针对成年赌徒的即时自适应干预措施（赌博习惯破解器）的智能手机应用程序交付：一项微随机试验的方案。

Smartphone App Delivery of a Just-In-Time Adaptive Intervention for Adult Gamblers (Gambling Habit Hacker): Protocol for a Microrandomized Trial.

作者信息

Rodda Simone N, Bagot Kathleen L, Merkouris Stephanie S, Youssef George, Lubman Dan I, Thomas Anna C, Dowling Nicki A

机构信息

Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand.

School of Psychology, Deakin University, Geelong, Australia.

出版信息

JMIR Res Protoc. 2022 Jul 26;11(7):e38919. doi: 10.2196/38919.

DOI:10.2196/38919

PMID:35881441

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9364163/

Abstract

BACKGROUND

People with gambling problems frequently report repeated unsuccessful attempts to change their behavior. Although many behavior change techniques are available to individuals to reduce gambling harm, they can be challenging to implement or maintain. The provision of implementation support tailored for immediate, real-time, individualized circumstances may improve attempts at behavior change.

OBJECTIVE

We aimed to develop and evaluate a Just-In-Time Adaptive Intervention (JITAI) for individuals who require support to adhere to their gambling limits. JITAI development is based on the principles of the Health Action Process Approach with delivery, in alignment with the principles of self-determination theory. The primary objective was to determine the effect of action- and coping planning compared with no intervention on the goal of subsequently adhering to gambling expenditure limits.

METHODS

Gambling Habit Hacker is delivered as a JITAI providing in-the-moment support for adhering to gambling expenditure limits (primary proximal outcome). Delivered via a smartphone app, this JITAI delivers tailored behavior change techniques related to goal setting, action planning, coping planning, and self-monitoring. The Gambling Habit Hacker app will be evaluated using a 28-day microrandomized trial. Up to 200 individuals seeking support for their own gambling from Australia and New Zealand will set a gambling expenditure limit (ie, goal). They will then be asked to complete 3 time-based ecological momentary assessments (EMAs) per day over a 28-day period. EMAs will assess real-time adherence to gambling limits, strength of intention to adhere to goals, goal self-efficacy, urge self-efficacy, and being in high-risk situations. On the basis of the responses to each EMA, participants will be randomized to the control (a set of 25 self-enactable strategies containing names only and no implementation information) or intervention (self-enactable strategy implementation information with facilitated action- and coping planning) conditions. This microrandomized trial will be supplemented with a 6-month within-group follow-up that explores the long-term impact of the app on gambling expenditure (primary distal outcome) and a range of secondary outcomes, as well as an evaluation of the acceptability of the JITAI via postintervention surveys, app use and engagement indices, and semistructured interviews. This trial has been approved by the Deakin University Human Research Ethics Committee (2020-304).

RESULTS

The intervention has been subject to expert user testing, with high acceptability scores. The results will inform a more nuanced version of the Gambling Habit Hacker app for wider use.

CONCLUSIONS

Gambling Habit Hacker is part of a suite of interventions for addictive behaviors that deliver implementation support grounded in lived experience. This study may inform the usefulness of delivering implementation intentions in real time and in real-world settings. It potentially offers people with gambling problems new support to set their gambling intentions and adhere to their limits.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12622000497707; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383568.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/38919.

摘要

背景

有赌博问题的人经常报告称，他们多次尝试改变行为但均未成功。尽管个人可以采用多种行为改变技巧来减少赌博危害，但实施或维持这些技巧可能具有挑战性。针对即时、实时、个性化情况提供量身定制的实施支持，可能会提高行为改变的尝试效果。

目的

我们旨在为需要支持以遵守赌博限额的个人开发并评估一种即时自适应干预（JITAI）。JITAI的开发基于健康行动过程方法的原则，并结合自我决定理论的原则进行实施。主要目标是确定与不进行干预相比，行动规划和应对规划对随后遵守赌博支出限额这一目标的影响。

方法

“赌博习惯破解者”作为一种JITAI提供，为遵守赌博支出限额（主要近端结果）提供即时支持。通过智能手机应用程序提供此JITAI，它提供与目标设定、行动规划、应对规划和自我监测相关的量身定制的行为改变技巧。“赌博习惯破解者”应用程序将通过一项为期28天的微随机试验进行评估。来自澳大利亚和新西兰的多达200名寻求解决自身赌博问题支持的个人将设定一个赌博支出限额（即目标）。然后，他们将被要求在28天内每天完成3次基于时间的生态瞬时评估（EMA）。EMA将评估对赌博限额的实时遵守情况、遵守目标的意图强度、目标自我效能感、冲动自我效能感以及处于高风险情境的情况。根据对每次EMA的回答，参与者将被随机分配到对照组（一组仅包含名称且无实施信息的25种自我制定策略）或干预组（带有便利的行动和应对规划的自我制定策略实施信息）。这项微随机试验将辅以一项为期6个月的组内随访，以探讨该应用程序对赌博支出（主要远端结果）和一系列次要结果的长期影响，以及通过干预后调查、应用程序使用和参与指数以及半结构化访谈对JITAI可接受性的评估。该试验已获得迪肯大学人类研究伦理委员会批准（2020 - 304）。