Pilot randomized controlled trial of an online intervention for problem gamblers

John A Cunningham, Alexandra Godinho, David C Hodgins, John A Cunningham, Alexandra Godinho, David C Hodgins

Abstract

Introduction: This pilot randomized controlled trial sought to evaluate whether an online intervention for problem gambling could lead to improved gambling outcomes compared to a no intervention control. Participants were recruited through a crowdsourcing platform.

Methods: Participants were recruited to complete an online survey about their gambling through the Mechanical Turk platform. Those who scored 5 or more on the Problem Gambling Severity Index and were thinking about quitting or reducing their gambling were invited to complete 6-week and 6-month follow-ups. Each potential participant who agreed was sent a unique password. Participants who used their password to log onto the study portal were randomized to either access an online intervention for gambling or to a no intervention control.

Results: A total of 321 participants were recruited, of which 87% and 88% were followed-up at 6 weeks and 6 months, respectively. Outcome analyses revealed that, while there were reductions in gambling from baseline to follow-ups, there was no significant observable impact of the online gambling intervention, as compared to a no intervention control condition.

Conclusions: While the current trial observed no impact of the intervention, replication is merited with a larger sample size, and with participants who are not recruited through a crowdsourcing platform.Trial registration: ClinicalTrials.govNCT03124589.

Keywords: Amazon Mechanical Turk; Data collection; Internet; Online web; Problem gambling; Research methods.

Figures

Fig. 1
Fig. 1
Trial consort diagram.

References

    1. Bertholet N., Godinhno A., Cunningham J.A. Smartphone application for unhealthy alcohol use: Pilot randomized controlled trial in the general population. Drug and Alcohol Dependence. 2019;195:101–105.
    1. Bucker L., Bierbrodt J., Hand I., Wittekind C., Moritz S. Effects of a depression-focused internet intervention in slot machine gamblers: A randomized controlled trial. PLoS One. 2018;13(6)
    1. Carlbring P., Smit F. Randomized trial of internet-delivered self-help with telephone support for pathological gamblers. Journal of Consulting and Clinical Psychology. 2008;76(6):1090–1094.
    1. Casey L.M., Oei T.P., Raylu N., Horrigan K., Day J., Ireland M., Clough B.A. Internet-based delivery of cognitive behaviour therapy compared to monitoring, feedback and support for problem gambling: A randomised controlled trial. Journal of Gambling Studies. 2017
    1. Cunningham J.A. Little use of treatment among problem gamblers. Psychiatric Services. 2005;56(8):1024–1025.
    1. Cunningham J.A., Godinho A., Bertholet N. 2019. Outcomes of two randomized controlled trials, employing participants recruited through Mechanical Turk, of internet interventions targeting unhealthy alcohol use. (under review)
    1. Cunningham J.A., Godinho A., Kushnir V. Can Amazon's Mechanical Turk be used to recruit participants for internet intervention trials? A pilot study involving a randomized controlled trial of a brief online intervention for hazardous alcohol use. Internet Interventions. 2017;10:12–16.
    1. Cunningham J.A., Godinho A., Kushnir V. Using Mechanical Turk to recruit participants for internet intervention research: Experience from recruitment for four trials targeting hazardous alcohol consumption. BMC Medical Research Methodology. 2017;17(1):156.
    1. Cunningham J.A., Hodgins D.C., Bennett K., Bennett A., Talevski M., Mackenzie C.S., Hendershot C.S. Online interventions for problem gamblers with and without co-occurring mental health symptoms: Protocol for a randomized controlled trial. BMC Public Health. 2016;16:624.
    1. Cunningham J.A., Hodgins D.C., Toneatto T. Problem gamblers' interest in self-help services. Psychiatric Services. 2008;59(6):695–696.
    1. Cunningham J.A., Hodgins D.C., Toneatto T. Pilot study of an internet-based personalized feedback intervention for problem gamblers. Journal of Gambling Issues. 2011;26:3–10.
    1. Cunningham J.A., Hodgins D.C., Toneatto T., Murphy M. A randomized controlled trial of a personalized feedback intervention for problem gamblers. PLoS One. 2012;7(2)
    1. Cunningham J.A., Hodgins D.C., Toneatto T., Rai A., Cordingley J. Pilot study of a personalized feedback intervention for problem gamblers. Behavior Therapy. 2009;40(3):219–224.
    1. Cunningham J.A., Kypri K., McCambridge J. Exploratory randomized controlled trial evaluating the impact of a waiting list control design. BMC Medical Research Methodology. 2013;13(1):150.
    1. Currie S.R., Hodgins D.C., Casey D.M. Validity of the Problem Gambling Severity Index interpretive categories. Journal of Gambling Studies. 2013;29(2):311–327.
    1. Diskin K.M., Hodgins D.C. A randomized controlled trial of a single session motivational intervention for concerned gamblers. Behaviour Research and Therapy. 2009;47(5):382–388.
    1. Ferris J., Wynne H. 2001. The Canadian problem gambling index: Final report. Retrieved from: .
    1. Hodgins D.C., Cunningham J.A., Murray R., Hagopian S. Online self-directed interventions for gambling disorder: Randomized controlled trial. Journal of Gambling Studies. 2019 (in press)
    1. Hodgins D.C., Currie S.R., Currie G., Fick G.H. Randomized trial of brief motivational treatments for pathological gamblers: More is not necessarily better. Journal of Consulting and Clinical Psychology. 2009;77(5):950–960.
    1. Hodgins D.C., Currie S.R., el-Guebaly N. Motivational enhancement and self-help treatments for problem gambling. Journal of Consulting and Clinical Psychology. 2001;69(1):50–57.
    1. Hodgins D.C., Fick G.H., Murray R., Cunningham J.A. Internet-based interventions for disordered gamblers: Study protocol for a randomized controlled trial of online self-directed cognitive-behavioural motivational therapy. BMC Public Health. 2013;13
    1. Kim S.W., Grant J.E., Potenza M.N., Blanco C., Hollander E. The gambling symptom assessment scale (G-SAS): A reliability and validity study. Psychitry Research. 2009;166(1):76–84.
    1. Luquiens A., Tanguy M.L., Lagadec M., Benyamina A., Aubin H.J., Reynaud M. The efficacy of three modalities of internet-based psychotherapy for non-treatment-seeking online problem gamblers: A randomized controlled trial. Journal of Medical Internet Research. 2016;18(2):e36.
    1. Merkouris S.S., Rodda S.N., Austin D., Lubman D.I., Harvey P., Battersby M.…Dowling N.A. GAMBLINGLESS: FOR LIFE study protocol: A pragmatic randomised trial of an online cognitive-behavioural programme for disordered gambling. BMJ Open. 2017;7(2)
    1. Peer E., Vosgerau J., Acquisti A. Reputation as a sufficient condition for data quality on Amazon Mechanical Turk. Behavioral Research Methods. 2014;46(4):1023–1031.
    1. Riper H., Blankers M., Hadiwijaya H., Cunningham J., Clarke S., Wiers R.…Cuijpers P. Effectiveness of guided and unguided low-intensity internet interventions for adult alcohol misuse: A meta-analysis. PLoS One. 2014;9(6)
    1. Slutske W.S. Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. American Journal of Psychiatry. 2006;163(2):297–302.
    1. Suurvali H., Hodgins D.C., Toneatto T., Cunningham J.A. Treatment-seeking among Ontario problem gamblers: Results of a population survey. Psychiatric Services. 2008;59:1343–1346.
    1. Suurvali H., Hodgins D.C., Toneatto T., Cunningham J.A. Hesitation to seek gambling-related treatment among Ontario problem gamblers. Journal of Addiction Medicine. 2012;6(1):39–49.
    1. Toce-Gerstein, M., & Volberg, R. A. (2004). The NODS-CLiP: A new brief screen for pathological gambling. Paper presented at the international symposium on problem gambling and co-occurring disorders, Mystic, CT. mhtml:
    1. Wulfert E., Hartley J., Lee M., Wang N., Franco C., Sodano R. Gambling screens: Does shortening the time frame affect their psychometric properties? Journal of Gambling Studies. 2005;21(4):521–536.

Source: PubMed

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