{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:15:15Z","timestamp":1764890115775,"version":"3.46.0"},"reference-count":55,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008625","name":"GambleAware","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,19]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Objectives<\/jats:title>\n To assess the feasibility and acceptability of three SMS-delivered safer gambling interventions (goal setting (GS), descriptive norms (DN), injunctive norms (IN)) aimed at reducing the transition from low or moderate risk of gambling harm to problematic gambling, and the feasibility of a full-scale randomised controlled trial evaluating their effectiveness and cost-effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Four-arm, parallel-group, pragmatic, randomised controlled feasibility study with a nested qualitative study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The study was conducted in the UK. Participants were recruited online via UK-licensed gambling operators\u2019 websites.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Adults aged \u226518 years, gambling online at least weekly, with low-to-moderate gambling risk levels.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were block randomised in equal proportions to a delayed intervention control group or one of three 6-week text message interventions delivered via the secure messaging app WIRE: (1) GS: weekly prompts to set gambling-related goals with personalised feedback; (2) DN: weekly messages challenging misperceptions about peer gambling behaviours and (3) IN: weekly messages addressing misperceptions about peer attitudes towards gambling.<\/jats:p>\n <\/jats:sec>\n \n Outcome measures<\/jats:title>\n Feasibility was assessed through recruitment and retention rates, intervention adherence, data completeness and feasibility and acceptability of the interventions and study procedures. Secondary outcomes included gambling risk behaviours and cognitions, anxiety, depression, quality of life, healthcare use and productivity, measured at baseline, 7-weeks, and 3- and 6-months post-randomisation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Recruitment took place between April 2021 and August 2022 with final follow-up in February 2023. 167 participants (mean age 51.5; 36% male) were randomised (GS=43; DN=41; IN=42; Control=41). Retention at 6-months was 95.2%, with >95% completion for all outcome measures. Intervention adherence was high, with >95% of DN and IN participants responding to \u22654 messages and 93% of GS participants setting \u22654 goals. Qualitative findings indicated broad acceptability of the interventions and study procedures.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The study was feasible to conduct, interventions and study procedures acceptable to participants, and predefined progression criteria met. Findings support proceeding to a full-scale randomised controlled trial of effectiveness and cost-effectiveness, focusing on the social norms interventions.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n ISRCTN37874344<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-104784","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T11:15:31Z","timestamp":1760699731000},"page":"e104784","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and acceptability of safer gambling interventions (social norms and goal setting) delivered via text message for those at low-to-moderate risk of gambling harm: a four-arm randomised controlled feasibility study"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"isrctn37874344","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5954-2598","authenticated-orcid":false,"given":"Emily","family":"Arden-Close","sequence":"first","affiliation":[{"name":"School of Psychology, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9501-9091","authenticated-orcid":false,"given":"Sarah","family":"Thomas","sequence":"additional","affiliation":[{"name":"Faculty of Health, Environment and Medical Sciences, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6300-6117","authenticated-orcid":false,"given":"Reece","family":"Bush-Evans","sequence":"additional","affiliation":[{"name":"School of Psychology, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Hamson-Ford","sequence":"additional","affiliation":[{"name":"School of Psychology, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvira","family":"Bolat","sequence":"additional","affiliation":[{"name":"Bournemouth University Business School, Faculty of Business and Law, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Hodge","sequence":"additional","affiliation":[{"name":"School of Sciences, Bath Spa University, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Phalp","sequence":"additional","affiliation":[{"name":"School of Computing and Engineering, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruijie","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Psychology, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"McAlaney","sequence":"additional","affiliation":[{"name":"School of Psychology, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"2025120415071102000_15.10.e104784.1","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1080\/14459795.2017.1331252","article-title":"A typical problem gambler affects six others","volume":"17","author":"Goodwin","year":"2017","journal-title":"Int Gambl Stud"},{"key":"2025120415071102000_15.10.e104784.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-019-7391-z","article-title":"Public health effects of gambling - debate on a conceptual model","volume":"19","author":"Latvala","year":"2019","journal-title":"BMC Public Health"},{"key":"2025120415071102000_15.10.e104784.3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S2468-2667(24)00167-1","article-title":"The Lancet Public Health Commission on gambling","volume":"9","author":"Wardle","year":"2024","journal-title":"Lancet Public Health"},{"key":"2025120415071102000_15.10.e104784.4","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2020.598589","article-title":"Reducing Internet Gambling Harms Using Behavioral Science: A Stakeholder Framework","volume":"11","author":"Gainsbury","year":"2020","journal-title":"Front Psychiatry"},{"key":"2025120415071102000_15.10.e104784.5","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s10899-023-10258-3","article-title":"Online Gambling: A Systematic Review of Risk and Protective Factors in the Adult Population","volume":"40","author":"Ghelfi","year":"2024","journal-title":"J Gambl Stud"},{"key":"2025120415071102000_15.10.e104784.6","doi-asserted-by":"crossref","first-page":"108037","DOI":"10.1016\/j.addbeh.2024.108037","article-title":"The impact of COVID-19 pandemic on gambling: A systematic review","volume":"155","author":"Catalano","year":"2024","journal-title":"Addict Behav"},{"key":"2025120415071102000_15.10.e104784.7","unstructured":"Gambling Commission . Statistics on gambling participation - annual report year 1 (2023): official statistics. Available: https:\/\/www.gamblingcommission.gov.uk\/statistics-and-research\/publication\/statistics-on-gambling-participation-annual-report-year-1-2023-official [Accessed 20 Mar 2023]."},{"key":"2025120415071102000_15.10.e104784.8","doi-asserted-by":"crossref","first-page":"2972","DOI":"10.1111\/add.15952","article-title":"Global prevalence of help-seeking for problem gambling: A systematic review and meta-analysis","volume":"117","author":"Bijker","year":"2022","journal-title":"Addiction"},{"key":"2025120415071102000_15.10.e104784.9","unstructured":"Office for Health Improvement & Disparities . Gambling-related harms evidence review: summary. Available: https:\/\/www.gov.uk\/government\/publications\/gambling-related-harms-evidence-review\/gambling-related-harms-evidence-review-summary\u20132 [Accessed 20 Mar 2025]."},{"key":"2025120415071102000_15.10.e104784.10","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.chb.2015.10.006","article-title":"Is all Internet gambling equally problematic? Considering the relationship between mode of access and gambling problems","volume":"55","author":"M. Gainsbury","year":"2016","journal-title":"Comput Human Behav"},{"key":"2025120415071102000_15.10.e104784.11","unstructured":"Bennett J . EGR report: egaming review london, uk. 2013. Available: http:\/\/www.egrmagazine.com\/writeable\/editor_uploads\/pdf\/2013_EGR_Mobile-report.pdf"},{"key":"2025120415071102000_15.10.e104784.12","doi-asserted-by":"publisher","DOI":"10.1080\/14459795.2017.1388831"},{"key":"2025120415071102000_15.10.e104784.13","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s10899-020-09935-4","article-title":"Unguided Chatbot-Delivered Cognitive Behavioural Intervention for Problem Gamblers Through Messaging App: A Randomised Controlled Trial","volume":"36","author":"So","year":"2020","journal-title":"J Gambl Stud"},{"key":"2025120415071102000_15.10.e104784.14","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibx019"},{"key":"2025120415071102000_15.10.e104784.15","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s10899-019-09873-w","article-title":"An Exploratory RCT to Support Gamblers\u2019 Intentions to Stick to Monetary Limits: A Brief Intervention Using Action and Coping Planning","volume":"36","author":"Rodda","year":"2020","journal-title":"J Gambl Stud"},{"key":"2025120415071102000_15.10.e104784.16","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1037\/mot0000127","article-title":"The development of goal setting theory: A half century retrospective","volume":"5","author":"Locke","year":"2019","journal-title":"Motiv Sci"},{"key":"2025120415071102000_15.10.e104784.17","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-013-9486-6"},{"key":"2025120415071102000_15.10.e104784.18","unstructured":"Cialdini R , Trost MR . Social influence, social.s, conformity and compliance. In: Gilbert DT , Fiske ST , Lindzey G , eds. The Handbook of Social Psychology. New York: McGraw Hill, 1998: 151\u201392."},{"key":"2025120415071102000_15.10.e104784.19","first-page":"81","article-title":"The international development of the \u2018Social Norms\u2019 approach to drug education and prevention","volume":"18","author":"McAlaney","year":"2011","journal-title":"Drugs: Education, Prevention and Policy"},{"key":"2025120415071102000_15.10.e104784.20","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2018.02180","article-title":"A Critical Appraisal of the Social Norms Approach as an Interventional Strategy for Health-Related Behavior and Attitude Change","volume":"9","author":"Dempsey","year":"2018","journal-title":"Front Psychol"},{"key":"2025120415071102000_15.10.e104784.21","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1037\/a0039125","article-title":"Efficacy of personalized normative feedback as a brief intervention for college student gambling: a randomized controlled trial","volume":"83","author":"Neighbors","year":"2015","journal-title":"J Consult Clin Psychol"},{"key":"2025120415071102000_15.10.e104784.22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0248262","article-title":"The efficacy of Personalized Normative Feedback interventions across addictions: A systematic review and meta-analysis","volume":"16","author":"Saxton","year":"2021","journal-title":"PLoS ONE"},{"key":"2025120415071102000_15.10.e104784.23","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1007\/s11469-016-9668-0","article-title":"Understanding the Effects of Social Desirability on Gambling Self-Reports","volume":"15","author":"Goldstein","year":"2017","journal-title":"Int J Ment Health Addiction"},{"key":"2025120415071102000_15.10.e104784.24","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1037\/adb0000792","article-title":"Accuracy of self-reported gambling frequency and outcomes: Comparisons with account data","volume":"36","author":"Heirene","year":"2022","journal-title":"Psychol Addict Behav"},{"key":"2025120415071102000_15.10.e104784.25","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i5239","article-title":"CONSORT 2010 statement: extension to randomised pilot and feasibility trials","volume":"355","author":"Eldridge","year":"2016","journal-title":"BMJ"},{"key":"2025120415071102000_15.10.e104784.26","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-065400","article-title":"Social norms and goal-setting interventions to promote responsible gambling in low-to-moderate online gamblers: protocol for a four-arm randomised controlled feasibility study","volume":"13","author":"Arden-Close","year":"2023","journal-title":"BMJ Open"},{"key":"2025120415071102000_15.10.e104784.27","unstructured":"Ferris J , Wynne H . The Canadian Problem Gambling Index: User Manual. Ottawa: Canadian Centre on Substance Abuse, 2001."},{"key":"2025120415071102000_15.10.e104784.28","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013537","article-title":"Informing efficient randomised controlled trials: exploration of challenges in developing progression criteria for internal pilot studies","volume":"7","author":"Avery","year":"2017","journal-title":"BMJ Open"},{"key":"2025120415071102000_15.10.e104784.29","doi-asserted-by":"publisher","DOI":"10.1037\/a0034431"},{"key":"2025120415071102000_15.10.e104784.30","doi-asserted-by":"crossref","DOI":"10.1016\/j.invent.2024.100790","article-title":"Promoting safer gambling through social norms and goal setting: A qualitative process analysis of participants\u2019 experiences in the EROGamb 2.0 feasibility trial","volume":"38","author":"Bush-Evans","year":"2024","journal-title":"Internet Interv"},{"key":"2025120415071102000_15.10.e104784.31","doi-asserted-by":"crossref","first-page":"114523","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample sizes for saturation in qualitative research: A systematic review of empirical tests","volume":"292","author":"Hennink","year":"2022","journal-title":"Social Science & Medicine"},{"key":"2025120415071102000_15.10.e104784.32","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199304050-00006"},{"key":"2025120415071102000_15.10.e104784.33","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"2025120415071102000_15.10.e104784.34","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9927-2"},{"key":"2025120415071102000_15.10.e104784.35","unstructured":"Hernandez Alava M , Pudney S , Wailoo A . Estimating the relationship between eq-5d-5l and eq-5d-3l: results from an english population study: report 063. Universities of Sheffield and York; 2020."},{"key":"2025120415071102000_15.10.e104784.36","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"2025120415071102000_15.10.e104784.37","doi-asserted-by":"crossref","DOI":"10.1186\/s40814-019-0493-7","article-title":"Should treatment effects be estimated in pilot and feasibility studies?","volume":"5","author":"Sim","year":"2019","journal-title":"Pilot Feasibility Stud"},{"key":"2025120415071102000_15.10.e104784.38","doi-asserted-by":"crossref","DOI":"10.1186\/s12874-018-0649-9","article-title":"Self-reported and routinely collected electronic healthcare resource-use data for trial-based economic evaluations: the current state of play in England and considerations for the future","volume":"19","author":"Franklin","year":"2019","journal-title":"BMC Med Res Methodol"},{"key":"2025120415071102000_15.10.e104784.39","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j..2002.384.doc.x","article-title":"Design and analysis of pilot studies: recommendations for good practice","volume":"10","author":"Lancaster","year":"2004","journal-title":"Evaluation Clinical Practice"},{"key":"2025120415071102000_15.10.e104784.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.08.015"},{"key":"2025120415071102000_15.10.e104784.41","doi-asserted-by":"crossref","first-page":"106402","DOI":"10.1016\/j.chb.2020.106402","article-title":"The use of personalized messages on wagering behavior of Swedish online gamblers: An empirical study","volume":"110","author":"Auer","year":"2020","journal-title":"Comput Human Behav"},{"key":"2025120415071102000_15.10.e104784.42","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-019-3710-z","article-title":"Designing and using incentives to support recruitment and retention in clinical trials: a scoping review and a checklist for design","volume":"20","author":"Parkinson","year":"2019","journal-title":"Trials"},{"key":"2025120415071102000_15.10.e104784.43","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1007\/s10899-023-10230-1","article-title":"Self-reported Deposits Versus Actual Deposits in Online Gambling: An Empirical Study","volume":"40","author":"Auer","year":"2024","journal-title":"J Gambl Stud"},{"key":"2025120415071102000_15.10.e104784.44","doi-asserted-by":"crossref","unstructured":"Santos T , Heirene RM , Cobb-Clark D , et al . Electronic Gaming Machine Consumers\u2019 Understanding of Past & Future Spending: Associations with Risk, Impulsivity, Self-Control, & Problematic Gambling. J Gambl Stud 2025. doi:10.1007\/s10899-025-10405-y","DOI":"10.1007\/s10899-025-10405-y"},{"key":"2025120415071102000_15.10.e104784.45","unstructured":"Moss N , Wheeler J , Sarkany A . Minority communities and gambling harms: qualitative and synthesis report. GambleAware. Available: https:\/\/www.gambleaware.org\/media\/23ebklk0\/minority-communities-gambling-harms-qualitative-and-synthesis-report.pdf [Accessed 20 Mar 2025]."},{"key":"2025120415071102000_15.10.e104784.46","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1080\/14459795.2015.1092566","article-title":"Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems","volume":"16","author":"Hing","year":"2016","journal-title":"Int Gambl Stud"},{"key":"2025120415071102000_15.10.e104784.47","unstructured":"Wang R , Yankouskaya A , Arden-Close E , et al . Relative risk of gambling products within great britain: findings from a rapid literature review and secondary analysis project. GambleAware. Available: https:\/\/www.gambleaware.org\/our-research\/publication-library\/articles\/relative-risk-of-gambling-products-within-great-britain-findings-from-a-rapid-literature-review-and-secondary-analysis-project\/ [Accessed 20 Mar 2025]."},{"key":"2025120415071102000_15.10.e104784.48","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1007\/s10899-022-10162-2","article-title":"The Impact of Personalized Feedback Interventions by a Gambling Operator on Subsequent Gambling Expenditure in a Sample of Dutch Online Gamblers","volume":"39","author":"Auer","year":"2023","journal-title":"J Gambl Stud"},{"key":"2025120415071102000_15.10.e104784.49","first-page":"100211","article-title":"A theoretical framework for social norm perception","volume":"44","author":"Dannals","year":"2024","journal-title":"Res Organ Behav"},{"key":"2025120415071102000_15.10.e104784.50","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1023\/A:1021013132430","article-title":"Measuring gambling outcomes among college students","volume":"18","author":"Neighbors","year":"2002","journal-title":"J Gambl Stud"},{"key":"2025120415071102000_15.10.e104784.51","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2004.00753.x"},{"key":"2025120415071102000_15.10.e104784.52","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.06.026"},{"key":"2025120415071102000_15.10.e104784.53","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"2025120415071102000_15.10.e104784.54","first-page":"449","article-title":"The EUROHIS-QOL WHOQOL-BREF","volume":"15","author":"da Rocha","year":"2012","journal-title":"Value Health"},{"key":"2025120415071102000_15.10.e104784.55","unstructured":"Santiago A , Carr\u00e9 A , Miranda R , et al . Study protocol for an online randomised controlled trial among non-treatment seeking problem gamblers: training inhibition in online problem."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-104784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:11:38Z","timestamp":1764889898000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-104784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":55,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,17]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/bmjopen-2025-104784"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-104784","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}