Prevention Messages for EGMs: Effects on Behaviours and Cognitions

Condition(s) studied

Investigational drug(s) / intervention(s)

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 replacement. Messages have a warning heading "Caution!". Content is, from top to bottom: (a) time spent gambling from beginning; (b) warning that gambling could lead to serious monetary loss; (c) 1 of 4 self-appraisal phrases about current gambling behaviour; (d) advice to the participant that a break could help choose what is best for them; (e) countdown before the message closes itself; (f) Health department logo is shown in the lower right corner as a more "neutral" endorsement of the messages.

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 player's bank meter reaches $0, the the pop-up described above appears as soon as new money is inserted in the EGM, no matter if the previous time limit is up or not.

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.

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 beforehand.

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 practice. For this study, participants will be allowed to withdraw from their bank account, at the bar counter, if they ask for it. However, this will not be offered to them upfront.

Study summary

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.

Eligibility

Primary outcome measure(s)

• Gambling behaviour (between group) - Gambling session's total duration — 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).
  Time elapsed between the first time the participant puts money in the EGM (0h00) to the end of the gambling session. Session's duration is left for the participant to decide. While the participant is told they can play for as long as they like, there is a 2 hrs limit on the session duration. This limit is hidden from the participant. Session's duration includes any breaks taken from gambling on the EGM.
• Gambling behaviour (between group) - Total time effectively spent gambling — 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).
  Same as Outcome 1 (Gambling session's total duration), but minus breaks taken from gambling on the EGM.
• Gambling behaviour (between group) - Number of breaks taken — 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).
  Number of breaks taken from gambling on the EGM during the gambling session.
• Gambling behaviour (between group) - Mean breaks' duration — 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).
  Average duration of breaks' taken from gambling on the EGM over the gambling session's total duration.
• Gambling behaviour (between group) - Total breaks duration — 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).
  Sum of breaks' duration taken from gambling on the EGM over the gambling session's total duration.
• Gambling behaviour (between group) - Mean time elapsed between breaks — 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).
  Average time separating any two breaks taken from gambling on the EGM over the gambling session's total duration.
• Gambling behaviour (between group) - Money betted (physical) — 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).
  Money physically inserted in the EGM during the gambling session. This is evaluated as a cumulative amount at each timepoint a prevention message is presented in the experimental group and at the timepoint where the participant decides to end their gambling session (max 2h00). Money betted is also evaluated between said timepoints (e.g. between 1h10 and 0h40, between 0h40 and 1h10, etc.).
• Gambling behaviour (between group) - Money betted (all) — 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).
  Money betted on the EGM during the gambling session. This is money used to "buy rounds on the EGM", whether it's money physically inserted in the EGM or money won while gambling and betted again. This is evaluated as a cumulative amount at each timepoint a prevention message is presented in the experimental group and at the timepoint where the participant decides to end their gambling session (max 2h00). Money betted is also evaluated between said timepoints (e.g. between 1h10 and 0h40, between 0h40 and 1h10, etc.).
• Gambling behaviour (between group) - Number of bets placed — 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).
  Number of bets placed on the EGM during the gambling session. This is evaluated as a cumulative number at each timepoint a prevention message is presented in the experimental group and at the timepoint where the participant decides to end their gambling session (max 2h00). Number of bets placed are also evaluated between said (e.g. between 1h10 and 0h40, between 0h40 and 1h10, etc.).
• Gambling behaviour (between group) - Gambling speed — 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).
  Number of bets placed on the EGM during the gambling session over a given amount of time (i.e. bets/min). This is evaluated at each timepoint a prevention message is presented in the experimental group and at the timepoint where the participant decides to end their gambling session (max 2h00). Gambling speed is also evaluated between said timepoints (e.g. between 1h10 and 0h40, between 0h40 and 1h10, etc.).
• Gambling behaviour (between group) - Gambling intensity (physical) — 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).
  Money physically inserted in the EGM during the gambling session over a given amount of time (i.e. $/min). This is evaluated at each timepoint a prevention message is presented in the experimental group and at the timepoint where the participant decides to end their gambling session (max 2h00). Gambling intensity is also evaluated between said (e.g. between 1h10 and 0h40, between 0h40 and 1h10, etc.).
• Gambling behaviour (between group) - Gambling intensity (all) — 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).
  Money betted on the EGM during the gambling session over a given amount of time (i.e. $/min). This is money used to "buy rounds on the EGM", whether it's money physically inserted in the EGM or money won while gambling and betted again. This is evaluated at each timepoint a prevention message is presented in the experimental group and at the timepoint where the participant decides to end their gambling session (max 2h00). Gambling intensity is also evaluated between said timepoints (e.g. between 1h10 and 0h40, between 0h40 and 1h10, etc.).
• Perceived self-control while gambling on EGMs (between group) — 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).
  Participant's perceived ability to control their gambling behaviour (e.g. sticking to their predetermined limits) over the gambling session's total duration. Evaluated with a 7-points Likert scale (1 = "I never had control" to 7 = "I always had control").
• General level of fun while gambling on EGMs (between group) — 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).
  Participant's general enjoyment of gambling on EGMS over the gambling session's total duration. Evaluated with a 7-points Likert scale (1 = "I hated it" to 7 = "I loved it").
• Psychological reactance to prevention pop-up messages (between group) — 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).
  Evaluated based on the Dillard \& Shen (2005) method: (a) Induction check (4 items, 7-points Likert scale, 1 = "Strongly disagree, 7 - "Strongly agree"); (b) Anger (4 items, 7-points Likert scale, 1 = "Strongly disagree, 7 - "Strongly agree"); (c) Cognitive response (count of negative thoughts in relation to the pop-up messages); (d) Attitude (7 word pairs, 7-points semantic differential scale).
• Perceived behavioural effectiveness of prevention pop-up messages (between group) — 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).
  Participant's perceived effectiveness of prevention pop-up messages on modifying their gambling behaviour during the gambling session. Evaluated with two 7-points Likert scale about the perceived effects of the prevention po-up messages on money betted and time spent during the gambling session (1 = "lowered gambling behaviour a lot" to 7 = "heightened gambling behaviour a lot").
• Change in gambling behaviours (within group) - Money betted (physical) — Change from Pre-experiment phase (i.e. "intake"; single measurement point; cover past 12 months) at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).
  Money physically inserted in the EGM. Change is evaluated by comparing self-reported betting habits on EGMs for the past 12 months (measured during the pre-experiment phase) and objectively measured money physically inserted in the EGM during the over the laboratory gambling session's total duration (Outcome 8; measured during the experiment phase).
• Change in gambling behaviours (within group) - Total time effectively spent gambling — Change from Pre-experiment phase (i.e. "intake"; single measurement point; cover past 12 months) at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).
  Time elapsed between the first time the participant puts money in the EGM to the end of the gambling session. Change is evaluated by comparing self-reported typical time spent gambling on EGMs for a single session for the past 12 months (measured during the pre-experiment phase) and objectively measured laboratory gambling session's total duration (Outcome 1; measured during the experiment phase). Note that, unbeknown to the participant, the laboratory gambling session is limited to 2 hrs max.
• Change in perceived self-control while gambling on EGMs (within group) — Change from Pre-experiment phase (i.e. "intake"; single measurement point; cover past 12 months) at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).
  Participant's perceived ability to control their gambling behaviour on EGMs (e.g. sticking to their predetermined limits). Evaluated with a 7-points Likert scale (1 = "I never had control" to 7 = "I always had control"). Change is evaluated by comparing self-reported typical perceived self-control while gambling on EGMs for the past 12 months (measured during the pre-experiment phase) and self-reported perceived self-control while gambling on EGMs over the laboratory gambling session's total duration (Outcome 14; measured in the post-experiment phase).
• Change in general level of fun while gambling on EGMs (within group) — Change from Pre-experiment phase (i.e. "intake"; single measurement point; cover past 12 months) at the end gambling session in the laboratory (Post-experiment phase). Session's length is decided by participant (but limited to 2 hours maximum).
  Participant's general enjoyment of gambling on EGMs. Evaluated with a 7-points Likert scale (1 = "I hated it" to 7 = "I loved it"). Change is evaluated by comparing self-reported typical level of fun while gambling on EGMs for the past 12 months (measured during the pre-experiment phase) and self-reported level of fun while gambling on EGMs over the laboratory gambling session's total duration (Outcome 15; measured in the post-experiment phase).

Trial sites (1)