Self-management in the age of complexity: An eHealth tool to support people experiencing problem gambling, poverty & homelessness

加拿大低收入人群中问题赌博（PG）的流行率比一般人群高出9倍。PG与其他健康和社会需求有关，如无家可归，残疾，物质使用和精神疾病。无论是作为独立服务还是作为综合护理方法的一部分，都缺乏提供PG护理的服务。 我们团队以前的工作将自我管理确定为治疗的一个重要因素， 包括技术在自我管理护理方面的潜力。作为回应，一个专家小组正在共同开发一个免费的、首个同类智能手机/网络应用程序，以帮助弱势群体自我管理其PG和其他复杂需求。通过收集客户信息，该应用程序将能够检测潜在的危机情况，并向用户推送支持性内容，例如与社交支持联系的选项，PG相关目标的提醒或其他资源，例如自助材料，赌博事实和激励报价。该应用程序将在现有PG编程/病例管理的背景下向客户介绍，作为鼓励采用的一种方式，然后由客户独立使用，以自我管理治疗后。预计该技术将促进客户的自我管理，改善与PG和其他复杂需求有关的客户成果，并加强客户与供应商的沟通。最后，我们将与商业、服务和技术合作伙伴合作，提供一个强大且充分证实的产品，并提供高质量的数据，以支持目标人群以及受问题赌博影响的人群使用该应用程序。该应用程序有足够的机会被商业化并纳入加拿大医疗保健和社会服务系统，并应用于PG的治疗和自我管理以及在一个以漫长的等待名单为标志的稀疏治疗环境中的相关健康状况。

The prevalence of problem gambling (PG) among low income persons in Canada is up to 9 times higher than within the general population. PG is associated with other health and social needs such as homelessness, disability, substance use and mental illness. There is a lack of services available to provide PG care either as a standalone service or as part of an integrated care approach. Previous work by our team identified self-management as an important element of treatment, including the potential of technology in self-managed care. In response, a team of experts is co-developing a free and first-of-its-kind Smartphone/web app to help persons in vulnerable populations self-manage their PG and other complex needs. By collecting client information the app will be able to detect potential crisis situations and push supportive content to the user, such as an option to connect with social supports, a reminder of a PG-related goal or other resources such as self-help materials, gambling facts and motivational quotes. The app will be introduced to clients within the context of existing PG programming/case management as a way to encourage uptake, and then used by clients independently to self-manage post-treatment. It is expected that the technology will facilitate client self-management, improve client outcomes relating to PG and other complex needs and enhance client-provider communication. Lastly, we will work with commercial, service and technical partners towards delivery of a robust and fully substantiated product, with high quality data to support use of the app within target populations and more generally in those affected by problem gambling. There is ample opportunity for the app to be commercialized and incorporated into the Canadian healthcare and social service systems and applied to the treatment and self-management of PG and related healt cessity in a sparse treatment environment marked by long wait lists.