A reasoned action approach to gambling behavior

Abstract

Gambling behavior is a prevalent problem requiring the development of effective behavioral interventions targeting reductions in the behavior. Many theories of social cognition can be adopted to identify the specific psychological mechanisms interventions should target and how interventions can be designed to manipulate them. The purpose of the paper is to demonstrate how the Reasoned Action Approach can be used to achieve these aims. The paper outlines the steps involved in identifying relevant psychological determinants for intervention when adopting the theory. Behavior change is then discussed and the importance of translating intentions and maintaining change is emphasized. It is hoped that the paper encourages the development of a greater number of theory-based interventions targeting reductions in gambling behavior. Doing so may lead to a reduction in the number of people participating in the behavior.

Keywords:

• psychology
• problem gambling
• motivation
• intervention
• cognition

PUBLIC INTEREST STATEMENT

Problem gambling has many detrimental behavioral and health consequences. The paper outlines how a prominent behavior change theory can be adopted to understand and change gambling behavior. The paper provides intervention designers with a detailed overview of how interventions targeting gambling behavior can be designed and implemented.

1. Introduction

Social cognition models and theories can be adopted to understand and change health-related behaviors. This approach enables researchers to explain the behavior of interest using a parsimonious set of constructs. Moreover, using these theories and models enables the identification of relevant psychological mechanisms to be targeted within an intervention. The purpose of this paper is to outline how a prominent social cognition model, the Reasoned Action Approach (RAA; Fishbein & Ajzen, 2010), can be adopted to understand and change participation in gambling behavior. To do this, the paper firstly outlines the issue of problem gambling behavior and the negative effects gambling has on human well-being. Following this, the social cognitive approach to predicting and changing behavior is introduced and two behavior change theories are presented. Focus is then given to the RAA and how the theory can be used to understand and change behavior. It is then demonstrated how the RAA can be used to identify key psychological intervention targets through undertaking formative work. Following this, a number of potential strategies to modify key psychological mechanisms are then outlined. Finally, the importance of ensuring intentions to stop gambling are both fostered and maintained is discussed. In sum, the paper provides an understanding of how a prominent model of social cognition can be adopted to develop behavior change interventions targeting participation gambling behavior.

2. Gambling behavior

Problem gambling can be significantly detrimental to a person’s health and well-being (Shaffer & Korn, 2002). For example, those with gambling addictions are likely to experience anxiety, depression and high rates of substance use (Cowlishaw & Kessler, 2016; Miguez & Becona, 2015). Problem gambling can also lead to unemployment and financial strains (Komoto, 2014; Stinchfield & Winters, 2001), and can negatively affect social relationships (Bonnaire et al., 2016; Wenzel et al., 2008). Problem gambling can also lead to suicide attempts (Ronzitti et al., 2017). Despite these negative consequences, gambling is a pervasive problem worldwide (Calado & Griffiths, 2016; Meyer et al., 2009) and is considered a public health concern (Adams et al., 2009). However, the availability and access to gambling platforms is vast (Gainsbury et al., 2015; King et al., 2010) and continues to evolve (Lopez-Gonzalez & Griffiths, 2018). For example, online platforms are particularly appealing due to its ease of access and speed (Chóliz, 2016). Although there exist many forms of gambling and some are more pervasive than others (e.g., gambling using online platforms) (Gainsbury et al., 2013), this paper refers to gambling generically. Therefore, rather than focus on a particular form of gambling, such as using the internet or entering a casino, the main purpose of the paper is to outline how gambling in general can be targeted using models of social cognition. The reader can apply the suggestions to a specific form of gambling or a specific population, if they so wish.

3. Social cognitive approach

Despite a lack of attention towards understanding the motives towards gambling, it is important to understand the reasons why an individual may be inclined to engage in the behavior (Binde, 2013). An understanding of any health-related behavior can be achieved from utilizing the insights of social cognition models. These models focus on the individual factors influencing behavior. These individual factors include a small number of psychological processes comprising cognitive and affective behavioral determinants (i.e. beliefs, feelings, motives, intentions). The identification of these processes enables theories to predict and explain behavior. In addition to providing an understanding of the behavior of interest, this approach also enables the identification of relevant modifiable cognitive mechanisms. Interventions and strategies can then be developed to manipulate the key hypothesized psychological determinants. Indeed, such models have been applied to change individual’s beliefs or knowledge on the assumption that such changes are necessary to bring about behavior change (Biddle & Mutrie, 2008). Models of social cognition commonly share the expectancy-value paradigm (Cook & Artino, 2016). This approach assumes behavior is processed logically by anticipating the consequences of the behavior (expectancy) and then attaching the perceived value to such consequences (value) (Feather & Newton, 1982). There have been many theories of social cognition developed to understand behavior (see Conner & Norman, 2015), but the most popular are the Theory of Reasoned Action (Fishbein & Ajzen, 1975) and the Theory of Planned Behavior (Ajzen, 1991). These will now be outlined.

4. The theory of reasoned action and planned behavior

The Theory of Reasoned Action was introduced at a time when Wicker (1969) had questioned the utility of attitudes in influencing behavior. However, Fishbein and Ajzen (1975) argued that attitude should be a good predictor of behavior only when the attitude and behavior measures show a high degree of correspondence. Termed the “principle of compatibility,” this occurs when measures of attitude and behavior are matched at the target (who), action (what), context (where), and time (when) (TACT) (Fishbein & Ajzen, 1975). Thus, global attitudes are deemed inappropriate to predict highly specific behaviors (Fishbein & Middlestadt, 1989). For example, assessing a person’s attitude towards gambling in general will be less useful than assessing a person’s attitude towards gambling on live horseracing at the weekend. This is an important point for when investigating why a certain population engage in a specific form of gambling, something which is revisited later in the paper.

In accordance with the social cognitive tradition, the Theory of Reasoned Action was developed to understand, predict and change human behavior. The theory comprises three key predictors of behavior. The proximal determinant of behavior is a behavioral intention which represents a person’s motivation to engage in the behavior. Intention is determined by two antecedents; attitude and subjective norm (see Figure 1). Attitude is a person’s cognitive evaluation of the behavior and subjective norm is the perceived pressure of others to participate in the behavior (injunctive norms). These two determinants are underpinned by sets of beliefs. More specifically, attitude and subjective norm are governed by behavioral and normative beliefs, respectively. Behavioral beliefs are the perceived consequences of engaging in behavior and people’s evaluation of these consequences. Normative beliefs are the perceived expectations of important referents and a person’s motivation to comply with these important others. These beliefs provide the psychological foundations of the determinants (i.e. attitude and subjective norm) and are fundamental in explaining the formation of the corresponding determinant. For example, to understand a person’s attitude, it is important to ascertain the underlying behavioral beliefs. Similarly, to understand subjective norm, the corresponding underlying normative beliefs should be identified. Whilst an individual will have many beliefs towards the behavior of interest, the number of beliefs influencing these determinants are not infinite; rather, an individual can only attend to a finite number of beliefs at any given moment. It is these salient beliefs, that which are most accessible in memory, that are important in determining attitude and subjective norm.

Figure 1. The theory of reasoned action (Fishbein & Ajzen, 1975)

One of the issues with the Theory of Reasoned Action was its inability to explain behaviors that were not under volitional control. Thus, the theory was updated to the Theory of Planned Behavior to account for nonvolitional behaviors. A key inclusion to the Theory of Planned Behavior was the perceived behavioral control construct (see Figure 2) which represents the amount of control a person perceives to exert over a behavior and is synonymous with Bandura’s (1977) self-efficacy construct. Similar to attitude and subjective norm, perceived behavioral control is influenced by underlying beliefs. These are control beliefs which are people’s evaluation about the presence of factors that may facilitate or impede the performance of the behavior. Similar to the Theory of Reasoned Action, the Theory of Planned Behavior assumes intention to also mediate attitude and subjective norm, and these determinants to be influenced by salient beliefs. Intention is also the proximal determinant of behavior.

Figure 2. The theory of planned behavior (Ajzen, 1991)

5. The reasoned action approach

The RAA developed from further iterations of the Theory of Planned Behavior (see Figure 3). More specifically, in the RAA attitude not only comprises a cognitive/instrumental component, but also includes an experiential/affective component. This relates to the feelings and emotions a person may have about the behavior. For example, an individual may view the behavior to be interesting or highly pleasant. Furthermore, the subjective norm construct was updated to perceived norm. Specifically, it was suggested that people do not only respond to the perceived social pressure of others (injunctive norms), but they are also influenced by what relevant others themselves do (descriptive norms). That is, the behaviors of others provide guidance as to whether the behavior should be undertaken. Finally, perceived behavioral control was updated to comprise two subcomponents; capacity and autonomy. Capacity relates to the confidence one has in undertaking the behavior and whether they can engage in the behavior if they wanted to. Autonomy refers to the perceived control one has over the behavior and whether participating in the behavior is up to them.

Figure 3. The reasoned action approach (Fishbein & Ajzen, 2010)

As with the Theory of Reasoned Action and the Theory of Planned Behavior, these three determinants are suggested to exert influence on behavior through intention. Additionally, the determinants are comprised of underlying salient beliefs. More specifically, attitude (affective and instrumental) is influenced by behavioral beliefs, perceived norm (instrumental and descriptive) by normative beliefs, and perceived behavioral control (capacity and autonomy) by control beliefs. Thus, to change behavior one would need to change intention through manipulating at least one of the attitudes, perceived norm, or perceived behavioral control. Changing one of these determinants would require a manipulation of the underlying behavioral, normative, or control beliefs.

5.1. Identifying intervention targets

It is not difficult to imagine how the RAA can be adopted to understand the psychological mechanisms underlying participation in gambling behaviors. One can simply use the three antecedents of intention to explain why an intention to gamble may occur. For example, in terms of attitude, a person may engage in the behavior due to the excitement of betting (affective attitude) or the prospect of winning a substantial amount of money (cognitive attitude). With regards to perceived norm, there may be many people approving the behavior, such as friends (injunctive norm), and these referents may also engage in gambling themselves (descriptive norm). Finally, with regards to control, an individual may lack the belief that they can refrain from gambling (capacity) or they may believe quitting is beyond their control (autonomy).

Although intuitiveness can provide an explanation for the psychological mechanisms underlying gambling behavior, it does not suffice to presume the influential determinants and underlying beliefs. Rather, formative research is required to establish the precise cognitive foundations of the behavior. Before this research is undertaken, it is of great importance that the behavior under investigation is stated precisely using the TACT principle. This is because the more specific the behavioral definition is, the more useful the information will be from the formative work. For example, it would be much better to investigate “workers gambling in the local betting shop after work” than simply “gambling after work.” The former provides a concrete definition of the target (workers), action (gambling), context (local betting shop), and time (after work), and the subsequent research would yield specific psychological mechanisms pertaining to this precise behavior. In contrast, the latter only provides information on the action (gambling) and time (after work), and the subsequent research may therefore not capture accurate psychological information of the behavior of interest. For example, a person may also gamble online after work using their mobile phone or may occasionally visit a casino throughout the week. Thus, the psychological mechanisms underlying “gambling after work” would include the trip the person has to the betting shop, the betting undertaken online, and the occasional visit to the casino. The reasons why an individual participates in these separate gambling behaviors are unlikely to be the same, which has significance for the resulting intervention. That is, the psychological mechanisms targeted by the intervention may not be accurate.

One may also wish to specify within the behavioral definition which form of gambling behavior the research concerns, especially as different forms of gambling tend to be influenced by different motives (Delfabbro, 2012). For example, betting on sports is often perceived as a skill whereas participating in a lottery is influenced by the opportunity to win large sums with only a small investment (Binde et al., 2017). Thus, in this case, the definition could include “gambling on sporting events” (action) to provide specificity on the precise gambling behavior of interest. Although this paper refers to gambling in general, it could be very important that the specific form of gambling is stated within the behavioral definition.

Once the behavior has been defined, one needs to understand the salient behavioral, normative, and control beliefs underlying the behavior through undertaking a belief elicitation study. This study involves a representative sample of the population which will vary depending on the group of interest. For example, as it has been established that reasons for gambling differ between genders (Flack & Stevens, 2019), the research study may be targeted towards males or females. The study may also be interested in a particular age group, status of employment, or geographical location. For example, one may be specifically interested in gambling in adolescents or the unemployed. In these examples, it is the responsibility of the researcher to recruit a sample that accurately reflects that population of which the research is targeting.

Once a representative sample has been identified and recruited, the researcher is well-positioned to gain important information regarding the underlying beliefs. Specifically, respondents are asked to identify the advantages and disadvantages of the behavior (behavioral beliefs), those who would approve and disapprove of participation (normative beliefs), and the factors that would make it easier and more difficult to perform the behavior (control beliefs). Again, participants should be informed of the behavioral definition and efforts should be made to ensure this is understood and adhered to throughout. This piece of work provides important information regarding the psychological foundations of the behavior. That is, the behavioral, normative, and control beliefs offer insights into the motivations associated with gambling. As there are likely to be many beliefs identified from the responders, it may be best to take a subset of these beliefs to take forward into the next piece of formative work. For example, the beliefs mentioned most frequently by responders using a percentage criterion (i.e. 25%) could represent the salient beliefs.

Following the identification of the underlying salient beliefs, a second piece of research is required to understand the specific psychological mechanisms influencing the behavior. More specifically, this study is needed to ascertain whether the behavior is influenced by attitude, perceived norm, and/or perceived behavioral control. The behavior may be influenced by one determinant (i.e. attitude), a combination of two (i.e. attitude and perceived norm), or all three determinants. This is entirely in accordance with the theory whereby the contribution of the determinants of intention are not required to be equal in all behaviors. Indeed, the contribution and importance of the psychological determinants will vary depending on the behavior investigated. For example, gambling with friends in a social environment may be influenced more by perceived norm (than attitude and perceived behavioral control), whereas gambling in a local bookmaker by oneself may be influenced more strongly by attitude (than perceived norm and perceived behavioral control). It is also important to establish the importance of intention and control factors in influencing behavior, in accordance with the theory.

To determine the key predictors of intention and behavior and to understand the variance explained by the determinants, correlations and regressions are undertaken. One should firstly establish that the behavior is influenced by intention. Confirming that the behavior is influenced by a behavioral intention not only provides evidence for the theory but means one can then establish which of the determinants (e.g., attitude, perceived norm, perceived behavioral control) mostly influence intention. The contribution of these determinants depends on the outputs of the correlations and regressions. For example, if a study finds attitude correlates more strongly with intention (than perceived norm and perceived behavioral control) and has a larger beta weight than the other determinants, the research suggests that the behavior is largely under the influence of attitude. In sum, this second piece of formative work provides important information on the psychology of the behavior through explaining whether the behavior consequence of attitude, normative factors, or issues of control.

Not only is information provided that explains the behavior of interest, but the findings offer important information regarding the development of an intervention. The specific psychological mechanisms of interest to an intervention depend on the relative weights of the determinants. For example, if attitude and perceived norm are key predictors of behavior then an intervention should seek to address these determinants. Similarly, if perceived norm and perceived behavioral control are key predictors of intention then attitude may be ignored. These determinants cannot be targeted directly, however. Rather, interventions should specifically modify the salient beliefs identified within the first piece of research (the elicitation study). It is up to the researcher to determine which of these beliefs to target. Theoretically, all underlying salient beliefs exert influence on the corresponding determinants (Ajzen, 1991). Thus, if the second study identified attitude as an important predictor of intention, and the elicitation research identified six behavioral beliefs underlying attitude, all six behavioral beliefs are of importance in forming the attitude construct. However, the elicitation study may have identified too many beliefs for the intervention to target. Researchers may therefore seek to identify the beliefs that are associated with intention or behavior, or the beliefs that best discriminate between those that perform the behavior and those that do not (or those that highly intend to perform the behavior and those that do not).

Once the relevant beliefs have been identified, two more decisions are required before an intervention can be developed. Firstly, it is important to establish whether the beliefs are amendable to change. This can be answered through examining the relative mean scores of beliefs. For example, if a belief in the second study yielded a score of 6.4 measured on a 7-point Likert scale, this perhaps suggests that the belief is already known within the sample. In this case, the designer may either decide that this belief is saturated and thus does not need to be addressed within an intervention. Conversely, it may be decided that the belief is still important, and the intervention will therefore ensure that this belief is maintained. Secondly, one must then decide whether it is feasible to change the belief. This decision is made subjectively and is dependent on the researchers’ experience (Hornik & Woolf, 1999). For example, the researcher may decide that they have the relevant resources and capability to modify the belief and then proceed to do so within the intervention. Conversely, the researcher may conclude that they lack the skills to change the belief, that it would take too much time, or that it would be too difficult.

In addition to targeting these currently held beliefs, an alternative way to change determinants is to introduce new beliefs. That is, including beliefs that were not identified as important in the formative research. For example, an individual may be shocked to discover the relatively modest number of people of a similar age to them that engage in online poker. Subsequently, introducing information on the descriptive norm may lead to a change in behavior through the relevant causal chain (belief–perceived norm–intention–behavior). As another example, an individual may not realize how gambling with friends enhances their likelihood of cardiovascular disease due to excessive alcohol consumption. Thus, providing this knowledge and subsequently changing attitude (cognitive) through a behavioral belief could lead to a reappraisal of the behavior. A useful way of identifying novel beliefs is to closely examine the beliefs not mentioned frequently by participants in the first formative study. As these beliefs were not identified by the majority of participants, they may offer novel intervention targets. Once it has been decided which psychological mechanisms are to be targeted, the designer is then ready to develop the intervention.

So far, then, the paper has introduced prominent theories of social cognition, with a focus on the contemporary RAA. It has been outlined how researchers should firstly define the behavior of interest before undertaking any formative research. Following this, two pieces of research are needed to: 1) identify the salient beliefs underlying the determinants and 2) understand the contribution of the determinants and underlying beliefs. These studies not only enable an explanation of the behavior, but they provide important information as to what should be targeted within intervention. The rest of the paper will focus on how one could attempt behavior change through manipulating identified psychological mechanisms. In addition to this, two other important issues will be discussed briefly; the intention-behavior gap and maintaining behavior change.

5.2. Changing cognitions

Theories of social cognition, such as the RAA, seek to primarily explain behavior through providing an accurate appraisal of why a person acts the way they do. However, such theories have been criticized for the lack of guidance on how to change psychological determinants (Sniehotta et al., 2014). Indeed, these theories were introduced to primarily predict and explain behavior, rather than advising on how to change it. Recent advances in behavior change theorizing has sought to standardize intervention content and provide clear information on the methods used in interventions. The key ingredients included within interventions are known as behavior change techniques (bcts) and they are defined as the observable, replicable components of behavior change interventions (Michie et al., 2013). It is important to note that bcts do not affect behavior directly, but rather influence the psychological mechanisms. Thus, the impact of bcts on behavior change occurs through the theorized causal structures (e.g., bcts–behavioral beliefs–affective attitude–intention–behavior). Evidence towards understanding the effectiveness of BCTs on psychological mechanisms has been given recent attention (Abraham, 2012). There are many bcts that can be adopted to target psychological determinants (see Michie et al., 2013), particularly with regards to gambling behavior. Examples of how behavioral, normative, and control beliefs can be altered are subsequently offered.

Behavioral beliefs can be targeted through the bcts “Beliefs about consequences,” “Pros and cons,” and “Information about emotional consequences.” For example, a person struggling financially may incorrectly believe that participating in the lottery or purchasing scratch tickets is a reasonable way to generate income. To change this behavioral belief, the bct “Beliefs about consequences” could be adopted whereby information is provided relating to the losses likely to be accumulated over time.

Changing norms could be achieved through adopting the bcts “Social influences,” “Information about others” approval,’ and “Social comparison.” This can include providing information on what relevant others think about their participation in the behavior and what relevant others do themselves. For example, an individual may gain satisfaction from the knowledge that family and friends would be supportive of them abstaining from gambling, and this information may make it more likely that the person would consider not gambling in the future. They may also find it helpful to relate to others that have successfully made a quit attempt.

Changing beliefs about control can occur through the bcts “Behavioral practice,” “Focus on past success,” and “Verbal persuasion about capability.” Consider, for example, a person with a well-paid job losing a considerable amount of money at the local casino after work. Although the person has previously abstained from gambling and acknowledges that they currently have an issue, presently the person lacks the relevant control beliefs to stop again. The individual could be asked to remember times when they did abstain or be made to practice abstinence in small steps. Alternatively, encouragement could be provided from relevant others that persuade the individual that they possess the ability to stop gambling. These bcts may then increase the individual’s perception of control through addressing appropriate control beliefs.

It should be noted that these examples are illustrative and apply only to specific salient beliefs. It would therefore not suffice to target these beliefs if the formative research does not render them important. For example, if family members are not identified as influential referents, it would not be worthwhile targeting that normative belief using the bcts suggested. Moreover, the bcts offered here are only suggestions as to what interventions could include to manipulate psychological mechanisms underlying gambling behavior. The onus is on the intervention developer to select carefully amongst the many bcts that are available. Researchers are encouraged to not only become accustomed with the available bcts, but to also understand which psychological mechanisms they can influence. With that said, the examples provide specific strategies that could be adopted to reduce participation in gambling through modifying underlying beliefs.

6. Studies adopting reasoned models

The RAA has been applied to a number of health-related behaviors (e.g., Hagger et al., 2018; McEachan et al., 2016). However, studies have not investigated how the model can be applied to gambling. Although this is the case, some studies have adopted the Theory of Planned Behavior to understand and change gambling behavior. Martin et al. (2010) and Wu and Tang (2012) both found intentions to gamble were influenced by attitude, subjective norm, and perceived behavioral control. St-Pierre et al. (2015) found adolescent gambling to be influenced by attitude and perceived behavioral control. Although these studies provide an explanation for gambling behavior, they do not identify the specific psychological mechanisms underlying the corresponding determinant. This inhibits the development of interventions. For example, the studies mentioned above all identified attitude as a key construct. However, without identifying the specific behavioral beliefs underlying attitude, it is not clear what specifically interventions should target. An intervention targeting adolescent gambling conducted by St-Pierre et al. (2017) targeted behavioral, normative, and control beliefs. However, the intervention, which was unsuccessful in changing psychological determinants and gambling behavior, only targeted beliefs commonly associated with gambling. It could be that the ineffectiveness of the intervention was a consequence of targeting beliefs not salient to the behavior. It is crucial, therefore, that when designing an intervention, the aforementioned formative research is undertaken.

7. The intention-behavior gap and behavioral maintenance

It was earlier outlined that the RAA posits intention to be the proximal antecedent of behavior. Thus, the theory suggests that successfully changing a person’s intention towards the behavior should lead to behavior change. Although it is important to change intention, research has established a significant gap between what a person intends to do and what subsequently occurs (Rhodes & de Bruijn, 2013). Indeed, many people state they intend to stop gambling but are unsuccessful in doing so (Konietzny & Caruana, 2019). In addition to the intention-behavior gap, another issue pertaining to social cognition models concerns the maintenance of behavior change. Initial behavioral change, through successful intention translation, does not guarantee change will be sustained in the future. Indeed, it is difficult for those that successfully quit gambling to continue this abstinence over time (Pickering et al., 2020). Research has suggested that the psychological mechanisms underlying initial behavior change are different to the mechanisms underpinning behavioral maintenance (Kwasnicka et al., 2016). Thus, support is needed for: (1) the translation of intention into behavior and (2) the maintenance of behavioral change.

There are many strategies that can foster the enactment of intentions. A popular and effective way of supplementing intentions is through planning. Implementation intentions (Gollwitzer, 1999) are specific if-then plans that specify in advance where, when and how to act in line with the desired intention. These cues enable the automatic activation of the intention. For example, a person intending to quit gambling may state in advance “if I have the urge to have a bet on my phone, I will turn my phone off” or “if I am asked to go to the casino, I will remember the amount of money that can be saved through declining the invitation.” When the cue is encountered (i.e. urge to bet on a mobile phone; invite to a casino), a response is automatically triggered (i.e. switch off mobile phone; recall the benefits). There are additional ways to ensure intention translation and readers are directed to Sheeran and Webb (2016) for an overview.

There are also many ways that successful behavior change can be maintained. When an intention is formed and the change is initially undertaken, people may underestimate the difficulty involved in changing. Similarly, a person may not have anticipated the various challenges that are required to be overcome to achieve successful abstinence. For example, a person may not have appreciated the impact that quitting gambling has on their social life, or they may have underestimated the difficulty at which missing out on social gambling activities is. It is therefore important that the person’s confidence to maintain the initial behavioral change is kept high. Behavioral maintenance can also be achieved through developing habits (Gardner, 2015). The formation of habits transfers action to the environmental stimuli and thus relies less on conscious processes. For example, a person could routinely go for a walk at a time when they would often place a bet on sporting events. Instead of placing a bet at a particular time, the decision to do so could be replaced with other automatic features (i.e. placing walking shoes at the door). With a focus on automaticity, the development of habitual behaviors may have important implications for the sustained abstinence from gambling behavior. More specifically, habits can replace the constant rumination of conscious decisions to gamble.

8. Conclusion

Gambling is a problem that has serious consequences to health and well-being. Many social cognition models have been developed to predict, explain, and change behavior. Developed from iterations of the Theory of Reasoned Action and the Theory of Planned Behavior, the RAA is a contemporary theory that explains a large amount of variance using a small number of constructs. Beyond parsimony, the theory enables the identification of relevant psychological mechanisms underlying behavior. Guidance is provided on how the theory can be adopted to explain the behavior of interest. Related to gambling, the theory can therefore be adopted to understand participation in gambling. The RAA can also be used to inform the development of behavior change interventions. The identification of key psychological mechanisms using the theory provides important information on what interventions should target. The RAA does not, however, provide explicit guidance on the content of behavioral interventions. That is, information is lacking on how psychological mechanisms could be changed. To attend to this, intervention designers should select and adopt appropriate bcts to modify relevant psychological mechanisms. Another limitation of the RAA is the gap between intention and behavior. Consideration should therefore be given to how intentions to stop gambling are both translated into successful behavior change and maintained over time. Undertaking this theoretical approach to gambling behavior may result in a reduction in the number people participating in the behavior.

Competing interests

There are no competing interests.

Additional information

Funding

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Notes on contributors

Tom St Quinton

Dr Tom St Quinton is a lecturer in Psychology in the School of Social and Health Sciences, Leeds Trinity University, UK. He holds BSc, MSc, and PhD degrees. His research interests relate to the use of health psychological theory to develop and implement theory-based interventions targeting health behaviors.