Gambling Harms in Adult Social Care: Developing an 'Introductory' Question to Identify Gambling Harms Among Service Users

Gambling harms are disproportionately experienced among disadvantaged groups and as such, adult social care (ASC) practitioners are well-placed to identify and support affected individuals. There exists no evidence-based 'introductory' question for practitioners to identify those at risk of gambling harms, which includes family and friends ('affected others'). To develop an 'introductory' question for use in English ASC, we conducted a scoping review that identified fifteen potential questions. Questions were refined through expert panel review groups (n = 13), cognitive interviewing (n = 18), test-retest reliability checks (n = 20) and validity testing (n = 2,100) against gold-standard measures of problem gambling behaviour. The question development process produced two questions suitable for testing in local authority (LA) ASC departments. These were (i) 'Do you feel you are affected by any gambling, either your own or someone else's?' and (ii) 'If you or someone close to you gambles, do you feel it is causing you any worries?' Each had good face validity, strong test-retest reliability, correlated highly with well-being measures and performed reasonably against validated measures of problem gambling. These two questions are currently being piloted by ASC practitioners in three English LAs to assess their feasibility for adoption in practice. Gambling harms are recognised as a serious problem for which a public health approach is recommended. Harms may be experienced by the gambler, their family and friends, and the wider community. Adult social care services within English local authorities (LAs) have been suggested as an appropriate location to ask people about gambling-related harms, offer brief advice and signpost to support services. No evidence-based 'introductory' question exists for use in these settings for practitioners to identify both gamblers and affected others at risk of gambling harms. We report findings from a National Institute for Health and Care Research (NIHR)-funded study that developed and piloted an 'introductory' question and trained staff about gambling harms within three LAs in England. This article focuses on the development of the 'introductory' question, and testing it for reliability, validity and comprehensibility in readiness for testing in three LA settings. Findings regarding the testing of the question in practice are reported elsewhere. This project was co-developed with People with lived experience partners (Betknowmore UK), GamCare (who delivered the training) and LA practitioners.