JMIR Publications

ABSTRACT

Background:

Like other addictive behaviors, problem gambling is often chronic and relapsing. While digital interventions offer low-threshold treatment and support, their effectiveness is often limited by small effect sizes, low adherence, and high dropout rates. Progress in digital technology has enabled the development of ecological momentary interventions (EMIs), which provide just-in-time support tailored to users’ needs. However, EMIs for addictive behaviors have hardly been developed so far.

Objective:

To explore and identify relevant predictors of gambling episodes assessed by ecological mo-mentary assessments (EMAs) and physiological smartwatch (Apple Watch) data, which in turn may be used for the further development of EMI-based interventions.

Methods:

A total of 109 at-risk gamblers were recruited online in a collaborative study between Switzerland and Korea. Over a period of 28 days, participants were asked to complete brief EMA surveys three times a day (morning, afternoon, and evening) asking about their gambling behavior and their levels of craving intensity, sleep quality, physical activity, boredom, vitality, depression, and anxiety. They were instructed to wear an Apple Watch that continuously and passively recorded several physiological indicators (e.g., heart rate (variability), sleep metrics, and physical activity). Machine learning techniques and multilevel modeling approaches will be used to develop prediction models for gambling episodes and to identify relevant predictors.

Results:

Data collection has been completed since April 2025 and datasets are currently being prepared for analysis. The collected data are expected to enable the development of prediction models for gambling episodes.

Conclusions:

Incorporating the relevant predictors found in this study into digital intervention programs and providing just-in-time individually tailored intervention elements could improve program engagement and effectiveness. The approach used in this study is transferable to other digital interventions for addictive behaviors and holds promise to exploit their potential.