Strategies to customize responsible gambling messages: A review and focus group study

Abstract

Background
Responsible gambling messages are widely used as a tool to enable informed choice and encourage appropriate gambling behavior. It is generally accepted that gamblers have different levels of risk of developing gambling problems and require various harm minimization tools and resources. Therefore, it is reasonable to expect that responsible gambling messages should be customized and target specific groups of gamblers. This project aimed to understand hypothesized differences between cohorts of gamblers and receive qualitative feedback on archetypal targeted messages used to increase use of responsible gambling tools.

Methods
Focus groups were held to test messages for specific cohorts: young adults (18–24 years), seniors (60+ years), frequent gamblers (weekly), and gamblers of skill-based games (poker, sports betting).

Results
Cohorts exhibited different preferences and responses to message archetypes. Seniors preferred messages about limit setting, whilst young adults and frequent gamblers responded to messages about their own play and expertise. Skill game gamblers were interested in the odds of winning and their own outcomes over time. However, all groups agreed that using positive, non-judgmental language in messaging is important.

Conclusions
This research makes an important contribution to the field by demonstrating that the wording of message content will likely influence the effectiveness of such messages differentially across various groups of gamblers for engaging gamblers in harm reduction tools. Guidance is provided on themes that can be used by public health marketers.

Electronic supplementary material
The online version of this article (10.1186/s12889-018-6281-0) contains supplementary material, which is available to authorized users.

Full text

R E S E A R C H A R T I C L E Open Access
Strategies to customize responsible
gambling messages: a review and focus
group study
Sally M. Gainsbury
1
, Brett L. L. Abarbanel
2,3
, Kahlil S. Philander
1,4*
and Jeffrey V. Butler
5
Abstract
Background: Responsible gambling messages are widely used as a tool to enable informed choice and encourage
appropriate gambling behavior. It is generally accepted that gamblers have different levels of risk of developing gambling
problems and require various harm minimization tools and resources. Therefore, it is reasonable to expect that responsible
gambling messages should be customized and target specific groups of gamblers. This project aimed to understand
hypothesized differences between cohorts of gamblers and receive qualitative feedback on archetypal targeted messages
used to increase use of responsible gambling tools.
Methods: Focusgroupswereheldtotestmessagesfor specific cohorts: young adults (18–24 years), seniors (60+ years),
frequent gamblers (weekly), and gamblers of skill-based games (poker, sports betting).
Results: Cohorts exhibited different preferences and responses to message archetypes. Seniors preferred messages about
limit setting, whilst young adults and frequent gamblers responded to messages about their own play and expertise. Skill
game gamblers were interested in the odds of winning and their own outcomes over time. However, all groups agreed
that using positive, non-judgmental language in messaging is important.
Conclusions: This research makes an important contribution to the field by demonstrating that the wording of message
content will likely influence the effectiveness of such messages differentially across various groups of gamblers
for engaging gamblers in harm reduction tools. Guidance is provided on themes that can be used by public
health marketers.
Keywords: Customized messaging, Targeting, Prevention messages, Problem gambling, Responsible gambling,
Education, Harm minimization, Youth, Seniors
Background
Many wellness oriented interventions are available for gam-
blers. Across jurisdictions, programs may include psycho-
social treatment, awareness campaigns, player education
programs, self-exclusion programs, and play management
resources, such as limit-setting tools. But whilst programs
are often available, there are typically barriers to
help-seeking for those who would benefit from their use.
These issues include stigma, shame, lack of knowledge, un-
willingness to admit a problem, and/or wishing to handle a
problem by oneself [1–3]. Effective interventions are im-
portant to assist gamblers at various levels of risk to acquire
and apply the requisite skills and knowledge necessary to
control their gambling to affordable levels. Encouraging
gamblers to seek help before their problems become severe
would minimize harm, as well as reduce the burden on
emergency and treatment services. However, individuals
who engage in risky gambling but are not experiencing ser-
ious problems may lack motivation to seek help proactively
and appear to be relatively hard to reach.
Given that modern player tracking systems can now dis-
play user-specific information on electronic gambling ma-
chine screens or personal electronic devices, there has
been substantial interest within the academic and respon-
sible gambling (RG) community in using customized RG
* Correspondence: kahlil.philander@wsu.edu
1
Brain and Mind Centre, School of Psychology, University of Sydney,
Camperdown, NSW, Australia
4
School of Hospitality Business Management, Carson College of Business,
Washington State University, Everett, WA, USA
Full list of author information is available at the end of the article
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Gainsbury et al. BMC Public Health (2018) 18:1381
https://doi.org/10.1186/s12889-018-6281-0
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messages to improve informed decision making [4].Pre-
vention messages are one of the most widely used public
health strategies for reducing harms from gambling. Mes-
saging seeks to elicit direct changes in behaviors/beliefs
and may also inform the public of associated risks or RG
programs. With recent technological changes in gambling
products, institutions responsible for executing RG pro-
grams have hypothesized that customized messages
maybemoreeffectivethanaone-size-fits-allmessaging
program. RG messaging is typically a broad-spectrum
strategy that is often the first-point of contact with
gamblers. Even small improvements in the effectiveness
of communicating such messages may have large down-
stream impacts on harm.
In this paper, we explore the use of customized mes-
sages targeting various segments of gamblers. Messages
are framed to increase gamblers’motivation to seek and
use relevant RG resources. As part of this study, we re-
view the broader public health messaging literature for
its relevance to RG messages. We examine whether the
themes emerging from the broader literature also mani-
fest in the content of focus group discussions within a
community sample of gamblers regarding a series of RG
messages presented to them. We make an academic con-
tribution to the public health messaging literature by
framing categories by which gambling messages could
be customized in order to facilitate engagement with
harm minimization resources. We also make an applied
contribution by exploring message archetypes which,
after adaptation to regional idiosyncrasies, could be
adopted by prevention programs within a cohort of
end-users.
Responsible gambling
Gambling disorder is an addictive disorder described as,
“persistent and recurrent problematic gambling behavior
leading to clinically significant impairment or distress”
[5]. The disorder is characterized by a range of symp-
toms, including distorted cognitions, chasing losses, pre-
occupation with gambling, and inability to stop [2,3,6].
Research indicates that gamblers generally support the
availability of RG tools, particularly those that assist cus-
tomers to play within their means, including player feed-
back and regular financial statements [7–12]. Despite
that, customer engagement with RG tools appears to be
relatively low.
Broadly, uptake of RG resources has been low. In a recent
British Columbia study, Cohen, McCormick, and Davies
[13] estimated that only 5% of the moderate to high-risk
population are enrolled in the province’s self-exclusion pro-
gram. Within Australia, one site reported that only 1600
out of 200,000 active customers (0.8%) used the deposit
limit tool available, and only 900 self-excluded from the site
(0.45%) [14]. Reports from a European online site indicated
that only 1.2% of users self-imposed limits on their expend-
iture [15], while another European site found only 13% of
users regularly engaged with a well-integrated RG tool [16].
Research on limit-setting tools suggests that the vast major-
ity of gamblers respond positively to the concept of
pre-commitment, but need direction to make use of such
tools [17–19].
Research from the broader health messaging literature,
relating to sexual health, alcohol consumption, and nutri-
tion behaviors, suggests that messages could have increased
effectiveness for such populations by communicating direct
and tailored content (e.g., RG tips), rather than simply pro-
viding information about the availability of programs and
resources [20–22]. Critical to the effectiveness of such mes-
sagesarethetypeofcontentused,thewaytheyareframed,
whether they engage consumers in self-referential process-
ing, their level of specificity and applicability to use in the
real world, and the use of social norms to influence the be-
havior of the individual. Findings on the importance of
these factors from the broader public health messaging lit-
erature are now reviewed in order to consider their rele-
vance to RG messaging.
Message content
Important elements of consumer communication in-
clude language, tonality, and message content [23,24].
Message content refers to the simplicity, degree of dir-
ectness, and comprehension of the words that commu-
nicate the appropriate level of danger, consequences,
and/or actions to avoid harm [25]. The type of language
used in warning messages may have varying impacts on
individuals, depending on culture, emotional state, level
of gambling problem, and the consumer’s sense of
self-esteem [26–28].
RG messages often inform gamblers of information
about the probabilities of winning, and how outcomes
are determined. These messages are predicated on the
use of warnings for alcohol and tobacco products,
informing consumers about the risks associated with ex-
cessive or inappropriate use. In the gambling context,
the use of informative or educational messages is based
on the concept of problem gambling being a result of ir-
rational thoughts and beliefs. It was hypothesized that if
gamblers understood the games and probabilities of win-
ning, they would be able to make informed decisions re-
garding their involvement [29–31]. Empirical research
suggests that effectively communicated information does
not consistently modify irrational beliefs or erroneous
estimations about the chances of winning [32–36].
The failure of such information to modify behavior is
likely due to cognitive biases that enable gamblers to
understand the low probabilities of winning, yet still be-
lieve that they may have a chance to win [36]. Even when
informative messages are accurately recalled, respondents
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still believe that their chances of winning are greater than
the information contained within the messages, and do
not modify their behavior [37,38]. Whilst informative
messages can correct irrational beliefs, there is limited em-
pirical understanding of how such messages may impact
gambling behavior [35,36].
Message framing
Prospect theory suggests that people behave differently
when messages are framed as either gains or losses [39].
Positive or gain-framed messages focus on the benefits of
making improvements in a particular behavior, whilst
negative or loss-framed messages contain information
about harmful consequences and hazards related to risky
behaviors [27]. Although educating consumers about the
risks of a product is connected to informed choice, re-
search on attitudes and persuasion suggests a focus on
negative impacts is too narrow [40], and a gambling limit
tool study showed that feedback about violating a limit
did not lead to the intended reduction in play [41]. Mes-
sages are more persuasive if they promote positive atti-
tudes, and if the identified behaviors are mutually
exclusive (e.g., setting deposit limits vs. having no limits)
[42]. The use of positive framing of messages has been
found to have a greater impact than negative framing. For
example, neuroimaging research has found that
gain-framed messages are more effective in improving
risky choice behaviors than loss-framed messages amongst
individuals with substance-use disorders [43,44]. When a
behavior is presented as a choice, positive messages are
more effective than negative messages [45]. Audiences
tend to respond with more enthusiasm to positive things
that they can do to prevent health problems [46], and re-
search across multiple public health domains suggests that
positively-framed messages are more effective than
loss-framed messages when advocating health prevention
behavior [46].
Self-appraisal messages
Self-appraisal messages encourage consumers to reflect
on their own personal situation and take appropriate ac-
tions. Persuasion research shows that when individuals
generate arguments and conclusions themselves, they
are more convincing for the individual than statements
provided by external sources [47]. Self-generated argu-
ments are often perceived as more accurate than infor-
mation provided by external sources [48–50]. Messages
that imply an outcome but allow perceivers to draw their
own conclusions may reduce feelings of resentment and
enhance the persuasiveness of messages [51]. Several la-
boratory and in-venue trials of self-appraisal messages
on electronic gaming machines (e.g., “Have you spent
more than you intended?”) have found that such mes-
sages increase awareness of time spent playing and
create more realistic thoughts about the chance of win-
ning, increasing the likelihood of taking a break and re-
ducing the duration of gambling sessions [38,52].
Specific and action focused
Less abstract messages that include specific actions, such
as setting a deposit limit, can increase message compli-
ance [53]. Research with smokers found that warning
messages should contain sufficient information and
identify steps to help smokers progress towards quitting
[54–56]. Online gambling messages that suggested spe-
cific information (e.g., “10 gambling commandments”)
generated five times more website “click-throughs”than
informative messages commonly used (e.g., “How prob-
lem gambling works”)[57]. A sense of urgency can also
be introduced by using phrases such as, “Have you…
yet?”. This is consistent with research on health warn-
ings which has demonstrated that messages that are
positive and have a sense of urgency are felt to be strong
motivators for action [58].
Targeted messaging for gamblers
Attempts to warn players of risks associated with gam-
bling and direct them to RG resources often use
in-venue signs with RG slogans and problem gambling
helpline numbers. Many studies have found that these
messages are largely ignored by gamblers [38,59,60].
The extent to which the message is read, absorbed, and
acted upon is dependent upon the personal relevance of
the message, the target recipient’s capacity to assimilate
the information, and their motivation to respond [25].
To be effective, RG messages should engage the gam-
bler’s cognitive, emotional, and motivational faculties,
and alter the behaviors of concern [61–63]. It is plaus-
ibly unreasonable to expect that messages broadcast to
all gamblers can be impactful given the many differences
between players, including the type of resources they
would each benefit from using.
Whilst legacy gambling systems were more inflexible,
new technology linking player accounts can enable sophis-
ticated RG strategies, including personalized messaging
that targets players based on individual characteristics and
patterns of play [64]. For example, gambling providers can
send direct emails, online messages, or SMS to customers.
Additionally, within venues where loyalty cards are used,
operators can send personalized RG messages to cus-
tomers through electronic gaming machine screens. Tai-
lored messaging has been shown to outperform traditional,
static health information strategies, and is more likely to be
read, remembered, and viewed as personally relevant [65].
Importantly, tailored messaging has been shown to be im-
portant in motivating change in problem drinkers and
problem gamblers, irrespective of whether they commence
treatment or not [66,67].
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Segmenting gambling cohorts
Targeted messages should be particularly useful in popu-
lations where there is great variability between members
[68] and that information is accessible in marketing da-
tabases. One key difference between gamblers is age.
Young adults (aged 18–24) appear to manifest more
gambling-related problems [69–71]. The reception of
warning messages by young adults is often considered to
be different from the general population [24,72]. In
their meta-analysis of evidence on warning message ef-
fectiveness, Argo and Main [23] argue that age correlates
negatively with warning perception, although they note
relatively limited empirical evidence to support this.
Young adults tend to perceive themselves as invulner-
able to the negative consequences of risky behaviors,
and have difficulty relating to negative consequences
that may occur in the future [73–76]. Young people also
tend to underestimate the severity of their gambling, fail
to recognize and accept gambling problems, and are less
likely to seek help [77]. They do not necessarily have a
poorer understanding of gambling odds than adults, but
they are more prone to erroneous beliefs about gam-
bling, as well as beliefs that gambling can be controlled
[78–80]. Due to the increased relevance of social norms
for youth, manipulating social context may increase the
effectiveness of messages for this target cohort [81]. For
example, smoking and drug prevention advertisements
highlighting social implications appear to be more per-
suasive than warnings of physiological illnesses with ad-
olescents and young adults [82,83].
In contrast, older adults are another group with unique
risks and importance. According to the 2014 Canadian
Community Health Survey [84], over 67% of persons aged
65 or older gamble. Many scholars have emphasized the im-
portance of protecting this group from the harms of gam-
bling, noting the risk factors associated with fixed-incomes,
social isolation, bereavement, and increased leisure time in
retirement [85–87]. One key difference between seniors and
other groups is that they show more obsessive passion for
gambling when their behavior is problematic [88]. They also
show a greater likelihood of responding to digital marketing
strategies than other sub-groups [89].
It is also plausible that different gambling product
users will receive messages differently. Gamblers who
engage in games with real or perceived skill (e.g., poker,
sports betting) view themselves as different, as they use
their ability to increase their odds of winning [90,91].
Online poker players are generally less likely to chase
losses than online casino gamblers [92], respond better
to time limit tools than monetary limit-setting tools (un-
like other gamblers [93]), and are a heterogenous group
in that more skillful online poker players have been
shown to respond less favorably to RG tools less skilled
players [7].
Frequent gamblers –usually characterized by partici-
pation in gambling once a week or more –have been
identified as having greater risk for gambling problems.
Research has shown that frequency of participation is a
highly predictive risk-factor for gambling-related prob-
lems [94–96], and may be a behavioral marker for gam-
bling disorder [97,98]. Given the specific characteristics
of this group, frequent gamblers appear to be another
plausible target group to be studied for tailored RG mes-
saging, alongside young adults, seniors, and skill game
gamblers.
There are several variables that can be considered in
designing and distributing RG messages, and message
impact is likely to differ between various segments of
gamblers due to their own needs and preferences. There
appears to be adequate evidence in the gambling litera-
ture to warrant customization of messages for young
adults, older adults, skill-game gamblers, and frequent
gamblers. While other risk groups exist, we examine
these categories as they can be identified in most mar-
keting databases. Age is collected as part of the entry
control requirements in the registration processes, while
game type and frequency are variables controlled by the
operator. In the next section, the approach to exploring
thematic differences in these cohorts’needs is described.
Methods
A series of online focus groups were conducted to gain
feedback on the wording of various RG messages created
based on the literature review for each of four selected
player cohorts. The study protocol was reviewed and ap-
proved by the Human Subjects Ethical Review Committee
at Southern Cross University. Focus groups were used be-
cause they are socially-oriented, in which participants lis-
ten to others’opinions and understandings in forming
their own responses [99]. Whilst focus groups typically
have high face validity, group size may be small and the
results may not be statistically generalizable [99,100]. The
results, however, still provide meaningful insights into
how participants respond to messages presented to them,
as well as feedback on message wording and content. As
any message used in actual marketing materials would
need to be adapted for its particular market, focus groups
are a useful method for exploring themes that a generic
strategy could consider.
The four player cohorts were identified based on a re-
view of the literature and are groups that could be easily
identified in player databases for message distribution.
In total, 39 participants attended the four focus groups:
1. Young Adults –those aged 18–24 years old (N= 10,
6 male)
2. Seniors –those aged 60 years old or older (N= 10, 4
male)
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3. Skill Game Gamblers –those who play games
involving an element of skill, such as poker or
sports betting (no age qualification for this group)
(N= 10, 7 male)
4. Frequent Gamblers –those who have gambled once
per week or more often (no age qualification for
this group) (N= 9, 6 male)
Each of the authors independently generated potential
messages for the cohorts. That list of potential messages
was then reviewed by all authors for content and rele-
vance within the literature framework and reduced to a
useful subset through consensus. Messages were selected
to be similar to archetypal messages used by RG pro-
grams, but also with consideration of the evidence for
their effectiveness found in the health messaging litera-
ture review. Messages were then reviewed for appropri-
ate length before inclusion in the focus group moderator
guide, which can be viewed as supplementary file
Additional file 1.
Each message contained an action phrase connected
to an RG tool to prompt respondents to consider their
behavioral response. The Play Summary tool displays the
player’s play history. The Player Assessment Quiz is an
online quiz that helps gamblers better understand their
own gambling behavior within the scope of health
habits. The Responsible Gambling Tips are seven tips
that encourage players to gamble responsibly, such as
“Don’t chase losses,”and “Take frequent breaks”.The
Odds Knowledge Quiz is an online quiz that tests the
participant’s knowledge of gambling odds, such as the
roulette wheel landing on a given number. The Limit
Setting tool is a budgeting tool that allows players to set
a weekly limit on the total amount they can transfer into
their online gambling account. Table 1below displays
the messages presented to the respective groups.
Participant recruitment
Participants were selected and screened by telephone
using a database comprised of randomly selected house-
holds in Manitoba, Canada. Participants qualified if they
were over the age of 18 and had reported gambling on-
line during the prior 12 months, to ensure the groups
were formed with participants who were potential recipi-
ents of these types of messages. Table 2below displays
core sample characteristics reported during the screen-
ing process, including gender, age, gambling activity, and
gambling frequency, which was measured as a simplified
dichotomous variable for screening into the frequent
gamblers group. During the recruitment and screening
process, all participants completed an informed consent
form. All participants were provided with a $50 incen-
tive for their participation.
Data collection
The four online focus groups ranged from 60 to 78 min
in duration and were conducted via iTracks, an online
focus group platform. Research suggests online focus
groups may elicit more themes with sensitive topics than
in-person focus groups [101]. The iTracks platform con-
ducts focus groups in a written format, similar to an on-
line chat room. The online focus group was conducted
in a similar manner to an in-person focus group, with a
moderator leading a discussion among a small group of
participants. The participants submitted typed answers
to the group, and the moderator was able to communi-
cate privately with individual participants. Through the
private messaging system, the moderator was able to ask
Table 1 Messages Presented to Each Focus Group, by RG Tool
RG Tool
Group Play Summary Player Assessment
Quiz
Responsible Gambling
Tips
Odds Knowledge
Quiz
Limit Setting (a) Limit Setting (b)
Young
Adults
Do you know how
much you are
spending? Check
your Play Summary.
What kind of player
are you? Take this
short quiz.
Play often? Check
out these 7
gambling tips.
Are you a gambling
expert? Test your
knowledge of
gambling odds.
All players need to
stick to their limits.
Have you set your
spend limit?
All players need to stick
to their limits. Do you
know how much you
have spent?
Seniors Have you spent more
than you can afford?
Check your Play
Summary.
What kind of player
are you? Take this
short quiz.
Play often? Check
out these 7
gambling tips.
Are you a gambling
expert? Test your
knowledge of
gambling odds.
All players need to
stick to their limits.
Have you set your
spend limit?
All players need to stick
to their limits. Do you
know how much you
have spent?
Skill Game
Gamblers
Do you know how
much you are
spending? Check
your Play Summary.
What kind of player
are you? Take this
short quiz.
Play often? Check
out these 7
gambling tips.
Are you a gambling
expert? Test your
knowledge of
gambling odds.
All players need to
stick to their limits.
Have you set your
spend limit?
All players need to stick
to their limits. Do you
know how much you
have spent?
Frequent
Gamblers
Have you spent
more than you can
afford? Check your
Play Summary.
What kind of player
are you? Take this
short quiz.
Play often? Check
out these 7
gambling tips.
Are you a gambling
expert? Test your
knowledge of
gambling odds.
All players need to
stick to their limits.
Have you set your
spend limit?
Even frequent players
need to stick to their
limits. Do you know
how much you have
spent?
Included with each message is a link to the respective RG tool
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individual follow-up questions whilst continuing the dis-
cussion in the main focus group.
Focus groups were structured to elicit responses to the
proposed messages, with an interest in collecting partici-
pant feedback on six pre-developed messages per group.
The messages were presented in five cases, one at a
time; each case focusing on a different RG tool (as dis-
played in Table 1). Participants were first asked for their
initial response to the message, and then asked why they
would or would not engage with the linked tool. Next,
the inquiry requested any proposed changes that partici-
pants would make to the message to make it more rele-
vant to them. Where relevant, the moderator would
send follow-up messages to individual participants to
elicit further details on their response to the individual
messages. Finally, participants discussed the types of
messages they found most effective, and offered up their
own wording, themes, or specific phrases that would get
them to engage with RG tools.
Analysis
The transcriptions of the focus groups were subjected to
content analysis with a focused coding approach. Con-
tent analysis was used because it provides a “careful, de-
tailed, systematic examination of a particular body of
material in order to identify patterns, themes, biases,
and meanings”[102]. In focused coding, researchers iden-
tify themes and look for associated data fitting under cat-
egories of interest [103]. Coding categories were established
based on the literature review and focused on message
tone, potential engagement, personalization options, num-
bers, and terminology (e.g., gambling vs. gaming, player vs.
gambler). The message tone theme was used to assess par-
ticipant interpretation of the tone of the message (e.g., en-
couraging, condescending), andtheiremotionalresponse
(positive, negative, neutral) to that tone. The potential en-
gagement category was used to code how participants indi-
cated they would or would not engage with the RG tool
associated with the message. The personalization options
theme covered participant suggestions of how the messages
could be individualized for different people or player types.
The numbers theme described inclusion of numbers from
individual play behaviors, such as amount of time or money
spent gambling. Finally, the terminology code was used to
identify where participants identified qualities of the vo-
cabulary used.
To establish inter-rater reliability, two researchers in-
dependently coded the data set (98.6% agreement across
76 entries), then together reviewed and settled the only
discrepancy in coding by considering its content, theme
definitions, and extant literature support.
Results
The messages recommended for each specific group as a
result of the analysis is presented in Table 3. Within all
groups, there was no difference in message preference
between genders.
Young adults
Young Adults were particularly responsive to message tone,
especially messages that were perceived as condescending.
Table 2 Sample characteristics (N= 39)
Percent
Gender Male 59.0
Female 41.0
Age 18–24 Years 30.8
25–40 Years 17.9
41–59 Years 25.6
60 Years and older 25.6
Gambling Activity Online,
within Prior 12 Months
Poker, Blackjack, and other
skill games
46.2
Sports Betting (including fantasy
leagues)
51.3
Bingo 10.3
Lotteries 56.4
Chance-based table games
(e.g., roulette or craps)
5.1
Slots 38.5
Gambling Frequency Once per week or more often 43.2
Less often than once per week 56.8
Table 3 Recommended messages for Young Adults, Seniors, Skill Game Gamblers, and Frequent Gambler group types
Group Generic Message 1 Message 2
Young Adults Only spend what you can afford to lose.
Check out the play management tools.
Are you a gambling expert? Test your
knowledge of gambling odds.
Keep it a game. Check out these 7 tips
to become a more responsible gambler.
Seniors Only spend what you can afford to lose.
Check out the play management tools.
How much have you spent gambling?
Check out your play summary here.
Stick to your limits and keep gambling
fun. Have you set a spending limit?
Skill Game Gamblers Only spend what you can afford to lose.
Check out the play management tools.
Check out your gambling odds. Test
your game knowledge here.
Check out your play summary. Click here
to see your spending habits.
Frequent Gamblers Only spend what you can afford to lose.
Check out the play management tools.
What kind of gambler are you? Take
this short assessment quiz here.
Even frequent players should have limits.
Have you set your spend limit?
Included with each message is a link to the respective RG tool
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One participant requested messaging that “does not sound
like it is ‘blaming you,’” and several others followed along
the same train of thought, asking for messages that were
not accusatory or patronizing, but rather were straightfor-
ward and honest in their phrasing. Simple messages were
preferred, as one participant explained, and not “dressed up
in language.”
Young Adults also indicated a preference for messa-
ging that provided tips to show how they can save
money, by using the linked RG skills and tools. Some
follow-up comments suggested that participants were in-
terested in messages with tips that helped them become
more successful gamblers (i.e., to win more money).
Other tools that drew a positive response from Young
Adults included the Play Summary tool, which was iden-
tified as a useful tool for accurately recording play when
gamblers’own perception might be distorted, and the
quiz testing knowledge of gambling odds, which was la-
beled as “beneficial.”Conversely, the Young Adult group
indicated a distinct lack of interest in the self-assessment
quiz, which they viewed as not useful.
The idea of presenting negative realities was also sug-
gested –the discussion turned to the potential harms of
problem gambling and a proposal for warning messages
similar to those on cigarette packs was presented as an
option for messaging.
Older adults
Like the Young Adults, Older Adults were also con-
cerned about tone, with one participant stating that they
wanted messages that “treats [one] like a responsible
adult,”and not like “my mother wagging her finger at
me.”Other participants suggested avoiding “condescend-
ing messages,”and that it felt “insulting”to “imply that
[they are] foolish to not set a limit”, when provided a
message on limit-setting tools. Beyond this concern, the
group was positive about the use of messages in general,
suggesting that they be clever, upbeat, and humorous,
with reminders to keep the game fun. Some participants
suggested that additional messages that show negative
consequences of problem gambling would also be useful,
as well as information on where to get help if a gambler
thinks they are losing control.
Older Adults identified the Play Summary as a useful
tool, though many indicated they already set limits when
they play. In addition, the quiz to test gambling know-
ledge and the limit setting tools were selected as tools
that the group would seek out if they received a message
promoting the tool.
Skill game gamblers
Skill Game Gamblers were largely interested in blunt,
straightforward language in their messages, with one
participant requesting messages that “[call] a spade a
spade.”Messages that were simple and direct were pre-
ferred, such as those that included specific values for
time and money spent gambling. Matching this prefer-
ence, Skill Game Gamblers indicated that the Play Sum-
mary was a valuable tool for them, making them think
about their own budget. The group also requested indi-
vidualized messages with their personal spend numbers,
as “seeing real numbers tells the story.”
The quiz testing gambling knowledge was also consid-
ered useful, primarily for the purpose of confirming their
own knowledge. One participant also indicated that a
message promoting this kind of quiz would get them to
engage with the tool to enhance their knowledge of re-
sponsible gambling, stating, “if I could learn something
that could help me place a responsible bet, I’d read on.”
Skill Game Gamblers also suggested that messages
should include reminders of the ramifications of over-
spending, as well as that the odds are against winning and
that in the long run, the house always wins. In addition,
Skill Game Gamblers were the only group to speak to ter-
minology use in describing those who gamble, suggesting
that use of the terms “gamble”or “gambler”instead of
“play”or “player”would be useful reminders that wagers
involve at least some chance component.
Frequent gamblers
As with the other groups, Frequent Gamblers empha-
sized the need for positive language in RG messaging,
and to avoid any language that might be accusatory or
might make someone feel guilty about their gambling
behavior. Simple, short messages were preferred, such as
reminders to “keep it a game.”One participant further
recommended messaging include information to educate
family and friends who might need the RG tools. Indi-
vidual spend numbers were requested as a reminder of
play behaviors, paralleling the request of Skill Game
Gamblers.
Frequent Gamblers were the only group to not posi-
tively endorse the Play Summary tool, with most partici-
pants indicating they were already aware of their limits
and spend, and thus felt they did not need the tool. Also,
distinct from other groups, Frequent Gamblers responded
positively to the self-assessment tool, expressing curiosity
about their classification. Several participants noted that
they “love taking short quizzes”and that they were inter-
ested into which player type they would fall.
Discussion
This research is the first study to empirically consider
the content of RG messages in identifiable cohorts. In
this study, thematic differences were found between sub-
groups of players. This was observed in both message
wording (e.g., tone) and in the action response (i.e., RG
tool) that they were prompted to consider. Young Adults
Gainsbury et al. BMC Public Health (2018) 18:1381 Page 7 of 11
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gravitated towards tips to help them be ‘better’gamblers,
which could be used to provide suggestions for losing less
money (e.g., not chasing losses). This is consistent with re-
search suggesting that young people are more prone to er-
roneous beliefs about gambling, such as the idea that
gambling can be controlled [78–80]. The focus group sup-
ported this, with participants reporting that they would
find the information in the quiz and list “beneficial,”and
that they would use the tools to “gain a greater under-
standing of what [they’re] looking at”when they’re placing
bets. In contrast, Older Adults looked for more light-
hearted messages, focused on keeping gambling fun.
Older Adults were also attracted to limit-setting features
that were not as popular among other groups. Older
Adults, many of whom are on a fixed income, may benefit
from tools that help them be mindful of how much money
they spend on gambling [104,105].
The self-assessment test of gambling behaviors and
limit setting tools were viewed more positively by Fre-
quent Gamblers. Frequency of gambling has been identi-
fied as predictive of problem gambling [106], and these
messages prompt the recipient to assess their own level
and style of gambling, and also suggest a tool that can
be used to help them keep their gambling within afford-
able levels [105].
Skill Game Gamblers preferred more direct communi-
cation, seeing themselves as able to incorporate informa-
tion into their gambling, including about potential risks
of gambling. Frequent Gamblers were interested in re-
sources to assist them in keeping track of their expend-
iture –such as activity statements in the Play Summary
tool. This is consistent with Philander and Gainsbury
[105] who suggest that because those who play games
with an element of skill are more likely to develop illu-
sions of control about their skill [107], messages for
these gamblers should encourage gamblers to be mindful
of the element of chance in games. The Play Summary
message also serves as a reminder to Skill Game Gam-
blers to be mindful of their sessions and expenditure.
Recreational Skill Game Gamblers can exhibit impulsive
personality traits and may demonstrate signs of chasing
behaviors [108–110], and this message may encourage
them to use the Play Summary tool as a means of keep-
ing themselves aware of expenditure resulting from such
behavior.
Messages were found to be more likely to be persua-
sive if they promote positive attitudes towards the de-
sired behavior. Motivation can be enhanced by reducing
the ‘cost’of compliance, increasing the perceived ability
to perform a specific action, using a positively-framed
message, and appealing to the individual’s sense of value.
Gamblers may be more likely to engage with RG re-
sources if they believe that these resources are typically
used by their peers, and those that they respect. Focus
group participants consistently discussed the importance
of messages not being patronizing or judgmental.
Educational- and awareness-based messaging is a tool
that the gambling field has adopted from the wider pub-
lic health field, with mixed success. Customizing RG
messages and pairing RG tools based on age, gambling
frequency, and type of gambling activities may enhance
the effectiveness of messages and subsequent engage-
ment with RG resources. Literature supports the use of
messages that encourage gamblers to consider their own
gambling, rather than providing explicit directions or in-
formation; a finding reinforced by participants in this
study. When individuals generate arguments and conclu-
sions themselves, they are more convinced than by state-
ments provided from external sources.
Limitations & future research
Whilst focus groups are highly useful for the in-depth ex-
ploration of topics, attitudes, and concerns, the findings
may not be generalizable due to the limited sample. In
addition, with only one group per segment type, the ability
to draw conclusions from the data is limited, as data satur-
ation may not have been reached. Third-person bias may
be at play, where messages that focus group participants
think will be persuasive may be influenced by participants
considering what is effective for other people, rather than
themselves. The results are also limited in that they only
considered four cohorts, each with some degree of over-
lap. It is likely that gambling operators can segment their
player databases in more sophisticated manners.
Further research should aim to analyze player databases
of gamblers to identify at-risk gamblers using more com-
plex segmentation, connected to a theoretical understand-
ing of persuasive messages and experimental design. Such
an approach could include qualitative research more spe-
cific to the given jurisdiction, followed by field experi-
ments testing multiple message options. Future work
should also consider how to deliver messages, in terms of
mode of delivery, frequency, and duration. Each of these
factors is important to effective communication.
Last, it is important to note that gambler preferences
are not the only consideration in the design of public
health strategies. Although gamblers may prefer one RG
tool to another, that does not mean that this is the tool
from which they would most likely benefit [111]. As
such, one important role for RG messages and public
health communication strategies is to effectively describe
available resources to enhance understanding among
relevant groups and evaluate related outcomes, even
where there is not intrinsic interest in their use.
Conclusions
By focusing messages on a specific intended audience,
messages can be developed to elicit greater individual
Gainsbury et al. BMC Public Health (2018) 18:1381 Page 8 of 11
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responsiveness and compliance. Our research suggests
that there are some commonalities in message compo-
nents that are perceived to be most effective in encour-
aging uptake of preventative and harm-minimizing
behaviors. This includes promoting positive attitudes to-
wards the desired behavior and reducing the perceived
cost of compliance –that is, positive framing, and mak-
ing behaviors easier and simpler to complete. Increasing
specificity of messages also enhances engagement, par-
ticularly if a sense of urgency is conveyed. Personalizing
messages to target specific population subgroups and
understanding the characteristics of those subgroups is
advantageous and likely to enhance the presentation of
health information.
Additional file
Additional file 1: Focus Group Moderator Guide for Strategies to
Customize Responsible Gambling Messages: A Review and Focus Group
Study. Moderator guide information for focus groups conducted,
including research background, initial questions, and proposed RG
messages for testing. (PDF 112 kb)
Abbreviation
RG: Responsible Gambling
Acknowledgements
Not applicable.
Funding
This research was funded by the Manitoba Gambling Research Program of
Manitoba Liquor and Lotteries Corporation; however, the findings and
conclusions of this paper are those solely of the author(s) and do not
necessarily represent the views of Manitoba Liquor and Lotteries Corporation.
This work was supported by an Australian Research Council Discovery Early
Career Research Award [DE1060100459] awarded to Dr. Sally Gainsbury. The
funding bodies had no role in the design of the study, collection, analysis, and
interpretation of data or in writing the manuscript.
Availability of data and materials
Deidentified transcripts available upon request from the corresponding
author for approved projects.
Authors’contributions
SG contributed to study design, data analysis, and report writing. BA
contributed to study design, data analysis, and report writing. KP contributed
to study design and report writing. JB contributed to study design and
report editing. All authors have read and approved the manuscript.
Ethics approval and consent to participate
The study protocol was reviewed and approved by the Human Subjects
Ethical Review Committee at Southern Cross University [ECN-15-347]. All
participants were provided with information sheets prior to the focus groups
and provided written informed consent during the focus group before these
commenced.
Consent for publication
Not applicable.
Competing interests
SG has received direct and indirect funding over the last three years for
research projects, consultancy and to cover travel expenses including from
NSW Office of Liquor, Gaming and Racing; Australian Media and
Communication Authority; British Columbia Lottery Corporation; National
Council of Problem Gambling Singapore; Australian Research Council;
Australian Department of Social Services; GambleAware; Gambling Research
Australia; Victorian Responsible Gambling Foundation; National Association
for Gambling Studies; Manitoba Gambling Research Program; Ontario
Problem Gambling Research Centre; Gambling Research Exchange Ontario;
Star/Echo Entertainment; Sportsbet; Crown Melbourne; Community Clubs
Victoria; Alberta Gambling Research Institute, Responsible Gambling Council;
Financial and Consumer Rights Council.
KP was previously the Director of Social Responsibility at the British
Columbia Lottery Corporation. In the past three years, he has received
funding from the British Columbia Lottery Corporation, Manitoba Gambling
Research Program, Responsible Gambling Council of Canada, UNLV
International Center for Gaming Regulation, U.S.-Japan Business Council,
Wynn Resorts, Board of Regents of the Nevada System of Higher Education,
and iDevelopment and Economic Association. He has received
reimbursement for travel from the National Council for Problem Gambling,
International Association of Gaming Advisors, National Centre for
Responsible Gambling, North American State and Provincial Lottery
Association, and Alberta Gambling Research Institute.
BA has received funding (2013–2018) from the Manitoba Gambling Research
Program, GP Consulting, U.S.-Japan Business Council, Wynn Las Vegas,
Victoria Responsible Gambling Foundation, Bermuda Casino Gambling
Commission, the State of Nevada, Canadian Partnership for Responsible
Gambling, iDevelopment and Economic Association, Majestic Star Casinos,
Oakland Raiders/National Football League, MGM Resorts International, and
Caesars Entertainment. She has received reimbursement for travel from
Association cluster sport international, British Columbia Lottery Corporation,
International Association of Gaming Advisors, GambleAware, Las Vegas
Convention and Visitors Authority, Ultimate Media Ventures, Canadian
Partnership for Responsible Gambling, and IGT Latin America. She is a
member of the Singapore National Council on Problem Gambling
International Advisory Panel.
JB has no competing interests, apart from funding mentioned in this study.
Publisher’sNote
Springer Nature remains neutral with regard to jurisdictional claims in
published maps and institutional affiliations.
Author details
1
Brain and Mind Centre, School of Psychology, University of Sydney,
Camperdown, NSW, Australia.
2
International Gaming Institute, University of
Nevada, Las Vegas, Box 456037, 4505 S. Maryland Pkwy, Las Vegas, NV
89154-6037, USA.
3
UCLA Gambling Studies Program, University of California,
Los Angeles, USA.
4
School of Hospitality Business Management, Carson
College of Business, Washington State University, Everett, WA, USA.
5
Department of Economics, School of Social Sciences, Humanities and Arts,
University of California, Merced, Merced, CA, USA.
Received: 18 April 2018 Accepted: 29 November 2018
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