Delphi Expert Consensus Method Research Articles

Adaptation of mental health first aid guidelines for eating disorders for Iran

BackgroundThis study aimed to adapt mental health first aid guidelines to support individuals with or at risk of developing eating disorders in Iran. This adaptation seeks to enhance the support available for the Iranian population dealing with these disorders.MethodsWe employed the Delphi expert consensus method, utilizing two panels: health professionals (n = 37 in the first round; n = 29 in the second) and individuals with lived experience (n = 20 in the first round; n = 18 in the second). The health professionals panel was selected from the graduates of various eating disorders associated scientific fields who had a history of providing services to or conducting research on people with eating disorders, and the lived experience panel had a history of eating disorders themselves or in their family. The panel of individuals with lived experience included those who had personal or familial histories of eating disorders. Efforts were made to ensure cultural, gender, and age diversity in the selection of panel members. Panellists rated the importance of each item for inclusion in the guidelines for Iran based on the English-language Mental Health First Aid guidelines for eating disorders. Items deemed essential by at least 80% of both panels were included in the final guideline. Additionally, panel members were invited to suggest any missing items.ResultsA total of 57 participants took part in the first round of the survey, and 47 participated in the second round. In the first round, 204 items across 11 categories were assessed, with 174 items endorsed by the panels. Thirteen items were re-scored in the second round, and 17 items were rejected. Participants suggested 11 new items in the first round. In the second round, 18 out of 24 items were endorsed, while six were rejected. Ultimately, 192 items were incorporated into the Iranian guidelines.ConclusionsThe adaptation process considered Iran's social and cultural characteristics, including the stigma associated with mental health disorders, religious beliefs and rituals such as fasting, linguistic differences between English and Farsi, distrust of strangers, the influence of friends and family, differences in food access, and low mental health literacy. We recommend piloting the adapted guidelines in high schools, universities, and non-governmental organizations to evaluate their feasibility and effectiveness in real-world settings. Furthermore, it is essential to establish mechanisms for feedback, update content based on the latest evidence, and collaborate with the media to promote educational programs and public participation.

Development of mental health first aid guidelines for psychosis for Brazil: A Delphi expert consensus study.

Psychotic symptoms can be highly debilitating for those experiencing them. Community members, including family and friends, can play a crucial role in providing support to a person during the early stages of psychosis, provided they have the necessary resources. Mental health first aid guidelines for psychosis have been developed for high-income countries and this study aimed to adapt those guidelines for Brazil. A Delphi expert consensus method was used to gather the views and opinions of 28 health professionals and 24 individuals with lived experience of psychosis in Brazil over two survey rounds. Firstly, 403 statements were translated from English to Brazilian-Portuguese. In the Round 1 survey, participants were asked to rate each statement based on how important they believed it was for it to be included in the Brazilian guidelines. They were also asked to suggest new actions if they wished. Consensus was reached on 257 statements. Eight new statements were created and endorsed from panelists' comments, and a further 45 statements were unique to the Brazilian guidelines. There was a modest level of similarity between the English-language and Brazilian guidelines. However, the Brazilian guidelines had a greater focus on the importance of family support for people with psychosis and stigma as a possible barrier for openly discussing help-seeking actions for mental health problems in Brazil.

IMproving psYchosocial adjustment to Traumatic Brain Injury from acute to chronic injury through development and evaluation of the myTBI online psychoeducation platform: protocol for a mixed-methods study

IntroductionThis protocol describes the myTBI study which aims to: (1) develop an online psychoeducation platform for people with traumatic brain injury (TBI), their family members/caregivers, and healthcare staff to improve...

Redevelopment of mental health first aid guidelines for substance use problems: a Delphi study

BackgroundSubstance use problems have a major impact on the physical and mental health of individuals, families and communities. Early intervention may have a positive effect on recovery and treatment outcomes for those with substance use problems, reducing related risk and harm. Separate mental health first aid guidelines on how a member of the public could assist someone experiencing or developing alcohol use and drug use problems in high income Western countries were developed using Delphi expert consensus in 2009 and 2011, respectively. This study aimed to synthesise and update these two original guidelines to reflect current evidence and best practice.MethodsThe Delphi expert consensus method was used to determine the inclusion of statements in the redeveloped guidelines. A questionnaire was developed using previously endorsed helping statements from the original guidelines on alcohol and drug use problems, as well as relevant content identified in systematic searches of academic and grey literature. Three panels of experts (people with lived experience, support people and professionals) rated statements over three consecutive online survey rounds to determine the importance of their inclusion in the guidelines. Statements endorsed by at least 80% of each panel were included.Results103 panellists completed all three survey rounds. They rated 469 statements and endorsed 300 of these for inclusion in the redeveloped guidelines.ConclusionsThis study has developed a broader and more comprehensive set of guidelines for how to support a person experiencing or developing a substance use problem. The redeveloped guidelines provide more detail on knowledge about and recognition of substance use problems, approaching and assisting people who want to change or are not ready to change, harm reduction, community-based supports and professional help, but have less on physical first aid actions. Mental Health First Aid International will use these guidelines in future updates of their training courses.

A Delphi Study Using Expert Consensus to Develop a Well-Defined Vision for a Centre of Excellence for Therapeutic Recreation in Continuing Care Settings

There is an increasing demand for evidence-based practice and the demonstration of client outcome achievement in therapeutic recreation (TR). There is also an ongoing need to research TR service provision in continuing care settings. The TR profession is well-suited to improving the well-being and quality of life of individuals living in continuing care homes, however, current TR services are not standardized and vary greatly between settings and practitioners. Centres of Excellence (CoE) are organizations that endeavour to establish high standards of practice in a specific profession or area of research. A CoE could be instrumental in improving the delivery of quality TR services in continuing care settings. A Delphi expert consensus method was used to obtain a well-defined vision for a CoE for TR in continuing care settings. Three rounds of online questionnaires were completed over a period of nine weeks by an expert panel of 11 TR professionals working in continuing care settings. The participants reached the consensus that the vision of the CoE should be, “To inspire and advocate for quality TR services in continuing care settings through increased research and evidence-based practice.” The findings from this study contribute to the development of a CoE for TR in continuing care settings. They could also contribute to the development of additional CoEs for TR with other client populations—a topic that has been largely unexplored in the research literature.

A Delphi Study Using Expert Consensus to Develop a Well-Defined Vision for a Centre of Excellence for Therapeutic Recreation in Continuing Care Settings

There is an increasing demand for evidence-based practice and the demonstration of client outcome achievement in therapeutic recreation (TR). There is also an ongoing need to research TR service provision in continuing care settings. The TR profession is well-suited to improving the well-being and quality of life of individuals living in continuing care homes, however, current TR services are not standardized and vary greatly between settings and practitioners. Centres of Excellence (CoE) are organizations that endeavour to establish high standards of practice in a specific profession or area of research. A CoE could be instrumental in improving the delivery of quality TR services in continuing care settings. A Delphi expert consensus method was used to obtain a well-defined vision for a CoE for TR in continuing care settings. Three rounds of online questionnaires were completed over a period of nine weeks by an expert panel of 11 TR professionals working in continuing care settings. The participants reached the consensus that the vision of the CoE should be, “To inspire and advocate for quality TR services in continuing care settings through increased research and evidence-based practice.” The findings from this study contribute to the development of a CoE for TR in continuing care settings. They could also contribute to the development of additional CoEs for TR with other client populations—a topic that has been largely unexplored in the research literature.

Identification of research priorities for suicide prevention in Nepal: a Delphi study

BackgroundSuicide is a significant public health concern in Nepal and there is a need for an evidence-based suicide prevention programme to facilitate stakeholders working towards suicide prevention in Nepal. Collaborative research between stakeholders focussing on shared priorities can help to prevent and control suicide. Hence, we aimed to develop a consensus list of research priorities for suicide prevention in Nepal.MethodsThe Delphi expert consensus method was used to elicit the prioritized research questions for suicide prevention in Nepal. Participants comprised suicide prevention experts (psychologists, psychiatrists, psychiatric nurses, researchers and advocates) and people with lived experience. Three rounds of Delphi were conducted; round 1: one to one interviews involving open ended questions used to generate research questions; round 2: ranking of the research questions using a 5-point Likert scale, and round 3: re-ranking of research questions in light of individual and group responses.ResultsForty-two participants participated in round 1 followed by 38 in round 2 and 39 in round 3 . 522 research questions were generated through round 1 which were grouped together and reduced to 33 research questions sent for ranking in round 2. Using a cut off of at least 70% of the panel ranking questions as ‘very important’ or ‘important’, 22 questions were retained. These research questions were sent for re-rating in round 3 resulting in a final list of prioritized questions.ConclusionsThis is the first expert consensus study to identify the top research priorities for suicide prevention in Nepal, and used experts in suicide prevention and those with lived experience. A consensus was reached regarding the studies needed to improve suicide data quality, assess the burden and identify factors associated with suicide. A priority driven approach to suicide prevention research may ensure that the research endeavour provides the most useful information for those whose day-to-day work involves trying to prevent suicide.

Managing tourism safety and risk: Using the Delphi expert consensus method in developing the event tourism security self-beliefs scale

Safety and security issues are one of the biggest challenges in the field of tourism, and limited data is available regarding the profiles for individuals who are responsible for the safety of the event tourism industry. This eDelphi study used a methodology with a panel of event security experts to complete several rounds of questionnaires utilizing write-in answers (qualitative content) as well as Likert-scale agreement/ranking (quantitative data) to develop a new survey instrument. Results from content adequacy identify a new instrument consisting of 13 items related to an employee's obligation, 11 items related to an employer's obligation, 11 items related to self-beliefs, six items related to hospitality culture, and six items related to motivation. The developed scale was constructed through consensus among experts in the field of risk management and can be used as a valid instrument for use by tourism managers and event organizers.

Acupoint selection for cancer pain: based on current evidence and Delphi method

Based on literature research and Delphi expert consensus method, the important acupoints for cancer pain was summarized to provide evidence basis for the formulation of Clinical Practice Guide of Acupuncture in the Treatment of Cancer Pain. Through systematic search of Chinese and English databases, 28 clinical studies regarding acupuncture for cancer pain were included. The acupoint selection methods and high-frequency acupoints were summarized and analyzed. Based on this, a Delphi questionnaire was designed and two rounds of questionnaire survey on 30 experts in acupuncture and tumor related fields in China and abroad were conducted. As a result, it was suggested that the individualized acupoint selection should be adopted for acupuncture treatment of cancer pain, with Zusanli (ST 36), Hegu (LI 4), Taichong (LR 3), Sanyinjiao (SP 6), Yanglingquan (GB 34) and ashi points as the main acupoints. Combined with clinical research evidence and expert consensus, the important acupoints for cancer pain were identified. However, clinical acupoint selection still needed further research and refinement.

Expert appraisal of criteria for assessing gaming disorder: an international Delphi study.

Background and aimsFollowing the recognition of ‘internet gaming disorder’ (IGD) as a condition requiring further study by the DSM‐5, ‘gaming disorder’ (GD) was officially included as a diagnostic entity by the World Health Organization (WHO) in the 11th revision of the International Classification of Diseases (ICD‐11). However, the proposed diagnostic criteria for gaming disorder remain the subject of debate, and there has been no systematic attempt to integrate the views of different groups of experts. To achieve a more systematic agreement on this new disorder, this study employed the Delphi expert consensus method to obtain expert agreement on the diagnostic validity, clinical utility and prognostic value of the DSM‐5 criteria and ICD‐11 clinical guidelines for GD.MethodsA total of 29 international experts with clinical and/or research experience in GD completed three iterative rounds of a Delphi survey. Experts rated proposed criteria in progressive rounds until a pre‐determined level of agreement was achieved.ResultsFor DSM‐5 IGD criteria, there was an agreement both that a subset had high diagnostic validity, clinical utility and prognostic value and that some (e.g. tolerance, deception) had low diagnostic validity, clinical utility and prognostic value. Crucially, some DSM‐5 criteria (e.g. escapism/mood regulation, tolerance) were regarded as incapable of distinguishing between problematic and non‐problematic gaming. In contrast, ICD‐11 diagnostic guidelines for GD (except for the criterion relating to diminished non‐gaming interests) were judged as presenting high diagnostic validity, clinical utility and prognostic value.ConclusionsThis Delphi survey provides a foundation for identifying the most diagnostically valid and clinically useful criteria for GD. There was expert agreement that some DSM‐5 criteria were not clinically relevant and may pathologize non‐problematic patterns of gaming, whereas ICD‐11 diagnostic guidelines are likely to diagnose GD adequately and avoid pathologizing.

Quelles indications d’hospitalisation d’un patient avec addiction ? Application du modèle des pathologies chroniques. Une étude de validité apparente

IntroductionThe medical identification of an addiction (use disorder) often results in inpatient admission with a view to its definitive suspension. However, for other chronic diseases, inpatient admission is indicated for specific situations and the objective is not the definitive suspension of the chronic disease. Our goal was to clarify addiction as a chronic disease and to determine explicit indications for inpatient admission. MethodThree-stage face validity study: (1) from the analysis of consensual definitions, search by the subset theory whether addiction can be considered as a chronic disease; (2) Develop generic indications for inpatient admissions based on the analysis of chronic disease care pathways validated by the HAS (French Health Agency) and apply them to addiction; (3) Validate by Delphi expert consensus method the determined indications. ResultsStep (1) showed that the definition of addiction allowed to include it in that of chronic disease. Step (2) determined 7 indications for inpatient admission of a patient with a chronic disease, and its application to addiction identified 15 indications for inpatient admission of a patient with addiction. In step (3), the Delphi method yielded consensus on 14 of the 15 indications. ConclusionBy clarifying addiction as a chronic disease, we were able to determine 14 indications for inpatient admission of a person with an addiction and to distinguish them from the long-term care of addiction. These explicit indications can help the general practitioner or community psychiatrist to better manage patients with addiction on the basis of their expertise with chronic diseases management.

Guidelines for news media reporting on mental illness in the context of violence and crime: A Delphi consensus study

Despite its rare occurrence, severe mental illness is commonly linked to violence and crime in the news media. To reduce harmful effects of reporting, this study aimed to develop best practice guidelines for media reporting on mental illness in the context of violence and crime. Best practice was determined through the Delphi expert consensus method where experts rated statements according to importance for inclusion in the guidelines. In this study, the experts represented three groups: people with lived experience of severe mental illness, media professionals and mental health professionals. The 77 statements that were endorsed as ‘important’ or ‘essential’ by 80 per cent or more of experts were included in the guidelines, while 36 items were rejected from inclusion. There was a high degree of consensus among stakeholder groups. These guidelines expand on existing media guidelines, elaborating on accurate portrayals and appropriate language and extending coverage to areas of mental health literacy, considering impact, reporting relevant risk factors, using social media and implementation in news organizations.

Development of Chinese mental health first aid guidelines for psychosis: a Delphi expert consensus study

BackgroundFamily and friends of a person developing a mental illness or in a mental health crisis can help the person until treatment is received or the crisis resolves. Guidelines for providing this ‘mental health first aid’ have been developed and disseminated in high-income countries. However, they may not be appropriate for use in China due to cultural and health care system differences. The aim of this study was to use the Delphi expert consensus method to develop culturally appropriate guidelines for a member of the public providing mental health first aid to someone with psychosis in mainland China.MethodsA Chinese-language survey, comprising statements about how to provide mental health first aid to a person with psychosis, was developed. This was based on the endorsed items from the first round of the English-language questionnaire for high-income countries. These statements were rated by two expert panels from mainland China – a mental health professional panel (N = 31) and a lived experience panel (N = 41) – on how important they believed each statement was for a member of the public providing first aid to a person with psychosis in China. There were three Delphi rounds, with experts able to suggest additional items in Round 1. Items had to have at least 80% endorsement from both panels for inclusion.ResultsOut of 208 statements, 207 were endorsed for inclusion in the Chinese-language guidelines. Eight new statements were also included. Compared to the English-language guidelines, the importance of family involvement was emphasized in the development of the Chinese-language guidelines.ConclusionsWhile many of the actions in the English-language guidelines were endorsed by Chinese participants, a number of additional items point to the importance of developing culturally appropriate mental health first aid guidelines. These guidelines will form the basis for the development of Chinese Mental Health First Aid course aiming at training members of the public on how to provide first aid to someone with a mental health problem.

Identifying research priorities in eating disorders: A Delphi study building consensus across clinicians, researchers, consumers, and carers in Australia.

Eating disorders are underrepresented among successful applications for medical research funding. Developing agreement on the top research priorities may assist in fostering collaborations, innovation, and meaningful consumer and carer involvement. This study aimed to develop consensus among Australian clinicians, researchers, consumers, carers, and interested members of affiliated industries, on the priorities for eating disorders research. The Delphi expert consensus method was used. Participants were 291 members of the Australia New Zealand Academy for Eating Disorders (ANZAED) or the National Eating Disorders Collaboration (NEDC). Three panels were formed based on participant expertise: "ED Specialists," Consumers/Carers, and Affiliates. A total of 32 potential research areas (29 in Survey 1, 3 in Survey 2) were rated on a 5-point scale of importance, with 80% agreement across all three panels required for endorsement as a priority. Participants also ranked 7 broad research domains in order of priority. Research areas describing early intervention and evidence-based treatments were the most highly rated, with more than 90% endorsement from each of the three panels. The research domains of accessible evidence-based treatments, early intervention and detection, and origins of eating disorders, were the most highly ranked. The ED specialists and Consumers/Carers panels had very similar patterns of responding, while the Affiliates panel showed small differences. Using the Delphi expert consensus method resulted in a collaborative consensus driven eating disorders research agenda for the Australian context and forms a model upon which other countries may also develop their funding priorities.

Development of best practice guidelines for suicide-related crisis response and aftercare in the emergency department or other acute settings: a Delphi expert consensus study

BackgroundFor those who have experienced suicidal behaviour, discharge from the hospital emergency department and other acute settings represents a period of heightened vulnerability for future suicide risk. Current guidelines for suicide response in acute settings often fail to fully address the barriers faced by emergency department personnel who have contact with a person who presents for suicidal behaviour, and have been developed largely without the input of consumers or service users. The aim of the study was to use the Delphi expert consensus method to develop guidelines for staff responding to suicidal presentations in acute settings.MethodsSystematic searches of academic and grey literature and interviews with key informants were conducted in order to develop a 525-item questionnaire, which comprised actions staff can take when responding to suicide-related presentations in acute settings. This was administered over three rounds to two panels consisting of Australian experts (39 health professionals, 50 consumers with lived experience). Items that reached consensus by at least 80% across both panels were included in the guidelines.ResultsA total of 420 items were rated as essential or important by at least 80% of both panels. The items included strategies that covered initial contact, assessment, referral, discharge and follow-up, staff training, and linkage with community aftercare services. Participation rate across all three rounds was 67.4% (78% consumers, 53.8% professionals).ConclusionThe guidelines include strategies for responding to suicidal behaviour in acute settings. These guidelines can be used to inform policy development and address barriers to best practice for those working in the area. Future research should investigate ways to optimise implementation of these guidelines in order to improve equal access to quality care for who present to acute settings for suicidal behaviour.

Suicide first aid guidelines for assisting persons from immigrant or refugee background: a Delphi study

ABSTRACTObjective: Suicide rates vary across different cultural groups and some immigrant or refugee populations display higher risk for suicide. This study aimed to produce guidelines to help members of the public provide assistance to a person from an immigrant or refugee background who is having suicidal thoughts or displaying suicidal behaviour.Method: The Delphi expert consensus method was used to identify warning signs and first aid actions to include in guidelines. Forty-four professionals and/or advocates with lived experience were asked to rate whether each statement contained in an online questionnaire should be included in the guidelines and to suggest additional statements considered by the respondent to be particularly relevant to a person from an immigrant or refugee background. The Delphi process started with 473 statements and 80 new items were written based on suggestions from panel members.Results: Out of the total 553 statements, 345 were endorsed as appropriate warning signs or helping actions. These statements were used to develop the guidelines.Discussion: The guidelines specific to people from immigrant or refugee backgrounds contain additional items to those included in similar guidelines for English-speaking countries. The guidelines may be used for gatekeeper training for suicide prevention in culturally diverse societies.

Design and validation of key text messages (Tonsil-Text-To-Me) to improve parent and child perioperative tonsillectomy experience: A modified Delphi study

ObjectiveParents can struggle while providing perioperative tonsillectomy care for their children at home. Short message service (SMS) technology is an accessible and direct modality to communicate timely, evidence-based recommendations to parents across the perioperative period. This study focused on validating a SMS protocol, Tonsil-Text-To-Me (TTTM), for parents of children undergoing tonsillectomy. MethodsThis study used a modified Delphi expert consensus method. Participants were an international sample of 27 clinicians/researchers. Participants rated level of agreement with recommendations across seven perioperative domains, derived systematically from scientific and lay literature. A priori consensus analysis was conducted using threshold criterion. A multidisciplinary team of local clinicians were also individually interviewed to consolidate text messages and implement recurrent suggestions. ResultsIn the modified Delphi panel, 30 statements reached threshold agreement (>3.0 of 4.0); recommendations surrounding diet (3.87) and hygiene (3.83) had the highest level of consensus, while recommendations regarding activity (3.42) and non-pharmacologic pain management (3.55) had the lowest consensus. The 30 statements reconfigured into 12 concise text messages. After further interviews with local clinicians, 14 final text messages were included in the SMS protocol to be sent two weeks preoperatively to one week postoperatively. ConclusionThis study illustrates the development of TTTM which is designed to deliver key sequential text messages at the optimal time during the perioperative setting to parents caring for their children who are undergoing tonsillectomy.

Assisting an Australian Aboriginal and Torres Strait Islander person with gambling problems: a Delphi study

BackgroundGambling problems appear to be more prevalent in the Australian Aboriginal and Torres Strait Islander population than in the non-Indigenous population. Although gambling harms can be significant, treatment-seeking rates are low. The Delphi expert consensus method was used to develop a set of guidelines on how a family or community member can assist an Aboriginal or Torres Strait Islander person with gambling problems.MethodsBuilding on a previous systematic review of websites, books and journal articles a questionnaire was developed that contained items about the knowledge, skills and actions needed for supporting an Aboriginal or Torres Strait Islander person with gambling problems. These items were rated over three rounds by an expert panel comprising professionals who provide treatment to or conduct research with Aboriginal and Torres Strait Islander people with gambling problems.ResultsA total of 22 experts rated 407 helping statements according to whether they thought the statements should be included in these guidelines. There were 225 helping statements that were endorsed by at least 90% of participants. These endorsed statements were used to develop the guidelines.ConclusionExperts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support an Aboriginal or Torres Strait Islander person to change.

Self-help strategies for sub-threshold anxiety: A Delphi consensus study to find messages suitable for population-wide promotion

BackgroundMany self-help strategies have been recommended for anxiety, but it is not clear which strategies are most effective and could be encouraged as part of an early intervention approach. This study used the Delphi expert consensus method to identify which strategies for mild (sub-threshold) anxiety are thought to be helpful and feasible to implement for individuals without professional assistance. MethodsParticipants were an international sample of 51 clinicians/researchers and 32 consumer advocates with expertise in anxiety. The scientific and lay literature was systematically searched for strategies claimed to be effective for anxiety. Participants rated the likely helpfulness of each strategy in reducing sub-threshold anxiety (related to generalised anxiety, social anxiety, or non-specific anxiety symptoms) and the feasibility of implementation in an iterative process across three questionnaire rounds. Results66 out of 324 candidate strategies were endorsed by at least 80% of both consumers and clinicians/researchers as likely to be helpful, and 18 were judged as feasible to carry out. Endorsed strategies were most frequently related to cognitive strategies and other psychological methods, interpersonal strategies, reducing physical tension, and lifestyle strategies. Few strategies were endorsed that were related to diet, supplements, or complementary medicine. LimitationsFindings may not apply to other forms of mild anxiety related to panic attacks or specific phobias. ConclusionsThis study contributes to the evidence-base on strategies that individuals can use to improve mild anxiety symptoms. Research is now required to evaluate whether promoting the strategies can help reduce the overall community burden from anxiety disorders.

How a concerned family member, friend or member of the public can help someone with gambling problems: a Delphi consensus study.

BackgroundGambling is an enjoyable recreational pursuit for many people. However, for some it can lead to significant harms. The Delphi expert consensus method was used to develop guidelines for how a concerned family member, friend or member of the public can recognise the signs of gambling problems and support a person to change their gambling.MethodsA systematic review of websites, books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions needed for supporting a person with gambling problems. These items were rated over three rounds by two international expert panels comprising people with a lived experience of gambling problems and professionals who treat people with gambling problems or research gambling problems.ResultsA total of 66 experts (34 with lived experience and 32 professionals) rated 412 helping statements according to whether they thought the statements should be included in these guidelines. There were 234 helping statements that were endorsed by at least 80 % of members of both of the expert panels. These endorsed statements were used to develop the guidelines.ConclusionTwo groups of experts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support a person to change.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-016-0110-y) contains supplementary material, which is available to authorized users.