Feasibility and acceptability of safer gambling interventions (social norms and goal setting) delivered via text message for those at low-to-moderate risk of gambling harm: a four-arm randomised controlled feasibility study.

Abstract

OBJECTIVES: To assess the feasibility and acceptability of three SMS-delivered safer gambling interventions (goal setting (GS), descriptive norms (DN), injunctive norms (IN)) aimed at reducing the transition from low or moderate risk of gambling harm to problematic gambling, and the feasibility of a full-scale randomised controlled trial evaluating their effectiveness and cost-effectiveness. DESIGN: Four-arm, parallel-group, pragmatic, randomised controlled feasibility study with a nested qualitative study. SETTING: The study was conducted in the UK. Participants were recruited online via UK-licensed gambling operators' websites. PARTICIPANTS: Adults aged ≥18 years, gambling online at least weekly, with low-to-moderate gambling risk levels. INTERVENTIONS: Participants were block randomised in equal proportions to a delayed intervention control group or one of three 6-week text message interventions delivered via the secure messaging app WIRE: (1) GS: weekly prompts to set gambling-related goals with personalised feedback; (2) DN: weekly messages challenging misperceptions about peer gambling behaviours and (3) IN: weekly messages addressing misperceptions about peer attitudes towards gambling. OUTCOME MEASURES: Feasibility was assessed through recruitment and retention rates, intervention adherence, data completeness and feasibility and acceptability of the interventions and study procedures. Secondary outcomes included gambling risk behaviours and cognitions, anxiety, depression, quality of life, healthcare use and productivity, measured at baseline, 7-weeks, and 3- and 6-months post-randomisation. RESULTS: Recruitment took place between April 2021 and August 2022 with final follow-up in February 2023. 167 participants (mean age 51.5; 36% male) were randomised (GS=43; DN=41; IN=42; Control=41). Retention at 6-months was 95.2%, with >95% completion for all outcome measures. Intervention adherence was high, with >95% of DN and IN participants responding to ≥4 messages and 93% of GS participants setting ≥4 goals. Qualitative findings indicated broad acceptability of the interventions and study procedures. CONCLUSIONS: The study was feasible to conduct, interventions and study procedures acceptable to participants, and predefined progression criteria met. Findings support proceeding to a full-scale randomised controlled trial of effectiveness and cost-effectiveness, focusing on the social norms interventions. TRIAL REGISTRATION NUMBER: ISRCTN37874344.