Abstract
BackgroundMobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults.ObjectiveThis study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical samples of adults.MethodsIn total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults (>18 years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance (P≤.05) assessed differences between nonclinical and clinical data sets.ResultsOf the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets; secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%); median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I2>90%), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance.ConclusionsIn this 10-year sample of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
Highlights
BackgroundEcological momentary assessment (EMA) is a survey method that allows collection of data on participant behaviors, affect, and perceptual experiences in real-time and real-life environments [1]
In this 10-year sample of studies using the Mobile ecological momentary assessment (mEMA) of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data
Across 105 unique data sets, the key findings of this review were as follows: (1) a variety of health-related behaviors and psychological constructs were assessed, with affect being the most common mEMA target; (2) mEMA protocols varied widely across studies; (3) compliance was inconsistently reported across studies; (4) meta-analysis estimated an overall compliance rate of 81.9%, with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions; (5) compliance was associated with prompts per day and items per prompt; and 6) no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance
Summary
Ecological momentary assessment (EMA) is a survey method that allows collection of data on participant behaviors, affect, and perceptual experiences in real-time (momentary) and real-life environments (ecological) [1]. In its original form, EMA required pen and paper diaries or logs to be completed on random (signal) or fixed (interval) time-based schedules or in response to a specific target behavior, psychological or social event (event-based). With the advent of handheld technologies, mobile EMA (mEMA) and increasingly mobile ecological momentary interventions (mEMIs) can be completed through automated schedules via handheld devices such as tablets and mobile phones. MEMA or mEMI has undeniable utility, but data are dependent on participants consistently responding to the mEMA or mEMI schedule (compliance) [3]. Mobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults
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