Feasibility of Using Text Messaging to Gather Qualitative Diary Data from COPD Sufferers: An Ecological Momentary Assessment and BYOD Approach (Preprint)
BACKGROUND The ubiquitous use of SMS text messaging offers a viable data collection method that aligns well with ecological momentary assessment (EMA) coupled with a bring-your-own-device (BYOD) approach. This unique conceptual model may extend to qualitative data collection through diary entries, which promises novel, in-the-moment insights for researchers interested in subjective patient-reported outcome measures (PROMS). OBJECTIVE This study aims to investigate the feasibility of using SMS text messaging to gather qualitative diary data from COPD sufferers, using EMA and participants’ mobile phones. It compares data gathered through this method with similar qualitative data gathered through email and with responses to quantitative, closed-ended categorical questions. METHODS This study involved 93 COPD-affected Alpha-1 sufferers who participated in a two-month long pilot intervention that used push messaging to respondents 2-to-3 times a day, either via SMS text messaging or email. In the first month of the study, respondents received 2 push messages a day urging them to answer closed-ended questions. The second month of the study integrated push messages which encouraged participants to engage in completion of daily, qualitative diary entries, in addition to the closed-ended questions. This research tracked and compared speed to answer and depth of responses between 69 (74%) individuals completing the push message requests through email and 24 (26%) who completed them through text messaging. It also compared completion rates of the diary entries to those of the closed-ended categorical questions. RESULTS Analysis of speed to answer, or the quickness in which respondents replied to the push messages, indicated that those answering by SMS text messaging were faster than those answering by email, both for categorical closed-ended questions and for diary questions. For the diary questions, specifically, those answering by SMS text messaging responded 6 hours and 29 minutes faster than those responding by email. We deemed this difference to be statistically significant. Depth of response, as measured by word count, varied between the two delivery methods as well, with those answering by email using, on average, 5.3 more words per entry than those answering by SMS text messaging (24.9 words per entry compared to 19.6 words per entry). Average compliance to the closed-ended questions over the study period was 94.4% (12,642/13,392) compared to 90.8% (2365/2604) for diary entries. This difference was also statistically significant. CONCLUSIONS SMS text messaging is a viable option for qualitative diary data collection among chronically ill individuals using an EMA and BYOD methodology. However, researchers must weigh considerations of time versus response rate and depth of response when employing SMS text messaging for this methodological approach. Benefits include quick response times, which matches the EMA method of responding as near to a trigger or intervention as possible. Weaknesses include the fact that qualitative diary data collected by SMS text messaging have inherent limits regarding depth of response. This study also recognized a lower compliance rate for those participating by SMS text messaging than by email, even though rates for both were quite high.