Feasibility and acceptability of ecological momentary assessment in a fully online study of community-based adults at high risk for suicide.

Abstract

Ecological momentary assessment (EMA) has increasingly been used to examine suicidality in naturalistic environments. Despite its potential to yield clinically relevant information, no EMA study has used an anonymous, fully online, design. This study reports on the feasibility and acceptability of real-time monitoring of suicide risk among 237 high-risk, anonymous, community-based adults (N = 237, 61.6% female, Mage = 27.12 years) who responded to six daily EMA prompts for 2 weeks. A subset (N = 69) completed a poststudy feedback survey to provide information on the acceptability of the study protocol. Response rates to EMA prompts (69.1%) demonstrated the feasibility of this design. Suicidal ideation was reported in 21.5% of prompts and by 86.1% of participants. Participants reported that their overall experience was positive, and that they would be willing to participate in a similar study again. Specific strengths and limitations of the study design were discussed in response to open-ended items. Finally, participants who created an alias email to ensure anonymity were less likely to report a suicide attempt (SA) history and more likely to complete the study. Overall, intensive EMA designs are feasible and acceptable when delivered online and to anonymous participants. Specific recommendations are provided for managing safety within these study designs, and for refinements in future work. (PsycInfo Database Record (c) 2021 APA, all rights reserved).