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Bilingual telephone-assisted computerized speech-recognition assessment: is a voice-activated computer program a culturally and linguistically appropriate tool for screening depression in English and Spanish?

The purpose of this study was to evaluate an automated voice-interactive program for screening depression in English and Spanish. The Center for Epidemiological Studies-Depression Scale (CES-D) was administered in two interview formats: a speech recognition program presented by cellular telephone, and a face-to-face method. In a single-session counterbalanced design, 32 English speakers and 23 Spanish speakers completed randomly ordered administrations of the two CES-D methods, the Beck Depression Inventory (BDI), and the Short Acculturation Scale (SAS). There was strong evidence that the two CES-D methods were psychometrically equivalent, reliable, and valid in both languages. The two methods were highly rated by both language groups. The Spanish speakers did not display a preference for either method, but the English speakers preferred the face-to-face method. The results also suggested that verbal response latency time was positively correlated with depression scores. Last, the Spanish-speakers' acculturation levels were not correlated with depression scores. Differences in age, education, and income between the language groups were confounded by unequal sample sizes. The findings generally supported the viability of the automated CES-D as a culturally and linguistically appropriate tool for screening depression in English and Spanish. Furthermore, the analyses of respondent voice characteristics show promise as a method for screening depression in both languages.