Gambling Problems, Risk Factors, Community Knowledge, and Impact in a U.S. Lao Immigrant and Refugee Community Sample

Abstract Objective 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. To discuss cultural implications for the treatment and prevention of gambling problems in Southeast Asian refugee and immigrant populations. Study Design Cross-sectional, Community-Based Interview Study. Methods Participants (N=200, Males=51%, Females=49%) were recruited from a Lao community center in a major U.S. metropolitan area (convenience sample; community center recruitment and peer nomination). Structured interviews on gambling and substance use were conducted by Lao center staff 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 paper, we reported a substantial number of participants from the sample endorsed gambling-related harms and problems (SOGS score of 5 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 compared to non-problem gamblers (p 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 due to 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 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.