# Survey Modalities and COVID-19 Vaccine Uptake in Vietnamese Americans: Cross-Sectional Study

## TL;DR

This study shows that offering paper surveys in Vietnamese improves participation among Vietnamese Americans in public health research.

## Contribution

The study demonstrates how survey modality and community-based approaches can enhance inclusivity in minority populations.

## Key findings

- Paper surveys increased participation among Vietnamese speakers and those without college education.
- Community-based organizations helped improve demographic representation in health research.
- Electronic surveys were preferred by those with higher education and prior COVID-19 experience.

## Abstract

Diverse survey methodologies are essential to ensure equitable representation in public health research, particularly among minority populations. This study evaluates demographic differences among Vietnamese Americans who completed paper versus electronic surveys while administering the National Institutes of Health Community Engagement Alliance Common Survey 2, which focused on COVID-19–related topics.

The study aimed to (1) describe the sociodemographic characteristics of survey respondents; (2) compare paper versus electronic survey modalities and their associations with respondent demographics; and (3) highlight the role of community-based organizations (CBOs) and community-engaged research in improving representativeness and inclusivity.

Vietnamese adults in Texas were recruited in two phases. In phase 1 (September 2021-March 2022), surveys were administered online. In response to CBOs’ feedback, phase 2 (December 2022-April 2023) added paper surveys administered by bilingual recruiters; surveys were available in English and Vietnamese. Descriptive analyses were conducted for both phases. Multivariate logistic regression, limited to phase 2, assessed factors associated with survey method preferences, including language, sex, education, COVID-19 history, and willingness to participate in COVID-19 trials.

Phase 1 included 224 electronic surveys. Phase 2 included 359 surveys (electronic: n=124, 34.5% and paper: n=235, 65.5%). Vietnamese speakers were significantly more likely to complete paper surveys (adjusted odds ratio [AOR] 100.9, 95% CI 24.3‐418.9; P<.001), as were female participants (AOR 5.09, 95% CI 1.43‐18.1; P=.01). Conversely, those with a history of COVID-19 (AOR 0.16, 95% CI 0.05‐0.52; P=.002), a college or higher education level (AOR 0.18, 95% CI 0.05‐0.67; P=.01), and high willingness to participate in COVID-19 trials (AOR 0.21, 95% CI 0.06‐0.81; P=.02) were less likely to complete paper rather than electronic surveys.

Incorporating paper surveys and engaging CBOs improved participation among Vietnamese speakers and those without postsecondary education, addressing the underrepresentation observed in phase 1. These findings highlight the importance of tailored survey methodologies to achieve demographic inclusivity in public health research.