Abstract
BackgroundEcological momentary assessment (EMA) can be a useful tool for collecting real-time behavioral data in studies of health and health behavior. However, EMA administered through mobile technology can be burdensome, and it tends to suffer from suboptimal user engagement, particularly in low health-literacy populations.ObjectiveThis study aimed to report a case study involving the design and evaluation of a mobile EMA tool that supports context-sensitive EMA-reporting of location and social situations accompanying eating and sedentary behavior.MethodsAn iterative, user-centered design process with obese, middle-aged women seeking care in a safety-net health system was used to identify the preferred format of self-report measures and the look, feel, and interaction of the mobile EMA tool. A single-arm feasibility field trial with 21 participants receiving 12 prompts each day for momentary self-reports over a 4-week period (336 total prompts per participant) was used to determine user satisfaction with interface quality and user engagement, operationalized as response rate. A second trial among 38 different participants randomized to receive or not to receive a feature designed to improve engagement was conducted.ResultsThe feasibility trial results showed high interface satisfaction and engagement, with an average response rate of 50% over 4 weeks. Qualitative feedback pointed to the need for auditory alerts. We settled on 3 alerts at 10-min intervals to accompany each EMA-reporting prompt. The second trial testing this feature showed a statistically significant increase in the response rate between participants randomized to receive repeat auditory alerts versus those who were not (60% vs 40%).ConclusionsThis paper reviews the design research and a set of design constraints that may be considered in the creation of mobile EMA interfaces personalized to users’ preferences. Novel aspects of the study include the involvement of low health-literacy adults in design research, the capture of data on time, place, and social context of eating and sedentary behavior, and reporting prompts tailored to an individual’s location and schedule.Trial RegistrationClinicalTrials.gov NCT03083964; https://clinicaltrials.gov/ct2/show/NCT03083964
Highlights
BackgroundPrecision medicine is an approach to care that involves classifying individuals into subpopulations that differ in their susceptibility to a particular disease or in their response to a specific treatment [1]
This paper reviews the design research and a set of design constraints that may be considered in the creation of mobile Ecological momentary assessment (EMA) interfaces personalized to users’ preferences
The fundamental principles of human-computer interaction informed us in designing an interactive prototype to support a user in responding to version 2 (V2) EMA questions
Summary
BackgroundPrecision medicine is an approach to care that involves classifying individuals into subpopulations that differ in their susceptibility to a particular disease or in their response to a specific treatment [1]. Subpopulations can be defined by genetics, but they can be defined by behavioral and environmental exposures that lead to differential responses to biomedical, behavioral, and environmental interventions. The latter targets might be referred to as precision health interventions and may be advanced by better measures of behavioral and environmental exposures [2]. Environmental exposures can be relatively constant or vary over relatively short intervals of time, which together make up what we will refer to in this study as situations. Ecological momentary assessment (EMA) can be a useful tool for collecting real-time behavioral data in studies of health and health behavior. EMA administered through mobile technology can be burdensome, and it tends to suffer from suboptimal user engagement, in low health-literacy populations
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