rachana sikka capstone presentation

Evolution of capstone

In the beginning. . .

Evolution of Capstone

Mental health and health disparitiesHmong refugees and mental health

issuesTracked issue for one year (media reports,

educational workshops, forums)Compiled academic, government and

agency researchConducted interviews and wrote preliminary

articles for class assignments

Evolution of Capstone: Version 1

Mental health screening efforts of new Hmong refugeesScreening tool/instrumentObservation of actual screening

Mental health programs and services for refugees (MN and Thailand)

Mental health and Hmong cultureProfiles of refugee families

Evolution of capstone

Council of Asian and Pacific Minnesotans legislative update (2/14/2005)

Advanced Reporting Methods-spring 2005Class project about gamblingFinished overview article mid-March

Evolution of Capstone: Version 2

Mental Health of new Hmong refugees

Casino Gambling Addiction in the Twin Cities Asian community

Overview policy article about mental health and Asians

May 2005

Casino Gambling Addiction in the Twin Cities Asian Community

Rachana Sikka

July 25, 2005

Agenda

Background information Rationale for focus on gambling Background research, interview, writing and

follow-up processes Components of article series Challenges and ethical issues Strengths and weaknesses Publication Outlets Conclusions

Gambling and Minnesota

Source: www.mpr.org

Gambling and Minnesota

“Pawlenty, tribal leaders unveil casino proposal”MPR 3/4/2005

“Two Indian tribes encouraged by gambling discussion with Gov. Pawlenty” MPR 10/28/2004

“Gambling Bills Pass Committee Test” MPR 3/19/2005

NATIONAL DESK | March 31, 2005  As Gambling Grows, States Depend On Their Cut to Bolster Revenues New York Times    

“Work & Life: Jobs are casino plans’ silver lining”StarTribune” 3/10/2005

“Pawlenty and northern tribes say gambling talks were productive” MPR 1/7/2005

Gambling

Definition: placing something of value at risk in the hopes of gaining something of greater value

Wagering in casinos and on lotteries, horse and dog racing, card games, and sporting events

Epidemiology of gambling

Epidemiology (National Council on Problem Gambling, 2003) Over 80 percent of U.S. adults have reported

gambling at least once in the past year and done so responsibly

About one percent of adults (2 million people) meet the criteria of a pathological gambler

Two to three percent have less serious, but significant problems with gambling

Gambling as a (public) health issue

Pathological gambling Impulse control disorder

High rates of comorbidity between substance use and gambling disorders

Increased rates of mental health disorders have been reported in problem and pathological gamblers

Higher suicide rates have been associated with gambling

Sources: Cunningham-Williams RM, Cottler LB, 1998; Compton III WM, Spitznagel EL, 1998; Cunningham-Williams RM, Cottler LB, 2001; Crockford DN, el-Guebaly N, 1998; Shaffer & Korn 2002

Gambling as a (public) health issue

Public health model for communicable disease can be applied to gambling (Shaffer & Korn, 2002)

Person who chooses to gamble

Specific gambling activityMoney, credit or something else of value

Microenvironment: gambling venue, family, local community

Macroenvironment: socioeconomic, cultural, social policy and political context

(Gordis, 2000)

Gambling and Asians

Asian groups in the U.S. show higher rates of gambling disorders compared with other groups (Handbook of Asian American Psychology, 1998)

Prevalence surveys of Chinese immigrants to Western countries Montreal: 5% problem gamblers, 2% pathological gamblers

(Lesieur HR, Blume SB, 1987) Calgary: 8% problem gamblers (Lo J, 1996) Sydney: 10% pathological gamblers (Blaszczynski A, Huynh

S, Dumlao VJ et al, 1998) Lifetime prevalence of pathological gambling in a

sample of Southeast Asian refugees: 59 percent (Petry NM, Armentano C, Kuoch T, Norinth T, Smith L, 2003)

Gambling and Asians in Minnesota

A report on the effects of problem gambling on Southeast Asian families and their adjustment to life in Minnesota (1996)Exploratory field study by the CAPM

Gambling and Asians in Minnesota

“Gambling among Southeast Asians living in Minnesota has led to considerable financial and emotional problems resulting in increased debt, family stress, loss of homes, incidents of divorce, neglect of children and even deaths.” (CAPM, 1996)

Focus on gambling and Asians

TimelyEffective “hook”

Fresh angleLocalizedMulti-dimensional issue

Medical/psychological, political, social, economic and cultural aspects

Background Research

Literature searchPubMed/Medline, PsychInfo, Current

Contents (keywords=gambling and Asians)Outside publications/reports

Governor’s Report on Compulsive Gambling: A Report to the Minnesota Legislature (2004)

A report on the effects of problem gambling on Southeast Asian families and their adjustment to life in Minnesota (1996)

Background Research

WebsitesMinnesota Department of Human ServicesMinnesota Institute of Public HealthMinnesota Public RadioStar TribuneMinnesota State LotteryCasino websites

Initial Contacts

CAPM: Legislative liaison/research analyst Gambling treatment provider lists

State-approved gambling treatment providers from MDHS

State and non-state approved providers from MN State Lottery

Southeast Asian Gambling Treatment Consortium: Program manager

Lao Assistance Center: Executive Director

Initial Contacts

Asked members of Council and Consortium, as well as gambling counselors about people who were dealing with gambling addiction

Marketing/Public Relations representatives of casinos (Mystic Lake, Grand Casinos, Treasure Island)

Mystic Lake Hotel Casino employee

Table of Contacts

Name JobPosition

Contact Info

Expertise Remarks

David Zander Research Analyst and Legislative Liaison, Council of Asian and Pacific Minnesotans

Phone: 651-296- 0538

Cultural anthropology

Angry and concerned about potential casino gambling expansion in Minnesota; thinks the creation of more casinos will have a more traumatic effect on Asian communities

Interview Process

CAPM (phone interview) Southeast Asian Gambling Consortium/Lao

Assistance Center (face-to-face interviews) Gambling counselors

Tried to interview gambling counselors who represented different segments of the Asian community (phone interviews)

Marketing/PR departments of Mystic Lake and Treasure Island casinos did not return phone messages

Interview Process

PR person at Grand Casino-Hinckley referred me to Goff & Howard Spoke with chairman in mid-March by phone

Visit to Mystic Lake: Employees not willing to talk Mystic Lake Hotel Casino employee interview through

a personal contact Phone interview

Was not able to interview someone of Asian descent who had a gambling problem Located woman in the personal profile through program

manager of Southeast Asian Gambling Consortium in mid-May

Face-to-face interview

Writing

Overview article Highlight issue, raise awareness of problem Bolster with academic/outside research and

interviews with program managers and treatment providers

Discuss programmatic and legislative efforts Narrative introduction to grab reader’s attention

Personal encounter at Mystic Lake Personal profile sidebar

Follow-up & Fact Checking

Overview articleCalled back all sources at least once with

follow-up questions, to double check facts and go over quotes

Especially important with sources representing casino perspectives

Personal ProfileFollowed up with source 2-3 times to fact

check and go over quotes

Overview Article

“Casino Gambling Addiction in the Asian Community”

3,610 words Personal observation Research studies

Local (Lao Assistance Center) Academic (Retry et al 2003)

Anecdotal/observational reports Council of Asian and Pacific Minnesotans (CAPM)

Overview Article

Interviews CAPM Gambling counselors (Lao, Korean, Vietnamese,

Chinese) Blackjack dealer/floor supervisor (Mystic Lake Hotel

Casino) Chairman of Howard & Goff: public relations/public

affairs firm for Mille Lacs Band of Ojibwe

Programmatic/Legislative efforts Southeast Asian Gambling Consortium

Overview Article: Main findings

Higher than average incidence of problem gambling among Southeast Asian men and women Also surfacing in Chinese and Korean communities

Limited education and language skills, low income, immigrant status, boredom and loneliness seem to factor into gambling

Difficult for counselors to do outreach Sophisticated marketing efforts by casinos Lack of entertainment options for people

with limited English proficiency

Personal Profile

Untitled1,023 wordsLocal woman of Laotian descent

Stepmother, biological mother and husband with gambling addiction

To protect privacy, real names not used

Narrative Piece

“Over the Buffet and through the Slot Machines”

1,432 wordsBased on personal

observation/encounter at Mystic Lake Hotel CasinoConversation with woman of Taiwanese

descent

Challenges

Sensitive, emotionally charged issue Cultural lens magnifies pre-existing stigma

Language barriers Difficulty finding personal stories Little published research and few “experts” Achieving balance and objectivity

Easy to get swayed by emotions Casino employees unwilling to talk

Programs vs. people

Ethical issues

Privacy/confidentiality Mystic Lake Hotel Casino employee People with gambling addiction and their families

Evoking sensitive/traumatic issues for sources Personal account of Laotian woman

Equity Giving equal voice to sources with limited English

proficiency

Limitations

Lack of connection to broader mental health and/or policy issuesVersion 2 of capstone project

Did not profile someone with gambling addictionFamily member as proxy

Slightly skewed toward an advocacy tone?

Strengths

FocusedTimelyNovel

An emerging issueRespected the privacy of sources while

still telling their storiesCaptured issues and voices of minority

populations

Publication Outlets

Ummm. . . City PagesLocal specialty newspaper and/or

magazineAsian Pages?Asian-American Press?Pulse of the Twin Cities?Minnesota Monthly?

Conclusions

Sensitive topics + minority and/or immigrant populations = time for trust to develop between journalist and sourceDifficult to achieve under real-world

deadline constraintsMedia can be an effective ally and

intervention tool for health/human service professionalsCan ease the transition to more intense

intervention and/or policy development

Conclusions

Public health knowledge helped to understand and interpret research, but sometimes hindered interview and writing processesKnowledge of survey construction/research

made interview preparation a headacheHard-wired to write in an academic fashion

Need to publish articles before issue becomes obsolete

My final two cents

Honing my journalistic skills will be a lifelong process

Journalism should be renamed “Journeyism”

Thanks a bunch!!!

Brian Southwell, Gary Schwitzer, Paul MacEnroe, John Finnegan

All named and unnamed sources, especially David Zander, Rick Devich, Sunny Chanthanouvong and Noriko Ishihara

Health journalism classmatesParents and friends

Deal me any questions or comments