Acceptance, communication mode, and use of audio computer-assisted self-
interviewing using touch screen to identify risk factors among pregnant minority women

Abstract

This paper evaluates the acceptability, communication mode, and use of audio computer-assisted self-interviewing (ACASI) among minority pregnant women receiving prenatal care in six Washington, DC, sites. We screened 2,913 women for demographic eligibility (at least 18 years old, less than 29 weeks’ gestation, black or Hispanic) and risk of harm from smoking, environmental tobacco smoke exposure, depression, or intimate partner violence. Questions were displayed on touch-screen laptop monitors and heard through earphones. The mean length of time to complete the screening interview was almost 6 minutes.

We compared ACASI experience, which included difficulty in using the computer, acceptability (enjoyment), and preferred communication mode, across sites, across the eligibility and risk groups, and across a subset of 878 enrolled women for whom we had information on educational attainment and receipt of WIC (the Supplemental Nutrition Program for Women, Infants, and Children, a proxy for income). Respondents reported that ACASI was not difficult to use and that they liked using the computer. Respondents who were black or Hispanic enjoyed it significantly more than did respondents of other races/ethnicities. Of the respondents who were demographically eligible and who were black or Hispanic, those who had lower education levels listened to questions significantly more than did their counterparts. Mainly listening vs. listening and reading did not impact burden in terms of the length of time it took to complete the screener.

The acceptance of ACASI as a screening tool opens the door for more uses of this technology in health-related fields. The laptop computer and headphones provide privacy and mobility, so the technology can be used to ask sensitive questions in almost any locale, including busy clinic settings.