Prevention and Treatment Services (Capital Health), Pictou County Health Authority (Addiction Services), Focal Research (Halifax), and Gambling Awareness Nova Scotia. A final draft was posted online through www.selectsurvey.net on May 22 (Appendix C). Select Survey was chosen as a survey collection tool because the data would remain confidential and stay within Nova Scotia borders. The survey ran through August 31, 2011. Gambling in the Rainbow Community – Final report 09-11

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Participants were solicited and directed to the online survey site through email network lists provided by project sponsors and by supporting agencies in the LGBT community. Social media techniques were also used to recruit participants, including the use of a Facebook fan page and targeted advertising, as well as banner advertising on www.kijiji.ca. The survey was promoted through advertisements and an article in Wayves (a monthly Nova Scotia LGBT publication) and media interviews with The Chronicle Herald (Halifax) and Global television (Maritimes) (see Appendix B). Project volunteers also administered surveys at Pride events in Halifax (July 24, 2011) and Sydney (August 6, 2011). Pride events in New Glasgow, Amherst, and Antigonish (as outlined in the grant application) did not occur, and in-person surveys were therefore not collected at these venues. In total, 104 surveys were collected in-person (40 in Halifax and 64 in Cape Breton) and 125 surveys were completed online. In total, 343 participants accessed the survey, and 229 surveys were completed for a completion rate of 66% (Appendix C). Gambling in the Rainbow Community was designed and supported as an initial smallscale needs assessment employing survey tools to investigate whether further research into gambling within the LGBT community would be warranted. Gambling in the Rainbow Community was intended as a community-based needs assessment rather than a fully scientific research study and, as such, there was potential for bias. Care was taken to avoid bias in the data-gathering by limiting the number of responses a single household could undertake. The project was also promoted widely through personal networks and niche advertising to solicit responses from a diverse sample of the LGBT community. However, survey limitations may include a reliance on personal networks and general distribution networks, which may result in a bias. Also, survey respondents may have participated in the survey expressly due to their involvement in gambling and may not be representative of general prevalence data on the subject. Further research is warranted to better understand the impact of gambling behaviours and attitudes in the LGBT community.

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Project Outcomes Involvement in Gambling 

Gambling product trial and usage - The findings from this question were mixed and require further investigation. Among the 229 participants who responded, approximately 22% had played VLTs and 29% had engaged in casino slot machine play in the previous year. Just over half of respondents infrequently purchased charity raffles (56%) and engaged in 50/50 draws, and 43% bought scratch tickets. Few had ever played poker (online, in casinos, and/or bars), casino table games, horse racing, ALC select, online or other sports betting.

Online gambling and gaming - Survey respondents also reported low participation rates for online gambling; in fact; the majority of respondents said they had never gambled using points or virtual money that could be traded for things of value (90%) or gambled on social networking sites using real money (96%). Participation rates were higher for gambling on internet practice sites without using real money (17%) and gambling on social networking sites (e.g.Facebook, Myspace) without using real money (18%)

Additional responses - Other forms of gambling that participants reported involvement with included card games, hospital lotteries, staff lotteries, and betting pools with staff or friends and family.

Gambling Habits and Attitudes The Canadian Problem Gambling Index (CPGI) and the Problem Gambling Screening index (PGSI) – The CPGI is a screening tool designed to measure at-risk and problem gambling behaviour. Potential individual responses are ‘never,’ ‘rarely,’ ‘often,’ and ‘almost always’ to nine (9) selected statements1. In analyzing the results, 24% of the respondents scored at some level of risk for problem gambling, while 73.3% scored at non-gambling or non-problem gambling levels. This contrasts with the results of Nova Scotia’s 2007 Adult Gambling Prevalence Study (NSAGPS, 2007) which indicates that 6% of the general population are at some level of risk for problem gambling 1

http://www.ccsa.ca/eng/priorities/gambling/CPGI/Pages/default.aspx

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while 93% of the population are at no risk of problem gambling. Analysis from this current assessment suggests that the rate of problem gambling behaviour in the LGBT community may be four times higher than in the general population. 

Behaviours while gambling – Nova Scotia’s 2007 Adult Gambling Prevalence Study (NSAGPS, 2007) asked a series of questions to understand more about the behaviour of individuals while gambling. Gambling in the Rainbow Community utilized these questions from NSAGPS to provide comparison data. Further analysis needs to be undertaken to compare results from the Prevalence Study to this research. o Used an ATM/Bank machine or bank card to get additional money while gambling – 14% of respondents answered rarely to this statement, while 6% answered often or almost always, and 79% answered never. o Borrowed money from someone else to continue gambling – 6% of respondents answered ‘rarely’ to this statement and 3% answered ‘often’ or ‘almost always.’ 90% answered ‘never.’ o Used debit or credit cards to get money for gambling – 90% of respondents answered ‘never’ to this statement; 9% answered ‘rarely,’ ‘often,’ or ‘almost always.’ o Gambled with money intended for another purpose – 8% answered ‘rarely’ to this statement and 5% of respondents answered ‘often.’ 85% of respondents answered ‘never.’ o Lent money to someone else for them to continue gambling – 15% of respondents answered ‘rarely’ or ‘often’ to this statement. 84% answered ‘never.’

On a scale of 1 to 10…how would you rate your gambling right now – Where an answer of 1 meant ‘no problem at all’ and 10 meant ‘a serious problem,’ 92% of respondents answered ‘1,’ 5% answered between ‘2-4,’ and 4% answered ‘between 6-10.’

Gambling Support Services Are you aware of any assistance or services to help… 

…LGBT people having problems with their gambling – 68% of respondents answered no or unsure to this question. 32% were aware of services available the LGBT community.

…Families/Friends of LGBT people having problems with their gambling – 70% of respondents answered ‘no’ or ‘unsure’ to this question. 29% of respondents were aware of services offered to others affected by addiction.

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Do you personally know of anyone else in the LGBT community who has been affected by problem gambling? 

61% of respondents answered ‘yes’ or ‘unsure’ to this question, while 38% answered ‘no.’

If you answered yes to the question above, are any of these people whom you know still being affected by problem gambling? 

30% of those who knew of people in the LGBT community affected by problem gambling reported they continued to be aware of individuals struggling with problem gambling. 25% of respondents answered ‘unsure,’ and 44% answered ‘no’

(To those who answered ‘yes’ above) what types of gambling were the primary concern? 

For those who knew of someone with gambling problems, the most commonly cited gambling product used was VLTs (70%). This number is higher than the 62% found in Nova Scotia 2007 Adult Gambling Prevalence Study (NSAGPS)2. Other gambling problems cited included slots at a casino (47%) and scratch ‘n Win lottery tickets (37%). In the Prevalence Study, 14% of respondents mentioned concern with casino slots and 5% mentioned concern with scratch ‘n wins tickets.

Education and Awareness Opportunities How interested do you think LGBT Nova Scotians would be in…

2

…More information about problem gambling in the LGBT community – 81% of respondents indicated interest in more information.19% of respondents were not at all interested.

…Greater awareness campaigns about problem gambling in the LGBT community – 83% of respondents expressed interest in having greater awareness campaigns while 16% expressed no interest.

…More research about problem gambling in the LGBT communities – 82% of respondents expressed interest in having more research on the topic (with 18% indicating they were very interested); 17% expressed they were not at all interested.

…More opportunities to discuss the impact of problem gambling in the LGBT community – 82% of respondents expressed interest in having more opportunities for discussion on the topic; 18% expressed having no interest in the subject.

Schrans, T. & Schellinck, T., 2007 – pg. 71

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Education, Awareness and Support Services – Comments  I don't really get the connection personally, so as a member of the LGBT community I would be interested in learning more about whether or not this is a problem for this particular community and, if so, in what ways and what severity. I am also concerned that it may unintentionally tarnish a community that already has its fair share of challenges. I know the services offered for gambling problems would aim to benefit the LGBT community, but are they so unique that they cannot be offered through the normal services offered to non-LGBT people?  Why would a review be focused upon a LGBTQ group?  I am concerned how little gambling is talked about. I have friends who have lost a great deal of money gambling, but we never really talk about it.  Some develop personal friendship with other players and sometimes even remain gambling until their friend arrives or spend more when they leave hoping to ‘cash in' on the payout that is accruing and (to them) an inevitability.  The two close friends who I am aware of that addressed their harmful gambling did so with the support of their partner, not via a service within the community. In both cases, the problem gambling developed when they were single and fairly closeted.  We need a positive proactive approach in strengthening the GLBT community at a larger level. Addiction Services should be more present

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Participant Demographics 

Gender - 50% of respondents identified as female and 47% identified as male. 2% of respondents answered they were transgender and 2% provided additional identification

Sexuality – 43% of respondents identified their sexuality as gay and 20.4% identified as lesbian. (15%) identified as bisexual and 16% identified as heterosexual/straight. 5% of respondents provided additional identification, including terms like “queer” and “pansexual.”

Age – Age ranges were slightly skewed to younger ages: 50% listed their age between 25 and 44 years of age, 4% of respondents were between 14-18 years of age, and 10% were over the age of 55.

Highest level of education – 74% of respondents indicated they had participated in some form of post secondary education (39% had obtained a college or university degree and 20% had obtained a graduate degree. 17% of respondents had completed a high school diploma or GED, and 7% had not completed a high school diploma. This number may be explained in part by the fact 10 participants listed their age as between 1418.

Current marital status – 38% of respondents reported that they were single-never been married and 27% responded that they were currently in a common-law relationship/domestic partnership/living with partner. 16% of respondents said they were married, 4% said they were separated, 6% said they were divorced, and 1% were widowed. Three other responses included being involved in a long term dating relationship or dating and not living together.

What county of Nova Scotia do you currently reside in – 51% of responses came from Halifax County and 23% identified as living in Cape Breton County. The remaining 21% of respondents identified other individual counties of Nova Scotia as their residence.

Do you live in a community with more than 10,000 residents – 72% of respondents indicated that they lived in an urban community, and the remaining 28% indicated they lived in a rural community.

In general would you say your health is … - 85% of respondents rated their individual health as good or excellent. 6% of respondents rated their health as fair, and 1% rated their health as poor.

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Recommendations and Lessons Learned Recommendations 

Given the findings of this study, more rigorous research is needed to better understand the scope and impact of gambling behaviour and attitudes in Nova Scotia.

Results of this study should be shared with community partners and institutions to better serve the LGBT communities they work with.

Addictions Services offices across Nova Scotia need to have greater awareness of the impact of problem gambling behaviours in the LGBT community.

Greater problem gambling awareness and education campaigns that focus on behaviours and services available should be made available to LGBT communities in Nova Scotia.

Lessons Learned 

LGBT communities are comfortable with online approaches to data gathering. Participant numbers were higher than anticipated. Online promotion through Facebook and Kijiji were popular routes for LGBT communities to learn about the survey.

Online surveys of this nature are voluntary and therefore non-random, meaning a lack of certainty about the level and accuracy of the data. This is a small population and a random sample within cost-effective parameters may not be possible; however, if the survey is repeated yearly or biannually with similar results, there can be more confidence in the numbers.

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Bibliography Canadian Centre on Substance Abuse. Canadian Problem Gambling Index (retrieved online 09-09-11) http://www.ccsa.ca/eng/priorities/gambling/CPGI/Pages/default.aspx Grant, J.E. & Potenza, M.N. (2006). Sexual orientation of men with pathological gambling: prevalence and psychiatric comorbidity in a treatment seeking sample. Comprehensive Psychology, 47, 515-518. Hershberger, S.L. & Bogaert, A.F. (2005). Male and female sexual orientation differences in gambling. Personality and Individual Differences, 38, 1401-1411. Liao, M. (2010). Problem gambling and the lesbian, gay, bisexual and transgender community. Problem Gambling Prevention Technical Assistance and Training Project, NAPAFASA. Schrans, T & Schellinck, T. (2008). The 2007 Adult Gambling Prevalence Study. Nova Scotia Department of Health and Wellness, Halifax: Nova Scotia Serras, A., Saules, K.K, Cranford, J.A & Eisenberg, D. (2010). Self-injury, substance use and associated risk factors in a multi-campus probability sample of college students. Psychology of Addictive Behaviors, 24:1, 119-128.

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Appendix A – Literature Review Literature Review Date Search Completed: December 21, 2010 Researched by: Katherine Radchuck Purpose A keyword search for literature fitting the desired criteria of gambling and the LGBT community was performed using a variety of electronic bibliographic databases listed below: Bibliographic Databases 1. OVID Medline ® In process & other Non-Indexed Citations December 20, 2010 2. OVID Medline ® 1950-November week 3 2010 3. Embase 1980 to 2010 week 50 4. NASW 14th edition 5. Social Work Abstracts 1968 to August 2010 6. PsycINFO 1967 to December week 2 2010 Keyword search strategy for literature identification 1. Homosexual 2. Gay 3. Lesbian 4. Sexual orientation 5. “1” AND “2” AND “3” AND “4” AND 6. Two-spirit OR two(adj1) spirit OR twospirit 7. Herdache OR hijra OR obibwe 8. Bigender OR bisexual 9. Transgender OR transsexual 10. Gender(adj1)queer OR intergender OR multi adj1 gender OR multi-gender OR multigender 11. “8” AND “9” AND “10” 12. “5” AND “11” 13. Gambl* Gambling in the Rainbow Community – Final report 09-11

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14. Gaming OR gamer* OR wager OR betting 15. VLT or Video adj1 lottery adj1 terminal* OR sports adj1 betting OR fixed adj1 odds adj1 betting OR fixed-odds adj1 betting OR pari-mutuel adj1 betting OR raffle 16. Problem* adj1 gambl* OR ludomania OR pathological adj1 gambl* OR gambl* adj1 addict OR disorder* adj1 gamble 17. Impulse ADJ1 control adj1 disorder* OR dependenc* OR addict* 18. “14” AND “15” AND “16” 19. “18” AND “17” 20. “13” AND “18” 21. “12” AND “20” Our search strategy uncovered 1011 literature results. Abstracts of these were reviewed to identify relevant studies and a common theme was uncovered. Most of the literature was based on substance addiction and dependency unrelated to the specific population. The terms dependence and addict were determined to be too vague and they were removed from the search. A more accurate search crossed 52,647 studies from the population keyword list and 18,343 studies from the gambling keyword list. From this search18 results were found with two duplicates and three triplets found. Out of the unique 14 studies, 5 were kept and read in entirety and 3 were kept. A study was kept for its indirect discussion of gambling to self-injury as well as the relationship between sexual orientation to self-injury. The study acknowledges need for further research on the desired criteria of gambling and the GLBT community. Sun Life Financial Chair in Adolescent Mental health Katherine Radchuck December 21, 2010

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Appendix B – Advertising and media (selected)

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Rainbow Report Proof  

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