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How we tested tools designed to help homeless people with gambling addiction

Posted on 19 June 2018 by Sophie Pilley, Senior Researcher .
Tags: QDT, Questionnaire Development and Testing Hub

At the National Centre for Social Research, it’s important to us that our work has a positive impact on society – to ensure that social research can really help to improve lives.

Recently, for example, we carried out a cognitive testing project to help screen and provide information to homeless people and frontline homelessness staff about gambling addiction.


Why was this study carried out?

Substance problems are well understood as factors which are influential in causing homelessness. As a result, frontline workers in hostels and shelters for homeless individuals are well-trained in identifying individuals with substance disorders.

Gambling, however, is rarely considered as a contributing factor, despite potentially having clear negative impacts on home life (such as rapid losses of money, and high instances of deception).

While homeless services automatically ask individuals about substance abuse upon contact, this is currently not the case for gambling.


What were we testing?

In the absence of standardised assessment tools designed specifically for this population, Dr Steve Sharman (then at the University of Lincoln) decided to create one in early 2017.

He asked our team at the NatCen Questionnaire Development and Testing Hub (QDT Hub) to help test the tools he’d created.

Steve’s toolset included: an information sheet to help practitioners understand and identify gambling problems; the Lincoln Homelessness and Gambling Scale (L-HAGS), a screening tool for gambling problems; and a resource sheet to provide information to people who were identified as at risk of experiencing gambling-related harm.

The tools were developed based on depth interviews. Steve’s aim was that the intervention would educate and inform homeless gamblers, allowing them to identify triggers and ways to avoid them, and suggesting strategies to help minimise risk.


What is cognitive interviewing?

Cognitive interviewing provides an insight into the mental processes people have when they are exposed to documents, such as survey questions or information leaflets.

The methods are used to help researchers identify problems with document wording, design, and implementation.

When we carry out cognitive interviewing, we aim to establish whether information is clear and easily understood – but also whether it’s successful in its intent (in other words, whether participants think they will act on the information or not).


What the Questionnaire Development and Testing Hub’s study involved…

We cognitively tested the tools with staff and service users to check for the following:

  • Comprehension of key information within the documents;
  • Missing areas within the information, screening questions and resource sheet;
  • Sensitivity of screening questions

We asked our participants to look at the documents, or have the documents read to them, and asked a number of follow-up questions to explore whether they found the information easy to understand, whether questions were sensitive, or if they thought anything could be added to the information pages.


What we found

Generally, staff and service users thought the documents were clear and covered the information they would want to know. They also made a number of small suggestions of changes, such as explaining some of the different methods of gambling.

While service providers showed concerns around the sensitivity of some of the screening questions, service users were happy to answer them and appeared to be very honest and open with interviewers.

Our recommendations from the cognitive testing were taken on board by Steve, who then made appropriate amendments to the documents.

Further details of the findings, recommendations and changes made can be seen in the report.


What's next?

We’re hoping that – after some further testing of the scoring system that indicates whether someone has a gambling problem – these documents can be piloted across a number of local authorities.

Eventually, it’d be fantastic to see them being brought into practice across the board.

This would allow staff at services access to information about gambling addiction, as well as helping homeless people with gambling problems to receive useful advice and support.

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