A self-administered problem gambling screen (FLAGS-II) as motivational intervention for problem gamblers

Abstract

The Focal Adult Gambling Screen (FLAGS-II; Schellinck, Schrans, Bliemel, & Schellinck, 2011) was evaluated for its ability to function as an effective secondary prevention tool for the estimated 97% of people with gambling problems that are not currently seeking formal treatment. Participant motivation was evaluated at two points in time in a pre-posttest (PP) experimental design that used " readiness to change " as the dependent variable as measured by the Gambling Readiness to Change (GRTC) scale. The study enrolled a sample of 165 non-treatment seeking regular video lottery terminal (VLT) gamblers from Nova Scotia, Canada (age M= 54, SD = 12.74, 57% female) that were randomly assigned to one of three groups. These groups differed only in their level of exposure to the FLAGS-II, its scoring instructions, and normative feedback during the interval between pre-post exposure evaluation. During the interval, the experimental group (EG, n = 60) received by mail, completed, and returned the FLAGS-II, together with scoring instructions, and normative feedback. The exposure control group (EC, n = 46) received by mail, completed, and returned the FLAGS-II during the interval without access to the scoring instructions, or the normative feedback, that the EG group received. The control group (CG, n= 59) received nothing in the interval. Analysis was conducted using an analysis of covariance under an intent to treat model using pre-exposure scores as a covariate. The significant results (alpha = .058, SE = .60) indicate that the EG group had an average one-third standard deviation improvement (d= .35) in their readiness to change scores compared with the CG group. The EC group showed a non-significant intermediate result (alpha = .334, SE = .63) between that of the EG and the CG readiness to change scores. Exploration of the covariate "severity of gambling problem" contributed nothing to the model, and "stage of change" was abandoned as a covariate due to a multicollinearity problem. Implications for the development of the FLAGS-II as part of a cohesive public health care model for problem gambling prevention and treatment are discussed using the stepped care model as a framework.

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