Category: Addictive Behaviors
Multiple trials have been conducted examining the efficacy of personalized feedback interventions (PFIs) for curbing problematic gambling behaviors, although little is known about their content or efficacy. The purpose of the present systematic review and meta-analysis was to examine the content and efficacy of PFIs for gambling behaviors.
Studies were included if they assessed the efficacy of a PFI for gambling behavior administered in either a single in-person session or remotely (i.e., via telephone or mail) and were excluded if the PFI was a component of a larger intervention. Thirteen studies encompassing 19 unique interventions were reviewed.
The content of intervention materials was identified by multiple reviewers following a systematic coding procedure. Materials were coded based on higher-order components (n = 6; e.g., gambling profile) and lower-order facets (n = 51; e.g., dollars wagered per day). Nearly all PFIs contained a gambling profile (N = 15; e.g., behavioral feedback, functional feedback, or feedback on a gambling screening instrument). Conversely, didactic information (N = 12; e.g., corrective information about common gambling-related cognitive distortions) and normative feedback (N = 11; e.g., percentile comparisons) was present in approximately half of the interventions. Reframed costs (e.g., the amount of money lost per-hour gambling) were present in only one intervention.
The mean overall effect size was small (d = .31). No specific type nor number of components was related to the efficacy of PFIs, though interventions that demonstrated significant effects typically included a gambling profile and normative feedback. The delivery of these interventions in a motivational interviewing style does not appear necessary for optimizing their effect. Effect sizes were highest among studies with the least stringent inclusion criteria (e.g., “self-identified gambling problem” versus a cut-off score on a validated measure of gambling pathology), suggesting that they may be most efficacious in curbing less severe levels of gambling pathology.
Given the present findings, researchers and practitioners should consider designing PFIs to include both gambling profile and normative feedback. The small effect sizes suggest that gambling PFIs may need to be delivered on a large scale (e.g., in public health initiatives) in order to have maximum impact and that they could be incorporated as components or adjuncts to other therapeutic interventions, especially when treating individuals with more severe gambling pathology. Future directions should focus on variables that moderate the efficacy of PFIs, such as levels of pathology, or on dismantling studies that can experimentally examine the impact of content components on efficacy.
Samuel Peter– Graduate Student, University of Memphis, Memphis, Tennessee
Emma Brett– Graduate Student, Oklahoma State University, Stillwater, Oklahoma
Matthew Suda– Postdoctoral researcher, University of Tennessee Health Science Center
Eleanor Leavens– Graduate Student, Oklahoma State University, Stillwater, Oklahoma
Mary Beth Miller– Brown University, Rhode Island
Thad Leffingwell– Oklahoma State University
James Whelan– University of Memphis