Gambling behaviors among adolescents and young adults have been experiencing an upward trend in the last years, possibly because of new habits developed during the COVID-19 lockdown restrictions. Different preventive strategies have been proposed: universal classroom-based interventions have shown promising evidence as preventive tools, but challenges exist in engaging the target audience effectively. Serious games, i.e., those designed with the specific intent to educate, broaden knowledge, and change behaviors, have been tested with positive outcomes. Digital escape rooms constitute a modality of serious game that has shown potential for a variety of educational purposes, but their efficacy for preventing addictive behaviors, as well as their long-term impact, has not been widely studied. The present project aims at assessing the gambling habits of a sample of 16-25-year-olds in the region of Aragon, Spain, that could be compared to the data gathered before the pandemic started, so not only the prevalence rates can be updated but also potential differences in habits (e.g., preferred gambling alternatives) can be detected. This will undoubtedly help the design of effective preventive measures, such as the GAMBL-OUT digital escape room, a serious game to be implemented in high schools with the aim of increasing knowledge, reducing intentions to gamble, and changing attitudes towards gambling.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
240
The GAMBL-OUT program consists of two sessions: the first one involves a digital escape room to be delivered in the classroom and a series of physical props to be used during the experience. In small groups (4-5 students), participants need to work together to solve different puzzles and riddles, all of them related to the story of young adults who are dealing with problem gambling. By the end of the game, which will have a limited time (50 minutes), each group will have gained access to a different password. The second session will start from here: each group will share their password so the final puzzle can be solved, and the game will conclude with in a group discussion about what was learned (40 minutes).
Department of Psychiatry. Miguel Servet University Hospital
Zaragoza, Spain
RECRUITINGProblem gambling screening (PGSI)
In the intervention group. This 9-item scale assesses problematic gambling behaviors in the last 12 months and harmful consequences related to gambling. Items are rated on a 4-point scale (0 = never, 3 = almost always). The final score ranges from 0 to 27 and can be interpreted as follows: 0 = non-problem gamblers, 1-2 = low-risk gamblers, 3-7 = moderate-risk gamblers, and 8 and above = problem gamblers).
Time frame: Baseline
Problem gambling screening (PGSI)
In the intervention group. This 9-item scale assesses problematic gambling behaviors in the last 12 months and harmful consequences related to gambling. Items are rated on a 4-point scale (0 = never, 3 = almost always). The final score ranges from 0 to 27 and can be interpreted as follows: 0 = non-problem gamblers, 1-2 = low-risk gamblers, 3-7 = moderate-risk gamblers, and 8 and above = problem gamblers).
Time frame: Three-months follow-up
Problem gambling screening (PGSI)
In the control group. This 9-item scale assesses problematic gambling behaviors in the last 12 months and harmful consequences related to gambling. Items are rated on a 4-point scale (0 = never, 3 = almost always). The final score ranges from 0 to 27 and can be interpreted as follows: 0 = non-problem gamblers, 1-2 = low-risk gamblers, 3-7 = moderate-risk gamblers, and 8 and above = problem gamblers).
Time frame: Baseline
Problem gambling screening (PGSI)
In the control group. This 9-item scale assesses problematic gambling behaviors in the last 12 months and harmful consequences related to gambling. Items are rated on a 4-point scale (0 = never, 3 = almost always). The final score ranges from 0 to 27 and can be interpreted as follows: 0 = non-problem gamblers, 1-2 = low-risk gamblers, 3-7 = moderate-risk gamblers, and 8 and above = problem gamblers).
Time frame: Three-months follow-up
Gender
Gender of participants: male, female, other. Both groups
Time frame: Baseline
Age
Open-ended question where subjects are asked to indicate numerically their current age. Both groups
Time frame: Baseline
Nationality
Country of birth of participants: Spain, other (please specify). Both groups
Time frame: Baseline
Current city of residence
Place of current residence: Zaragoza capital, Zaragoza province, Huesca capital, Huesca province, Teruel capita, Teruel province. Both groups
Time frame: Baseline
Cohabitation
Who do you live with: first degree relatives (parents, siblings), second degree relatives (grandparents, uncles, aunts, uncles), friends, alone, other (please specify). Both groups
Time frame: Baseline
Country of birth of parents
Open-ended question where participants have to indicate in which country their father was born, or where their mother was born. Both groups
Time frame: Baseline
Education
Which year of the baccalaureate are you currently in: first or second. Both groups
Time frame: Baseline
Employment situation
Indicate how many hours per week you work: no work, between 1 and 10 hours per week, between 11 and 20 hours per week, between 20 and 30 hours per week, between 30 and 40 hours per week. Both groups
Time frame: Baseline
Amount of money available for leisure per month
Multiple-choice question ad-hoc where subjects must mark the range of money in euros they have available for leisure. The response options are: 0-100; 101-400; 401-600; 601-1000; 1000 or more. None of the response options is better than the others. In the intervention group
Time frame: Baseline
Amount of money available for leisure per month
Multiple-choice question ad-hoc where subjects must mark the range of money in euros they have available for leisure. The response options are: 0-100; 101-400; 401-600; 601-1000; 1000 or more. None of the response options is better than the others. In the control group
Time frame: Baseline
Gambling knowledge scale (ad-hoc)
In the intervention group. This questionnaire is composed of 18 separate items that collect information on different aspects of gambling knowledge. Each item is evaluated on a Likert scale with four response options: 'is totally incorrect', 'is incorrect', 'is correct', 'is totally correct'.
Time frame: Baseline
Gambling knowledge scale (ad-hoc)
In the intervention group. This questionnaire is composed of 18 separate items that collect information on different aspects of gambling knowledge. Each item is evaluated on a Likert scale with four response options: 'is totally incorrect', 'is incorrect', 'is correct', 'is totally correct'. There is no overall score on this scale as each item assesses different aspects of gambling knowledge.
Time frame: up to 2 weeks
Gambling knowledge scale (ad-hoc)
In the intervention group. This questionnaire is composed of 18 separate items that collect information on different aspects of gambling knowledge. Each item is evaluated on a Likert scale with four response options: 'is totally incorrect', 'is incorrect', 'is correct', 'is totally correct'. There is no overall score on this scale as each item assesses different aspects of gambling knowledge.
Time frame: Three-months follow-up
Gambling knowledge scale (ad-hoc)
In the control group. This questionnaire is composed of 18 separate items that collect information on different aspects of gambling knowledge. Each item is evaluated on a Likert scale with four response options: 'is totally incorrect', 'is incorrect', 'is correct', 'is totally correct'. There is no overall score on this scale as each item assesses different aspects of gambling knowledge.
Time frame: Baseline
Gambling knowledge scale (ad-hoc)
In the control group. This questionnaire is composed of 18 separate items that collect information on different aspects of gambling knowledge. Each item is evaluated on a Likert scale with four response options: 'is totally incorrect', 'is incorrect', 'is correct', 'is totally correct'. There is no overall score on this scale as each item assesses different aspects of gambling knowledge.
Time frame: up to 2 weeks
Gambling knowledge scale (ad-hoc)
In the control group. This questionnaire is composed of 18 separate items that collect information on different aspects of gambling knowledge. Each item is evaluated on a Likert scale with four response options: 'is totally incorrect', 'is incorrect', 'is correct', 'is totally correct'. There is no overall score on this scale as each item assesses different aspects of gambling knowledge.
Time frame: Three-months follow-up
Ad hoc questions asking attitudes towards gambling
In the intervention group
Time frame: Baseline
Ad hoc questions asking attitudes towards gambling
In the intervention group
Time frame: up to 2 weeks
Ad hoc questions asking attitudes towards gambling
In the intervention group
Time frame: Three-months follow-up
Ad hoc questions asking attitudes towards gambling
In the control group
Time frame: Baseline
Ad hoc questions asking attitudes towards gambling
In the control group
Time frame: up to 2 weeks
Ad hoc questions asking attitudes towards gambling
In the control group
Time frame: Three-months follow-up
Ad hoc questions asking intention to gamble in the future
In the intervention group
Time frame: Baseline
Ad hoc questions asking intention to gamble in the future
In the intervention group
Time frame: up to 2 weeks
Ad hoc questions asking intention to gamble in the future
In the intervention group
Time frame: Three-months follow-up
Ad hoc questions asking intention to gamble in the future
In the control group
Time frame: Baseline
Ad hoc questions asking intention to gamble in the future
In the control group
Time frame: up to 2 weeks
Ad hoc questions asking intention to gamble in the future
In the control group
Time frame: Three-months follow-up
Ad hoc questions asking the gambling habits
In the intervention group
Time frame: Baseline
Ad hoc questions asking the gambling habits
In the intervention group
Time frame: Three-months follow-up
Ad hoc questions asking the gambling habits
In the control group
Time frame: Baseline
Ad hoc questions asking the gambling habits
In the control group
Time frame: Three-months follow-up
Implementation outcome: General opinion of the intervention
The participants indicate their general opinion of the intervention once it is over: 'very positive, I loved it', 'positive, it was a good experience', 'neutral, I was indifferent', 'negative, there were aspects that did not convince me', 'very negative, I was disappointed'. Both groups
Time frame: Three-months follow-up
Implementation outcome: Ease of use of the platform
Participants indicate how easy the platform was for them to use: yes or no. Both groups
Time frame: Three-months follow-up
Implementation outcome: Duration of the intervention
Opinion on the length of the intervention: 'I thought it was too short', 'I thought it was adequate', 'I thought it was too long'. Both groups
Time frame: Three-months follow-up
Implementation outcome: Difficulty of the instructions received through the platform
Opinion on the difficulty of the instructions received through the platform: 'yes', "no", "most yes", "most no". Both groups
Time frame: Three-months follow-up
Implementation outcome: Amount of information received
Opinion on the amount of information received: 'excessive', 'adequate', 'insufficient'. Both groups
Time frame: Three-months follow-up
Implementation outcome: Need for prior knowledge to carry out the intervention
Opinion on the need for prior knowledge to carry out the intervention: yes or no. Both groups
Time frame: Three-months follow-up
Implementation outcome: Adequacy of the content of the intervention for the target population
Opinion on the appropriateness of the content of the intervention for the target population: 'I think it is too easy', 'I think it is suitable for adolescents', 'I think it is too complex', 'other (specify)'. Both groups
Time frame: Three-months follow-up
Implementation outcome: Effectiveness in conveying information to you about the risks of gambling addiction
Do you think that the Escape Room has been effective in providing you with information about the risks of gambling addiction?: 'very effective', 'effective', 'neutral', 'not very effective', 'not at all effective'. Both groups
Time frame: Three-months follow-up
Implementation outcome: Perception of increased knowledge of gambling
Opinion on perceived increase in knowledge of gambling: 'a lot', 'some', 'a little', 'not at all'. Both groups
Time frame: Three-months follow-up
Implementation outcome: Integration of educational messages into the dynamics of the Escape Room.
Opinion on the adequate integration of the educational messages in the Escape Room dynamics: 'quite well', 'well', 'little', 'practically not at all'. Both groups
Time frame: Three-months follow-up
Implementation outcome: Adequacy of this Escape Room for the prevention of gambling among young people
Opinion on the suitability of this Escape Room for the prevention of gambling in young people: yes or no. Both groups
Time frame: Three-months follow-up
Implementation outcome: Opinion on whether participants think it is likely that high schools in Aragon will integrate this Escape Room into their regular programming.
Opinion on whether participants think it is likely that high schools in Aragon will integrate this Escape Room into their regular programming: yes or no. Both groups
Time frame: Three-months follow-up
Implementation outcome: Recommendation of this Escape Room to young people in the participants' environment.
Opinion on whether the participants would recommend this Escape Room to young people in their environment for their training on the functioning and risks of gambling: yes or no. Both groups
Time frame: Three-months follow-up
Implementation outcome: Consideration of whether this Escape Room is a useful resource for the prevention of gambling among young people.
Consideration of whether this Escape Room is a useful resource for gambling prevention in young people: yes or no. Both groups
Time frame: Three-months follow-up
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