Preventing gambling-related harm in adolescents (PRoGRAM-A), a secondary school‐based social network intervention: Results from a pilot cluster randomised controlled trial

Abstract

Aim To conduct a pilot cluster randomised controlled trial (cRCT) of a gambling prevention intervention (PRoGRAM-A) among young people aged 13–15 to determine the utility of conducting a Phase III RCT assessing effectiveness and cost-effectiveness. Design Two-arm, pilot cluster randomised controlled trial with an embedded process evaluation, health economic scoping study and social network analysis. Six schools were identified based on Scottish Index of Multiple Deprivation and school roll size. Schools were randomised to either intervention (n = 4) or control (n = 2). The trial was delivered between October 2023 and November 2024. Setting Six state funded secondary schools in Scotland (four intervention, two control). Participants Students (intervention n = 762, and control n = 352) in secondary school year 3 (aged 13–15 years old). Intervention and comparator PRoGRAM-A (Preventing Gambling Related Harm in Adolescents), a peer-led social network intervention to protect young people, their friends and family members from gambling related harm (GRH). Control schools delivered their standard Personal, Social, Health and Education (PSHE) curriculum, which did not include any form of gambling education. Measurements 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. Findings All five progression criteria were met. All schools were recruited and retained in the study with minimal missing outcome data. The process evaluation indicated that PRoGRAM-A was acceptable to multiple stakeholders and delivered with fidelity to the delivery manual. The proposed primary outcome for a future Phase III cRCT was self-reported gambling participation (measured by asking about types of gambling participation ‘in the last 4 weeks’ and ‘in the last 12 months'). This pilot study found no statictically significant differences between the control and intervention groups at follow-up. Conclusions The school-based gambling prevention intervention PRoGRAM-A appears to be an acceptable intervention which can be delivered with high fidelity. The trial methods were acceptable with all settings recruited and retained. Progression to a larger randomised controlled trial to test effectiveness and costs effectiveness is warranted.