Effects of personalized and normative feedback via the Positive Play Quiz on responsible gambling intention, self-efficacy and behavior: A randomized controlled trial

Aims: To evaluate whether a personalized and normative feedback (PNF) intervention for responsible gambling increases gambling insight as well as intention and self-efficacy to engage in responsible gambling and behavioral engagement.

Design: Two-arm randomized controlled trial. Outcome measurements occurred post-randomization and 3 months later.

Setting: Online, Canada.

Participants: Canadian community members who gambled at a land-based casino or online in the last 3 months [61.9% men; mean age = 56.52 (standard deviation = 14.80)] recruited via an online panel (n = 4091).

Intervention and comparator: Participants were randomized to receive PNF (n = 1940) or no feedback (n = 2151).

Measurements: Primary outcomes included gambling insight, intentions and self-efficacy to engage in seven responsible gambling behaviors post-randomization as well as engagement in these behaviors during the 3-month follow-up.

Findings: Post-intervention, participants receiving PNF (relative to no feedback) had greater gambling insight (d = 0.32, P = 4.59^e-25) as well as greater intentions and self-efficacy to learn about how the games they play work (d_intention = 0.31, P = 4.92^e-24; d_{self-efficacy} = 0.25, P = 4.35^e-16), learn about the odds of winning at these games (d_intention = 0.30, P = 1.43^e-21; d_{self-efficacy} = 0.25, P = 2.13^e-15) and use operator-provided tools to help limit their gambling (d_intention = 0.20, P = 1.36^e-10; d_{self-efficacy} = 0.18, P = 3.92^e-9). However, post-intervention differences in intention and self-efficacy to limit time and money spent gambling, openness about gambling with others and balancing gambling with other activities were not observed. Meaningful increases in behavioral engagement 3 months later were observed but were not significant.

Conclusions: PNF for responsible gambling (relative to no feedback) appears to increase gambling insight, intentions and self-efficacy to engage in gambling literacy and use of limit-setting tools. Exploratory analyses indicated receiving PNF (relative to no feedback) led to behavioral changes during the 3-month follow-up period.