Use of audio computer-assisted self-interviewing (ACASI) technology to facilitate collection of oral health data in two American Indian tribes

Background: American Indians/Alaska Natives have a higher prevalence of dental disease than other racial/ethnic groups in the U.S. The Center for Native Oral Health Research at the University of Colorado Denver was funded by the National Institute for Dental and Craniofacial Research to develop/evaluate interventions to improve oral health in Native populations. The remote nature of many tribal communities presents challenges for collection and transmission of study data. Internet access is often unavailable, making Web-based data collection untenable. To facilitate acquisition of participant survey data, we developed an audio computer-assisted self-interviewing (ACASI) system, which directs participants through the survey electronically on local machines. Purpose: To describe the development and acceptability of the ACASI system used for two clinical trials designed to reduce early childhood caries in two American Indian tribes. Methods & Results: The ACASI system was developed in SSI Web (Sawtooth Software) and implemented on Dell Inspiron Mini Computers. Questions and response options were read aloud by the computer and presented visually. Participant response was provided through mouse and keyboard input. To enhance acceptability, the survey was narrated by a member of the participating tribe with which a given subject was affiliated. Data were backed up to flash drives following each data collection session and transmitted via Virtual Private Network from field offices to the data coordinating center in Denver. Pilot testing was conducted in both tribal communities with parents of young children. Survey data and feedback regarding satisfaction with and acceptability of the system were collected. These data were used to identify refinements to improve efficiency and acceptability of the system. Discussion: ACASI allowed electronic capture of survey data in the field in a manner that did not require internet access, reduced data collection and entry burden for staff, and provided support for participants with limited literacy skills.