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Journal article
Adapting an Evidence-Based e-Learning Cognitive Behavioral Therapy Program Into a Mobile App for People Experiencing Gambling-Related Problems: Formative Study
JMIR Formative Research, Vol.6(3), pp.1-19
2022
PMCID: PMC8994147
PMID: 35108213
Abstract
Many people who experience harm and problems from gambling do not seek treatment from gambling treatment services because of personal and resource barriers. Mobile health (mHealth) interventions are widely used across diverse health care areas and populations. However, there are few in the gambling harm field, despite their potential as an additional modality for delivering treatment and support.
This study aims to understand the needs, preferences, and priorities of people experiencing gambling harms and who are potential end users of a cognitive behavioral therapy mHealth intervention to inform design, features, and functions.
Drawing on a mixed methods approach, we used creators and domain experts to review the GAMBLINGLESS web-based program and convert it into an mHealth prototype. Each module was reviewed against the original evidence base to maintain its intended fidelity and conceptual integrity. Early wireframes, design ideas (look, feel, and function), and content examples were developed to initiate discussions with end users. Using a cocreation process with a young adult, a Māori, and a Pasifika peoples group, all with experiences of problem or harmful gambling, we undertook 6 focus groups: 2 cycles per group. In each focus group, participants identified preferences, features, and functions for inclusion in the final design and content of the mHealth intervention.
Over 3 months, the GAMBLINGLESS web-based intervention was reviewed and remapped from 4 modules to 6. This revised program is based on the principles underpinning the transtheoretical model, in which it is recognized that some end users will be more ready to change than others. Change is a process that unfolds over time, and a nonlinear progression is common. Different intervention pathways were identified to reflect the end users' stage of change. In all, 2 cycles of focus groups were then conducted, with 30 unique participants (13 Māori, 9 Pasifika, and 8 young adults) in the first session and 18 participants (7 Māori, 6 Pasifika, and 5 young adults) in the second session. Prototype examples demonstrably reflected the focus group discussions and ideas, and the features, functions, and designs of the Manaaki app were finalized. Attributes such as personalization, cultural relevance, and positive framing were identified as the key. Congruence of the final app attributes with the conceptual frameworks of the original program was also confirmed.
Those who experience gambling harms may not seek help. Developing and demonstrating the effectiveness of new modalities to provide treatment and support are required. mHealth has the potential to deliver interventions directly to the end user. Weaving the underpinning theory and existing evidence of effective treatment with end-user input into the design and development of mHealth interventions does not guarantee success. However, it provides a foundation for framing the intervention's mechanism, context, and content, and arguably provides a greater chance of demonstrating effectiveness.
Details
- Title
- Adapting an Evidence-Based e-Learning Cognitive Behavioral Therapy Program Into a Mobile App for People Experiencing Gambling-Related Problems: Formative Study
- Authors
- Gayl Humphrey (Corresponding Author) - University of AucklandJoanna Ting Chu - University of AucklandRebecca Ruwhiu-Collins - Hāpai Te Hauora | Māori Public Health (New Zealand)Stephanie Erick-Peleti - Hāpai Te Hauora | Māori Public Health (New Zealand)Nicki Dowling - Deakin UniversityStephanie Merkouris - Deakin UniversityDavid Newcombe - University of AucklandSimone Rodda - University of AucklandElsie Ho - University of AucklandVili Nosa - University of AucklandVarsha Parag - University of AucklandChristopher Bullen - University of Auckland
- Publication details
- JMIR Formative Research, Vol.6(3), pp.1-19
- Publisher
- JMIR Publications, Inc.
- Date published
- 2022
- DOI
- 10.2196/32940
- ISSN
- 2561-326X
- PMID
- 35108213; PMC8994147
- Copyright note
- ©Gayl Humphrey, Joanna Ting Chu, Rebecca Ruwhiu-Collins, Stephanie Erick-Peleti, Nicki Dowling, Stephanie Merkouris, David Newcombe, Simone Rodda, Elsie Ho, Vili Nosa, Varsha Parag, Christopher Bullen. Originally published in JMIR Formative Research (https://formative.jmir.org), 25.03.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.
- Grant note
- This study was funded by a New Zealand Health Research Council project grant (18-237), awarded through a contestable funding process.
- Organisation Unit
- School of Health - Psychology
- Language
- English
- Record Identifier
- 991196149602621
- Output Type
- Journal article
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