Validation of a Low-Burden, Once-Daily Obsessive-Compulsive Disorder Measure Over 70 Days: Ecological Momentary Assessment Study Background: Ecological momentary assessments (EMAs) are an increasingly popular tool used to measure real-time symptom burden within mental health care, including for obsessive-compulsive disorder (OCD). However, prior studies in the literature have been limited by brief assessment periods, high participant burden, and heterogeneity in both sampling and symptom assessment methodologies. Objective: This study aimed to validate a 12-item EMA questionnaire of OCD symptoms by evaluating its psychometric properties over an extended monitoring period. Methods: Adults with OCD (22/41, 53.7%) and demographically matched healthy controls (19/41, 46.3%) completed up to 70 daily smartphone-delivered EMA surveys assessing the frequency and emotional impact of obsessions and compulsions. Participants with OCD also underwent clinician-administered Yale-Brown Obsessive-Compulsive Scale evaluations at weeks 0, 2, and 10. Results: Our scale demonstrated high internal consistency (Cronbach α=0.96) and convergent validity, with significant correlation with Yale-Brown Obsessive-Compulsive Scale scores at week 2 (ρ=0.59; =.004) and week 10 (ρ=0.53; =.01). Participant retention (89.1%) and questionnaire completion rate (89%) were also higher than those seen in the literature (75.2% and 74.2%, respectively). Conclusions: Overall, we provide initial psychometric support for the use of a low-burden EMA tool to capture day-to-day OCD symptom fluctuations over extended periods. Such tools may enhance longitudinal symptom monitoring, improve treatment response tracking, and address limitations inherent in traditional retrospective assessments.

JMIR Formative Res: Validation of a Low-Burden, Once-Daily Obsessive-Compulsive Disorder Measure Over 70 Days: Ecological Momentary Assessment Study #OCD #MentalHealth #ObsessiveCompulsiveDisorder #EcologicalMomentaryAssessment #MentalHealthAwareness

@tomasvet.bsky.social
#DigitalHealth #WearableTechnology #BehavioralResearch #AmbulatoryAssessment #EcologicalMomentaryAssessment #UserCenteredDesign #HealthBehavior

An Ecological Momentary Assessment Protocol to Measure Stress, Socialization, and Other Contributors to Smoking Behaviors Among LGBTQ+ Adolescents: Multimethod Evaluation of #feasibility, Acceptability, and Appropriateness From the Puff Break Research Study Background: Smartphone-based ecological momentary assessment (EMA) methods highlight the impact of minority stress and socialization (eg, discrimination, social support) on smoking behaviors in LGBTQ+ adults, however studies among LGBTQ+ adolescents are limited. The Puff Break EMA protocol was developed to address this gap. Objective: The purpose of this study is to report on the acceptability, #feasibility, and appropriateness of the Puff Break EMA protocol. Methods: We utilized a multi-method design to evaluate the acceptability, #feasibility and appropriateness of the Puff Break EMA protocol. Participants who reported tobacco/nicotine or cannabis product use within the last 30 days engaged in a two-week EMA trial, receiving five daily assessments measuring tobacco, nicotine and cannabis use, stress and socialization, and product craving. Post trial, participants completed a 15-minute exit survey and 60 minute semi-structured exit interview. The exit survey utilized the 12-item Weiner (2017) Acceptability, Appropriateness, and #feasibility measures and 6-item Mobile Application Rating Scale (MARS), App Specific Subscale and also included 7 open-ended responses. The exit interview focused on a review of participant’s data to help understand smoking patterns and experiences with the Puff Break EMA protocol along with questions guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to understand how a future EMA mobile intervention aimed at monitoring and reducing tobacco, nicotine, and cannabis product use could effectively be disseminated to, accessed by, and implemented with LGBTQ+ adolescents. Lastly, lessons learned were obtained through feedback and data collected throughout the study. Results: Fifty adolescents between the ages of 15-19 (M=17.82, SD=1.19) were enrolled in the study August 2023 and July 2024. Participants predominantly reported using vaporized tobacco and nicotine products (94.0%), followed by cannabis products (78%). The study sample was diverse regarding sexual orientation and gender identities with 32% identifying as gay or lesbian, 32% bisexual or pansexual, and 14% transgender (neither transmasculine nor transfeminine). The median EMA response rate was 75%. Results indicated high #feasibility (M=4.43), acceptability (M=4.15), and appropriateness (M=4.46), of the Puff Break EMA protocol. The MARS subscale also indicated high acceptability and #feasibility for the EMA method to increase knowledge, awareness, and intentions to monitor tobacco/nicotine use (M=4.14). Triangulated results from closed and open-ended survey responses identified 5 key themes related to #feasibility, acceptability, and appropriateness. Participants highlighted the ease of the Puff Break EMA protocol, prompt survey reminders, and increased product use awareness. Key feedback from exit interviews included increased flexibility for survey timing, better response-option alignment, and appropriate only for populations interested in monitoring or reducing their product use. Conclusions: Findings indicate that using EMA methods to understand the impact of stress and socialization experiences on smoking behaviors in LGBTQ+ adolescents are feasible, appropriate, and acceptable. Clinical Trial: Not Applicable

JMIR Formative Res: An Ecological Momentary Assessment Protocol to Measure Stress, Socialization, and Other Contributors to Smoking Behaviors Among LGBTQ+ Adolescents: Multimethod Evaluation of #feasibility, Acceptability,… #LGBTQ #youth #mentalhealth #smokingcessation #ecologicalmomentaryassessment

A 6-Month Evaluation of the Peer-Ceived Momentary Assessment Method in a Small Sample of Liver Transplant Patients and Their Support Persons: Longitudinal Observational Study Background: Patient-reported outcomes, including ecological momentary assessments (EMAs), are acquired from patients via repeated self-reports of their perceived momentary physical and emotional states before and after medical procedures. Patient-reported outcomes are used to measure health outcomes and quality of care. However, certain observable states or behaviors (eg, moods such as fatigue, hope, or medication adherence), or behaviors suggestive of health decline (eg, depression, cognitive decline), are not easily measured via self-reports in certain situations (eg, patients undergoing certain medical procedures, patients with dementia, and others). The peer-ceived momentary assessment (PeerMA) method involves support persons or peers (eg, family members and friends) to report their perception of a patient’s subjective physical and emotional states and has been validated in healthy populations. Objective: We examined the value of the PeerMA method in assessing the disease progression and recovery pathways of patients undergoing liver transplantation. Herein, the PeerMA method is operationalized via the patient’s informal caregivers and the patient-based EMA, and wearable-based physical activity datasets from the patients. We report the #feasibility results and human factors influencing the acceptance and reliability of the PeerMA method in a small study comprising 8 patients and support persons. Methods: We conducted a longitudinal observational study of 6 months (autumn 2019 to spring 2020), collecting EMA/self-reports from 8 patients (at the liver transplant clinic at Stanford University Hospital, California) about their perceived levels of hope, sleep, fatigue, depression, and pain in addition to PeerMA-based reports of the same aspects from 7 caregivers. We collected physical activity records from 5 patients using a Fitbit bracelet. Participants completed pre- and poststudy surveys, contributing qualitative data. We implemented the PeerMA method using a smartphone app, making it easy to use by both patients and support persons. Results: We collected 1142 patient-days and 976 support person–days. On average, each patient received 103 EMAs and responded to 64 (63%) of them, while support persons received 87 PeerMAs and responded to 64 (74%) of them. We report empirical evidence about the methodological #feasibility of PeerMA, showing its dual and unique information streams unavailable by EMA alone. We show examples where support person assessments and physical activity data can inform health professionals about the actual state of a patient regarding outcomes such as hope, sleep quality, fatigue, pain, and depression. We discuss human factors influencing the acceptance of the method and make methodological recommendations. Conclusions: It is possible to leverage data acquired via the PeerMA method and a wearable activity monitor to complement EMA. The PeerMA method incorporates frequent observations from support persons in patients’ daily lives, which can be compared and analyzed next to the patient’s self-reports. Such data may help to study and assist patients during disease recovery, which is beneficial for patients recovering from an organ transplant. Trial Registration:

JMIR Formative Res: A 6-Month Evaluation of the Peer-Ceived Momentary Assessment Method in a Small Sample of Liver Transplant Patients and Their Support Persons: Longitudinal Observational Study #HealthOutcomes #PatientCare #LiverTransplant #PeerSupport #EcologicalMomentaryAssessment

And of course our preregistration will follow soon 👀

#ESM #experiencesamplingmethod #EMA #ecologicalmomentaryassessment #preprint #OSF #psyarxiv

Smartphone Ecological Momentary Assessment and Wearable Activity Tracking in Pediatric Depression: Cohort Study Background: Adolescent depression is a significant public health concern. The presentation of depressive symptoms varies widely among individuals, fluctuating in intensity over time. EMA offers a unique advantage by enhancing ecological validity and reducing recall bias, allowing for a more accurate and nuanced understanding of MDD symptoms. This methodology provides valuable insights into the fluctuating nature of depression, which could inform more personalized and timely interventions. Objective: This study aims to: (1) evaluate the #feasibility of collecting smartphone-based Ecological Momentary Assessment (EMA) data alongside activity and sleep tracking in adolescents with depression; (2) investigate the severity and variability of mood symptoms reported over time; and (3) explore the relationship between mood, activity, and sleep. Methods: Thirty-six participants (23 with Major Depressive Disorder (MDD), 13 unaffected controls; 75% female, mean age 19.50 years) completed twice-daily EMA check-ins over two weeks, complemented by continuous activity and sleep monitoring using FitBit Charge 3 devices. The study examined #feasibility, #usability of EMA app, symptom severity and variability, and relationships between mood, activity, and sleep. We applied linear mixed-effects regression to the data to examine relationships between variables. Results: Participants completed a total of 923 unique checkins (mean check-ins per participant = 25.60). Overall compliance rates were high (91.57%) indicating the approach is highly feasible. MDD participants demonstrated greater symptom severity and variability over time compared to controls (β = 34.48, p = 2.17x10-06). Individuals with MDD exhibited greater diurnal variation (β = -2.54, p = 5.14x10-03) with worse mood in the morning and worse mood than anxiety scores over time (β = -6.93, p = 5.95x10-06). Life stress was a significant predictor of more severe EMA scores (β = 24.50, p = 9.99x10-03). MDD cases exhibited more inconsistent sleep patterns (β = 32.14, p = 5.44x10-04), shorter total sleep times (β = -94.38, p = 2.82x10-03), and a higher frequency of naps (β = 14.05, p = 4.02x10-03). MDD cases took fewer steps per day (mean = 5828.64, sd = 6188.85) than controls (mean = 7088.47, sd = 5378.18) over the course of the study, but this difference was not significant (p = 0.33), activity levels were not significantly predictive of EMA score (p = 0.75). Conclusions: This study demonstrates the #feasibility of integrating smartphone-based EMA with wearable activity tracking in adolescents with depression. High compliance rates support the practicality of this approach, while EMA data provide valuable insights into the dynamic nature of depressive symptoms, particularly in relation to sleep and life stress. Future studies should validate these findings in larger, more diverse samples. Clinically, EMA and wearable tracking may enhance routine assessments and inform personalized interventions by capturing symptom variability and external influences in real time.

JMIR Formative Res: Smartphone Ecological Momentary Assessment and Wearable Activity Tracking in Pediatric Depression: Cohort Study #MentalHealth #DepressionAwareness #PediatricHealth #EcologicalMomentaryAssessment #WearableTech

Ecological Momentary Assessment of Parental Well-Being and Time Use: Mixed Methods Compliance and #feasibility Study Background: Parents often juggle multiple conflicting responsibilities, including work, childcare, and the household, making them a particularly burdened group. However, the impact of daily routines and associated (poor) well-being among parents has received relatively little attention. Ecological Momentary Assessment (EMA) is increasingly being used to capture real-time data and can help address this research gap. Objective: This study aims to examine compliance rates and the #feasibility of EMA for measuring daily well-being and time use among parents. Methods: An exploratory mixed-methods study was conducted with 74 German parents (57/74, 77% women, (age: mean 37.6, SD 5.9 years). Participants completed a baseline questionnaire, followed by 4 daily EMA surveys (at 7:30 AM, 12 PM, 16:30 PM, and 21:30 PM) over a 1-week period, and a follow-up questionnaire. A subset of parents was also subsequently interviewed. Sociodemographic background and expected #feasibility (open-ended questions) were surveyed at baseline, and #feasibility was assessed at follow-up (closed- and open-ended questions) and in the interviews. State well-being (affective and cognitive), state stress, state as well as retrospective time-use were measured in the EMA surveys. Compliance and #feasibility were examined using a combination of quantitative (descriptive analyses) and qualitative methodologies. Results: Participants completed an average of 83% (SD 13%) of the daily surveys. Compliance varied by gender and age, where men (90% vs 80%) and older parents showed higher rates. Participants generally found the survey frequency and length manageable, though some suggested adjustments to the study period depending on their individual routines. The 7:30 AM survey was reported as the most challenging due to childcare drop-offs (40%-49%), followed by the 16:30 PM survey for similar reasons (7%-17%). The qualitative analysis further revealed additional points for improvement, for instance, the need for personalization (eg, individual adjustment of the survey timings and intervals), technical support, and the incorporation of gamification elements. Most interviewees (46% vs 23%) found the used measurement of well-being and stress to be appropriate. Regarding time use, they felt that the predefined activity groups (eg, personal care, working) were suitable (46%) but noted challenges assigning less frequent activities (eg, medical appointments) (5%-54%). Reporting the timings of time-use via consecutive questions (ie, specifying the duration or start and end times of an activity) was perceived as confusing (9%-69%), with participants expressing a preference for a visual overview, such as a Gantt chart. Conclusions: The study demonstrates that, when accounting for certain sociodemographic and study design factors, EMA can be a feasible method for data collection regarding daily well-being and time use, even in highly time-constrained populations like parents. This shows great potential for future research, such as exploring work-family conflict or performative gender roles and complementing established methods (eg, retrospective daily diaries). Trial Registration: OSF Registries osf.io/8qj3d; https://osf.io/8qj3d

JMIR Formative Res: Ecological Momentary Assessment of Parental Well-Being and Time Use: Mixed Methods Compliance and #feasibility Study #ParentalWellBeing #EcologicalMomentaryAssessment #TimeUse #ParentingChallenges #MixedMethodsResearch

Gaining insights into older adults' physical activity to optimize digital health interventions

👉 Want to learn more about her PhD? Check it out here: biblio.ugent.be/publication/... or contact us for a copy!

#PhDDefense #DigitalHealth #EcologicalMomentaryAssessment #PhysicalActivity #HealthTech

Smartwatch-Based Ecological Momentary Assessment for High-Temporal-Density, Longitudinal Measurement of Alcohol Use (AlcoWatch): #feasibility Evaluation Background: Ecological momentary assessment methods have recently been adapted for use on smartwatches. One particular class of these methods, developed to minimize participant burden and maximize engagement and compliance, is referred to as microinteraction-based ecological momentary assessment (μEMA). Objective: This study explores the #feasibility of using these smartwatch-based μEMA methods to capture longitudinal, high-temporal-density self-report data about alcohol consumption in a nonclinical population selected to represent high- and low-socioeconomic position (SEP) groups. Methods: A total of 32 participants from the Avon Longitudinal Study of Parents and Children (13 high and 19 low SEP) wore a smartwatch running a custom-developed μEMA app for 3 months between October 2019 and June 2020. Every day over a 12-week period, participants were asked 5 times a day about any alcoholic drinks they had consumed in the previous 2 hours, and the context in which they were consumed. They were also asked if they had missed recording any alcoholic drinks the day before. As a comparison, participants also completed fortnightly online diaries of alcohol consumed using the Timeline Followback (TLFB) method. At the end of the study, participants completed a semistructured interview about their experiences. Results: The compliance rate for all participants who started the study for the smartwatch μEMA method decreased from around 70% in week 1 to 45% in week 12, compared with the online TLFB method which was flatter at around 50% over the 12 weeks. The compliance for all participants still active for the smartwatch μEMA method was much flatter, around 70% for the whole 12 weeks, while for the online TLFB method, it varied between 50% and 80% over the same period. The completion rate for the smartwatch μEMA method varied around 80% across the 12 weeks. Within high- and low-SEP groups there was considerable variation in compliance and completion at each week of the study for both methods. However, almost all point estimates for both smartwatch μEMA and online TLFB indicated lower levels of engagement for low-SEP participants. All participants scored “experiences of using” the 2 methods equally highly, with “willingness to use again” slightly higher for smartwatch μEMA. Conclusions: Our findings demonstrate the acceptability and potential utility of smartwatch μEMA methods for capturing data on alcohol consumption. These methods have the benefits of capturing higher-temporal-density longitudinal data on alcohol consumption, promoting greater participant engagement with less missing data, and potentially being less susceptible to recall errors than established methods such as TLFB. Future studies should explore the factors impacting participant attrition (the biggest reason for reduced engagement), latency issues, and the validity of alcohol data captured with these methods. The consistent pattern of lower engagement among low-SEP participants than high-SEP participants indicates that further work is warranted to explore the impact and causes of these differences.

JMIR Formative Res: Smartwatch-Based Ecological Momentary Assessment for High-Temporal-Density, Longitudinal Measurement of Alcohol Use (AlcoWatch): #feasibility Evaluation #Smartwatch #EcologicalMomentaryAssessment #AlcoholResearch #HealthTech #PublicHealth

Using #TextMessaging #mhealth Ecological Momentary Assessment to Record Changes in e-Cigarette and Combustible Cigarette Use: Pilot Randomized Clinical Trial Background: Ecological momentary assessment (EMA) provides insight into the effectiveness and #feasibility of smoking-related interventions. Objective: To assess adherence to an EMA protocol and compare EMA-derived responses with measures collected through multiple surveys. Methods: A sub-analysis was conducted using data from a 12-week, open-label and two-arm pilot randomized clinical trial among adult smokers with chronic obstructive pulmonary disease, coronary artery disease, peripheral vascular disease, or asthma in the last 12 months (n=109). Participants were randomized to either electronic cigarette (EC) or nicotine replacement therapy (NRT) treatment arms. We compared EMA data collected via automated SMS prompts sent to participants four times daily for 12 weeks, including cigarettes per day (CPD), craving and satisfaction to survey data collected at 12 weeks. Convergent validity between survey- and EMA-reported measures was evaluated using Pearson correlation and paired t-tests. CPD was modeled using negative binomial regression. Relative rates (RR) of reaching at least 50%, 75%, and 100% CPD reduction between two arms were calculated using both EMA and survey data. Results: The majority of participants were non-Hispanic White (58%), female (55%), with median age of 60 (IQR 54-65). Among the 109 participants, 59.6% were consistently adherent to the EMA protocol over the 12-week period. Median weekly EMA response rate remained high over the 12-week study period even though a modest decline was observed (week 1, 97.8%; week 12, 89.4%). The mean CPD declined significantly (week 1, 14.2 (SD = 9.9); week 12 , 4.6 (SD = 6.7), (p < .001)). EMA-derived and survey-based CPD measurements were positively correlated (r = 0.73; 95% CI 0.60, 0.82) as were measures of craving (r = 0.38; 95% CI 0.17, 0.56). No significant paired difference in CPD was observed between EMA measurements and surveys. A significant effect of time on CPD EMA data (Incidence rate ratio (IRR) 1-week change = 0.93, p 0) and 20.7% mostly switched (defined as a reduction in CPD > 75% and EC use > 0) in week 12. Conclusions: EMA is a suitable method to collect recall-based smoking-related data. Though results from mixed effect modeling and RR comparisons were similar using EMA or survey data, EMA provides unique advantages, namely greater granularity in the time and the capability to detect switching patterns in near real-time. These findings provide the #feasibility of EMA in developing smoking cessation interventions in the future tobacco harm reduction research. Clinical Trial: ClinicalTrials.gov Identifier NCT04465318; https://clinicaltrials.gov/study/NCT04465318

JMIR Formative Res: Background: Ecological momentary assessment (EMA) provides insight into the effectiveness and #feasibility of smoking-related interventions. Objective: To assess adherence to an EMA protocol… #TextMessaging #mhealth #EcologicalMomentaryAssessment #eCigarettes #SmokingCessation

Yes! Submit your abstracts and join us in Leuven next summer for all the ESM/EMA/AA fun! Leuven is also always this sunny!*

*may be a lie

#PsychSciSky #AmbulatoryAssessment #ExperienceSampling #EcologicalMomentaryAssessment

Impact of Providing a Personalized Data Dashboard on Ecological Momentary Assessment Compliance Among College Students Who Use Substances: Pilot Microrandomized Trial Background: The landscape of substance use behavior among young adults has observed rapid changes over time. Intensive longitudinal designs are ideal for examining and intervening in substance use behavior in real time but rely on high participant…

JMIR Formative Res: Impact of Providing a Personalized Data Dashboard on Ecological Momentary Assessment Compliance Among College Students Who Use Substances: Pilot Microrandomized Trial #SubstanceUse #CollegeStudents #EcologicalMomentaryAssessment #DataDashboard #HealthResearch