A First Step Toward Best Practices in Iowa

When Frank Biagioli, executive officer of the Iowa Gambling Treatment Program (IGTP), put out a request for proposals for a review of his statewide program in 2000, response was lukewarm at best. Despite a strong desire for a scientific analysis of the effectiveness and reach of the Iowa program, the end of the year loomed with no leads in sight.
 
Enter Howard Shaffer, associate professor and director, Harvard Medical School Division on Addictions. Biagioli approached Shaffer at a conference and pitched the idea for the research project.
 
"He was extremely interested in the project, and we began a series of discussions on how to get this going," Biagioli said. "Because of its tremendous knowledge base about addictions and problem gambling, the Harvard research team was the ideal group to take this project on."

Nearly two years later, Shaffer and his research team released a comprehensive analysis of the entire Iowa treatment program. The 135-page report includes detailed comparative information on nearly 3,000 problem gambling treatment cases in Iowa over the course of four years. According to the report, the data provides valuable information on IGTP participants' background and demographics, financial status, gambling habits, mental health and treatment services. Data collection opportunities included crisis contacts, placement screening, admission, treatment services, discharge and follow-up. At admission, IGTP gamblers held an average of approximately $14,000 in gambling debt and lost about $522 per week.

According to Richard LaBrie, associate director of research and data analysis at the Institute and a member of the research team, the data serves as an important first step in the development of best treatment practices for Iowa, establishing an evidence base for moving forward. In addition, while certain characteristics of the Iowa population and gaming industry make the data set unique, the data can serve as a valuable tool for other treatment programs across the country.

"This is a very unique database in that it involves such a large number of people," LaBrie said. "Looking at the data … provides the opportunity to learn as much as possible about people with gambling problems in Iowa, which will be a tremendous resource as the IGTP moves forward. And for anyone running a hot line … planning legislation, developing treatment programs, etc., this data can serve as a little laboratory."

The next step in the research process will be to link the completed characteristics and treatment experience research to outcome data. The team is currently developing the methodologies for a formal outcome study, which LaBrie plans to begin sometime in 2003. This outcome research will establish the effectiveness of the IGTP and lead to the development of informed best practice models, LaBrie said.

"We are extremely excited about this process and the results we have so far," Biagioli said. "This study really is the first of its kind … and we can learn quite a bit from the sample. As we move forward, this data provides a lot of valuable information for treatment providers and clinicians. This is going to help us develop guiding principles for delivering treatment."

A full copy of the Harvard report on the Iowa program can be found on the Division on Addiction's Web site. For more information about the IGTP, visit the organization's Web site.