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

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.