Intrinsic and Extrinsic Barriers to Health Care: Implications for Problem Gambling

  • author:

    Dave Clarke
  • published in

    : 2007
  • summary

    : To establish guidelines for research into help for problem gambling, this paper reviews literature on barriers to access and utilisation of health care for alcohol abuse, substance abuse and mental health problems. Research findings from international and New Zealand studies are examined, highlighting gender differences and cultural aspects. Intrinsic factors are presented within the transtheoretical model of change (TTM). Extrinsic barriers consist of predisposing, enabling and need factors, according to the socio-behavioral model (SBM). The dynamic interaction between intrinsic and extrinsic factors is explained by the network-episode model (NEM) which emphasises the importance of social networks and events. Personal, socio-cultural and institutional reasons for delays in seeking help are presented. The greatest barriers to seeking health care are intrinsic. Specific research questions regarding the implications for barriers to help for problem gamblers and their families are proposed. In conclusion, the SBM and the NEM seem to explain barriers to health care access and utilisation for addictive disorders and mental health problems better than the TTM. Barriers to health care access and utilisation for substance abuse and mental health problems may have some relevance to similar barriers for problem gamblers and their families.
  • related url


    Note: This link will take you to an external website. is not responsible for accessibility and content of external websites.

  • type

    : article in serial publication
  • publisher

    : Springer
  • is part of a publication

    : International Journal of Mental Health and Addiction
  • volume

    : 5
  • issue

    : 4
  • copyright

    : © Springer
  • original language

    : English
  • article pagination

    : start page: 279 - end page: 291
  • keywords

    : New Zealand , problem behavior , socio-behavioral model , transtheoretical model of change
  • Article entered in GambLIB database on march 6. 2008, 00:03
  • Item added by staff