How learning misconceptions can improve outcomes and youth engagement with gambling education programs

Evaluation of Effectiveness of the Unplugged Program on Gambling Behaviours among Adolescents: Study Protocol of the Experimental Controlled Study "GAPUnplugged"

Gambling risk behaviour is an emerging problem among adolescents. "Unplugged" is an effective Social Influence curriculum for preventing substance use among students. This study aims to develop and test a new component focused on gambling added to the Unplugged program. Schools of Piedmont region and Rome city were invited to participate in the study. A self-completed anonymous questionnaire including questions on socio-demographic characteristics, addictive behaviours, beliefs, attitudes and risk perceptions about gambling, normative perceptions, parental practices, school climate, refusal skills, impulsiveness, self-esteem, antisocial behaviours and sensation seeking was prepared for baseline and follow-up surveys. The protocol of the study was submitted and approved by the Novara Ethical Committee and registered in ClinicalTrials.gov (NCT05630157, Protocol ID: 080.742, 11/17/2022). Twenty-nine schools accepted to participate in the study. Sixty-three classes (1325 students) satisfied the eligibility criteria for intervention and were allocated to the intervention arm, and the other 61 (1269 students) were allocated to the control arm. Because of drop-out, absentees, refusals, and invalid questionnaires, data on 1874 students (998 in the intervention and 876 in the control arm), were available for the analysis at baseline. Data management of follow-up questionnaires is in progress. Results of the present study will be useful to clarify the effectiveness of prevention interventions in reducing gambling behaviours among adolescents. Moreover, this will be the first experience of evaluating a new component focused on a different risk behaviour, added to a curriculum previously shown as effective on other risk behaviours.

The Price of Gambling: Examining Gambling Disorders

Gambling disorders are a serious public health problem. This manuscript will provide a comprehensive overview on this topic. Gambling disorder involves repeated patterns of gambling behaviors, that result in significant distress or impairment in a person's interpersonal relationships, employment, educational/career opportunities, and finances over a period of 12 months. Gambling is defined as an activity that involves risking something of value with the hopes of acquiring something of greater value. Comparable to substance use disorders, individuals with a gambling disorder may be unsuccessful in exercising control over their problematic behavior, engage in the behavior despite negative consequences, and have preoccupations/cravings to gamble. Gambling disorder has higher comorbidity rates of mental disorders including depression, anxiety, substance use, and personality disorders. Gamblers rarely seek treatment. Treatments must be tailored to the individual which may include psychological interventions, cognitive behavioral therapy, gamblers anonymous, and psychopharmacological agents such as selective serotonin reuptake inhibitors, mood stabilizers, and opioid antagonists to treat clinical symptoms.

Pictograms to aid laypeople in identifying the addictiveness of gambling products (PictoGRRed study)

The structural addictive characteristics of gambling products are important targets for prevention, but can be unintuitive to laypeople. In the PictoGRRed (Pictograms for Gambling Risk Reduction) study, we aimed to develop pictograms that illustrate the main addictive characteristics of gambling products and to assess their impact on identifying the addictiveness of gambling products by laypeople. We conducted a three-step study: (1) use of a Delphi consensus method among 56 experts from 13 countries to reach a consensus on the 10 structural addictive characteristics of gambling products to be illustrated by pictograms and their associated definitions, (2) development of 10 pictograms and their definitions, and (3) study in the general population to assess the impact of exposure to the pictograms and their definitions (n = 900). French-speaking experts from the panel assessed the addictiveness of gambling products (n = 25), in which the mean of expert's ratings was considered as the true value. Participants were randomly provided with the pictograms and their definitions, or with a standard slogan, or with neither (control group). We considered the control group as representing the baseline ability of laypeople to assess the addictiveness of gambling products. Each group and the French-speaking experts rated the addictiveness of 14 gambling products. The judgment criterion was the intraclass coefficients (ICCs) between the mean ratings of each group and the experts, reflecting the level of agreement between each group and the experts. Exposure to the pictograms and their definition doubled the ability of laypeople to assess the addictiveness of gambling products compared with that of the group that read a slogan or the control group (ICC = 0.28 vs. 0.14 (Slogan) and 0.14 (Control)). Laypeople have limited awareness of the addictive characteristics of gambling products. The pictograms developed herein represent an innovative tool for universally empowering prevention and for selective prevention.

Behavior Change Techniques and Delivery Modes in Interventions Targeting Adolescent Gambling: A Systematic Review

BACKGROUND

Adolescent gambling can lead to significant harms, yet participation rates continue to rise. Interventions targeting gambling reduction have been implemented in this population. However, it is not clear which behavior change techniques (BCTs) and modes of delivery (MOD) are most effective at reducing gambling.

OBJECTIVE

The objective of the study was to identify 'promising' BCTs and MODs by systematically reviewing interventions targeting adolescent gambling behavior. 'Promising' was defined as those present in at least 25% of all interventions and in at least two effective interventions.

METHODS

Three databases were searched (PsycINFO, Medline, and Scopus) from database inception to May 2021. Interventions were eligible if they were randomized controlled trials; targeting adolescents (aged 10-25 years); and assessing gambling behavior post-intervention. BCTs were identified using the Behavior Change Technique Taxonomy v1.

RESULTS

From the initial 3,315 studies, the removal of duplicates and ineligible articles resulted in sixteen studies included in the review. Eleven of these reported successfully reducing gambling behavior. Eighteen BCTs and six MODs were used across the interventions. The BCTs identified as promising were '4.2. Information about antecedents', '4.4. Behavioral experiments', '5.3. Information about social and environmental consequences', and '5.6. Information about emotional consequences'. Promising MODs were 'face-to-face', 'computer', and 'playable electronic storage'.

CONCLUSIONS

The study reviewed the content of interventions targeting adolescent gambling behavior. Four BCTs were identified as promising and should therefore be adopted in future interventions. To facilitate the delivery of these techniques, the study also identified three promising MODs. Interventions developed using these BCTs and MODs may successfully reduce adolescent gambling behavior.