Evidence map›Paper›PMID 41088489›Full record

Trial reportAddiction science & clinical practice2025

GamblingLess: In-The-Moment: a mixed-methods acceptability and engagement evaluation of a gambling just-in-time adaptive intervention.

N A Dowling, S S Merkouris, C J Greenwood, G J Youssef, A C Thomas, C O Hawker, D I Lubman, S N Rodda

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Addiction science & clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

N A DowlingSchool of Psychology, Deakin University, Burwood, Australia. nicki.dowling@deakin.edu.au.
S S MerkourisSchool of Psychology, Deakin University, Burwood, Australia.
C J GreenwoodSchool of Psychology, Deakin University, Burwood, Australia.
G J YoussefSchool of Psychology, Deakin University, Burwood, Australia.
A C ThomasSchool of Psychology, Deakin University, Burwood, Australia.
C O HawkerSchool of Psychology, Deakin University, Burwood, Australia.
D I LubmanMonash Addiction Research Centre and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
S N RoddaSchool of Psychology, Deakin University, Burwood, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMobile health interventions, particularly dynamic Just-In-Time Adaptive Interventions (JITAIs), can overcome barriers to gambling treatment by offering timely, accessible support in people's everyday lives. GamblingLess: In-The-Moment is a theoretically-informed and evidence-based app-delivered JITAI to people who want to quit or reduce their gambling. The JITAI aims to reduce gambling symptom severity through short-term reductions in the likelihood of gambling episodes by improving cognitive vulnerability (craving intensity, self-efficacy, or positive outcome expectancies). It administers three daily ecological momentary assessments (EMAs) to deliver tailored interventions in moments of cognitive vulnerability. Given that intervention acceptability and engagement are likely to improve clinical outcomes, this study aimed to comprehensively examine these constructs for GamblingLess: In-The-Moment.

methodsA 28-day micro-randomised trial (MRT) was conducted, with a supplementary six-month within-group follow-up evaluation and a mixed-methods acceptability/engagement evaluation. The acceptability/engagement evaluation included: (1) app use and engagement indices across the MRT (n = 192; 66% male; age

resultsApp use and engagement indices indicated that the JITAI was an attractive option for gambling support. Participants completed 5,116 EMAs (compliance rate = 32%, averaging 27 EMAs), spent an average of 30 min in the app, and completed an average of nine intervention activities from a pool of 53 activities they could repeatedly access. Subjective quality and perceived impact scores well exceeded minimally acceptable standards but 77% of participants preferred a hybrid push-pull approach and many endorsed less frequent EMAs (52%) but a longer program (58%). Participants also endorsed additional features, such as in-person support, motivational messages, gambling feedback, saving favourite activities, online discussion boards, virtual computer coaches, and in-app rewards. Interviews revealed two distinct themes: (1) facilitation of gambling reductions through check-ins/availability, personal tailoring, seamless and holistic support, and treatment experience suitability; and (2) promoting behaviour change through enhanced awareness, goal-setting, skill-building, and positive habit formation.

conclusionsGamblingLess: In-The-Moment was highly accepted and was generally perceived as effective in supporting reductions in gambling behaviour. The findings underscore the iterative process for JITAI development and highlight several avenues for its optimisation, particularly in relation to enhancing user engagement and reducing user fatigue.

trial registrationThe evaluation was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000490774) in March, 2022.

Indexed as

GamblingMobile ApplicationsPatient Acceptance of Health CareAdultEcological Momentary AssessmentFemaleHumansMaleMiddle AgedSelf EfficacyTelemedicineAppEcological momentary interventionGamblingJust-in-time adaptive interventionMHealthMicrorandomized trialMobile health

Identifiers

PMID41088489
PMCPMC12522354

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.