scholarly journals Mobile Ecological Momentary Assessment and Intervention and Health Behavior Change among Adults in Rakai, Uganda: a Pilot Randomized Controlled Trial. (Preprint)

2020 ◽  
Author(s):  
Laura Kristen Beres ◽  
Ismail Mbabali ◽  
Aggrey Anok ◽  
Charles Katabalwa ◽  
Jeremiah Mulamba ◽  
...  
Keyword(s):  
Behavior Change ◽  
Health Behaviors ◽  
Mobile Phone ◽  
Ecological Momentary Assessment ◽  
Vegetable Consumption ◽  
The Mean ◽  
Ecological Momentary ◽  
Ema Data ◽  
Momentary Assessment ◽  
Health Messaging

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.

scholarly journals Are Retrospective Assessments Means of People’s Experiences? Accounting for Interpersonal and Intrapersonal Variability when Comparing Retrospective Assessment Data to Ecological Momentary Assessment Data

2021 ◽  
Author(s):  
IJsbrand Leertouwer ◽  
Noémi Katalin Schuurman ◽  
Jeroen Vermunt
Keyword(s):  
Ecological Momentary Assessment ◽  
Assessment Data ◽  
Interindividual Differences ◽  
Retrospective Assessment ◽  
The Mean ◽  
The Difference ◽  
Ecological Momentary ◽  
Ema Data ◽  
Momentary Assessment ◽  
Intrapersonal Variability

Retrospective Assessment (RA) scores are often found to be higher than the mean of Ecological Momentary Assessment (EMA) scores about a concurrent period. This difference is generally interpreted as bias towards salient experiences in RA. During RA, participants are often asked to summarize their experiences in unspecific terms, which may indeed facilitate bias. At least in this unspecific form, the summary that participants apply to their remembered experiences can take many different forms. In this study, we reanalyzed an existing dataset (N = 92) using a repeated N = 1 approach. We reported on interindividual differences between EMA data and RA score, and assessed for each participant whether it was likely that their RA score was an approximation of the mean of their experiences as captured by their EMA data. We found considerable interpersonal differences in the difference between EMA scores and RA scores, as well as some extreme cases. Furthermore, for a considerable part of the sample (n = 46 for positive affect, n = 60 for negative affect), we did not reject the null hypothesis that their RA score represented the mean of their experiences as captured by their EMA data. We conclude that in its current unspecific form, RA may facilitate bias, although not for everyone. Future studies may determine whether more specific forms of RA reduce bias, while acknowledging interindividual differences.

scholarly journals Mood and Stress Evaluation of Adult Patients With Moyamoya Disease in Korea: Ecological Momentary Assessment Method Using a Mobile Phone App

10.2196/17034 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e17034 ◽  
Author(s):  
Yong Sook Yang ◽  
Gi Wook Ryu ◽  
Chang Gi Park ◽  
Insun Yeom ◽  
Kyu Won Shim ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Moyamoya Disease ◽  
Ecological Momentary Assessment ◽  
Public Place ◽  
The Mean ◽  
Ecological Momentary ◽  
Ema Method ◽  
Momentary Assessment ◽  
Different Levels ◽  
Over Time

Background Moyamoya disease (MMD) is a known progressive obstructive cerebrovascular disorder. Monitoring and managing mood and stress are critical for patients with MMD, as they affect clinical outcomes. The ecological momentary assessment (EMA) method is a longitudinal study design by which multiple variable assessments can be performed over time to detect momentary fluctuations and changes in psychological dimensions such as mood and stress over time. Objective This study aimed to identify predicting factors associated with momentary mood and stress at both the within-person and between-person levels and to examine individual fluctuation of mood over time in the short term using an EMA method combined with a mobile phone app. Methods Participants aged older than 18 years were recruited from a tertiary hospital in Seoul, Korea, between July 2018 and January 2019. The PsyMate scale for negative affect (NA) and positive affect (PA) and the Trier Inventory for Chronic Stress Scale were uploaded on patient mobile phones. Using a mobile app, data were collected four times a day for 7 days. Pearson correlations and mixed modeling were used to predict relationships between repeatedly measured variables at both the between-person and within-person levels. Results The mean age of the 93 participants was 40.59 (SD 10.06) years, 66 (71%) were female, and 71 (76%) were married. Participants provided 1929 responses out of a possible 2604 responses (1929/2604, 74.08%). The mean momentary NA and PA values were 2.15 (SD 1.12) and 4.70 (SD 1.31) out of 7, respectively. The momentary stress value was 2.03 (SD 0.98) out of 5. Momentary NA, PA, and stress were correlated (P<.001) and varied over time in relation to momentary variables. Common momentary variables associated with momentary mood and stress at both the within-person (level 1) and between-person (level 2) levels were identified. Momentary NA increased when being alone and being at the hospital at both levels, whereas momentary PA increased when eating or drinking, resting, being at a café, restaurant or a public place but decreased when being alone at both levels. Momentary stress increased when being at the office, at a public place, or as the time of the day went by but decreased when resting or during the weekend. Different factors affecting mood and stress at different levels were identified. Fluctuations in individual momentary mood over time at the within-person level were captured. Conclusions The EMA method using a mobile phone app demonstrated its ability to capture changes in mood and stress in various environmental contexts in patients with MMD. The results could provide baseline information for developing interventions to manage negative mood and stress of patients with MMD based on the identified predictors affecting mood and stress at two different levels.

Ecological Momentary Assessment Using a Mobile Phone

2012 ◽  
pp. 398-407
Author(s):  
David Habsara Hareva ◽  
Hiroki Okada ◽  
Hisao Oka
Keyword(s):  
Mobile Phone ◽  
Real Time ◽  
Ecological Momentary Assessment ◽  
Health Conditions ◽  
Time Data ◽  
Physical Disorders ◽  
Ecological Momentary ◽  
Ema Data ◽  
Momentary Assessment ◽  
Supportive Intervention

The mobile phone has become a popular tool for providing information and capturing responses from different groups of people because of its technological features and portability. EMA (Ecological Momentary Assessment) is commonly used by health researchers to contemporaneously capture information regarding human experience. The authors proposed the use of a mobile EMA system as a supportive intervention to collect real-time patient data and to give back real-time advice. In this study, a mobile EMA system has been utilized by patients with a variety of conditions, including mood disorders, behavior disorders, and physical disorders. The real-time data collection included one or more pieces of information at each moment to improve understanding the causal mechanisms of disease. The effectiveness of real-time advice has been examined by comparing a mobile EMA system with and without this function. Patient compliance was high on average, at approximately 89%, and was higher, at approximately 93%, when advice was given. In several cases, the supportive intervention was shown to help patients improve their health conditions. However, the results were dependent on the patients’ motivation, environment, and relationship with their doctor. The EMA data regarding advice given showed that symptoms tended to improve in most cases.

scholarly journals Mood and Stress Evaluation of Adult Patients With Moyamoya Disease in Korea: Ecological Momentary Assessment Method Using a Mobile Phone App (Preprint)

2019 ◽  
Author(s):  
Yong Sook Yang ◽  
Gi Wook Ryu ◽  
Chang Gi Park ◽  
Insun Yeom ◽  
Kyu Won Shim ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Moyamoya Disease ◽  
Ecological Momentary Assessment ◽  
Public Place ◽  
The Mean ◽  
Ecological Momentary ◽  
Ema Method ◽  
Momentary Assessment ◽  
Different Levels ◽  
Over Time

BACKGROUND Moyamoya disease (MMD) is a known progressive obstructive cerebrovascular disorder. Monitoring and managing mood and stress are critical for patients with MMD, as they affect clinical outcomes. The ecological momentary assessment (EMA) method is a longitudinal study design by which multiple variable assessments can be performed over time to detect momentary fluctuations and changes in psychological dimensions such as mood and stress over time. OBJECTIVE This study aimed to identify predicting factors associated with momentary mood and stress at both the within-person and between-person levels and to examine individual fluctuation of mood over time in the short term using an EMA method combined with a mobile phone app. METHODS Participants aged older than 18 years were recruited from a tertiary hospital in Seoul, Korea, between July 2018 and January 2019. The PsyMate scale for negative affect (NA) and positive affect (PA) and the Trier Inventory for Chronic Stress Scale were uploaded on patient mobile phones. Using a mobile app, data were collected four times a day for 7 days. Pearson correlations and mixed modeling were used to predict relationships between repeatedly measured variables at both the between-person and within-person levels. RESULTS The mean age of the 93 participants was 40.59 (SD 10.06) years, 66 (71%) were female, and 71 (76%) were married. Participants provided 1929 responses out of a possible 2604 responses (1929/2604, 74.08%). The mean momentary NA and PA values were 2.15 (SD 1.12) and 4.70 (SD 1.31) out of 7, respectively. The momentary stress value was 2.03 (SD 0.98) out of 5. Momentary NA, PA, and stress were correlated (<i>P</i>&lt;.001) and varied over time in relation to momentary variables. Common momentary variables associated with momentary mood and stress at both the within-person (level 1) and between-person (level 2) levels were identified. Momentary NA increased when being alone and being at the hospital at both levels, whereas momentary PA increased when eating or drinking, resting, being at a café, restaurant or a public place but decreased when being alone at both levels. Momentary stress increased when being at the office, at a public place, or as the time of the day went by but decreased when resting or during the weekend. Different factors affecting mood and stress at different levels were identified. Fluctuations in individual momentary mood over time at the within-person level were captured. CONCLUSIONS The EMA method using a mobile phone app demonstrated its ability to capture changes in mood and stress in various environmental contexts in patients with MMD. The results could provide baseline information for developing interventions to manage negative mood and stress of patients with MMD based on the identified predictors affecting mood and stress at two different levels. CLINICALTRIAL

scholarly journals Differences in Affective Dynamics Among Eating-Disorder Diagnostic Groups

2020 ◽  
Vol 8 (5) ◽  
pp. 857-871
Author(s):  
Gail A. Williams-Kerver ◽  
Stephen A. Wonderlich ◽  
Ross D. Crosby ◽  
Li Cao ◽  
Kathryn E. Smith ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Ecological Momentary Assessment ◽  
Mixed Models ◽  
Emotional Experience ◽  
Affect Intensity ◽  
Emotion Differentiation ◽  
Affective Experiences ◽  
Ecological Momentary ◽  
Ema Data ◽  
Momentary Assessment

Emotion-regulation theories suggest that affect intensity is crucial in the development and maintenance of eating disorders. However, other aspects of emotional experience, such as lability, differentiation, and inertia, are not as well understood. This study is the first to use ecological momentary assessment (EMA) to examine differences in several daily negative affect (NA) indicators among adults diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED). We used EMA data from three large studies to run a series of linear mixed models; the results showed that participants in the AN and BN groups experienced significantly greater NA intensity and better emotion differentiation than participants in the BED group. Alternatively, the BN group demonstrated significantly greater NA lability than the AN group and greater NA inertia than the BED group. These results suggest that several daily affective experiences differ among eating-disorder diagnostic groups and have implications toward distinct conceptualizations and treatments.

scholarly journals Affect fluctuations examined with ecological momentary assessment in patients with current or remitted depression and anxiety disorders

2020 ◽  
pp. 1-10 ◽  
Author(s):  
R. A. Schoevers ◽  
C. D. van Borkulo ◽  
F. Lamers ◽  
M.N. Servaas ◽  
J. A. Bastiaansen ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Ecological Momentary Assessment ◽  
Affect Regulation ◽  
Depression And Anxiety ◽  
Remitted Depression ◽  
Ecological Momentary ◽  
Ema Data ◽  
Momentary Assessment ◽  
A Current

Abstract Background There is increasing interest in day-to-day affect fluctuations of patients with depressive and anxiety disorders. Few studies have compared repeated assessments of positive affect (PA) and negative affect (NA) across diagnostic groups, and fluctuation patterns were not uniformly defined. The aim of this study is to compare affect fluctuations in patients with a current episode of depressive or anxiety disorder, in remitted patients and in controls, using affect instability as a core concept but also describing other measures of variability and adjusting for possible confounders. Methods Ecological momentary assessment (EMA) data were obtained from 365 participants of the Netherlands Study of Depression and Anxiety with current (n = 95), remitted (n = 178) or no (n = 92) DSM-IV defined depression/anxiety disorder. For 2 weeks, five times per day, participants filled-out items on PA and NA. Affect instability was calculated as the root mean square of successive differences (RMSSD). Tests on group differences in RMSSD, within-person variance, and autocorrelation were performed, controlling for mean affect levels. Results Current depression/anxiety patients had the highest affect instability in both PA and NA, followed by remitters and then controls. Instability differences between groups remained significant when controlling for mean affect levels, but differences between current and remitted were no longer significant. Conclusions Patients with a current disorder have higher instability of NA and PA than remitted patients and controls. Especially with regard to NA, this could be interpreted as patients with a current disorder being more sensitive to internal and external stressors and having suboptimal affect regulation.

Statistical Considerations for Analyzing Ecological Momentary Assessment Data

2021 ◽  
pp. 1-17
Author(s):  
Jacob J. Oleson ◽  
Michelle A. Jones ◽  
Erik J. Jorgensen ◽  
Yu-Hsiang Wu
Keyword(s):  
Ecological Momentary Assessment ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
General Purpose ◽  
Statistical Characteristics ◽  
Statistical Approaches ◽  
Survey Responses ◽  
Ecological Momentary ◽  
Ema Data ◽  
Momentary Assessment

Purpose: The analysis of Ecological Momentary Assessment (EMA) data can be difficult to conceptualize due to the complexity of how the data are collected. The goal of this tutorial is to provide an overview of statistical considerations for analyzing observational data arising from EMA studies. Method: EMA data are collected in a variety of ways, complicating the statistical analysis. We focus on fundamental statistical characteristics of the data and general purpose statistical approaches to analyzing EMA data. We implement those statistical approaches using a recent study involving EMA. Results: The linear or generalized linear mixed-model statistical approach can adequately capture the challenges resulting from EMA collected data if properly set up. Additionally, while sample size depends on both the number of participants and the number of survey responses per participant, having more participants is more important than the number of responses per participant. Conclusion: Using modern statistical methods when analyzing EMA data and adequately considering all of the statistical assumptions being used can lead to interesting and important findings when using EMA. Supplemental Material https://doi.org/10.23641/asha.17155961

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