hawker-smartphonedelivered-2021.pdf (204.86 kB)
A Smartphone-delivered ecological momentary intervention for problem gambling (GamblingLess: Curb Your Urge): Single-Arm acceptability and feasibility trial
journal contribution
posted on 2021-03-01, 00:00 authored by Chloe HawkerChloe Hawker, Stephanie MerkourisStephanie Merkouris, George YoussefGeorge Youssef, Nicki DowlingNicki DowlingBackground
Low uptake rates of traditional gambling treatments highlight the need for innovative treatment modalities. Smartphone apps can provide unprecedented access to real-time ecological momentary interventions (EMIs) delivered in people’s everyday lives.
Objective
This study aims to examine the acceptability, feasibility, and preliminary effectiveness of GamblingLess: Curb Your Urge, the first smartphone app–delivered EMI that aims to prevent gambling episodes by reducing craving intensity in people seeking help for gambling problems.
Methods
This study was a single-arm, 5-week acceptability and feasibility trial (1-week baseline and 4-week intervention periods) involving ecological momentary assessments (EMAs) delivered 3 times daily. The EMAs measured gambling episodes, cravings, and self-efficacy. Web-based evaluations at baseline, postintervention, and 1-month follow-up measured gambling outcomes (severity, cravings, frequency, expenditure, and self-efficacy) and the intervention’s perceived helpfulness, relevance, burden, satisfaction, and impact in relation to gambling cravings.
Results
A total of 36 participants, of whom 22/36 (61%) were male and 34/36 (94%) were problem gamblers, completed the baseline measures, with 61% (22/36) completing the postintervention evaluation and 58% (21/36) completing the follow-up evaluation. The intervention was considered acceptable, as participants perceived all intervention content to be above average in helpfulness and the EMA to be highly relevant but somewhat burdensome. Participants reported that they were satisfied with the intervention and that the intervention improved their knowledge, attitudes, awareness, behavior change, intention to change, and help-seeking behavior for gambling cravings. Regarding the intervention’s feasibility, compliance rates for the EMA (51%) and EMI (15%) were low; however, the intervention was used 166 times, including 59 uses within 60 minutes of EMA completion and 107 on-demand uses. Regarding the intervention’s preliminary effectiveness, descriptive EMA data showed that, compared with the baseline period, 71% and 72% reductions in the average number of gambling episodes and craving occurrences were reported in the intervention period, respectively. In addition, clustered paired-sample two-tailed t tests revealed a significant 5.4% reduction in real-time craving intensity (P=.01) immediately after intervention use, which increased to 10.5% (P=.01), where use was recommended based on craving occurrence. At the group level, significant medium-to-large reductions were observed in mean gambling symptom severity (P=.01 and .003), cravings (P=.03 and .02), frequency (P=.01 and .004), and expenditure (P=.04 and .003) at postintervention and follow-up; moreover, increased mean gambling self-efficacy and craving self-efficacy (P=.01 and .01) were observed at postintervention and increased gambling self-efficacy (P=.04) was observed at follow-up. At the individual level, over a quarter of participants (6/22, 27% to 10/21, 48%) could be categorized as recovered or improved regarding their gambling symptom severity and cravings.
Conclusions
The results support the acceptability, feasibility, and preliminary effectiveness of this app-delivered EMI for preventing gambling episodes through craving management in people with gambling problems, which has implications for extending the reach of evidence-based treatment to moments
History
Journal
Journal of Medical Internet ResearchVolume
23Issue
3Pagination
e25786 - e25786Publisher
JMIR Publications Inc.Location
[Pittsburgh, Pa.?]Publisher DOI
Link to full text
ISSN
1439-4456eISSN
1438-8871Language
engPublication classification
C1 Refereed article in a scholarly journalUsage metrics
Categories
No categories selectedKeywords
cravingecological momentary assessmentecological momentary interventiongamblingmobile phonerelapseself-efficacyself-helpsmartphonetreatmenturgeScience & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesMedical InformaticsTIME ADAPTIVE INTERVENTIONSMOBILE TECHNOLOGYRATING-SCALEHEALTHSUPPORTAPPSRECOVERYEFFICACYIMPACTTOOL
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC