The Questionable Ecological Validity of Ecological Momentary Assessment: Considerations for Design and Analysis

BACKGROUND Barriers to assessing depression in advanced dementia include the presence of informant and patient recall biases. Ecological momentary assessment provides an improved approach for mood assessment by collecting observations in intervals throughout the day, decreasing recall bias, and increasing ecological validity. OBJECTIVE This study aims to evaluate the feasibility, reliability, and validity of the modified 4-item Cornell Scale for Depression in Dementia for Momentary Assessment (mCSDD4-MA) tool to assess depression in patients with advanced dementia. METHODS A intensive longitudinal pilot study design was used. A total of 12 participants with advanced dementia were enrolled from an inpatient psychogeriatric unit. Participants were assessed using clinical depression assessments at admission and discharge. Research staff recorded observations four times a day for 6 weeks on phones with access to the mCSDD4-MA tool. Descriptive data related to feasibility were reported (ie, completion rates). Statistical models were used to examine the interrater reliability and construct and predictive validity of the data. RESULTS Overall, 1923 observations were completed, representing 55.06% (1923/3496) of all rating opportunities with 2 raters and 66.01% (1923/2913) with at least one rater. Moderate interrater reliability was demonstrated for all items, except for <i>lack of interest</i>. Moderate correlations were observed between observers and patient-reported outcomes, where observers reported fewer symptoms relative to participants’ self-reports. Several items were associated with and able to predict depression. CONCLUSIONS The mCSDD4-MA tool was feasible to use, and most items in the tool showed moderate reliability and validity for assessing depression in dementia. Repeated and real-time depression assessment in advanced dementia holds promise for the identification of clinical depression and depressive symptoms.

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Ecological Momentary Assessment of Depression in People With Advanced Dementia: Longitudinal Pilot Study

JMIR Aging ◽

10.2196/29021 ◽

2021 ◽

Vol 4 (3) ◽

pp. e29021

Author(s):

Iulia Niculescu ◽

Hannah Quirt ◽

Twinkle Arora ◽

Terry Borsook ◽

Robin Green ◽

...

Keyword(s):

Pilot Study ◽

Ecological Momentary Assessment ◽

Interrater Reliability ◽

Ecological Validity ◽

Reliability And Validity ◽

Clinical Depression ◽

Advanced Dementia ◽

Patient Reported ◽

Ecological Momentary ◽

Momentary Assessment

Background Barriers to assessing depression in advanced dementia include the presence of informant and patient recall biases. Ecological momentary assessment provides an improved approach for mood assessment by collecting observations in intervals throughout the day, decreasing recall bias, and increasing ecological validity. Objective This study aims to evaluate the feasibility, reliability, and validity of the modified 4-item Cornell Scale for Depression in Dementia for Momentary Assessment (mCSDD4-MA) tool to assess depression in patients with advanced dementia. Methods A intensive longitudinal pilot study design was used. A total of 12 participants with advanced dementia were enrolled from an inpatient psychogeriatric unit. Participants were assessed using clinical depression assessments at admission and discharge. Research staff recorded observations four times a day for 6 weeks on phones with access to the mCSDD4-MA tool. Descriptive data related to feasibility were reported (ie, completion rates). Statistical models were used to examine the interrater reliability and construct and predictive validity of the data. Results Overall, 1923 observations were completed, representing 55.06% (1923/3496) of all rating opportunities with 2 raters and 66.01% (1923/2913) with at least one rater. Moderate interrater reliability was demonstrated for all items, except for lack of interest. Moderate correlations were observed between observers and patient-reported outcomes, where observers reported fewer symptoms relative to participants’ self-reports. Several items were associated with and able to predict depression. Conclusions The mCSDD4-MA tool was feasible to use, and most items in the tool showed moderate reliability and validity for assessing depression in dementia. Repeated and real-time depression assessment in advanced dementia holds promise for the identification of clinical depression and depressive symptoms.

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Evaluating the Ecological Validity of the Dutch Eating Behavior Questionnaire Among Obese Adults Using Ecological Momentary Assessment

Assessment ◽

10.1177/1073191117719508 ◽

2017 ◽

Vol 26 (5) ◽

pp. 907-914 ◽

Cited By ~ 3

Author(s):

Tyler B. Mason ◽

Carly R. Pacanowski ◽

Jason M. Lavender ◽

Ross D. Crosby ◽

Stephen A. Wonderlich ◽

...

Keyword(s):

Eating Behavior ◽

Ecological Momentary Assessment ◽

Ecological Validity ◽

Obese Adults ◽

Ecological Momentary ◽

Momentary Assessment

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Implications for Using Mobile Ecological Momentary Assessment to Collect Climate Data from Vulnerable Urban Populations

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641064 ◽

2020 ◽

Vol 64 (1) ◽

pp. 273-277

Author(s):

Jacklin Stonewall ◽

Michael Dorneich ◽

Ulrike Passe ◽

Linda Shenk

Keyword(s):

Ecological Momentary Assessment ◽

Ecological Validity ◽

Lessons Learned ◽

Decision Makers ◽

Indoor Environments ◽

Recall Bias ◽

Climate Data ◽

Ecological Momentary ◽

Momentary Assessment ◽

Heat Events

This work documents the use of Ecological Momentary Assessment (EMA) to gather data on household behaviors related to outdoor temperatures. In order for urban decision-makers to take effective action to address heat events, they must understand vulnerable residents’ current practices in relation to outdoor temperature. However, vulnerable residents are often excluded from research and can be difficult to reach. EMA allows researchers to gather data in real time and in a subject’s natural environment, which reduces recall bias and improves ecological validity. In this study, EMA was used via a mobile phone app to gather information on home cooling behaviors from residents in vulnerable neighborhoods. Few participants reported making changes to their indoor environments apart from adjusting the thermostat. Despite low participation, the experience of conducting this research has resulted in valuable “lessons learned”. These lessons are used to inform implications and considerations for future use of EMA with vulnerable populations.

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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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