Initial Usability and Feasibility of a Web-Based Behavioural Activation Program for Young Adults With Comorbid Depression and Problem Gambling: A Case Study and Case Series
DOI:
https://doi.org/10.4309/jgi.2020.45.8Keywords:
gambling, depression, comorbidity, youth, applicationAbstract
Approximately 20%–32% of youth and adults with problem gambling also experience comorbid depression, yet treatment for this comorbidity is not readily accessible. We sought to extend and customize DoNamic, our existing web-based app for treating depression, to also treat young adults who experience comorbid problem gambling. We conducted a laboratory-based usability case study (Study 1) and a usability and feasibility clinical case series (Study 2). Study 1 involved an individual with problem gambling who tested the DoNamic version tailored to problem gambling (DoNamic-PG) in the laboratory. Changes based on participant feedback were implemented. Study 2 involved two cycles of testing in which five participants used the revised version of DoNamic-PG and provided feedback. Indicators of feasibility and usability of DoNamic-PG were predominately met; however, even with the increased accessibility and ease of use of DoNamic-PG, recruitment issues suggest it may not fully overcome the problem of attracting gamblers into treatment. This study highlights an existing concern in the field of problem gambling: Even when interventions are accessible for problem gambling populations, they are not necessarily used. Ultimately, the results of our case studies highlight how existing apps can be adjusted for specific subgroups. DoNamic-PG has the potential to be a feasible and usable app that could increase the accessibility, efficiency, and quality of care for younger adults with depression and problem gambling, if recruitment problems can be overcome. The next steps for developing DoNamic-PG include further feasibility testing, followed by trials to determine its efficacy and effectiveness.
Résumé
Entre 20 et 32 % des jeunes et des adultes aux prises avec une dépendance au jeu éprouvent aussi des problèmes de dépression. Et pourtant, il n’est pas facile d’obtenir un traitement pour ce trouble concomitant. Nous souhaitons donc adapter DoNamic, notre application web pour le traitement de la dépression, aux besoins des jeunes adultes qui éprouvent un trouble dépressif concomitant à leur dépendance au jeu. À cette fin, nous avons mené une étude d’utilisabilité en laboratoire (étude 1), puis une série d’essais cliniques sur l’utilisabilité et la faisabilité (étude 2). Dans l’étude 1, nous avons demandé à un joueur pathologique de mettre à l’essai en laboratoire une version de DoNamic adaptée aux problèmes de dépendance au jeu (DoNamic-PG), puis nous avons effectué des changements à l’application en fonction des commentaires du participant. L’étude 2 comprenait deux cycles d’essais cliniques au cours desquels cinq participants ont utilisé la version révisée de DoNamic-PG, puis ont fourni leurs commentaires. Les indicateurs de faisabilité et d’utilisabilité de DoNamic-PG ont été en bonne partie atteints; toutefois, même si l’application est plus accessible et facile à utiliser, les difficultés de recrutement suggèrent que cette solution ne suffit pas pour inciter les joueurs à se faire traiter. Cela met en évidence un enjeu actuel des traitements de la dépendance au jeu : même lorsqu’il existe des solutions de traitement accessibles, les joueurs compulsifs ne les utilisent pas nécessairement. Les résultats de nos études de cas révèlent par contre qu’il est possible d’adapter les applications existantes aux besoins de sous-groupes spécifiques et que DoNamic-PG constitue une application potentiellement utilisable pour accroître l’accessibilité, l’efficacité et la qualité des soins offerts aux jeunes adultes aux prises avec des problèmes concomitants de jeu et de dépression, à condition d’améliorer le recrutement. Les prochaines étapes du développement de DoNamic-PG comprennent d’autres études de faisabilité, suivies d’essais cliniques pour déterminer l’efficacité et la performance de l’application.
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