scholarly journals Combining ecological momentary assessment, wrist-based eating detection, and dietary assessment to characterize dietary lapse: A multi-method study protocol

2021 ◽  
Vol 7 ◽  
pp. 205520762098821
Author(s):  
Stephanie P Goldstein ◽  
Adam Hoover ◽  
E Whitney Evans ◽  
J Graham Thomas

Objectives Behavioral obesity treatment (BOT) produces clinically significant weight loss and health benefits for many individuals with overweight/obesity. Yet, many individuals in BOT do not achieve clinically significant weight loss and/or experience weight regain. Lapses (i.e., eating that deviates from the BOT prescribed diet) could explain poor outcomes, but the behavior is understudied because it can be difficult to assess. We propose to study lapses using a multi-method approach, which allows us to identify objectively-measured characteristics of lapse behavior (e.g., eating rate, duration), examine the association between lapse and weight change, and estimate nutrition composition of lapse. Method We are recruiting participants (n = 40) with overweight/obesity to enroll in a 24-week BOT. Participants complete biweekly 7-day ecological momentary assessment (EMA) to self-report on eating behavior, including dietary lapses. Participants continuously wear the wrist-worn ActiGraph Link to characterize eating behavior. Participants complete 24-hour dietary recalls via structured interview at 6-week intervals to measure the composition of all food and beverages consumed. Results While data collection for this trial is still ongoing, we present data from three pilot participants who completed EMA and wore the ActiGraph to illustrate the feasibility, benefits, and challenges of this work. Conclusion This protocol will be the first multi-method study of dietary lapses in BOT. Upon completion, this will be one of the largest published studies of passive eating detection and EMA-reported lapse. The integration of EMA and passive sensing to characterize eating provides contextually rich data that will ultimately inform a nuanced understanding of lapse behavior and enable novel interventions. Trial registration: Registered clinical trial NCT03739151; URL: https://clinicaltrials.gov/ct2/show/NCT03739151

Author(s):  
Rebecca J Crochiere ◽  
Fengqing (Zoe) Zhang ◽  
Adrienne S Juarascio ◽  
Stephanie P Goldstein ◽  
J Graham Thomas ◽  
...  

Abstract Ecological momentary assessment (EMA; brief self-report surveys) of dietary lapse risk factors (e.g., cravings) has shown promise in predicting and preventing dietary lapse (nonadherence to a dietary prescription), which can improve weight loss interventions. Passive sensors also can measure lapse risk factors and may offer advantages over EMA (e.g., objective, automatic, semicontinuous data collection), but currently can measure only a few lapse predictors, a notable limitation. This study preliminarily compared the burden and accuracy of commercially available sensors versus established EMA in lapse prediction. N = 23 adults with overweight/obesity completed a 6-week commercial app-based weight loss program. Participants wore a Fitbit, enabled GPS tracking, completed EMA, and reported on EMA and sensor burden poststudy via a 5-point Likert scale. Sensed risk factors were physical activity and sleep (accelerometer), geolocation (GPS), and time, from which 233 features (measurable characteristics of sensor signals) were extracted. EMA measured 19 risk factors, lapse, and categorized GPS into meaningful geolocations. Two supervised binary classification models (LASSO) were created: the sensor model predicted lapse with 63% sensitivity (true prediction rate of lapse) and 60% specificity (true prediction rate of non-lapse) and EMA model with 59% sensitivity and 72% specificity. EMA model accuracy was higher, but self-reported EMA burden (M = 2.96, SD = 1.02) also was higher (M = 1.50, SD = 0.94). EMA model accuracy was superior, but EMA burden was higher than sensor burden. Findings highlight the promise of sensors in contributing to lapse prediction, and future research may use EMA, sensors, or both depending on prioritization of accuracy versus participant burden.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Christopher C Imes ◽  
Christopher E Kline ◽  
Dara D Mendez ◽  
Ran Sun ◽  
Yang Yu ◽  
...  

Introduction: Intention to engage in physical activity (PA) is an important concept in behavior change theories. However, age, body mass index (BMI), and sleep may influence one’s intention to engage in PA and intention might not predict actual activity. Purpose: This secondary analysis examined predictors of intention to engage in PA and if the factors associated with intention predicted objectively measured moderate-to-vigorous physical activity (MVPA) in adults who were overweight or obese and enrolled in a weight loss study. Methods: We used 6- and 12-mo data from the EMPOWER Study, an observational study examining triggers of lapse following intentional weight loss. Objective measures included up to 7 days of overlapping accelerometer and actigraphy data to assess daily MVPA and sleep. Self-report data included responses to the question “Do you intend to be physically active today?” hereafter called intention, collected at the beginning of each day via ecological momentary assessment. Analyses were performed examining: 1) the effects of subject-level covariates (e.g., age, sex, race, BMI) on intention, 2) the effects of objectively measured sleep characteristics (e.g., total sleep time [TST], number of awakenings, sleep fragmentation) on intention, and 3) the relationships between sleep, intention, and MVPA. Logistic regression using generalized estimating equations and linear mixed-effect models were used. Results: The analyses included 680 person-days at 6 mo and 678 person-days at 12 mo. Participants (N=136) were mostly female (89.8%) and white (81.8%) with a mean (± SD) age of 51.5 ± 9.9 years and BMI of 33.5 ± 4.6. At 6 mo, participants intended to engage in PA on 81.2% of days, had a mean TST of 408.9 ± 81.8 min/night, and a mean of 32.4 ± 14.7 awakenings/night. At 12 mo, PA intention decreased to 80.6% of days, TST increased to 416.5 ± 82.5 min/night, and awakenings increased to 34.0 ± 14.4 per night (p = .089 for TST; p = .043 for awakenings). Mean daily MVPA decreased from 19.0 ± 23.9 min at 6 mo to 17.3 ± 23.4 min at 12 mo (p = .185). Intention increased with increasing age (odds ratio [OR] = 1.04; 95% confidence interval [95% CI] = 1.02 -1.07). At 6 mo, sleep fragmentation, after adjusting for age, negatively affected intention (OR = 0.96; 95% CI = 0.94 - 0.98); however, it did not significantly affect intention at 12 mo. When comparing days with no PA intention to days in which participants intended to engage in PA, mean MVPA nearly tripled from 7.4 min (95% CI = 3.6 - 11.2) to 21.2 min (95% CI = 18.4 - 24.0). Furthermore, when controlling for age, time of assessment, and intention, participants engaged in an estimated 0.135 (95% CI = 0.241 - 0.029) fewer min of MVPA for each awakening. Conclusions: Based on these findings, future weight loss programs should include interventions that improve sleep quality by reducing fragmentation and strengthen the link between intention and engagement in PA.


Assessment ◽  
2021 ◽  
pp. 107319112098388
Author(s):  
Kevin M. King ◽  
Max A. Halvorson ◽  
Kevin S. Kuehn ◽  
Madison C. Feil ◽  
Liliana J. Lengua

There is a small body of research that has connected individual differences in negative urgency, the tendency to report rash actions in response to negative emotions, with self-report depressive and anxiety symptoms. Despite the conceptual overlap of negative urgency with negative emotionality, the tendency to experience frequent and intense negative emotions, even fewer studies have examined whether the association of negative urgency with internalizing symptoms hold when controlling for negative emotionality. In the current study, we estimated the bivariate association between negative urgency and internalizing symptoms, tested whether they remained significant after partialling out negative emotionality, and tested whether these effects generalized to real-time experiences of negative emotions. We used data from five independent samples of high school and college students, assessed with global self-report ( n = 1,297) and ecological momentary assessment ( n = 195). Results indicated that in global self-report data, negative urgency was moderately and positively associated with depressive and anxiety symptoms, and the partial association with depressive symptoms (but not anxiety symptoms) controlling for negative emotionality remained significant and moderate in magnitude. This pattern was replicated in ecological momentary assessment data. Negative urgency may convey risk for depressive symptoms, independent of the effects of negative emotionality.


Author(s):  
Alona Emodi-Perlman ◽  
Daniele Manfrendini ◽  
Tamar Shalev-Antsel ◽  
Ilanit Yevdayev ◽  
Pessia Frideman-Rubin ◽  
...  

Diagnosis of Awake Bruxism (AB) is problematic due to the inability to use continuous recordings during daytime activities. Recently, a new semi-instrumental approach was suggested, viz., an Ecological Momentary Assessment (EMA), with the use of a smartphone application. With the application subjects are requested to report, at least 12 times per day, the status of their masticatory muscle activity (relaxed muscles, jaw bracing without tooth contact, teeth contact, teeth clenching or teeth grinding). The aim of the present study was to compare the EMA to the assessment of AB as defined by a single point self-report. The most frequent condition recorded by the EMA was relaxed muscles (ca. 60%) and the least frequent one - Teeth grinding (0.6 %). The relaxed muscle condition also showed the lowest coefficient of variance over a 7day period of report. Additionally, only the relaxed muscles and the Jaw bracing conditions presented an acceptable ability to discriminate between AB positive and AB negative subjects, as defined by single point self-report questions. The combination between self-report and EMA may have a potential to promote our ability to diagnose AB. We suggest to re-consider the conditions of Teeth contact and Teeth grinding while using EMA to evaluate AB.


2018 ◽  
Author(s):  
Catiana Leila Possamai Romanzini ◽  
Marcelo Romanzini ◽  
Mariana Biagi Batista ◽  
Cynthia Correa Lopes Barbosa ◽  
Gabriela Blasquez Shigaki ◽  
...  

BACKGROUND The use of ecological momentary assessment (EMA) to measure sedentary behavior (SB) in children, adolescents, and adults can increase the understanding of the role of the context of SB in health outcomes. OBJECTIVE The aim of this study was to systematically review literature to describe EMA methodology used in studies on SB in youth and adults, verify how many studies adhere to the Methods aspect of the Checklist for Reporting EMA Studies (CREMAS), and detail measures used to assess SB and this associated context. METHODS A systematic literature review was conducted in the PubMed, Scopus, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SPORTDiscus databases, covering the entire period of existence of the databases until January 2018. RESULTS This review presented information about the characteristics and methodology used in 21 articles that utilized EMA to measure SB in youth and adults. There were more studies conducted among youth compared with adults, and studies of youth included more waves and more participants (n=696) than studies with adults (n=97). Most studies (85.7%) adhered to the Methods aspect of the CREMAS. The main criteria used to measure SB in EMA were self-report (81%) with only 19% measuring SB using objective methods (eg, accelerometer). The main equipment to collect objective SB was the ActiGraph, and the cutoff point to define SB was <100 counts/min. Studies most commonly used a 15-min window to compare EMA and accelerometer data. CONCLUSIONS The majority of studies in this review met minimum CREMAS criteria for studies conducted with EMA. Most studies measured SB with EMA self-report (n=17; 81.0%), and a few studies also used objective methods (n=4; 19%). The standardization of the 15-min window criteria to compare EMA and accelerometer data would lead to a comparison between these and new studies. New studies using EMA with mobile phones should be conducted as they can be considered an attractive method for capturing information about the specific context of SB activities of young people and adults in real time or very close to it.


Buildings ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 54 ◽  
Author(s):  
Lina Engelen ◽  
Fabian Held

Studying the workplace often involves using observational, self-report recall, or focus group tools, which all have their established advantages and disadvantages. There is, however, a need for a readily available, low-invasive method that can provide longitudinal, repeated, and concurrent in-the-moment information to understand the workplace well. In this study, ecological momentary assessment (EMA) was used to collect 508 real-time responses about activities, posture, work performance, social interactions, and mood in 64 adult office workers in three Australian workplaces. The response rate was 53%, and the time to fill out the survey was 50 seconds on average. On average, the participants were sitting, standing, and walking in 84%, 9%, and 7% of survey instances, respectively. The participants reported they were working alone at their desks in 55% of all reported instances. Reported mood varied up to nine points within one person over the course of the post-occupancy observations. EMA can be used to paint a rich picture of occupants’ experiences and perceptions and to gain invaluable understanding of temporal patterns of the workplace, how the space is used, and how aspects of the workplace interact. This information can be used to make improvements to the physical and social workspaces and enhance occupants’ work performance and mood.


Author(s):  
Eric Granholm ◽  
Jason L Holden ◽  
Tanya Mikhael ◽  
Peter C Link ◽  
Joel Swendsen ◽  
...  

Abstract Schizophrenia is a major cause of disability worldwide. As new treatments for functioning are tested, the need grows to demonstrate real-world functioning gains. Ecological momentary assessment (EMA) may provide a more ecologically valid measure of functioning. In this study, smartphone-based EMA was used to signal participants with schizophrenia (N = 100) and controls (N = 71) 7 times a day for 7 days to respond to brief questionnaires about social interactions and functioning behaviors. Excellent adherence was found, with both groups completing an average of 85% of surveys and only 3% of participants with schizophrenia excluded for poor adherence. Four-week test–retest reliability was high (r = .83 for total productive behaviors). Relative to controls, participants with schizophrenia reported significantly less total productive activity (d = 1.2), fewer social interactions (d = 0.3), more nonproductive behaviors (d = 1.0; watching TV, resting), and more time at home (d = 0.8). Within the schizophrenia group, participants living independently showed better functioning on EMA relative to participants in supported housing (d = 0.8) and participants engaged in vocational activities showed better functioning than individuals not engaged in vocational activities (d = 0.55). Modest correlations were found between EMA and an in-lab self-report measure of functioning activities performed in the community, but not between EMA and measures of functional capacity or potential. This study demonstrated the feasibility, sensitivity reliability, and validity of EMA methods to assess functioning in schizophrenia. EMA provides a much-needed measure of what individuals with schizophrenia are actually doing in real-world contexts. These results also suggest that there may be important disjunctions between indices of abilities and actual real-world functioning.


Cephalalgia ◽  
2006 ◽  
Vol 26 (11) ◽  
pp. 1335-1343 ◽  
Author(s):  
H Kikuchi ◽  
K Yoshiuchi ◽  
N Miyasaka ◽  
K Ohashi ◽  
Y Yamamoto ◽  
...  

Recalled evaluation of headache intensity is often affected by several factors. Recently, computerized ecological momentary assessment (EMA) has been developed to avoid such problems as recall bias. Here, we compared recalled headache intensity with momentary headache intensity using EMA in tension- type headache (TTH). Forty patients with TTH wore watch-type computers for 1 week to record momentary headache intensity and also rated their headache intensities by recall. We calculated intraclass correlation coefficients between recalled headache intensity and indices from EMA recordings in the whole study population and in two subgroups divided by variability of momentary headache intensity. The results showed that consistency and agreement of momentary and recalled headache intensity were low, and this was especially marked in the subjects whose headache varied widely. These observations suggested that variability of headache intensity may affect recall of headache intensity and this should be taken into consideration in both clinical and research settings.


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