Preventing gambling‑related harm in adolescents: a pilot cluster randomized controlled trial

Abstract Introduction PRoGRAM-A (Preventing Gambling Related Harm in Adolescents) is a peer-led, social network intervention to protect young people, their friends and family members from gambling related harm (GRH), through student led message diffusion. The aim of this study was to conduct a pilot cluster randomised control trial (cRCT) of PRoGRAM-A among young people aged 13-15 to determine the utility of conducting a Phase III RCT assessing effectiveness and cost-effectiveness Methods Two-arm, pilot cluster Randomised Control Trial with an embedded process evaluation, health economic scoping study and social network analysis. Results The primary outcome of this study was whether progression to a full-scale Phase III cRCT was warranted, using pre-set progression criteria. These criteria sought to address uncertainties in the intervention and cRCT design with thresholds set according to a traffic light system. All five progression criteria were met. All schools were recruited and retained in the study and there were low levels of missing data on outcomes. The process evaluation indicated that PRoGRAM-A was acceptable to multiple stakeholders and delivered with fidelity to the delivery manual. Students predicted having 1,323 conversations, but actually had 1,555. They spoke, on average, to 2.4 (step) parents or siblings, 1.6 other family members and 6.9 people outside their family. Conclusions PROGRAM-A is an acceptable school-based peer-led intervention to prevent gambling behaviour, which can be delivered with high fidelity. Message diffusion was strong, trial methods were acceptable with all settings recruited and retained. Progression to a larger RCT to test effectiveness and costs effectiveness is warranted. Key messages • Social network, peer to peer prevention interventions delivered in the school setting indicate strong message diffusion. • PRoGRAM-A is an acceptable intervention which can be delivered with high fidelity.