Feasibility of Audio Computer-Assisted Self-Interviewing With Color-Coding and Helper Assistance (ACASI-H) for Survey Completion

Background: The U.S. is a multicultural society, with increasing numbers of older adult immigrants. Many older adult immigrants, such as older Hmong adults, have limited English proficiency (LEP), and cannot read or have difficulty reading even in their first language; non-literate (NL). Little has been done to identify feasible data collection approaches for including these LEP or NL populations in research, leaving a gap in knowledge about their health.

Purpose: The purpose of this study was to test the feasibility of culturally and linguistically adapted audio computer assisted self-interviewing (ACASI) with color labeled response categories and helper assistance (ACASI-H) to collect health data with Hmong elders.

Methods: Thirty Hmong dyads (elder respondent and family helper) were recruited from two community centers in a Midwestern city and completed an ACASI-H instrument with 13 health questions, followed by a face-to-face debriefing interview. The ACASI instrument provided audio of the questions in Hmong with the color labeled responses for the elder and displayed questions in English text for the family helper. ACASI-H instrument completion was video recorded. ACASI-H interviews and debriefing interviews were audio recorded and transcribed. Directed and conventional content analyses were used to analyze the debriefing interviews.

Results: All Hmong elders completed the interview and reported that ACASI-H instrument questions were consistent with their health experience. They lacked computer experience. ACASI-H’s interface was user friendly. Twenty-nine of the 30 dyads used the Hmong oral translation. Some elders struggled with the color labeling at first, but helpers guided them to use the color coding correctly. All dyads liked the color labeled response categories. All elders confirmed that including a helper during the instrument completion process was necessary.

Conclusions: Findings support use of oral survey question administration with a technologically competent helper and color labeled response categories for engaging LEP older adults in a survey interview.