This paper evaluates the acceptability, communication mode and use of audio computer-assisted self-interview (A-CASI) among minority pregnant women receiving prenatal care in six Washington, DC sites. A total of 2,913 women were screened for demographic eligibility (18+ years old,gestation, Black/African-American or Hispanic) and risk (smoking, environmental tobacco smoke exposure, depression, intimate partner violence). Questions were displayed on touch screen laptop monitors and heard through earphones. The mean length of time to complete the screener was almost 6 minutes.
A-CASI experience, which included difficulty in using the computer, acceptability (enjoyment), and preferred communication mode, was compared across sites, the eligibility and risk groups and a subset of 878 enrolled women for whom educational attainment and receipt of WIC (a proxy for income) were available. Respondents thought A-CASI was not difficult to use and liked using the computer. Black/African-American or Hispanic respondents enjoyed it significantly more than did respondents of other race/ethnicities. Respondents who were demographically eligible, Black/ African-American or Hispanic, or with lower education levels listened to questions significantly more than did their counterparts. Mainly listening or listening and reading does not impact burden in terms of the length of time it took to complete the screener.
The acceptance of A-CASI 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.