Quality of Research
Documents Reviewed
The documents below were reviewed for Quality of Research. The research point of
contact can provide information regarding the studies reviewed and the availability
of additional materials, including those from more recent studies that may have been conducted.
Study 1Williams, R. J., Wood, R. T., & Currie, S. R. (2010). Stacked Deck: An effective, school-based program for the prevention of problem gambling. Journal of Primary Prevention, 31(3), 109-125.  Study 2Williams, R. (2002). Final report. Prevention of problem gambling: A school-based intervention. Unpublished manuscript, School of Health Sciences, University of Lethbridge, Alberta, Canada.
Outcomes
| Outcome 1: Attitudes toward gambling |
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Description of Measures
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Attitudes toward gambling were measured using two self-report scales created by the program developers. In one study, a 2-item scale was used. The first question asked the student about gambling's benefit versus harm to society, with response options ranging from "benefits far outweigh the harm" to "harm far outweighs the benefits." The second item asked the student to indicate whether gambling is morally wrong. Total scores ranged from -4 to +4, with lower scores reflecting more negative (or healthy) attitudes toward gambling. Another study used a 4-item scale with similar questions, as well as questions on how the student feels about legalized gambling and how the student would rank gambling as a leisure pastime. For this measure, total scores ranged from 4 to 18, with higher scores reflecting more negative (or healthy) attitudes toward gambling. Assessments were administered at baseline and 3-month follow-up.
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Key Findings
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In one Canadian study, schools were assigned to one of three groups: a group receiving the standard Stacked Deck, a group receiving the standard Stacked Deck plus a booster session, and an assessment-only control group. At 3-month follow-up, attitudes toward gambling in the standard group were significantly more negative (i.e., healthier) than those in the control group (p < .001), and attitudes in the booster session group were significantly more negative than those in the standard group (p = .013).
A second Canadian study involved two schools in the Calgary high school system and two Aboriginal high schools in southern Alberta. Schools at each of the two sites were randomly assigned to the standard Stacked Deck group or an assessment-only control group. In the Aboriginal school selected for implementation, the program was adapted for the Blackfoot culture and delivered by a qualified teacher, who was a Blackfoot elder. From baseline to 3-month follow-up, the Stacked Deck group showed a greater increase in negative (i.e., healthier) attitudes toward gambling compared with the control group (p < .01).
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Studies Measuring Outcome
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Study 1, Study 2
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Study Designs
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Experimental
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Quality of Research Rating
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2.4
(0.0-4.0 scale)
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| Outcome 2: Problem gambling |
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Description of Measures
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Problem gambling was measured using a 2-part self-report item created by the program developers. The first part asked, "Has your gambling caused you or anyone else any problems in the past 12 months? By this we mean things such as stress or anxiety, arguments with friends or family, worries about money, health problems, legal problems, or problems at school or work." If the student answered affirmatively, a follow-up question asked the student to indicate the type of problems, their frequency, and their seriousness. Students were deemed problem gamblers if they reported "serious" or "very serious" problems of any frequency. Assessments were administered at baseline and 3-month follow-up.
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Key Findings
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In a Canadian study, schools were assigned to one of three groups: a group receiving the standard Stacked Deck, a group receiving the standard Stacked Deck plus a booster session, and an assessment-only control group. At 3-month follow-up, the rate of problem gambling was significantly lower in the standard group (p = .032) and the booster session group (p = .013) than in the control group.
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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2.7
(0.0-4.0 scale)
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| Outcome 3: Resistance to fallacies about gambling |
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Description of Measures
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Resistance to fallacies about gambling was assessed using two self-report measures created by the program developers that address common misperceptions about gambling (e.g., illusion of control, belief that one is luckier than other people). In one study, a 10-item scale was used. Scores ranged from 0 to 10, with higher scores reflecting greater resistance to gambling fallacies. Another study used a 9-item scale. Scores ranged from 0 to 19, with lower scores reflecting greater resistance to gambling fallacies. Assessments were administered at baseline and 3-month follow-up.
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Key Findings
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In one Canadian study, schools were assigned to one of three groups: a group receiving the standard Stacked Deck, a group receiving the standard Stacked Deck plus a booster session, and an assessment-only control group. From baseline to 3-month follow-up, the standard group and booster session group showed a greater increase in resistance to gambling fallacies compared with the control group (p < .001).
A second Canadian study involved two schools in the Calgary high school system and two Aboriginal high schools in southern Alberta. Schools at each of the two sites were randomly assigned to the standard Stacked Deck group or an assessment-only control group. In the Aboriginal school selected for implementation, the program was adapted for the Blackfoot culture and delivered by a qualified teacher, who was a Blackfoot elder. From baseline to 3-month follow-up, the Stacked Deck group showed a greater increase in resistance to gambling fallacies compared with the control group (p < .001).
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Studies Measuring Outcome
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Study 1, Study 2
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Study Designs
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Experimental
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Quality of Research Rating
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2.4
(0.0-4.0 scale)
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| Outcome 4: Gambling frequency |
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Description of Measures
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Gambling frequency was assessed using a self-report questionnaire created by the program developers. Using a 6-point scale ranging from "did not play" to "daily," participants indicated for each of 10 types of gambling activities the number of days on which they bet or personally spent money in the past 3 months. Assessments were administered at baseline and 3-month follow-up.
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Key Findings
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In a Canadian study, schools were assigned to one of three groups: a group receiving the standard Stacked Deck, a group receiving the standard Stacked Deck plus a booster session, and an assessment-only control group. From baseline to 3-month follow-up, the standard group and booster session group showed a greater decrease in gambling frequency compared with the control group (p = .017).
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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2.4
(0.0-4.0 scale)
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Study Populations
The following populations were identified in the studies reviewed for Quality of
Research.
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Study
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Age
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Gender
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Race/Ethnicity
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Study 1
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13-17 (Adolescent)
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53% Male
47% Female
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100% Non-U.S. population
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Study 2
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13-17 (Adolescent)
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51.5% Male
48.5% Female
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100% Non-U.S. population
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Quality of Research Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the Quality of Research for an intervention's
reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
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Outcome
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Reliability
of Measures
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Validity
of Measures
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Fidelity
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Missing
Data/Attrition
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Confounding
Variables
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Data
Analysis
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Overall
Rating
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1: Attitudes toward gambling
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1.3
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2.0
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1.6
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2.6
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3.4
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3.5
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2.4
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2: Problem gambling
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1.8
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3.3
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1.6
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2.7
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3.4
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3.7
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2.7
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3: Resistance to fallacies about gambling
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1.3
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2.0
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1.6
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2.6
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3.4
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3.5
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2.4
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4: Gambling frequency
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0.8
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2.3
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1.6
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2.7
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3.4
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3.8
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2.4
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Study Strengths Reliability tests were performed for some outcome measures, and for those, the test-retest reliability was found to be good. Some of the measures showed good concurrent and predictive validity. Implementation fidelity was supported through trainings and periodic observations of the trainings by the program developers. Follow-up rates 3 months after the intervention were acceptable. Imputation was used to address missing data for variables missing less than 5% of values. The numerous between-group differences identified at baseline were addressed statistically.
Study Weaknesses For many outcomes, little information was provided about the reliability and validity of the measurement instruments. Teacher trainings were observed, but curriculum delivery was not observed and no intervention checklists were completed by the facilitator or students. Data were examined for missing values and accuracy, but it is not specified whether rates of missing data were equal between groups. While imputation was used to address missing data for variables missing less than 5% of values, it is unclear how researchers handled variables with a greater proportion of missing values. Many statistical tests were performed, and no multiple testing correction was used, thereby increasing the potential for outcomes due to chance to be found significant.
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Readiness for Dissemination
Materials Reviewed
The materials below were reviewed for Readiness for Dissemination. The implementation
point of contact can provide information regarding implementation of the intervention
and the availability of additional, updated, or new materials.
Williams, R., & Wood, R. (2010). Stacked Deck: A Program To Prevent Problem Gambling, grades 9-12. Facilitator's guide [with CD-ROM]. Center City, MN: Hazelden.
Williams, R., & Wood, R. (n.d.). Stacked Deck: A Program To Prevent Problem Gambling. Curriculum implementation training. Center City, MN: Hazelden.
Williams, R., & Wood, R. (n.d.). Stacked Deck training PowerPoint slides, Lessons 1-6.
Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the intervention's Readiness for Dissemination
using three criteria:
- Availability of implementation materials
- Availability of training and support resources
- Availability of quality assurance procedures
For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.
Implementation
Materials
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Training and Support
Resources
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Quality Assurance
Procedures
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Overall
Rating
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3.5
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2.5
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2.4
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2.8
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Dissemination Strengths The facilitator's guide provides detailed and well-structured content for each program session. Each session includes a review of the information presented in preceding sessions, increasing students' exposure to key content. The materials provide guidance on addressing issues and problems that might occur with students. A detailed matrix describing the content, methods, and supplies associated with each training session accompanies the curriculum implementation training guide. A pre- and posttest questionnaire that is well aligned with the structure of the program is available to support outcome monitoring.
Dissemination Weaknesses Little guidance is provided on how to integrate the program with existing school curricula. The training includes limited instruction beyond requirements of session delivery, omitting important information for enhancing the delivery skills of the facilitators. Little attention is given to an overall quality assurance process, with no guidance provided for monitoring and maintaining fidelity to the model.
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Costs
The cost information below was provided by the developer. Although this cost information
may have been updated by the developer since the time of review, it may not reflect
the current costs or availability of items (including newly developed or discontinued
items). The implementation point of contact can provide current information and
discuss implementation requirements.
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Item Description
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Cost
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Required by Developer
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Facilitator's guide (includes CD-ROM with six sets of PowerPoint slides and reproducible materials)
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$59.99
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Yes
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1-day, on-site facilitator training for up to 24 participants (includes curriculum implementation training guide)
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$2,200 plus travel expenses
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No
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2-day, on-site training of trainers for up to 24 participants
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$4,200 plus travel expenses
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Yes, if planning to conduct facilitator training
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Training webinar
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Free
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No
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Additional Information Discounts are available for bulk orders.
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Replications
No replications were identified by the developer.
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