Randomized Controlled Trial of a Personalized Feedback Intervention for Problem Gamblers

1. John A. Cunningham, David C. Hodgins, Tony Toneatto, Michelle Murphy Introduction Results • Only one in ten problem gamblers will ever seek treatment, often because of stigma, embarrassment, or desire to handle their problems on their own. • As a self-help method found to be effective with other addictive behaviours, provision of personalized feedback summaries with normative information would allow gamblers to compare and evaluate their own gambling activities to that of others in the general population and reduce the amount they gamble. • This RCT evaluated the efficacy of two versions of a personalized feedback intervention for problem gamblers. • Of the 209 participants in the randomized trial, 84.2% (n = 176) provided follow-up data for at least one of the follow-up points. Specific follow-up rates at each time point were: 3-month follow-up = 77% (n = 161); 6-month follow-up = 75.1% (n = 157); 12-month follow-up = 69.9% (n = 146). • There were no significant (p > .05) differences in attrition rates and gambling and demographic characteristics (i.e. gender, education, employment) between the different experimental conditions. • Participants receiving partial feedback intervention reduced the number of days gambled from baseline to 12-month follow-up, compared to participants in the full feedback condition and waiting list control, p < .02 (Figure). • No significant differences (p > .05) observed between condition in total dollars spent on betting in past 30 days and largest amount spent gambling on any day at 12-month follow-up. Methods Randomized Controlled Trial of a Personalized Feedback Intervention for Problem Gamblers • Design:▪ Randomized controlled design with modified waiting list control • ▪ Recruitment using Random Digit Dialing survey of Ontario population • Participants: ▪ Adult (18+ y.o.a.) current problem gamblers (n = 209); CPGI ≥ 3 • ▪ Stated interested in receiving free computerized summary comparing their gambling to other Canadians, and to help develop and evaluating self-help material for gamblers. • Conditions: 1) Full personalized feedback intervention • 2) Partial feedback intervention – all feedback intervention as in (1) but without normative feedback content • 3) Waiting list control – full feedback intervention after 6 mo. follow - up • Personalized Feedback Content: • A brief internet-based intervention (www.CheckYourGambling.net) offered personalized feedback based on the client’s gambling patterns, gender and age. • Final Report summarized: ▪ The type and frequency of gambling ▪ How their gambling compares to others • ▪ How gambling affects their finances • ▪ Problem Gambling Index score • Also described endorsed cognitive distortions held about gambling (e.g., “I try to figure out what my luckiest numbers are”), and provided suggestions for reframing these beliefs. Conclusion • Interestingly, the current trial showed an impact of the personalized feedback intervention, but only when the normative information was not included. • These findings are contrary to our pilot trial (Cunningham, et al., 2009) that had found some initial evidence that the full feedback intervention could reduce levels of gambling. Similar interventions targeting problem drinking also had demonstrated that personalized feedback incorporating norms were efficacious. • ▪ Therefore, results show that personalized feedback may have impact on gambling, but is unclear as of yet the best version of the materials and the size of the impact. • Lack of impact observed with the full personalized feedback could be due to difficulties with obtaining good normative data for problem gamblers, especially for different types of gambling activities. • Overall, personalized feedback interventions were well received by problem gamblers and materials may be helpful at reducing their gambling. • Internet tools like the CYG website are an easy to access and non-threatening portal that could be used to motivate participants to seek further help online or in person.