Are sexual health survey items understood as intended by African and Asian migrants to Australia? Methods, results and recommendations for qualitative pretesting

Daniel Vujcich; Meagan Roberts; Graham Brown; Jo Durham; Zhihong Gu; Lisa Hartley; Roanna Lobo; Limin Mao; Piergiorgio Moro; Amy B Mullens; Baden Offord; Enaam Oudih; Alison Reid

doi:10.1136/bmjopen-2021-049010

Are sexual health survey items understood as intended by African and Asian migrants to Australia? Methods, results and recommendations for qualitative pretesting

BMJ Open. 2021 Dec 8;11(12):e049010. doi: 10.1136/bmjopen-2021-049010.

Authors

Daniel Vujcich¹, Meagan Roberts², Graham Brown³, Jo Durham⁴, Zhihong Gu⁵, Lisa Hartley⁶, Roanna Lobo², Limin Mao⁷, Piergiorgio Moro⁸, Amy B Mullens⁹, Baden Offord⁶, Enaam Oudih¹⁰, Alison Reid²

Affiliations

¹ School of Population Health, Curtin University Faculty of Health Sciences, Perth, Western Australia, Australia daniel.vujcich@curtin.edu.au.
² School of Population Health, Curtin University Faculty of Health Sciences, Perth, Western Australia, Australia.
³ Centre for Social Impact, University of New South Wales, Sydney, New South Wales, Australia.
⁴ School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
⁵ Hepatitis, HIV/AIDS and Sexual Health Program, Ethnic Communities Council of Queensland Ltd, West End, Queensland, Australia.
⁶ Centre for Human Rights Education, Curtin University, Perth, Western Australia, Australia.
⁷ Centre for Social Health in Research, University of New South Wales, Sydney, New South Wales, Australia.
⁸ Multicultural Health and Support Service, Centre for Culture, Ethnicity and Health, Richmond, Victoria, Australia.
⁹ School of Psychology and Counselling, University of Southern Queensland - Ipswich Campus, Ipswich, Queensland, Australia.
¹⁰ PEACE and MOSAIC, Relationships Australia South Australia, Adelaide, South Australia, Australia.

Abstract

Introduction: More research and policy action are needed to improve migrant health in areas such as sexual health and blood-borne viruses (SHBBV). While Knowledge, Attitudes and Practice Surveys (KAPS) can inform planning, there are no SHBBV KAPS suitable for use across culturally and linguistically diverse contexts. This study pretests one instrument among people born in Sub-Saharan Africa, South-East and North-East Asia living in Australia.

Methods: Employees of multicultural organisations were trained to collect data over three rounds using a hybrid qualitative pretesting method. Two researchers independently coded data. Researchers made revisions to survey items after each round. Responses to feedback questions in the final survey were analysed.

Results: Sixty-two participants pretested the survey. Issues were identified in all three rounds of pretesting. Of the 77 final survey respondents who responded to a survey experience question, 21% agreed and 3% strongly agreed with the statement 'I found it hard to understand some questions/words'.

Conclusion: It is essential to pretest SHBBV surveys in migrant contexts. We offer the following pretesting guidance: (1) large samples are needed in heterogeneous populations; (2) intersectionality must be considered; (3) it may be necessary to pretest English language surveys in the participants' first language; (4) bilingual/bicultural workers must be adequately trained to collect data; (5) results need to be interpreted in the context of other factors, including ethics and research aims; and (6) pretesting should occur over multiple rounds.

Keywords: HIV & AIDS; public health; qualitative research.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Health Surveys
Humans
Sexual Health*
Surveys and Questionnaires
Transients and Migrants*