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Background: Low response rates are an increasing problem in population-based gambling surveys. Selective non-response may cause biased findings. Supporting information from administrative registers, whenever available for non-respondents can be utilized to estimate the effect of non-response to the gambling-related outcomes. The aim of this study is to evaluate the effect of non-response to the prevalences of two gambling measures: gambling participation and problem gambling.
Methods: Population-based Finnish Gambling Harms mixed-mode (online and postal) Survey 2016 was conducted among 18-year-olds or older in three geographical regions in Finland (response rate 36.2%). Weighted prevalences of gambling measures were calculated exploiting the respondents' data (n = 7,153). The study sample (N = 19,741) was individually linked to socio-demographic data from Statistics Finland to obtain information on both respondents and non-respondents. Multiple imputation was utilized to calculate the adjusted prevalences of gambling measures by register-based variables: sex, age, residential area, family structure, household equivalised disposable income, highest education degree, employment status, and native language. Crude prevalences were compared against weighted and non-response adjusted prevalences.
Results: For gambling participation, there was no difference between the crude (81.9% [95% CI 81.0-82.8%]) and the weighted (83.2% [95% CI 82.3-84.0%]) prevalences (p-value 0.09), or between the crude and the non-response adjusted (82.3% [95% CI 81.6-83.0%]) prevalences (p-value 0.49). However, the non-response adjusted (2.8% [95% CI 2.4-3.3%]) prevalence of problem gambling was higher compared to the crude (1.9% [95% CI 1.6-2.3%]) prevalence (p-value 0.002), while there was no difference between the crude and the weighted (2.2% [95% CI 1.9-2.7%]) prevalences (p-value 0.26).
Conclusions: Non-response had an effect of problem gambling prevalence in a Finnish Gambling Harms Survey 2016. The presence of non-response bias should be checked when analysing population surveys. Using administrative register data enables unique opportunities to increase the reliability of the results and to adjust the estimates for non-response.
Trial Registration: Clinical trial number: not applicable.
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http://dx.doi.org/10.1186/s12889-025-23016-4 | DOI Listing |
BMC Public Health
August 2025
Department of Promotional and Preventive Work, Finnish Institute for Health and Welfare, Mannerheimintie 166, Helsinki, 00300, Finland.
Background: Although past research has shown a strong association between gambling participation and harms, relatively few studies have attempted to quantify the cost of these harms to society. The need to quantify costs has been identified in several countries, however, no consensus exists in the field of gambling studies on how one should estimate them.
Methods: Three methods were selected for costs calculations: Causality adjustment factors (with two variations: CAF 80%/ CAF 50%), Excess costs, and a method based on Bayes theorem.
Nordisk Alkohol Nark
August 2025
Promotional and Preventive work unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Control policies in the fields of alcohol and gambling show similarities across Nordic countries. The so-called Nordic model has consisted of strong state intervention and, in many cases, monopolistic provision. However, internal and external pressures pose challenges to the model.
View Article and Find Full Text PDFJ Behav Addict
July 2025
1Turku Brain and Mind Center, University of Turku, Turku, Finland.
Background: Abnormal striatal cue reactivity is one of the neurobiological hallmarks of substance use disorders (SUDs). Cue reactivity is associated with relapse, prompting efforts to target its underlying mechanisms with therapeutic interventions. However, the neural correlates of cue reactivity in behavioral addictions, such as gambling disorder (GD), remain poorly understood.
View Article and Find Full Text PDFBMC Public Health
May 2025
Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Background: Low response rates are an increasing problem in population-based gambling surveys. Selective non-response may cause biased findings. Supporting information from administrative registers, whenever available for non-respondents can be utilized to estimate the effect of non-response to the gambling-related outcomes.
View Article and Find Full Text PDFHarm Reduct J
April 2025
Finnish Institute for Health and Welfare, Department of Health Services, P.O. Box 30, Helsinki, FI-00271, Finland.
Effective and comprehensive harm reduction strategies to mitigate gambling-related harms are needed worldwide. The development of such strategies is however resource intensive. Using existing models in multiple contexts would thus be advisable.
View Article and Find Full Text PDF