Prevention Messages for EGMs: Effects on Behaviours and Cognitions
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Prevention pop-up messages, Mandatory time limit, Responsible gambling information, Electronic gambling machine (model IGT GL20).
- Who it may be relevant to
- Registry conditions: Gambling. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Canada
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Messages de prévention Sur Les Appareils de Loterie vidéo : Effets Sur Les Comportements et Les Cognitions [Prevention Messages for Electronic Gambling Machines: Effects on Behaviours and Cognitions]
Overview
The goals of this randomized controlled trial are to test the manifold effects of prevention pop-up messages on participants' behaviours, cognitions and affects. This study is conducted among regular EGMs' players (defined as having played EGMs at least once every two weeks for the past 12 months) who are not classified as probable pathological gamblers by the PGSI. After answering a series of short questionnaires by phone, participants are asked to schedule a gambling session which is done in a laboratory on the university's campus. This laboratory replicates a typical bar, and is equipped with real EGMs. Participants are recruited under the false pretense of giving their opinion on the realism of the bar replica, and on the overall feeling of the gambling session in it. They are told that: (a) they are free to gamble as much and for as long as they like; (b) they are allowed to take breaks; (c) gambling is to be done with their own money; (d) the only compensation for participation are the potential winnings made while gambling; (e) net winnings across their whole session are paid, but losses are real. There is only one participant at a time in the laboratory for the gambling session. After having stopped by their own volition (some exceptions apply, see "Detailed Description" for further details), participants are debriefed on the real goals of this study and reimbursed any incurred losses while gambling. They are then be asked to answer another series of questionnaires.
Detailed description
EGMs and online gambling are the reputedly most damaging gambling type from a public health perspective. Pop-up messages are often used as a responsible gambling (RG) measure to prevent harm for these screen-based types of gambling. Despite some evidence of effectiveness in the literature for these messages, limitations persists, among which low ecological validity is of particular concern.
Indeed, gambling studies set in a controlled environment, usually a laboratory setting, often require participants to engage in a gambling task while wagering some form of virtual credits or money provided upfront by the researchers as a compensation for participation. Their behaviour is then assumed alike what would happen in a real gambling setting, even though gamblers are not risking their own money. Surprisingly, this assumption has not been subject to much scientific scrutiny. Moreover, some studies provide data which seems to contradict this assumption.
This study address this limitation by heightening the realism factor. This study starts with an intake interview by phone to evaluate eligibility, PGSI category, sociodemographic characteristics, gambling behaviours on EGMs (past 12 months), general level of fun while playing EGMs (past 12 months) and perceived self-control while playing EGMs. Participants are then asked to schedule a gambling session which is done in a laboratory on the university's campus. This laboratory replicates a typical bar, and is equipped with real EGMs. Participants are recruited under the false pretense of giving their opinion on the realism of the bar replica, and on the overall feeling of the gambling session in it. They are told that:
* They are free to gamble as much and for as long as they like. * They are allowed to take breaks. * Gambling is to be done with their own money. * The only compensation for participation are the potential winnings made while gambling. * Net winnings across their whole session are paid , but losses are real.
There is only one participant at a time in the laboratory for the gambling session. While in the bar replica, the participant is joined by a research assistant who plays the role of barmaid/barman. The assistant is there for general realism purposes, operating the cash register (Square terminal), and ensuring the general safety of the session. The bar replica has three EGMs, but only one can be played on and used to show the prevention pop-up messages. The other two EGMs are turned on for ambiance purposes, but have their money collector disabled to prevent participants playing on them or switching between EGMs mid-session. Limiting play to only one EGM also eases the recording of gambling behaviours and proper showing of the prevention messages. Participants are told the two "unusable" EGMs are awaiting to be serviced because of their money collector malfunction.
A second research assistant is located in an adjacent room. They are responsible for (a) recording all gambling behaviours using a computer connected to the EGM; and (b) operating the pop-up messages presentation schedule. A spy camera (disguised as a smoke detector) with a live-feed is used to observe gambling related behaviours that can't be recorded by the EGM's computer (e.g. taking a break).
The gambling session ends when the participant cashes out and unambiguously tell the research assistant they want to end their session. The participant is then brought to an office for a series of questionnaires which are, in order:
* Perception of realism of the bar replica and the gambling session in it. * Debriefing about the true goals of the study and validation of consent to participate in the study. At this point, participants will be able to guess in which group they were assigned. * Prevention pop-up messages recall (free and cued recall). * Cognitive and emotional response to prevention pop-up messages. * Evaluation of protocol credibility (i.e. if participant really believed they were gambling their own money and were really risking their own money).
Note that while the participant is told they can gamble for as long as they like, in reality there is a 2 hours time limit to the gambling session duration. This time limit is hidden from the participant. The gambling session starts with the first time money is inserted in the EGM by the participant (the "clock" is set at 0 hours) and ends with either the participant ending it of their own volition or upon reaching the time limit (2 hours). Breaks during gambling session are permitted (e.g. for going to the bathroom, for buying snacks from the barman/barmaid, etc.) and don't stop the "clock".
If the participant has not yet ended their gambling session on their own volition upon reaching the 2 hours time limit, they will be asked to take a small break to answer some questions. The existence of a time limit will be communicated to them during the debriefing. In the eventuality of a participant refusing to stop playing or wanting to rapidly quit the laboratory (e.g. because they are angry about losing money), the debriefing will be done earlier, before the questionnaire about their perception of realism of the bar replica and the gambling session in it. While not optimal, early debriefing is nevertheless considered acceptable in order to force the end of the gambling session or to prevent a participant from hastily quitting the study without receiving all the information to make an informed decision about their participation. There will be no more gambling done after debriefing.
Upon debriefing the participant will be reimbursed all money lost (if any).
The mains objectives are to test to what extent do RG pop-up messages affect:
1. Participants' gambling behavior (e.g. money betted, gambling session length, gambling intensity, etc.). 2. Participants' cognitions (e.g. thoughts elicited by messages, perceived effectiveness of message, etc.). 3. Participants' emotions (e.g. enjoyment of gambling, emotional response to messages, etc.).
Secondary objectives are to test:
1. to what extent are the main effects moderated by participants' characteristics (e.g., gender, age, education, PGSI category, etc.). 2. the feasibility of studies conducted in a laboratory setting with the use of real money (or using deception to make the participants believe they are gambling their own money). This objective is answered with four sub-questions:
* Was it possible to recruit enough participants for the study considering they were confronted with the prospect of loosing their own money by participating in the study and were not guaranteed any compensation other than what they could win on the EGMs? * Did the laboratory "bar" replicated well the overall "vibe" of a typical gambling venue with EGMs? * Did the participants found their gambling session in the bar replica as realistic as a real one? * Did the participants believed they were gambling their own money during the study (i.e. to what extent did the deception worked)?
Interventions
- Behavioral Prevention pop-up messages
Messages are shown full screen on the EGM's play screen on a fixed presentation schedule. Clock of the gambling session starts the first time the participant puts money in the EGM. From this event, messages are shown at those timepoints: \[1\] +10 minutes; \[2\] +40 minutes; \[3\] +70 minutes; \[4\] +100 minutes. Messages block the screen for 15 seconds before automatically closing. Up to 4 different messages are presented during the gambling session. Order is determined by sortition without rep - Behavioral Mandatory time limit
Activated either when (a) the previous time limit is up; or (b) the player bank meter reaches $0. When the previous time limit is up, a pop-up takes up the upper third of the play screen and requires the player to set a new time limit using one of five choice buttons (four firsts buttons: 15, 30, 45 or 60 minutes; fifth button: cash out, which prints a receipt and ends the gambling session). As the EGM cannot track who is playing, there are no limits on consecutive gambling sessions. When the pl - Behavioral Responsible gambling information
Located in a submenu accessed through a button on the main touch screen. This open a window which contains basic information on randomness and responsible gambling advice. The information is presented in small white font on a black background. - Device Electronic gambling machine (model IGT GL20)
EGM model currently in use in Quebec, Canada, the location where this study is conducted. The EGMs used in this study are fully functional and unaltered except for the presentation of prevention pop-up messages in the experimental arm of this study. These machines are equipped with basics responsible gambling features, the two main ones described in this section (i.e. "Mandatory time limit"; "Responsible gambling information"). Wins/losses sequence is fully randomized and not determined beforeha - Device Square terminal
This terminal allows for buying non-alcoholic beverages (soft drinks or coffee) and chips during the experimentation. This is done to enhance the realism of the bar setting. It also allows for real cash withdrawal from bank account during gambling session. Quebec's code of conduct for EGMs commercialization prohibits retailers from having an ATM near their EGMs, and prohibits them from lending money to consumers or withdrawing cash for them to gamble. However, this rule is not always followed in
Primary outcome measures
- Gambling behaviour (between group) - Gambling session's total duration [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Gambling behaviour (between group) - Total time effectively spent gambling [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Gambling behaviour (between group) - Number of breaks taken [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Gambling behaviour (between group) - Mean breaks' duration [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Gambling behaviour (between group) - Total breaks duration [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Gambling behaviour (between group) - Mean time elapsed between breaks [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Gambling behaviour (between group) - Money betted (physical) [Time frame: Assessed at following timepoints from start of gambling session in the laboratory (Experiment phase; 0 hours 0 minutes): [1] +10 minutes; [2] +40 minutes; [3] +70 minutes; [4] +100 minutes; [5] end of gambling session (+2 hours maximum).]
- Gambling behaviour (between group) - Money betted (all) [Time frame: Assessed at following timepoints from start of gambling session in the laboratory (Experiment phase; 0 hours 0 minutes): [1] +10 minutes; [2] +40 minutes; [3] +70 minutes; [4] +100 minutes; [5] end of gambling session (+2 hours maximum).]
- Gambling behaviour (between group) - Number of bets placed [Time frame: Assessed at following timepoints from start of gambling session in the laboratory (Experiment phase; 0 hours 0 minutes): [1] +10 minutes; [2] +40 minutes; [3] +70 minutes; [4] +100 minutes; [5] end of gambling session (+2 hours maximum).]
- Gambling behaviour (between group) - Gambling speed [Time frame: Assessed at following timepoints from start of gambling session in the laboratory (Experiment phase; 0 hours 0 minutes): [1] +10 minutes; [2] +40 minutes; [3] +70 minutes; [4] +100 minutes; [5] end of gambling session (+2 hours maximum).]
Secondary outcome measures (12)
- Perceived realism - Gambling location type most resembling the session in the laboratory [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Perceived realism - Session in the laboratory VS gambling on EGMs in a bar/restaurant [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Perceived realism - Similarities between session in the laboratory VS gambling on EGMs in a bar/restaurant [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Perceived realism - Differences between session in the laboratory VS gambling on EGMs in a bar/restaurant [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Perceived realism - What could be done to heighten realism of the session in the laboratory [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Perceived realism - Effect of using one own money on realism [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Perceived realism - Effect of using one own money on realism (free) [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Perceived correspondence between habitual gambling behaviour and gambling behaviour during the session in the laboratory [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Perceived correspondence between habitual gambling behaviour and gambling behaviour during the session in the laboratory (free) [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Protocol credibility [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Protocol credibility (free) [Time frame: Assessed at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).]
- Recruitment potential - Volunteers [Time frame: Assessed after recruitment for the study is ended (80 participants recruited) or 1 year after recruitment for the study has begun, whichever came first.]
Eligibility criteria
Inclusion criteria
- At least 18 years old (legal age to gamble in Quebec, Canada, where the study is conducted)
- Functional literacy in french (study is conducted in french and requires reading and understanding simple texts)
- Having played EGMs and least once every two weeks for the past 12 months
Exclusion criteria
- Classified as a probable pathological gambler (score ≥ 8 on the PGSI)
- Currently receiving treatment for problem gambling
- Currently under self-exclusion from gambling venues
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Prevention
Study locations
Canada · 1 center
- Centre québécois d'excellence pour la prévention et le traitement du jeu — Québec
Publications
- Dillard JP, Shen L. On the nature of reactance and its role in persuasive health communication. Communication monographs. 2005; 72(2): 144-168.
- Ferris J, Wynne H. The Canadian Problem Gambling Index: Final Report. 2001. https://www.greo.ca/Modules/EvidenceCentre/files/Ferris%20et%20al(2001)The_Canadian_Problem_Gambling_Index.pdf
- Delfabbro P, King DL, Browne M, Dowling NA. Do EGMs have a Stronger Association with Problem Gambling than Racing and Casino Table Games? Evidence from a Decade of Australian Prevalence Studies. J Gambl Stud. 2020 Jun;36(2):499-511. doi: 10.1007/s10899-020-09950-5. PMID 32306234
- Bjorseth B, Simensen JO, Bjornethun A, Griffiths MD, Erevik EK, Leino T, Pallesen S. The Effects of Responsible Gambling Pop-Up Messages on Gambling Behaviors and Cognitions: A Systematic Review and Meta-Analysis. Front Psychiatry. 2021 Jan 25;11:601800. doi: 10.3389/fpsyt.2020.601800. eCollection 2020. PMID 33569015
- Ginley MK, Whelan JP, Pfund RA, Peter SC, Meyers AW. Warning messages for electronic gambling machines: evidence for regulatory policies. Addiction Research & Theory. 2017; 25(6): 495-504. doi: 10.1080/16066359.2017.1321740
- Livingstone C, Rintoul A, Francis L. What is the evidence for harm minimisation measures in gambling venues? Evidence Base: A Journal of Evidence Reviews in Key Policy Areas. 2014; (2), 1-24. https://search.informit.org/doi/10.3316/informit.
- Williams RJ, West BL, Simpson RI. Prevention of problem gambling: A comprehensive review of the evidence and identified best practices. 2012. https://opus.uleth.ca/bitstream/handle/10133/3121/2012-PREVENTION-OPGRC.pdf?sequence=3&isAllowed=y
- MacLaren VV. Video Lottery is the Most Harmful Form of Gambling in Canada. J Gambl Stud. 2016 Jun;32(2):459-85. doi: 10.1007/s10899-015-9560-z. PMID 26233645
Identifiers
NCT: NCT06341504 · ALVMsg2023 · 263472