Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: May 28, 2025
Open Peer Review Period: May 28, 2025 - Jul 23, 2025
Date Accepted: Dec 17, 2025
(closed for review but you can still tweet)
Survey Modalities and COVID-19 Vaccine Uptake in Vietnamese Americans: Cross-Sectional Study
ABSTRACT
Background:
Diverse survey methodologies are essential to ensure equitable representation in public health research, particularly among minority populations.
Objective:
This study evaluates demographic differences among Vietnamese Americans who completed paper versus electronic surveys while administering the NIH Community Engagement Alliance (CEAL) Common Survey 2, which focused on COVID-19-related topics.
Methods:
Vietnamese adults in Texas were recruited in two phases. In Phase 1 (September 2021–March 2022), surveys were administered online. Feedback from community-based organizations (CBOs) informed the addition of paper surveys and bilingual recruiters in Phase 2 (December 2022–April 2023). Surveys were available in English and Vietnamese. Data from both phases were analyzed using multivariate logistic regression to identify factors associated with survey method preferences, including language, sex, education, COVID-19 history, and willingness to participate in COVID-19 trials.
Results:
Two hundred twenty-four participants completed the online survey in Phase 1, while 359 completed surveys in Phase 2, of which 124 (34.5%) were electronic and 235 (65.4%) were paper. Multivariate analysis revealed that 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 females (AOR 5.09, 95% CI: 1.43–18.1; P=.012). 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=.010), and high willingness to participate in COVID-19 trials (AOR 0.21, 95% CI: 0.06–0.81; FF=0.023) were less likely to complete paper rather than electronic surveys.
Conclusions:
Incorporating paper surveys and engaging CBOs improved participation among Vietnamese speakers and those without post-secondary 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.
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