Final report
PHASE ONE: Technical Assessment and Field Studies
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- Methods
- Results
- PHASE TWO: Focus Group DISCUSSIOns
PHASE ONE: Technical Assessment and Field Studies
This part of the study involved developing and testing the technical feasibility of the proposed smartphone-based EGM relapse prevention intervention. Specifically, we sought to develop and test systems that would be feasible to operate from standard smartphones utilising their in-built geolocation attributes and other functions (e.g. alerts, SMS messaging to people with problem gambling and their counsellors).
The smartphone application makes use of GPS coordinates in order to detect a person’s location. The coordinates are then compared to a database of predefined locations of gambling industry venues. The mobile application sends the GPS data to a server via an Application Programming Interface (API). The server holds the location data in a database and uses an algorithm to decide whether a message should be sent to a person. The algorithm includes factors like accuracy of the GPS reading, the distance from the location, the speed at which the person moves and the amount of time the person is spending in alert area. Messages are delivered as smartphone notifications instead of SMS. Figure 1: Diagrammatic overview of prototype application development 
We field tested the prototype app using hybrid technology that allows application to other operating systems (such as Windows mobile) and others in future, loading it onto six Android and Apple (IOS) smartphones held by the participants (University staff members who volunteered). They reported back on their experience as they moved in and out of proximity to known gambling venues.
All components of the architecture were successfully developed, including the mobile application, the API server and the database. The scope of the system was limited to geo-location functionality and messaging. Other content and functionality will be explored in future phases. Accuracy: The accuracy of the GPS location is very dependent on the signal strength from satellites and whether the person’s phone is powered on or not. GPS coordinates from satellites can be accurate to within a couple of meters, whereas location information from cell-towers could be out by a few 100 meters. We noted that signal density and spatial accuracy is a real issue that needs to be taken into account in further developments of the app, for example in defining the ‘hot zone’ to accommodate variations in signal density. Proximity: Instead of performing a distance calculation between every coordinate received and every pre-defined gambling venue, we generated boundary coordinates for gambling venues. This allows simple database lookups to be undertaken automatically to determine whether a person is within a certain range of a registered electronic gambling machine location. It also reduces the amount of processing and resources needed on the server. Movement: We made use of the speed factor to prevent sending messages to people while they are moving, as it is unlikely that they are actively gambling and more likely that they are just moving past a known venue. The smart phone application sends location data, based on the speed at which the person moves. The faster a person moves the less frequent the application sends the GPS coordinates and vice-versa. Duration: We made provision for the amount of time a person spends within a zone that contains gambling machines. For example, there are many places that offer more services than just gambling so we have had to consider what is a reasonable maximum duration spent at a particular venue before a message is triggered. Refinement: We are constantly re-factoring the algorithm as we get more test results and feedback and will continue to do so in the future. PHASE TWO: Focus Group DISCUSSIOns
The main aim for this phase of the research was to elicit the acceptability and utility of a smartphone-based app to people with problem gambling from the priority population groups (Māori, Pacific and Asian). In the focus groups we sought to elicit participants’ views of possible components and actions that could occur when proximity to a gambling site is imminent with regard to appropriateness and potential effects. New ideas were sought and discussed, and issues such as timing, language and tone of messages and possible adverse effects of the intervention were also addressed.
A series of qualitative focus group discussions were conducted with problem gambling practitioners and individuals with experience of problem gambling (consumers). These groups aimed to explore the acceptability and utility amongst this population with regard to the potential for a smartphone-based ‘App’ to provide substantial support for those experiencing/addressing problem gambling.
Problem Gambling Practitioners: An invitation to participate in a focus group discussion for this project was extended to practitioners via the researchers networks with problem gambling treatment providers. Representation was sought across Māori, Pacific, Asian and Mainstream services with a balance of male and female also being obtained. To accommodate practitioners’ availability, two separate discussions were held; the first group consisted of six participants and the second group had a total of four participants. Individuals with Experience of Problem Gambling (Consumers): Consumers were recruited through problem gambling treatment providers in Auckland. Information on the study (a flyer and the Participant Information Sheet) were displayed in reception areas and/or provided to clients by practitioners. Clients who were interested in participating were able to complete a short form indicating their interest and contact details. This form could be returned to reception, or the client could contact the research team directly. In total, fifty-six people participated across eight focus group discussions: two with problem gambling practitioners; and, six with individuals with experience of problem gambling (consumers). A diverse range of participants was sought, with separate focus group discussions being held with Practitioners, and Māori, Pacific, Asian and European/Other consumers. Table provides a summary of the ethnic composition of the focus groups. With regard to gender, in the Practitioner groups, 60% participants were female and 40% were male, whereas in the consumer groups 20% were female and 80% were male, a gender mix that is characteristic of people with problem gambling especially in Māori, Pacific and Asian population groups. Table : Overview of focus group composition
Inclusion and Exclusion Criteria Individuals were eligible for inclusion in the focus group discussions if they fulfilled the following criteria:
Individuals were excluded from the focus group discussions if they fulfilled any of the following criteria: Individuals with experience of Problem Gambling (Consumers):
The focus group discussions were led by experienced facilitators who were ethnically matched with participants. Informed consent was gained from each participant (see for copies of the Participant Information Sheets and Consent Forms). Each discussion was audio recorded, transcribed and translated into English by research assistants (where applicable), and supplemented with notes recorded during the interviews. At the conclusion of each group, participants were provided with a $20 supermarket voucher as an expression of gratitude for their participation.
Each focus group discussion was guided by a semi-structured interview schedule (see ) that was developed by the research team in accordance with the key aims and research questions. A series of mock smartphone screenshots (see ) were used in conjunction with the interview schedule to elicit discussion in relation to a number of scenarios.
The transcribed qualitative data were analysed for key themes using the general inductive method (Thomas, 2003). This approach to thematic data analysis enables themes, clusters and categories to be identified. In this project, patterns of views and experiences were formed through analysis of direct quotes, which were then used to form overall themes and a comprehensive picture of participants’ views and experiences. The research team sought to ensure methodological rigour by a ‘consistency check’ of the analysis: other members of the research team reviewed the data and, in line with the approach recommended by Patton, agreed on key themes by consensus (Patton, 1990).
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