AAPI Health Survey
AA S 591.02
San Francisco State University
Verbal Consent to Participate in Research
Hello, my name is ________________ and I am an undergraduate student at SFSU in the
AA S department conducting a research study on AAPI health. I am surveying people
about AAPI health beliefs as part of this study.
Your answers will be kept confidential, and there is little or no risk or benefit to you in
answering these questions. Would you like to participate in the survey?
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San Francisco State University
Implied Consent to Participate in Research
Data collected from this confidential survey will be used for completion of a class
assignment in AA S 591.02 at San Francisco State University. The information gathered
will be used for research on Asian American and Pacific Islander (AAPI) health
perceptions.
You must be 18 years of age or older to participate. There are no risks or benefits to you
in participating in this survey. You may choose to participate or not. You may answer
only the questions you feel comfortable answering, and you may stop at any time. There
is a small risk that you might feel some discomfort in answering these questions, but you
may stop participating at any time or you may refuse to answer any question. If you do
participate, completion and return of the survey indicates your consent to the above
conditions.
The survey should take approximately 20 minutes to complete. Any questions or
concerns should be directed to the principal investigator, Baldeep Pabla, LCSW, at
bpabla@mail.sfsu.edu.
AAPI Health Survey
AA S 591.02
San Francisco State University
AAPI Health Survey
1. Do you identify as Asian American or Pacific Islander (AAPI)?
A. If so, which ethnicity do you identify as?
2. Do you believe that your ethnicity is represented in Asian American Studies and/or
general courses?
A. If so, do you believe that your ethnicity is represented accurately?
3. How do you define mental health?
4. Are you aware of the cultural health tendencies within the culture you identify with?
5. Are there particular emotional or mental stressors that are associated with the culture
you identify with?
6. Are you currently stressed?
A. If not, when do you get stressed?
B. If so, do you talk to anyone about your stress?
7. Do you think your professors care about your mental health?
8. Do you feel like SFSU offers you support?
9. Are you aware of the services and resources available on campus?
10. What’s the best way to inform you about these events and services?
11. Do you believe that there are enough resources or services devoted to specific issues
you may be going through?
12. What would make you more likely to utilize these services or groups on campus?
13. If the school was more supportive and open about mental health care, how do you
think it would affect your family’s perception of mental health care overall?
14. How would you rate your overall health from 1-10, with 1 being poor and 10 being
excellent?
15. Would you like to provide any additional comments on AAPI health or AAPI mental
health?
AAPI Health Survey Paper | Rubric
Student Name: _________________________________________
Date: ___________________
Beginning
(1 Point)
Accomplished
(3 Points)
Exemplary
(4 Points)
Format
Paper does not follow the research project
guidelines for length, spacing, or format.
Paper is 3-5 pages, double-spaced, with APA
format for the cover page and citations.
However, there are a few formatting issues
present (e.g. abstract missing).
Paper is 3-5 pages, double-spaced, with APA
format for the cover page and citations. There
are minimal or no formatting issues present.
Introduction
Paper does not have a clearly-identifiable thesis
or hypothesis in the introduction.
Paper has a somewhat identifiable thesis or
hypothesis in the introduction.
Paper has a clearly identifiable thesis or
hypothesis in the introduction.
Methods
Paper does not describe the methods taken to
obtain information cited.
Paper makes general statements about
methods taken without identifying specific
topics, databases, or questions that guiding
obtaining the information cited.
Paper clearly identifies methods taken by
specific references to databases, research
questions, or topics of interest that guided
obtainment of information cited.
Results
Paper does not tie results to the thesis,
hypothesis, or larger questions posed in the
introduction.
Paper attempts to link results back to the
thesis, hypothesis, or larger questions posed in
the introduction.
Paper clearly identifies 3-5 results and links
them to the thesis, hypothesis, or larger
question posed in the introduction.
Conclusion
Paper does not recount 3-5 results and does
not summarize what the findings might mean.
Paper does not tie the findings to readings,
class lectures, or class discussions.
Paper recounts 3-5 results but is unable to
summarize and link the findings to readings,
class lectures, or class discussions. Paper
makes recommendations for future research or
services.
Paper recounts 3-5 results and summarizes
what they might mean as related to readings,
class lectures, or class discussions. Paper also
makes recommendations for future research or
services.
Items
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AA S 591.02
Baldeep Pabla, LCSW
AAPI Health Survey
Purpose: This assignment takes the form of Community Based Participatory Action Research
(CBPAR). CBPAR is a framework for research that aims to address the practical concerns of
people in a community. It is a collaborative approach to research that involves all stakeholders
throughout the research process, from establishing the research question, to developing data
collection tools, to analysis and dissemination of findings.
In order to capture the perceptions, experiences, and current needs of San Francisco State
University (SFSU) Asian American & Pacific Islander (AAPI) students, we will engage with
CBPAR in the following ways:
1. Survey Creation | As a class, we will compile a list of questions that seek to capture the
perceptions and needs of AAPI students as they relate to mental health concerns.
2. Survey Administration | Individually, you will be responsible for signing up to attend Health
Promotion & Wellness (HPW) events on campus in order to interview students using the survey.
You will be responsible for completing 3-5 surveys.
3. Response Analysis | You will submit your findings on November 13th, 2018 with a 3-5 page,
APA-style paper that explores your findings by comparing & contrasting them to existing
literature on AAPI mental health concerns.
Guidelines for each of these three sections are presented on the following page.
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1. Survey Creation
We will complete this portion together during our class session on 09.18.18.
2. Survey Administration
You will receive sign-up information to attend the following. Please remember to sign in with Jul
or the HPW Lead at the following:
Therapy Dogs
Tea Time-Out
Wellness Wednesdays Self-Care Station
Every 1st and 3rd Tuesday from 12pm-1pm
Every Wednesdays 9:45am-10:45am
Every Wednesdays 12:45pm-1:45pm
3. Response Analysis
The response paper should be 3-5 double-spaced pages in length, not counting a required APAstyle cover page, abstract, in-text citations, and a works cited page. The paper is going to be
graded based on four main sections: Introduction, Method, Results and Conclusion.
In the introduction section, students are required to introduce the topic of AAPI mental health,
the rationale behind this survey, and make a clear thesis statement containing what you
hypothesized for the survey responses.
In the method section, students are expected to state the methods they went about in engaging
students to take the survey, which event they attended, and what kind of databases, research
methods, experiments, or studies did the student come across when looking for comparative
research on AAPI mental health.
In the results/discussion section, students are required to summarize their findings in some
logical manner, either by theme or major concepts you discovered from the survey responses or
literature reviews. After you present your findings, students are expected to discuss and make
some assessment of their findings by giving some explanation to why they think their findings
came out the way it did using concepts presented in readings, class lectures, or class discussions.
In the conclusion section, you are required to summarize your key findings (3-5 findings). Then,
you should discuss the significance and or contributions of your topic to Asian American
community health. Lastly, you will provide some recommendations to future research.
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