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ACT Vet: A mixed-methods pilot study of efficacy, usability and cost-effectiveness of an Acceptance and Commitment Therapy (ACT) based app for veterans with harmful gambling and PTSD
ABSTRACT
Background:
Acceptance and Commitment Therapy (ACT) may be beneficial for veterans experiencing harmful gambling and co-occurring mental health issues. Psychological treatment and support based on ACT is gaining popularity in the digital health domain and has the potential to widen access for vulnerable groups. Although ACT and gambling apps exist, respectively, there is currently an absence of eHealth tools for veterans with harmful gambling and related comorbidities such as post-traumatic stress disorder (PTSD).
Objective:
This mixed-methods pilot intervention will create and test a digital health-based ACT app (ACT Vet) for veterans with experience of harmful gambling and PTSD. The intervention is 12 weeks’ duration. App testing will assess efficacy, usability, and cost-effectiveness through self-report measures and detailed interviews.
Methods:
A smartphone app will deliver ACT via a structured manual of six modules (steps), each centred on one of ACT’s core components. Combined, the six steps aim to encourage psychological flexibility and diminish the impact, and likelihood of, harmful gambling. The pilot study will include UK Armed Forces veterans recruited via a range of methods, while consent and data collection will occur within the app. Data is collected at five time points (baseline, weeks 3, 6, 9, 12). The primary outcome is altered gambling harm scores between baseline and week 12, with secondary outcomes relating to psychological flexibility, changes in mental health, quality of life, and gambling-related financial costs. Process evaluation includes general app use and mHealth App Usability Questionnaire scores. Qualitative data, related to real-time app use and general feedback, will be subject to thematic analysis.
Results:
Pilot recruitment will commence in February 2024 and continue for five months. Analysis and dissemination will occur between July and December 2024.
Conclusions:
This study will examine the efficacy, usability, and cost-effectiveness of ACT Vet; a manualised gambling app, for veterans with co-occurring harmful gambling and PTSD. Potential findings from ACT Vet may determine whether an eHealth tool can have cost-saving benefits for veterans, members of the general population, and UK statutory gambling and mental health treatment services. If successful, the app scope could be extended beyond veterans and to other populations and difficulties. Clinical Trial: N/a
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