186560 Developing a binational and bilingual health questionnaire for the US-Mexico border

Tuesday, October 28, 2008: 1:35 PM

Patricia Cravioto, MPH, PhD , Instituto de Psiquiatria, Mexico City, Mexico
Francis C. Notzon, PhD , International Statistics Program, National Center for Health Statistics, Hyattsville, MD
Carmen Sanchez-Vargas, MD, MPH , Coordinating Office of Global Health, Centers for Disease Control and Prevention, El Paso, TX
Background: Little information other than vital statistics is available on health status of the US-Mexico border population. Information is sorely needed for disease prevention and health promotion activities.

Methods: Health professionals from Mexico and the US jointly developed a BRFSS-based questionnaire for both sides of the US-Mexico border. Cognitive testing, pilot interviews and other evaluation techniques were used to ensure comparable.

Results: Collaborators from CDC, the Mexican Secretaría de Salud and border state health departments met in El Paso in 2004 and agreed to develop a cross-border survey based on the BRFSS. The initial English draft included a number of border-specific questions, such as cross-border usual source of health care, recent use of cross-border health care, cross-border source of health insurance, and others. The initial English version was tested in three Texas border counties. Mexican researchers developed a Spanish translation which was evaluated by bilingual researchers from both countries. Following a 2-day workshop on cognitive testing techniques, the Spanish-language version was evaluated using cognitive evaluation methods: 16 trained interviewers interviewed 32 subjects, the average length of time used on each interview was 3 hrs, and 4 interviews were videotaped. Findings: 40% of the questions were identified as having cognitive problems; rewording was suggested for each. Seven questions were reported as extremely hard to understand by 90% of interviewees.

Conclusion: Careful development, translation, and evaluation are required to ensure that binational/bilingual surveys will produce comparable results. Collaborative discussion of the aims of each question and cognitive testing are essential.

Learning Objectives:
• Identify the need for careful development of questionnaires for binational and bilingual health surveys; • Discuss the importance of cognitive testing techniques for evaluating questionnaires; • Articulate the need for health information for small areas or populations within the US and Mexico.

Keywords: Survey, Health Information

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I directed the development, testing and evaluation of the Spanish-language questionnaire for the US-Mexico border as part of my duties in my previous position as Directora de Investigacion Operativa Epidemiologica, Direccion General de Epidemiologia, Secretaria de Salud Publica, Mexico.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.