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The purpose of this report is to assist the Massachusetts Gaming Commission to understand the likely impacts of gambling advertising, determine the extent to which gambling behavior and gambling problems in Massachusetts are influenced by gambling advertising, and provide recommendations for how to prevent or mitigate harm resulting from gambling advertising in Massachusetts. The information presented in this report is important given the recent legalization of sports betting in the Commonwealth and its rapid implementation.

Much of the material in this report distills lessons from the extensive literature that already exists on the impacts of advertising generally, and what is known specifically about the impacts of advertising on gambling behavior. Data from three online panel surveys carried out in Massachusetts between 2014 and 2023 is useful in highlighting the potential impacts of gambling advertising in Massachusetts. Readers are cautioned that the results of online panel surveys, which typically include high proportions
of regular gamblers, cannot be generalized to the population but are informative regarding the direction of changes of behavior in populations.

The Massachusetts Gambling Impact Cohort (MAGIC) is a prospective study of gambling and problem gambling conducted in Massachusetts from September 2013 to September 2019. Multi-modal recruitment was utilized to recruit a statewide sample of 3,139 adults, 18 and older, with the sample over-selected for individuals at higher risk of future problem gambling. The cohort was assessed five times over a six-year period with the vast majority of assessments being self-administered online. The assessment collected comprehensive information on gambling-related behavior, attitudes, motivations, context, fallacies; problem gambling; physical health; mental health; substance use and abuse; social functioning; personality; and demographics.

MAGIC had four primary research goals:
1. To monitor changes in gambling and problem gambling over time within the cohort that might identify impacts of Massachusetts casino introduction (Plainridge Park Casino in 2016; MGM Springfield in 2018; Encore Boston Harbor in 2019).
2. To determine the stability and course of problem, at-risk, and recreational gambling within the cohort.
3. To identify predictors of problem gambling onset, continuation, remission, and relapse.
4. To use the findings from the above research to provide recommendations to optimize the prevention and treatment of problem gambling in Massachusetts.

This infographic was created to help guide substance misuse prevention professionals in social media efforts using Facebook and LinkedIn. The document includes definitions, tools, and tips to help get you started.

This toolkit provides a compilation of tips and talking points for making the case for community prevention. They are based on Prevention Institute’s daily analysis of how the media is (and isn’t) framing community prevention. Using this information, you can expand and shift the frame of how the media depicts community prevention, to ensure that the whole picture is shown and that community prevention is framed accurately and comprehensively.

This toolkit assists in developing a social marketing effort to promote adoption and use of innovations.

This toolkit provides resources and tools for communications on creating and maintaining coalitions, increasing participation and membership, communications to promote interest, and encouraging involvement in community work.

This toolkit supports planning for advocacy efforts and responding to opposition with tools and related resources to use to advocate for change in your community.

The fundamental drivers of health inequity are systemic factors that shape people’s physical and social surroundings in ways that create barriers to health. This interactive tool outlines how to address the five fundamental drivers of health inequity by developing legal and policy strategies to transform policies and systems. It provides real-world examples of how communities across the country have used equitable policymaking to confront the drivers of health inequity and create systems change.

THRIVE enables communities to determine how to improve health and safety, and promote health equity. It is a framework for understanding how structural drivers, such as racism, play out at the community level in terms of the social-cultural, physical/built, and economic/ educational environments. We call these community-level indicators the community determinants of health. In addition to being a framework, THRIVE is also a tool for engaging community members and practitioners in assessing the status of community determinants, prioritizing them, and taking action to change them in order to improve health, safety, and health equity. As a framework, THRIVE is widely applicable to local, state, and national initiatives to inform policy and program direction. As a tool, THRIVE can be used in a variety of planning and implementation processes, from neighborhood-level planning to community health needs assessments (CHNA) and community health improvement planning (CHIP) processes.

The Praxis Project uses a social determinants of health (SDOH) framework to guide our work. Many traditional SDOH frameworks lack the explicit naming of systems of oppression that cause disparities in health determinants. In an effort to incorporate these systems of oppression and to highlight the root causes of these determinants from a justice and community power perspective, The Praxis Project created this visual representation. This entire framework—from the root causes, to the social determinants of health, to the subsequent health outcomes—is Praxis’ Social Determinants of Health Equity framework.