title: Quality of data in multiethnic health surveys.
abstract: OBJECTIVE
  There has been insufficient research on the influence of ethno-cultural and language differences in public health surveys. Using data from three independent studies, the authors examine methods to assess data quality and to identify causes of problematic survey questions.
  
  
  METHODS
  Qualitative and quantitative methods were used in this exploratory study, including secondary analyses of data from three baseline surveys (conducted in English, Spanish, Cantonese, Mandarin, and Vietnamese). Collection of additional data included interviews with investigators and interviewers; observations of item development; focus groups; think-aloud interviews; a test-retest assessment survey; and a pilot test of alternatively worded questions.
  
  
  RESULTS
  The authors identify underlying causes for the 12 most problematic variables in three multiethnic surveys and describe them in terms of ethnic differences in reliability, validity, and cognitive processes (interpretation, memory retrieval, judgment formation, and response editing), and differences with regard to cultural appropriateness and translation problems.
  
  
  CONCLUSIONS
  Multiple complex elements affect measurement in a multiethnic survey, many of which are neither readily observed nor understood through standard tests of data quality. Multiethnic survey questions are best evaluated using a variety of quantitative and qualitative methods that reveal different types and causes of problems.
authors.affiliation: Northern California Cancer Center, Union City 94587-3106, USA. Rpasick@nccc.org
authors.forename: R J
authors.initials: RJ
authors.lastname: Pasick
authors.forename: S L
authors.initials: SL
authors.lastname: Stewart
authors.forename: J A
authors.initials: JA
authors.lastname: Bird
authors.forename: C N
authors.initials: CN
authors.lastname: D'Onofrio
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D001213:Asian / Q000523:psychology*; D001294:Attitude to Health / Q000208:ethnology*; D001943:Breast Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D003144:Communication Barriers; D003431:Cross-Cultural Comparison; D005191:Family Characteristics / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007802:Language; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011322:Primary Prevention; D011340:Problem Solving; D015203:Reproducibility of Results; D012107:Research Design; D012495:San Francisco; D012650:Self Disclosure; D011795:Surveys and Questionnaires / Q000592:standards*; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control*