Feasibility of Audio‐Computer‐Assisted Self‐Interviewing With Color‐Coding and Helper Assistance (ACASI‐H) for Hmong Older Adults

Abstract

Many older adult immigrants in the US, including Hmong older 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 to enable inclusion of LEP or NL populations in research, limiting knowledge about their health. This study’s purpose 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) for collection of health data with Hmong older adults. Thirty dyads (older adult and a helper) completed an ACASI-H survey with 13 health questions and a face-to-face debriefing interview. ACASI-H survey completion was video-recorded and reviewed with participants. Video review and debriefing interviews were audio-recorded and transcribed. Directed and conventional content analyses were used to analyze the interviews. All respondents reported that ACASI-H survey questions were consistent with their health experience. They lacked computer experience and found ACASI-H’s interface user-friendly. All but one whose helper provided translation used the pre-recorded Hmong oral translation. Some Hmong older adults struggled with the color labeling at first, but helpers guided them to use the colors correctly. All dyads liked the color-labeled response categories and confirmed that a helper was necessary during the survey process. Findings support use of oral survey question administration with a technologically competent helper and color-labeled response categories when engaging LEP older adults in health-related data collection.

Completing Self-administered Questionnaires: Hmong Older Adults and Their Family Helpers

“…We designed a naturalistic study procedure and setting in which helpers had a formal role helping NES and NL respondents during the survey completion process. This investigation is part of a larger feasibility study of ACASI-H (details in Lor and Bowers 2017).…”

Hmong Older Adults’ Perceptions of Insider and Outsider Researchers

“…The findings reported in this paper are part of a larger mixed methods study (using survey, video, and qualitative interviews), which tested the feasibility of a data collection mode with older Hmong adults (Lor & Bowers, 2017) and requested that participants provided information about what they believed would encourage them and others from their community to take part in research. The Health Sciences Institutional Review Board (IRB) approved this study.…”

“…Consequently, there is a role reversal between children and elders, where children are seen as the ones who have the necessary experience for survival due to their English skills. Elders rely on children to translate and navigate the health care system (Lor & Bowers, 2017). In addition, the Hmong are excluded from national survey research due to language barriers (Lor, 2017).…”

Color-encoding visualizations as a tool to assist a nonliterate population in completing health survey responses

“…Prior pilot testing was conducted to determine appropriate color/response category associations (36). Based on pilot testing, the survey used brighter colors for positive connotations and darker colors, except red, for negative connotations.…”