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Acculturation and Health Survey Question Comprehension Among Latino Respondents in the US

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Abstract

Although research has documented cultural variability in respondent comprehension and interpretation of survey questions, little information is currently available on the role that acculturation might play in minimizing cross-cultural differences in the comprehension or interpretation of survey questions. To investigate this problem, we examine the potential effects of acculturation to host culture on respondent comprehension of a set of health survey questions among two distinct Latino populations on the US mainland: Mexican–Americans and Puerto Ricans. Specifically, comprehension-related respondent behaviors coded from 345 face-to-face interviews conducted with Mexican–American, Puerto Rican, African American, and non-Latino White adults living in Chicago are examined. Findings indicate that Latino respondents who were born outside of the US and who have a preference for communicating in Spanish, relative to English, were more likely to express comprehension difficulties. These findings suggest that pretest survey instruments with immigrant populations may be a useful strategy for identifying problematic questions.

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References

  1. Bachman JG, O’Malley PM. Yea-saying, nay-saying and going to extremes: black-white differences in response styles. Public Opin Q. 1984;48:491–509.

    Article  Google Scholar 

  2. Hui CH, Triandis HC. Effects of culture and response format on extreme response style. J Cross Cult Psychol. 1989;20:296–309.

    Article  Google Scholar 

  3. Ross CE, Mirowsky J. Socially-desirable response and acquiescence in a cross-cultural survey of mental health. J Health Soc Behav. 1984;25:189–97.

    Article  PubMed  CAS  Google Scholar 

  4. Weech-Maldonado R, Elliott MN, Oluwole A, Schiller KC, Hays RD. Survey response style and differential use of CAHPS rating scales by Hispanics. Med Care. 2008;46:963–8.

    Article  PubMed  Google Scholar 

  5. Johnson TP, van de Vijver FJR. Social desirability in cross-cultural research. In: Harkness JA, van de Vijver FJR, Mahler PH, editors. Cross-cultural survey methods. New York: Wiley; 2003. p. 193–209.

  6. Warnecke RB, Johnson TP, Chávez N, Sudman S, O’Rourke D, Lacey L, et al. Improving question wording in surveys of culturally diverse populations. Ann Epidemiol. 1997;7:334–42.

    Article  PubMed  CAS  Google Scholar 

  7. Johnson TP, Bowman PJ. Cross-cultural sources of measurement error in substance use surveys. Subst Use Misuse. 2003;38:1447–90.

    Article  PubMed  Google Scholar 

  8. Jenkins JH. Conceptions of schizophrenia as a problem of nerves: a cross-cultural comparison of Mexican–Americans and Anglo–Americans. Soc Sci Med. 1988;26:1233–43.

    Article  PubMed  CAS  Google Scholar 

  9. Johnson TP, O’Rourke D, Chávez N, Sudman S, Warnecke R, Lacey L, et al. Social cognition and responses to survey questions among culturally diverse populations. In: Lyberg PBL, Collins M, de Leeuw E, Dippo C, Schwarz N, et al. editors. Survey measurement and process quality. New York: Wiley; 1997.

  10. Johnson TP, Cho YI, Holbrook AL, O’Rourke D, Warnecke RW, Chávez N. Cultural variability in the effects of question design features on respondent comprehension of health surveys. Ann Epidemiol. 2006;15:661–8.

    Article  Google Scholar 

  11. Meredith LS, Siu AL. Variation and quality of self-report health data: Asians and Pacific Islanders compared with other ethnic groups. Med Care. 1995;33:1120–31.

    Article  PubMed  CAS  Google Scholar 

  12. Morse JM, Morse RM. Cultural variation in the inference of pain. J Cross Cult Psychol. 1988;19:232–42.

    Article  Google Scholar 

  13. Centers for Disease Control and Prevention. CDC Health disparities and inequalities report—United States, 2011. MMWR. 2011;60(Suppl).

  14. Motel S, Patten E. The 10 largest Hispanic origin groups: characteristics, rankings, top counties. Pew Hispanic Center: Washington; 2012.

  15. Carter-Pokras O, et al. Health status of Mexican-origin persons: do proxy measures of acculturation advance our understanding of health disparities? J Immigr Minor Health. 2008;10:475–88.

    Article  PubMed  Google Scholar 

  16. Pérez-Escamilla R, Putnik P. The role of acculturation in nutrition, lifestyle, and incidence of type 2 diabetes among Latinos. J Nutr. 2007;137:860–70.

    PubMed  Google Scholar 

  17. Lara M, et al. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367–97.

    Article  PubMed  Google Scholar 

  18. Smith PB, Bond MH. Social psychology across cultures. 2nd ed. Massachusetts: Allyn and Bacon; 1999.

  19. Abraído-Lanza A, Chao MT, Flórez KR. Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Soc Sci Med. 2005;61:1243–55.

    Article  PubMed  Google Scholar 

  20. Jurkoswki JM, Johnson TP. Acculturation and cardiovascular disease screening practices. Ethn Dis. 2005;15:411–7.

    Google Scholar 

  21. Mainous AG, Majeed AM, Koopman RJ, Baker R, Everett CJ, Tilley BC, Diaz VA. Acculturation and diabetes among Hispanics: evidence from the 1999–2002 National Health and Nutrition Survey. Public Health Rep. 2006;121:60–6.

    PubMed  Google Scholar 

  22. Tardif CY, Geva E. The link between acculturation disparity and conflict among Chinese Canadian immigrant mother-adolescent dyads. J Cross Cult Psychol. 2006;37:191–211.

    Article  Google Scholar 

  23. Meyler D, Stimpson JP, Peek MK. Acculturation and self-esteem among older Mexican Americans. Aging Mental Health. 2006;10:182–6.

    Article  PubMed  CAS  Google Scholar 

  24. Lipsky S, Caetano R, Field CA, Larkin GL. The role of intimate partner violence, race, and ethnicity in help-seeking behaviors. Ethn Health. 2006;11:81–100.

    Article  PubMed  Google Scholar 

  25. Xu J. Why do minorities participate less? The effects of immigration, education, and electoral process on Asian American voter registration and turnout. Soc Sci Res. 2005;34:682–702.

    Article  Google Scholar 

  26. Rojas-Guyler L, Ellis N, Sanders S. Acculturation, health protective sexual communication, and HIV/AIDS risk behavior among Hispanic women in a large midwestern city. Health Educ Behav. 2005;32:767–79.

    Article  PubMed  Google Scholar 

  27. Marín G, Gamba RJ, Marín BV. Extreme response style and acquiescence among Hispanics: the role of acculturation and education. J Cross Cult Psychol. 1992;23:498–509.

    Article  Google Scholar 

  28. Triandis HC, Marín G, Lisanski J, Betancourt H. Simpatía as a cultural script of Hispanics. J Pers Soc Psychol. 1984;47:1363–75.

    Article  Google Scholar 

  29. Davis RE, Resnicow K, Couper MP. Survey response styles, acculturation, and culture among a sample of Mexican American adults. J Cross Cult Psychol. 2011;42:1219–36.

    Article  PubMed  Google Scholar 

  30. Kim YY. Becoming intercultural: An integrative theory of communication and cross-cultural adaptation. Sage: Thousand Oaks; 2001.

  31. Kim YY. Adapting to a new culture: an integrative communication theory. In: Gudykunst WB, editors. Theorizing about intercultural communication. Thousand Oaks: Sage; 2005. p. 375–400.

  32. Ward C. The A, B, Cs of acculturation. In: Matsumoto D, editor. The handbook of culture and psychology. Oxford University Press: New York; 2001. p. 411–445.

  33. Marín G, Sabogal F, Marín B, Otero-Sabogal R, Pérez-Stable E. Development of a short acculturation scale for Hispanics. Hispanic J Behav Sci. 1987;9:183–205.

    Article  Google Scholar 

  34. Holbrook AL, Cho YI, Johnson TP. The impact of question and respondent characteristics on comprehension and mapping difficulties. Public Opin Q. 2006;70:565–95.

    Article  Google Scholar 

  35. Flesch R. How to write plain English. New York: Harper and Row; 1979.

  36. Oksenberg L, Cannell C, Kalton G. New strategies for pretesting survey questions. J Off Stat. 1991;7:349–65.

    Google Scholar 

  37. Fowler FJ. Improving survey questions: design and evaluation. Sage; Thousand Oaks; 1995.

  38. Bollen KA. Structural equations with latent variables. New York: Wiley; 1989.

    Google Scholar 

  39. Raudenbush SW, Bryk AS, Cheong YF, Congdon RT. HLM 7: hierarchical linear and nonlinear modeling. Lincolnwood: Scientific Software International Inc; 2011.

    Google Scholar 

  40. Raudenbush SW, Bryk AS. Hierarchical linear models: applications and data analysis methods. 2nd ed. Sage: Thousand Oaks; 2002.

  41. McQuiston C, Parrado EA, Flaskerud JH. AIDS knowledge and measurement considerations with unacculturated Latinos. West J Nurs Res. 2002;24:354–72.

    Article  PubMed  Google Scholar 

  42. Berry JW Conceptual approaches to acculturation. In Chun KM, Organista PB, Marín G, editors. Acculturation: advances in theory, measurement, and applied research. Washington: American Psychological Association; 2003. p. 17–37.

  43. Zane N, Mak W. Major approaches to the measurement of acculturation among ethnic minority populations: a content analysis and an alternative empirical strategy. In Chun KM, Organista PB, Marín G. editors. Acculturation: advances in theory, measurement, and applied research. American Psychological Association: Washington; 2003. p. 39–60.

  44. Schoua-Glusberg A. Response 2 to Fowler’s chapter: coding the behavior of interviewers and respondents to evaluate survey questions. In: Madans KMJ, Maitland A, Willis G, editors. Question evaluation methods. New York: Wiley; 2011.

  45. Johnson TP, Cho YI, Holbrook AL. A preliminary assessment of cultural variability in respondent actions captured by behavior codes. Vancouver: The Joint Statistical Meetings; 2010.

  46. Johnson TP, Holbrook AL, Shavitt S, Cho YI, Chávez N, Weiner S. Cross-cultural validity of behavior codes. Phoenix, Arizona: 66th Annual Meeting of the American Association for Public Opinion Research; 2011.

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Cho, Y.I., Holbrook, A. & Johnson, T.P. Acculturation and Health Survey Question Comprehension Among Latino Respondents in the US. J Immigrant Minority Health 15, 525–532 (2013). https://doi.org/10.1007/s10903-012-9737-9

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