Gambling problems, risk factors, community knowledge, and impact in a US Lao immigrant and refugee community sample.

ABSTRACT

OBJECTIVES: The objectives of this study were to examine gambling-related problems, risk factors, help-seeking attitudes, community perceptions, and correlates of problem gambling in a Lao sample of Southeast Asian refugees and immigrants and to discuss cultural implications for the treatment and prevention of gambling problems in Southeast Asian refugee and immigrant populations. STUDY DESIGN: This was a cross-sectional, community-based interview study. METHODS: Participants (N = 200, males = 51%, females = 49%) were recruited from a Lao community center in a major US metropolitan area (convenience sample; community center recruitment and peer nomination). Structured interviews on gambling and substance use were conducted by Lao center staff members in both English and Lao languages. RESULTS: Gambling-related problems were measured using the South Oaks Gambling Screen (SOGS), gambling frequency, and quantity measures. In a previous study, we reported a substantial number of participants from the sample endorsed gambling-related harms and problems (SOGS score of five or more = 24%) and common methods of play were slots, house betting, cards at a casino, and sports betting. Among those endorsing five or more gambling problems, reasons for gambling included making money (68%), social life (31.3%), entertainment (58.3%), and reducing boredom (35.4%). Less commonly endorsed reasons were depression or stress (14.6%) and escape (10.4%). Many participants reported a family history of gambling problems. Those with problem gambling had twice the level of sibling problem gambling histories relative to those without problem gambling (35.4% vs. 11.1%). There were substantially more participants in the problem gambling group who had started gambling before the age of 13 years than in non-problem gamblers (P < .05). Many recognized gambling as a significant issue in the community and reported knowing several individuals affected by gambling-related problems. CONCLUSIONS: Many participants recognized gambling as a significant issue in the Lao community. We include insights gleaned from a research partnership with a community organization. Although data cannot be generalized to the Lao community because of limitations in sampling methodology, participants viewed gambling as a culturally common social practice. Cultural norms affected where community members gamble, types of games, and betting practices. In this context, community members may view gambling-related harms as both a community-level and individual-level concern. These data suggest a significant need for rigorous research to inform policies and a culturally sensitive approach to public health prevention, intervention, and education. We discuss the challenges and cultural barriers to research and community engagement and offer suggestions for prevention and intervention ideas efforts.