Delphi - Gesellschaft für Forschung, Beratung und Projektentwicklung mbH, Kaiserdamm 8, 14057, Berlin, Germany.
Federal Centre for Health Education (BZgA), Cologne, Germany.
J Gambl Stud. 2020 Dec;36(4):1341-1358. doi: 10.1007/s10899-019-09883-8.
Web-based interventions have the potential to reduce the treatment gap for problem gambling. In the past years, several web-based help options were made available to the public. However, only few studies were conducted to test their effects. This study investigated the efficacy of two interventions for problem gamblers provided online by the German Federal Center for Health Education (BZgA). The first intervention is the guided program "Check Out" (CO), the second is email counselling (EC). A web-based randomized controlled trial with follow-up surveys after 3, 6 and 12 months was conducted. Participants were allocated to CO, to EC or to a waitlist (WL). Outcomes were the degree of problem gambling according to the Problem Gambling Severity Index, the number of days gambled in past 30 days, the highest stake during the past 30 days and the subjective well-being (WHO-5). 167 individuals were included in the trial. In comparison to the WL at the 3 months follow-up, participants of CO showed significant improvements with moderate to strong effect sizes in all outcomes. Strongest effects were found in the problem gambling severity (d = 0.91; p = 0.023), followed by the well-being (d = 0.70; p = 0.011), the gambling days (d = 0.59; p = 0.001) and the highest stake (d = 0.55; p = 0.012). Improvements were sustained until last follow-up. Compared to the WL, users of EC had beneficiary results in the problem gambling severity (d = 0.74; p = 0.022). No significant effect differences were found between CO and EC. However, according to process evaluation, users of CO reported a significantly stronger working alliance than users of EC (d = 0.70; p = 0.019) and used the intervention considerably longer (d = 0.84; p = 0.004). CO helps treatment-seeking individuals to sustainably reduce their gambling behavior and to increase their general well-being. Compared to EC, CO seems a better support option, since its effects include a wider range of outcomes. Possible reasons are the more engaging program structure and elements of CO, as well as the closer interaction between client and counselor.
基于网络的干预措施有可能缩小赌博问题的治疗差距。在过去的几年中，已经向公众提供了几种基于网络的帮助选项。然而，只有少数研究对其效果进行了测试。本研究调查了德国联邦健康教育中心（BZgA）在线提供的两种针对赌博问题者的干预措施的效果。第一种干预措施是“Check Out”（CO）指导计划，第二种是电子邮件咨询（EC）。采用基于网络的随机对照试验，并在 3、6 和 12 个月后进行随访调查。参与者被分配到 CO、EC 或候补名单（WL）。结果是根据《赌博问题严重程度指数》评估的赌博问题严重程度、过去 30 天内赌博的天数、过去 30 天内的最高赌注以及主观幸福感（WHO-5）。共有 167 人参与了试验。与 3 个月随访时的 WL 相比，CO 组参与者在所有结局中均显示出显著改善，且具有中度至强的效应量。在赌博问题严重程度（d=0.91;p=0.023）方面效果最强，其次是幸福感（d=0.70;p=0.011）、赌博天数（d=0.59;p=0.001）和最高赌注（d=0.55;p=0.012）。这些改善一直持续到最后一次随访。与 WL 相比，EC 的使用者在赌博问题严重程度方面有受益效果（d=0.74;p=0.022）。CO 和 EC 之间没有发现显著的效果差异。然而，根据过程评估，CO 的使用者报告与 EC 的使用者相比，工作联盟要强得多（d=0.70;p=0.019），并且使用干预的时间明显更长（d=0.84;p=0.004）。CO 帮助寻求治疗的个体可持续地减少他们的赌博行为，并提高他们的整体幸福感。与 EC 相比，CO 似乎是一种更好的支持选择，因为它的效果包括更广泛的结果。可能的原因是 CO 具有更吸引人的程序结构和元素，以及客户和顾问之间更密切的互动。
