Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.
Department of Psychiatry, University of Toronto, Toronto, Canada.
PLoS One. 2019 Apr 17;14(4):e0214502. doi: 10.1371/journal.pone.0214502. eCollection 2019.
Brief interventions have been increasingly investigated to promote early intervention in gambling problems; an accurate estimate of the impact of these interventions is required to justify their widespread implementation. The goal of the current investigation was to evaluate the efficacy of in-person brief interventions for reducing gambling behaviour and/or problems, by quantifying the aggregate effect size associated with these interventions in the published literature to date.
Randomized controlled trials including the following design features were identified via systematic review: an adult sample experiencing problems associated with gambling; an in-person individual psychosocial intervention of brief duration (≤3 sessions); a control/comparison group; and an outcome related to gambling behaviour and/or problems.
Five records compared brief interventions to assessment only control; using a random effect model, brief interventions were associated with a small but statistically significant reduction in gambling behaviour across short-term follow-up periods versus assessment only control (g = -.19, 95% CI [-.37, -.01]). Aggregate effect sizes for gambling problems and long-term follow-up periods were not statistically significant. Five records compared brief interventions to longer active interventions; there was no significant difference between brief interventions and longer active interventions.
Results supported the efficacy of brief interventions for problem gambling compared to inactive control in the reduction of gambling behaviour; no differences were found across brief versus longer interventions for both gambling behaviour and problems. While these findings must be interpreted in the context of the limited number of studies and small magnitude of the combined effect sizes, the current meta-analysis supports the further investigation of the public health impact of these cost-effective interventions.
简短干预措施已被越来越多地用于促进对赌博问题的早期干预;为了证明这些干预措施的广泛实施是合理的,需要对这些干预措施的影响进行准确评估。目前的研究目的是通过量化迄今为止已发表文献中这些干预措施的综合效应大小,来评估面对面的简短干预措施对减少赌博行为和/或问题的效果。
通过系统评价确定了具有以下设计特征的随机对照试验:一个有赌博问题的成年人样本;个体心理社会干预时间短(≤3 次);对照组或比较组;以及与赌博行为和/或问题相关的结果。
有 5 个记录比较了简短干预与仅评估对照;使用随机效应模型,与仅评估对照相比,简短干预在短期随访期间与赌博行为的减少相关,具有较小但统计学上显著的差异(g=-.19,95%CI [-.37,-.01])。针对赌博问题和长期随访期的综合效应大小没有统计学意义。有 5 个记录比较了简短干预与更长时间的主动干预;简短干预与更长时间的主动干预之间没有显著差异。
与不活跃的对照组相比,简短干预在减少赌博行为方面对赌博问题是有效的;简短干预与较长干预相比,在赌博行为和问题方面没有差异。虽然这些发现必须在研究数量有限和综合效应大小较小的背景下进行解释,但目前的荟萃分析支持进一步研究这些具有成本效益的干预措施对公共卫生的影响。