Group-based interventions to reduce gambling involvement among male football fans: a synopsis of findings from a feasibility study

Background
Gambling is associated with serious social and health harms, including suicidal ideation and suicide attempts. The risk of these adverse effects increases with consumption and imposes a substantial economic burden to the National Health Service and wider society, beyond the negative impacts on individuals and their families. Sports betting is a major growth area for the gambling industry. Sports bettors are disproportionately male and younger, two risk factors for gambling harms. It is important to develop and implement preventative interventions that limit the escalation of gambling harms among this group. We report on the feasibility of an intervention delivered within and by professional football clubs, a setting which has proved highly successful in attracting men to other behaviour change interventions (e.g. weight loss).

Methods
In what was originally designed as a three-phase study, a face-to-face group-based intervention (Football Fans and Betting) was refined in Phase 1, for delivery by trained community coaches at professional football club stadia. Eight 90-minute weekly sessions included interactive ‘classroom-based’ education around gambling behaviours, the industry and impacts, and group-based physical activity to promote social connectivity. Phase 2 assessed the feasibility of approaches to recruitment and retention and the acceptability of Football Fans and Betting to both coaches and participants. Phase 3 was intended to comprise a pragmatic, two-arm pilot randomised controlled trial of the Football Fans and Betting intervention at four professional football clubs in England.

Results
Data collected from participants and coaches via one-to-one interviews, observations and focus groups revealed significant barriers to recruitment, despite considerable iterative efforts to optimise ‘branding’ and strategies. Many of our target population did not perceive themselves as needing support. Instead, Football Fans and Betting was attractive to those with more severe gambling symptomology but who were ineligible as they required more specialist safeguarding support than Football Fans and Betting offered. It proved problematic to promote Football Fans and Betting as a programme to prevent progression to more serious gambling harms to men who were embedded in social networks where gambling was perceived as normal. The irony that many professional football clubs partner with gambling companies was noted by participants and some expressed scepticism around club intentions for delivering Football Fans and Betting. Despite considerable efforts to run Football Fans and Betting at six English professional football clubs during 2022 and 2023, insufficient numbers were recruited and retained. Phase 3 did not take place as progression to a pilot trial was unviable. Despite low numbers participating in Football Fans and Betting, those who undertook the programme found it to be useful in supporting behaviour change and in providing greater insight into industry tactics. Football Fans and Betting was most successful in feasibility delivery when it was delivered within grassroots and local community contexts.

Conclusions
In the current climate of gambling industry penetration into professional football, promoting a gambling harms prevention intervention proved an insurmountable challenge.

Limitations
The study failed to attract sufficient numbers to the intervention.

Future work
Embedding Football Fans and Betting or similar interventions within footballing communities that are not hampered by commercial gambling arrangements should be considered, along with an emphasis on the importance of early intervention to prevent progression to serious harms from gambling. Funding This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR127665.