Initial usability and feasibility of a web-based behavioural activation program for young adults with comorbid depression and problem gambling: A case study and case series

Approximately 20%–32% of youth and adults with problem gambling also experience comorbid depression, yet treatment for this comorbidity is not readily accessible. We sought to extend and customize DoNamic, our existing web-based app for treating depression, to also treat young adults who experience comorbid problem gambling. We conducted a laboratory-based usability case study (Study 1) and a usability and feasibility clinical case series (Study 2). Study 1 involved an individual with problem gambling who tested the DoNamic version tailored to problem gambling (DoNamic-PG) in the laboratory. Changes based on participant feedback were implemented. Study 2 involved two cycles of testing in which five participants used the revised version of DoNamic-PG and provided feedback. Indicators of feasibility and usability of DoNamic-PG were predominately met; however, even with the increased accessibility and ease of use of DoNamic-PG, recruitment issues suggest it may not fully overcome the problem of attracting gamblers into treatment. This study highlights an existing concern in the field of problem gambling: Even when interventions are accessible for problem gambling populations, they are not necessarily used. Ultimately, the results of our case studies highlight how existing apps can be adjusted for specific subgroups. DoNamic-PG has the potential to be a feasible and usable app that could increase the accessibility, efficiency, and quality of care for younger adults with depression and problem gambling, if recruitment problems can be overcome. The next steps for developing DoNamic-PG include further feasibility testing, followed by trials to determine its efficacy and effectiveness.