Evaluation and revision of questionnaires for use among low-literacy immigrant Latinos

Abstract

As more Spanish speaking immigrants participate in and become the focus of research studies, questions arise about the appropriateness of existing research tools. Questionnaires have often been adapted from English language instruments and tested among college- educated Hispanic-Americans. Little has been written regarding the testing and evaluation of research tools among less educated Latino immigrants. The purpose of this study was to revise and evaluate the appropriateness of a battery of existing Spanish-language questionnaires for a physical activity intervention for immigrant Hispanic women. A three-step process was utilized to evaluate, adapt and test Spanish versions of the Self-Efficacy and Exercise Habits Survey, an abbreviated version of the Hispanic Stress Inventory-Immigrant version and the Latina Values Scale. The revised tools demonstrated acceptable validity and reliability. The adaptations improved the readability of the tools, resulting in a greater response rate, less missing data and fewer extreme responses. Psychometric limitations to the adaptation of Likert scales are discussed.

Methodological concerns related to response bias in migrant and seasonal farmworkers

“…This is because certain methods that may improve participation and comprehension, such as the use of incentives and face‐to‐face interviews, may also induce ARB and/or SDB. In the present study, face‐to‐face interviews were deemed essential, as the low literacy rate of the subjects would have resulted in many of the surveys being both incompletely and incorrectly filled out [Flaskerud, ; McQuiston et al, ; D'Alonzo, ]. However, this survey methodology, in which the questions were read aloud and research assistants recorded the respondents’ answers, appear to have exacerbated the power differential between researcher and subject, and contributed to ARB and SDB [Mirowsky and Ross, ; Triandis et al, ; Hui and Triandis, ; Marin et al, ; Johnson et al, ].…”

“…In short, MSFWs face a variety of income, education, and social inequities that collectively contribute to their status as a vulnerable population. A growing body of literature suggests that vulnerable populations have low “research literacy.” This implies that research participants from vulnerable populations are likely unfamiliar with traditional data collection tools, such as quantitative surveys or in‐person interviews [D'Alonzo, ]. It is common for these quantitative data collection tools to employ Likert scale questions in which the subject is asked to supply a ranking along a 0–5 (or 10) point scale.…”

“…It is common for these quantitative data collection tools to employ Likert scale questions in which the subject is asked to supply a ranking along a 0–5 (or 10) point scale. These methods may not be appropriate for use in these low literacy, low socioeconomic status (SES), and immigrant groups [Lange, ; D'Alonzo, ]. For example, in a review of Likert scale questions in health surveys among Central American and Vietnamese refugees, Flaskerud [] found that both groups responded with a “yes” or “no” answer to each of the five levels of an ordinal scale rather than selecting one of the five levels.…”

“…Several studies have shown that vulnerable populations, such as MSFWs, are also more likely to exhibit a phenomenon known as acquiescence response bias (ARB), which is the tendency to answer questions affirmatively, regardless of their content [Aday et al, ; Hui and Triandis, ; Marin et al, ; D'Alonzo, ; Davis et al, ]. Hypotheses for why Latinos show greater ARB than non‐Latino whites include a cultural value of emphasizing agreement, as well as a possible tendency for ethnic minorities to display acquiescence [Mirowsky and Ross, ; Triandis et al, ; Hui and Triandis, ; Marin et al, ; Johnson et al, ].…”

Implementation of a Training Program for Low‐Literacy Promotoras in Oral Rehydration Therapy

“…Quantitative and qualitative data were collected through promotora feedback on the training program. Likert scales have been reported to problematic with low‐literacy Latinos; therefore, self‐evaluatory questions regarding skills gained during the training and required for participation as a promotora were developed using “I am sure that I can” ( Estoy segura que puedo ), “Maybe I can” ( Quizas si puedo ), and “I am sure I cannot” ( Estoy segura que no puedo ) based on previous Likert‐scale research (D'Alonzo, ). Three additional open‐ended questions allowed the participants to provide feedback regarding the most helpful part of the training, which parts needed improvement, and suggestions to improve future training.…”