Investigating the momentary association between maternal support and children's fruit and vegetable consumption using ecological momentary assessment

BACKGROUND An extraordinary increase in mobile phone ownership has revolutionized opportunities to employ mHealth approaches in lower- and middle-income countries (LMICs). Ecological Momentary Assessment (EMA) and Intervention (EMAI) uses mobile technology to gather data and deliver timely, personalized behavior change interventions in an individual’s natural setting. To our knowledge, there have been no previous trials of EMAI in sub-Saharan Africa. OBJECTIVE To advance the evidence base for mHealth interventions in LMICs, we conducted a pilot randomized trial to assess the feasibility of EMAI and to establish estimates of the potential effect of EMAI on a range of health-related behaviors in Rakai, Uganda. METHODS This prospective, parallel group, randomized pilot trial compared health behaviors between adult participants submitting EMA data and receiving behaviorally-responsive interventional health messaging (EMAI) to those submitting EMA data, alone. Using a fully-automated mobile phone application, participants submitted daily reports on five different health behaviors during a 30-day period prior to randomization (P1). Participants were then block randomized to control arm, continuing EMA reporting through exit, or intervention arm, EMA reporting plus behavioral health messaging receipt. Participants exited after 90 days of follow-up, divided into study Periods 2 (P2: randomization+29 days) and 3 (P3: 30 days post-randomization to exit). We used descriptive statistics to assess EMAI feasibility through completeness of data, and differences in reported behaviors between time periods and study arms. RESULTS The study included 24 participants per arm (48% female, median age 31 years). EMA data collection was feasible, with 85.5% of the combined 4,418 days reporting some behavioral data. There was a decrease in the mean proportion of days when alcohol was consumed in both arms over time (control: P1, 9.6% of days to P2, 4.3% of days, P=.03; intervention P1, 7.2% of days to P3, 2.4% of days, P=.01). Decreases in sex with a non-long-term partner without a condom were also reported in both arms (P1 to P3 control: 1.9% of days to 1.0% of days, P=.02, intervention: 6.6% of days to 1.3% of days P=.03). An increase in fruit and vegetable consumption was found in the intervention (P1 to P3 fruit: 78.6% of days to 87.0% of days, P=<.001; vegetable: 65.6% of days to 76.6% of days, P =.03 ) but not the control arm. Between arms, there was a significant difference in the change in reported vegetable consumption between P1 and P3 (control: 7.99% decrease in the mean proportion of days vegetables consumed, intervention: 11.05% increase, P=.01). CONCLUSIONS Preliminary estimates suggest that EMAI may be a promising strategy to promote behavior change across a range of behaviors. Larger trials examining the effectiveness of EMAI in LMICs are warranted. CLINICALTRIAL ClinicalTrials.gov NCT04375423; https://www.clinicaltrials.gov/ct2/show/NCT04375423.

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Momentary and personal characteristics predicting maternal fruit and vegetable preparation for children using ecological momentary assessment

Eating Behaviors ◽

10.1016/j.eatbeh.2021.101492 ◽

2021 ◽

Vol 41 ◽

pp. 101492

Author(s):

Bridgette Do ◽

Shirlene D. Wang ◽

Christine H. Naya ◽

Genevieve F. Dunton ◽

Tyler B. Mason

Keyword(s):

Ecological Momentary Assessment ◽

Personal Characteristics ◽

Fruit And Vegetable ◽

Ecological Momentary ◽

Momentary Assessment

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Factors in the home environment associated with toddler diet: an ecological momentary assessment study

Public Health Nutrition ◽

10.1017/s1368980018000186 ◽

2018 ◽

Vol 21 (10) ◽

pp. 1855-1864 ◽

Cited By ~ 2

Author(s):

Katherine L Campbell ◽

Aleksandra Babiarz ◽

Yan Wang ◽

Nicholas A Tilton ◽

Maureen M Black ◽

...

Keyword(s):

Home Environment ◽

Low Income ◽

Ecological Momentary Assessment ◽

Vegetable Consumption ◽

Dietary Recommendations ◽

Sugar Sweetened Beverage ◽

Environment Factors ◽

Dietary Behaviours ◽

Ecological Momentary ◽

Momentary Assessment

AbstractObjectiveTo identify home environment factors associated with toddler dietary behaviours using ecological momentary assessment (EMA).DesignHome environment and toddler’s diet were assessed by mothers through EMA (random beeps over ≤8 d and a brief survey). Dietary outcomes were fruit/vegetable consumption, eating episode (‘snack’ v. ‘meal’) and sugar-sweetened beverage (SSB) consumption. Home environment factors included interacting with mother, eating alone/with others, eating in a high chair/chair at the table, watching television and movement/translocation. Multilevel logistic mixed-effects regression models assessed both within- (individual toddlers across time) and between- (toddlers-on-average) subject effects.SubjectsLow-income mother–toddler dyads (n 277).SettingUrban and suburban Maryland, USA.ResultsEMA captured eating/drinking episodes for 249/277 (89·9 %) toddlers (883 eating episodes, 1586 drinking episodes). Toddlers-on-average were more likely (adjusted OR, P value) to eat fruit/vegetables when not moving around (0·43, P=0·043), eat with the television off (0·33, P<0·001) and eat in a high chair/chair (3·38, P<0·001); no within-subject effects were shown. For eating episodes, both toddlers-on-average and individual toddlers were more likely to eat snacks when not in a high chair/chair (0·13, P<0·001 and 0·06, P<0·001, respectively) and when eating alone (0·30, P<0·001 and 0·31, P<0·001, respectively). Also, individual toddlers were more likely to eat snacks when moving around (3·61, P<0·001). Toddlers-on-average were more likely to consume SSB when not in a high chair/chair (0·21, P=0·001), eating alone (0·38, P=0·047) or during a snacking episode (v. a meal: 3·96, P=0·012); no within-subject effects shown.ConclusionsFactors in the home environment are associated with dietary behaviours among toddlers. Understanding the interplay between the home environment and toddler diet can inform future paediatric dietary recommendations.

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Investigating the Relationship between Perceived Meal Colour Variety and Food Intake across Meal Types in a Smartphone-Based Ecological Momentary Assessment

Nutrients ◽

10.3390/nu13030755 ◽

2021 ◽

Vol 13 (3) ◽

pp. 755

Author(s):

Laura M. König ◽

Julia E. Koller ◽

Karoline Villinger ◽

Deborah R. Wahl ◽

Katrin Ziesemer ◽

...

Keyword(s):

Ecological Momentary Assessment ◽

Vegetable Consumption ◽

Multilevel Modelling ◽

Food Groups ◽

Dietary Recommendations ◽

Eating Occasions ◽

Ecological Momentary ◽

The Relationship ◽

Momentary Assessment ◽

Colour Variety

Although most people are aware of the health benefits of consuming sufficient amounts of fruit and vegetables, many do not adhere to current dietary recommendations. Recent studies have suggested meal colour variety as an intuitive cue for healthy and enjoyable lunch meal choices. The present study extends this research by testing the “colourful = healthy” association across meal types. Using smartphone-based Ecological Momentary Assessment, 110 participants recorded 2818 eating occasions over a period of eight days. For each eating occasion, a picture, a short written description of the meal, the meal type (breakfast, lunch, afternoon tea, dinner, snack) and the perceived meal colour variety were recorded. Foods were classified into seven food groups based on the pictures and descriptions. Data were analysed using multilevel modelling. For all meal types except afternoon tea which did not include vegetables, perceived that meal colour variety was positively related to vegetable consumption (bs ≥ 0.001, ts ≥ 3.27, ps ≤ 0.002, quasi-R2s ≥ 0.06). Moreover, perceived meal colour variety was negatively associated with sweets consumption for breakfast, dinner and snacks (bs ≤ −0.001, ts ≤ −2.82, ps ≤ 0.006, quasi-R2s ≥ 0.01). The “colourful = healthy” association can be generalized across meal types and thus may be a promising strategy to promote a healthier diet.

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Emotionsregulation bei Depression

Psychologische Rundschau ◽

10.1026/0033-3042/a000172 ◽

2013 ◽

Vol 64 (4) ◽

pp. 235-243 ◽

Cited By ~ 14

Author(s):

Sven Barnow ◽

Maren Aldinger ◽

Ines Ulrich ◽

Malte Stopsack

Keyword(s):

Ecological Momentary Assessment ◽

Ecological Momentary ◽

Momentary Assessment

Die Anzahl der Studien, die sich mit dem Zusammenhang zwischen Emotionsregulation (ER) und depressiven Störungen befassen, steigt. In diesem Review werden Studien zusammengefasst und metaanalytisch ausgewertet, die den Zusammenhang zwischen ER und Depression mittels Fragebögen bzw. Ecological Momentary Assessment (EMA) erfassen. Dabei zeigt sich ein ER-Profil welches durch die vermehrte Nutzung von Rumination, Suppression und Vermeidung bei gleichzeitig seltenerem Einsatz von Neubewertung und Problemlösen gekennzeichnet ist. Mit mittleren bis großen Effekten, ist der Zusammenhang zwischen Depression und maladaptiven Strategien besser belegt als bei den adaptiven Formen, wo die Effekte eher moderat ausfielen. EMA-Messungen bestätigen dieses Profil. Da EMA-Studien neben der Häufigkeit des Strategieeinsatzes auch die Erfassung anderer ER-Parameter wie Effektivität und Flexibilität ermöglichen, sollten solche Designs in der ER-Forschung zukünftig vermehrt Einsatz finden.

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Using Personal Cell Phones for Ecological Momentary Assessment

European Psychologist ◽

10.1027/1016-9040/a000127 ◽

2013 ◽

Vol 18 (1) ◽

pp. 3-11 ◽

Cited By ~ 42

Author(s):

Emmanuel Kuntsche ◽

Florian Labhart

Keyword(s):

Data Collection ◽

Ecological Momentary Assessment ◽

Communication Systems ◽

Cell Phones ◽

Personal Digital Assistants ◽

Natural Environments ◽

Mobility Patterns ◽

Standard Data ◽

Ecological Momentary ◽

Momentary Assessment

Ecological Momentary Assessment (EMA) is a way of collecting data in people’s natural environments in real time and has become very popular in social and health sciences. The emergence of personal digital assistants has led to more complex and sophisticated EMA protocols but has also highlighted some important drawbacks. Modern cell phones combine the functionalities of advanced communication systems with those of a handheld computer and offer various additional features to capture and record sound, pictures, locations, and movements. Moreover, most people own a cell phone, are familiar with the different functions, and always carry it with them. This paper describes ways in which cell phones have been used for data collection purposes in the field of social sciences. This includes automated data capture techniques, for example, geolocation for the study of mobility patterns and the use of external sensors for remote health-monitoring research. The paper also describes cell phones as efficient and user-friendly tools for prompt manual data collection, that is, by asking participants to produce or to provide data. This can either be done by means of dedicated applications or by simply using the web browser. We conclude that cell phones offer a variety of advantages and have a great deal of potential for innovative research designs, suggesting they will be among the standard data collection devices for EMA in the coming years.

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