Online Interventions for Gamblers With and Without Co-occurring Problem Drinking

Online Interventions for Problem Gamblers With and Without Co-occurring Problem Drinking: Randomized Controlled Trial

Many problem gamblers are also problem drinkers,with lifetime prevalence in nationally representative samples ranging from 45% to 73%. Heavy drinking often occurs while problem gamblers are engaging in gambling activities, resulting in increased risky gambling behaviour. Further, co-occurring problem drinking negatively impacts on the treatment outcomes of problem gamblers. Thus, targeting problem drinking among problem gamblers may have the dual benefits of reducing both the problem drinking itself, and of acting as a mediator for reductions in problem gambling behaviour. The present study seeks to determine whether providing simultaneous access to help for gambling and drinking is of benefit for those with these co-occurring problems.

Problem gambling and problem drinking frequently co-occur. Further, the treatment needs of people with co-occurring gambling and drinking problems may be different from those of problem gamblers who do not drink alcohol in a hazardous fashion. The current project will evaluate whether there is a benefit to providing access to a problem drinking Internet intervention (G+A intervention) in addition to an Internet intervention for problem gambling (G-only intervention) in participants with gambling problems who do or do not have co-occurring problem drinking. People with gambling concerns will be recruited using targeted advertisements. Potential participants will be screened using an online survey to identify participants meeting criteria for problem gambling. As part of the baseline screening process, measures of alcohol consumption will be assessed. Eligible participants who agree to take part in the study will be randomized into one of two online interventions for gamblers - an intervention that only targets gambling issues (G-only) versus one that contains an intervention for drinking (G+A). It is predicted that for problem gamblers with co-occurring problem drinking, participants provided access to the G+A website will display significantly reduced gambling outcomes at three- and six-month follow-ups as compared to those provided access to the G-only website. However, for problem gamblers without co-occurring problem drinking, it is predicted that participants will display no significant difference between the G-only and G+A websites at three- and six-month follow-ups.

The gambling only Internet intervention (G-only) will consist of a new online version of self-change tools that have previously been translated successfully into an online form and shown to have a significant impact on gambling in three trials. A major focus of this intervention is to provide individuals with clear and concise behavioral and cognitive strategies for meeting the goal of reducing or quitting gambling.

The G+A intervention condition will consist of the G-only intervention and an online intervention for drinking. The online drinking intervention chosen is Check Your Drinking, a brief online intervention designed to provide personalized normative feedback aimed at motivating reductions in drinking

The gambling Internet intervention consists of a new online version of self-change tools that have previously been translated successfully into an online form and shown to have a significant impact on gambling in three trials. A major focus of this intervention is to provide individuals with clear and concise behavioral and cognitive strategies for meeting the goal of reducing or quitting gambling.

A brief online intervention designed to provide personalized normative feedback aimed at motivating reductions in drinking

The NORC DSM-IV Screen for Gambling Problems (NODS) past 3 month version indicating DSM-IV gambling severity.

Inclusion Criteria: 18 years of age or over Score of 3 or greater on the Problem Gambling Severity Index of the Canadian Problem Gambling Index (PGSI- CPGI) Exclusion Criteria: None

Cunningham JA, Hodgins DC, Keough M, Hendershot CS, Schell C, Godinho A. Online interventions for problem gamblers with and without co-occurring unhealthy alcohol use: Randomized controlled trial. Internet Interv. 2020 Jan 18;19:100307. doi: 10.1016/j.invent.2020.100307. eCollection 2020 Mar.

Cunningham JA, Hodgins DC, Keough M, Hendershot CS, Bennett K, Bennett A, Godinho A. Online interventions for problem gamblers with and without co-occurring problem drinking: study protocol of a randomized controlled trial. Trials. 2018 May 25;19(1):295. doi: 10.1186/s13063-018-2672-x.

Information about research at the Centre for Addiction and Mental Health, Canada's largest mental health and addiction teaching hospital, fully affiliated with the University of Toronto, and a PAHO/WHO Collaborating Centre