ABSTRACT

With the high uptake of gambling in Kenya, especially among University students, it is inevitable that some of them may end up suffering from gambling disorder. Apart from compromised psychological health, disordered gamblers experience difficulties in their financial and social wellbeing. Currently, there is lack of evidence based interventions for gambling disorder that have been developed and empirically tested in Kenya. This research sought to establish the efficacy of Brief Motivational Interviewing Intervention (BMII) for treating gambling disorder among university students in Kenya. The intervention was guided by Motivational Interviewing principles and was delivered in psycho – educational group format. The study had four specific objectives; to find out the prevalence of gambling disorder among gamblers; to determine the efficacy of BMII in decreasing gambling disorder symptoms; to determine the efficacy of BMII in decreasing frequency of gambling and; to determine the efficacy of BMII in decreasing typical amount of money placed per bet. The research design used was a parallel group, two arm, superiority randomized control trial. The treatment group received the intervention; BMII. The control group did not. The study targeted university students who gamble. Multistage sampling approach was used. Simple random sampling was used to select the university. Purposive sampling was used to select the study participants. Randomization was then used to assign the participants to the treatment and control groups. A total of 228 students participated in the study. The findings of the study revealed that a majority (69.3%) of participants were disordered gamblers while 68.9% gambled more than twice a week and 56.6% of the participants typically placed between 51 – 100 Kenya shillings per bet. One way ANOVA was calculated to determine the differences between control and treatment groups at pre – test and post – test. Paired samples t – tests were calculated to test the hypotheses. The results revealed that there were significant differences in symptoms of gambling disorder between treatment and control group at post – test at  p<.05, {F (1,193) = 24.637, p=.000} and that BMII was efficacious in decreasing gambling disorder symptoms at p<.05 (MD =-1.733, t (100) = -7.087, p<.000). On frequency of gambling, the results revealed that there were significant differences between control group and treatment group at post-test at p<.05 {F (1,192) = 48.005, p=.000} and that BMII was efficacious in decreasing frequency of gambling at p<.05, (MD= -.683, t (100) = -6.072, p=.000). There were also significant differences in terms of typical amount of money placed per bet between control group and treatment group at post – test at p<0.05, {F (1,192) = 8.274, p=.004}. BMII was found to be efficacious in decreasing typical amount placed per  bet at p<.05 (MD=-.455; t (100) = -3.294, p=.001). BMII was established to be efficacious in treatment of gambling disorder among university students. It is recommended as an evidence

– based intervention that can be utilised in gambling disorder treatment among university students in Kenya.

CHAPTER ONE INTRODUCTION

            Background of the Study

Gambling can be defined as “Staking money or something of material value on an event having an uncertain outcome in the hope of winning additional money and/or material goods” (Williams et al., 2017). Examples of gambling games include sports betting, casino, poker and lotteries. Gambling is said to be as old as the organized society. The first legalized gambling happened in Venice in 1638 (Schwartz, 2019). Over the centuries, gambling has evolved from a social vice to being legalised. It has also evolved from being land based casinos to online gambling. The increase in legalised gambling opportunities more so online gambling across the globe has stimulated a high rate of gambling participation in many countries. In Australia, legalization of internet gambling led to an increase in gambling prevalence from less than 1% to 8.1% between 1999 and 2011. In Britain, at least 15% of the population had participated in online gambling regularly (Gainsbury, 2015; Gambling Commission, 2014). In Spain, the legalization of online gambling led to 44.64% increase in pathological gamblers within two years (Chóliz, 2016). In the United States of America (USA), it is estimated that between 0.42% and 4% of the population are addicted to gambling (Black & Shaw, 2019). In India, 27.9% of high school students have gambled while 7.1% are problem gamblers (Jaisoorya et al., 2017). In Africa, the prevalence of gambling is high with 54% of youth having engaged in gambling (Geopoll, 2017). Aguocha & colleagues (2019) found that 57.2% of secondary school students in Nigeria had gambled while 42% of youth in

Ghana had gambled. Research in East Africa showed that 40% of youth in Uganda had gambled while 17.7% were problem gamblers (Anyanwu, Bajunirwe & Tamwesigire, 2020). Another study by Geopoll (2017) found that 57% of youth in Uganda had participated in gambling. In Kenya, gambling has not been a major public health concern until the last five years when online sports betting made its debut. Between 57 – 76% of Kenyans have participated in gambling (Geopoll, 2017; 2019a) while 29% of the gamblers are students (Wangari, 2018). Youth with post – secondary education form the bulk of Kenyans involved in gambling. According to Mwadime (2017), most of those who gamble in Kenya are aged below 40 years. Koross ( 2016) reports that over 78% of university students in Kenya gamble at least once a week. Macharia (2018) also found that more than 75% of Kenyan university students were engaged in sports betting. In Kenya, 87% of gambling is done through online sports betting (Infotrack, 2019). According to Hing et al., (2016) young males who are educated or fulltime students are more likely to bet more frequently and spend more money in sports betting.

Although gambling may provide an innocuous chance for excitement for the occasional gambler, it can have serious adverse consequences on the compulsive gambler. A compulsive gambler is an individual who is unable to control his gambling and often gambles excessively. The occasional gambler is able to control  his gambling and does not wager frequently. Compulsive gambling affects the individual psychologically and financially. It also leads to other social problems such as crime and death (Mestre – Bach et al., 2018; Tovino, 2016). This makes it a public health concern. The proliferation of undesirable effects of compulsive gambling on the psychological wellbeing of the individual has led to an interest among mental

health professionals in diagnosis and treatment of the condition. The American Psychiatric Association (2013) classifies compulsive gambling as disorder under substance–related and Addictive Disorders in the Diagnostic and Statistical Manual for Mental disorders fifth Edition (DSM-V). It was previously referred to as Pathological gambling in the DSM IV-TR (American Psychiatric Association, 1994). It is commonly referred to as problem gambling in literature. Gambling disorder is described in the DSM-V as persistent. Recurrent problematic gambling behaviour led to clinically significant impairment or distress in the last 12 months. Some of the symptoms associated with gambling disorder are preoccupation with gambling, chasing loses, unsuccessful attempts to control gambling and financial difficulties due to gambling (American Psychiatric Association, 2013). Individuals suffering from gambling disorder lose time from school or work, get into severe debt and legal problems, experience relationship problems, psychological distress and physical health problems (Latvala, Lintonen & Konu, 2019; Keen, et al., 2015; Koross, 2016). The seriousness of the negative effects of gambling disorder has led to various attempts to find treatments for the problem.