Miller Martine, Howell Freya, White James, Griffiths Dave, Noble Leon, Weir Christopher J, Niven Angela, Stoddart Andrew, Ensor Hanna, Wardle Heather, Purves Richard, Dobbie Fiona
Usher Institute, University of Edinburgh, Edinburgh, UK.
Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK.
BMC Public Health. 2025 Jul 3;25(1):2327. doi: 10.1186/s12889-025-23565-8.
Young people’s engagement in gambling can be linked to gambling-related harm. This can cause stress, anxiety, relationship issues, debt, and lost opportunities. There is a lack of independently funded, and evidence-based school-based interventions that seek to prevent and reduce the harms associated with gambling. PRoGRAM-A is one of the first independently research funded interventions to prevent gambling related harm in adolescents. This paper presents findings from an embedded process evaluation of the pilot cluster randomised control trial of PRoGRAM-A, with a specific focus on intervention fidelity, feasibility and acceptability.
Multi-modal study design comprised of qualitative focus groups with students ( = ); and individual interviews with teachers ( = ), PRoGRAM-A trainers ( = ), student friends and family ( = ) and stakeholders ( = ). Structured Observations of the full cycle of PRoGRAM-A across two intervention schools were also undertaken.
PRoGRAM-A was delivered with a high degree of fidelity (95%) to the training manual. It was also found to be both feasible and acceptable to students, staff and parents. It was appealing to schools as it allowed teachers to address the topic of gambling, which had already been flagged as an issue for some of the schools, but they lacked the skill and capacity to take action. Peer Supporters enjoyed the interactive nature of the training workshop. Parents and carers were supportive of the intervention and stakeholders recognised the growing need for a non-industry funded school-based intervention to raise awareness among students of gambling and gambling-related harm (GRH). Suggested intervention refinements include embedding examples of lived experience to aid students’ engagement with the topic of gambling and GRH. Increasing social skills activities to ensure students are comfortable and confident when initiating conversations and making follow-up sessions more interactive (in-line with the two-day workshop).
This study demonstrated that it is feasible and acceptable to deliver the PRoGRAM-A gambling harm reduction intervention within secondary schools with a high degree of fidelity. Addressing the topic of gambling and GRH within the school curriculum was deemed to be acceptable by all sample groups, including students.
Research Registry researchregistry8699.
The online version contains supplementary material available at 10.1186/s12889-025-23565-8.
年轻人参与赌博可能会导致与赌博相关的危害。这可能会引发压力、焦虑、人际关系问题、债务以及机会丧失。目前缺乏独立资助且基于证据的校内干预措施来预防和减少与赌博相关的危害。“项目A”是首批获得独立研究资助以预防青少年赌博相关危害的干预措施之一。本文介绍了对“项目A”试点整群随机对照试验进行的嵌入式过程评估结果，特别关注干预的保真度、可行性和可接受性。
多模式研究设计包括与学生进行的定性焦点小组访谈（ = ）；以及与教师（ = ）、“项目A”培训师（ = ）、学生的朋友和家人（ = ）以及利益相关者（ = ）进行的个人访谈。还对两所干预学校的“项目A”全周期进行了结构化观察。
“项目A”在很大程度上忠实于培训手册（保真度为95%）。研究还发现，它对学生、教职员工和家长来说既可行又可接受。它对学校有吸引力，因为它使教师能够处理赌博这一话题，而这对一些学校来说已经是一个问题，但他们缺乏采取行动的技能和能力。同伴支持者喜欢培训工作坊的互动性质。家长和照顾者支持这项干预措施，利益相关者认识到越来越需要一项非行业资助的校内干预措施，以提高学生对赌博及与赌博相关危害（GRH）的认识。建议的干预改进措施包括融入实际生活经验的例子，以帮助学生参与赌博和GRH这一话题。增加社交技能活动，以确保学生在发起对话时感到舒适和自信，并使后续课程更具互动性（与为期两天的工作坊一致）。
本研究表明，在中学内以高保真度实施“项目A”减少赌博危害干预措施是可行且可接受的。在学校课程中涉及赌博和GRH这一话题被所有样本群体（包括学生）认为是可以接受的。
研究注册库researchregistry8699。
在线版本包含可在10.1186/s12889 - 025 - 23565 - 8获取的补充材料。
