Researching the Links between Smartphone Behavior and Adolescent Wellbeing: The Study Protocol for the FUTURE (WP4) Ecological Momentary Assessment Study (Preprint)

2021 ◽  
Author(s):  
Steriani Elavsky ◽  
Jana Blahošová ◽  
Michaela Lebedíková ◽  
Michal Tkaczyk ◽  
Martin Tancoš ◽  
...  

BACKGROUND Smartphone ownership has increased among teens within the last decade, with up to 89% of adolescents owning a smartphone and through it engaging daily with the online world. Although the results of recent meta-analyses suggest that engaging digital technology plays only a small role in adolescent wellbeing, parents, professionals, and policy makers remain concerned about the impact that the instant connectivity of smartphones has on adolescent wellbeing. OBJECTIVE Herein, we introduce the protocol of a research study investigating the associations between adolescent smartphone use and different facets of well-being (social, physical, psychological) that aims to apply innovative methods to address limitations of existing empirical studies. METHODS This 12-month prospective study of adolescents uses a repeated measurement-burst design with Ecological Momentary Assessment (EMA) methodology. Adolescents (N=203; age range 13-17) complete baseline assessments through online questionnaires, four 14-day intensive data collection bursts, and an online questionnaire at the end of the study. As part of the four measurement bursts, adolescent smartphone behavior is assessed objectively by passive data collection of smartphone data logs and through self-reports in short questionnaires administered via a custom-built Android app. RESULTS The protocol describes the study objectives, research tools (including the development of the Android app and specialized software) and process (including pilot studies the main study, and targets for machine learning approaches). The design of the study will allow for the assessment of both within- and between-person variability in smartphone behavior, as well as short-term variation and long-term change in smartphone behavior and how it impacts indicators of social, physical, and psychological wellbeing. Preliminary analyses of the data from the first data collection burst of the main study indicate acceptable level of compliance (72.25%) with the daily questionnaires. CONCLUSIONS The innovative methods applied in this study (objective smartphone logs, EMA, machine learning) will allow for a more nuanced assessment of the links between smartphone use and wellbeing, informing strategies to help adolescents navigate the online world more constructively in terms of the development of their physical, social and psychological wellbeing.

2013 ◽  
Vol 18 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Emmanuel Kuntsche ◽  
Florian Labhart

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.


2021 ◽  
Author(s):  
Richard Stachel-Hilldorfer ◽  
Ben Stachel-Hilldorfer

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.


Author(s):  
Lianne P. de Vries ◽  
Bart M. L. Baselmans ◽  
Meike Bartels

Abstract Feelings of well-being and happiness fluctuate over time and contexts. Ecological Momentary Assessment (EMA) studies can capture fluctuations in momentary behavior, and experiences by assessing these multiple times per day. Traditionally, EMA was performed using pen and paper. Recently, due to technological advances EMA studies can be conducted more easily with smartphones, a device ubiquitous in our society. The goal of this review was to evaluate the literature on smartphone-based EMA in well-being research in healthy subjects. The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searching PubMed and Web of Science, we identified 53 studies using smartphone-based EMA of well-being. Studies were heterogeneous in designs, context, and measures. The average study duration was 12.8 days, with well-being assessed 2–12 times per day. Half of the studies included objective data (e.g. location). Only 47.2% reported compliance, indicating a mean of 71.6%. Well-being fluctuated daily and weekly, with higher well-being in evenings and weekends. These fluctuations disappeared when location and activity were accounted for. On average, being in nature and physical activity relates to higher well-being. Working relates to lower well-being, but workplace and company do influence well-being. The important advantages of using smartphones instead of other devices to collect EMAs are the easier data collection and flexible designs. Smartphone-based EMA reach far larger maximum sample sizes and more easily add objective data to their designs than palm-top/PDA studies. Smartphone-based EMA research is feasible to gain insight in well-being fluctuations and its determinants and offers the opportunity for parallel objective data collection. Most studies currently focus on group comparisons, while studies on individual differences in well-being patterns and fluctuations are lacking. We provide recommendations for future smartphone-based EMA research regarding measures, objective data and analyses.


2021 ◽  
Author(s):  
Aditya Ponnada ◽  
Shirlene Wang ◽  
Daniel Chu ◽  
Bridgette Do ◽  
Genevieve Dunton ◽  
...  

BACKGROUND Ecological momentary assessment (EMA) uses mobile technology to enable in-situ self-report data collection on behaviors and states. In a typical EMA study, participants are prompted several times a day to answer sets of multiple-choice questions. While the repeated nature of EMA reduces recall bias, it may induce participation burden. There is a need to explore complementary approaches to collecting in-situ self-report data that are less burdensome, yet provide comprehensive information on an individual’s behaviors and states. One new approach, microinteraction ecological momentary assessment (μEMA), restricts EMA items to single, cognitively simple questions answered on a smartwatch with single-tap answers; i.e., EMA is limited to only those answerable with a quick, glanceable microinteraction. However, the viability of using μEMA to capture behaviors and states in a large-scale intensive longitudinal data collection (ILD) study has not yet been demonstrated. OBJECTIVE This paper describes 1) the μEMA protocol currently used in the Temporal Influences on Movement and Exercise (TIME) Study conducted with young adults, 2) the interface of the μEMA app to gather self-report responses on a smartwatch, 3) qualitative feedback from participants following a pilot study of the μEMA app, 4) changes made to the main TIME study μEMA protocol and app based on the pilot feedback, and 5) preliminary μEMA results from a subset of active participants in the TIME Study. METHODS The TIME Study involves data collection on behaviors and states using passive sensors on smartwatches and smartphones along with intensive phone-based EMA, four-day hourly EMA bursts every two weeks among 250 people. Every day, participants also answer a nightly EMA survey. On non-EMA burst days, participants answer μEMA questions on the smartwatch assessing momentary states such as physical activity, sedentary behavior, and affect. At the end of the study, participants take part in a semi-structured interview to describe their experience with EMA and μEMA. A pilot study was used to test and refine the μEMA protocol for the main study. RESULTS Changes made to the μEMA study protocol based on pilot feedback included adjustments to the single-question selection method and watch vibrotactile prompting. We also added sensor-triggered questions for physical activity and sedentary behavior. As of June 2021, 81 participants completed at least six months of data collection in the main study. For 662,397 μEMA questions delivered, the compliance rate was 67.61% (SD = 24.36) and completion rate was 79.03% (SD = 22.19). CONCLUSIONS This study provides opportunities to explore a novel approach for collecting temporally dense intensive longitudinal self-report data in a sustainable manner. Data suggest that μEMA may be valuable for understanding behaviors and states at the individual level, thus possibly supporting future longitudinal interventions that require within-day, temporally dense self-report in the real world. CLINICALTRIAL Not applicable


Field Methods ◽  
2018 ◽  
Vol 30 (2) ◽  
pp. 91-104 ◽  
Author(s):  
Kimberly A. Tyler ◽  
Kristen Olson

We assessed the feasibility of ecological momentary assessment using short message service (SMS) surveying with 150 homeless youth. We found that on average, participants completed 18.8 days of texts, but 30% of youth ( N = 44) had texting data on 28 or more days. The average number of texts answered per day was 8.49 (of a possible 11). Forty-three percent of days had answers to all 11 texts sent that day, and 69.4% of days had answers to eight or more texts. We found significant differences in response rates by phone type. Seventy-three percent of youth reported that responding to our texts was very easy or somewhat easy and 69% endorsed the response option “just enough,” regarding the number of texts sent per day. The 30-day texting period was deemed “about right” by 74% of youth. Details of using SMS with homeless youth are provided, and results indicate that this data collection technique is feasible with this population.


2019 ◽  
Author(s):  
Dara D Mendez ◽  
Sarah A Sanders ◽  
Hassan A Karimi ◽  
Pedram Gharani ◽  
Stephen L Rathbun ◽  
...  

BACKGROUND There are significant racial disparities in pregnancy and postpartum health outcomes, including postpartum weight retention and cardiometabolic risk. These racial disparities are a result of a complex interplay between contextual, environmental, behavioral, and psychosocial factors. OBJECTIVE This protocol provides a description of the development and infrastructure for the Postpartum Mothers Mobile Study (PMOMS), designed to better capture women’s daily experiences and exposures from late pregnancy through 1 year postpartum. The primary aims of PMOMS are to understand the contextual, psychosocial, and behavioral factors contributing to racial disparities in postpartum weight and cardiometabolic health, with a focus on the daily experiences of stress and racism, as well as contextual forms of stress (eg, neighborhood stress and structural racism). METHODS PMOMS is a longitudinal observation study that is ancillary to an existing randomized control trial, GDM2 (Comparison of Two Screening Strategies for Gestational Diabetes). PMOMS uses an efficient and cost-effective approach for recruitment by leveraging the infrastructure of GDM2, facilitating enrollment of participants while consolidating staff support from both studies. The primary data collection method is ecological momentary assessment (EMA) and through smart technology (ie, smartphones and scales). The development of the study includes: (1) the pilot phase and development of the smartphone app; (2) feedback and further development of the app including selection of key measures; and (3) implementation, recruitment, and retention. RESULTS PMOMS aims to recruit 350 participants during pregnancy, to be followed through the first year after delivery. Recruitment and data collection started in December 2017 and are expected to continue through September 2020. Initial results are expected in December 2020. As of early May 2019, PMOMS recruited a total of 305 participants. Key strengths and features of PMOMS have included data collection via smartphone technology to reduce the burden of multiple on-site visits, low attrition rate because of participation in an ongoing trial in which women are already motivated and enrolled, high EMA survey completion and the use of EMA as a unique data collection method to understand daily experiences, and shorter than expected timeframe for enrollment because of the infrastructure of the GDM2 trial. CONCLUSIONS This protocol outlines the development of the PMOMS, one of the first published studies to use an ongoing EMA and mobile technology protocol during pregnancy and throughout 1 year postpartum to understand the health of childbearing populations and enduring racial disparities in postpartum weight and cardiometabolic health. Our findings will contribute to the improvement of data collection methods, particularly the role of EMA in capturing multiple exposures and knowledge in real time. Furthermore, the results of the study will inform future studies investigating weight and cardiometabolic health during pregnancy and the postpartum period, including how social determinants produce population disparities in these outcomes. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13569


10.2196/30472 ◽  
2021 ◽  
Vol 5 (9) ◽  
pp. e30472
Author(s):  
Mor Yerushalmi ◽  
Andrew Sixsmith ◽  
Ariel Pollock Star ◽  
David B King ◽  
Norm O'Rourke

Background The World Health Organization ranks bipolar disorder (BD) as the 7th leading cause of disability. Although the effects on those with BD are well described, less is reported on the impact of BD on cohabiting partners or any interactions between the two; this requires in vivo data collection measured each day over several months. Objective We set out to demonstrate the utility of ecological momentary assessment with BD couples measured using yoked smartphone apps. When randomly prompted over time, we assumed distinct patterns of association would emerge between BD symptoms (both depression and hypo/mania) and partner mood (positive and negative affect). Methods For this pilot study, we recruited an international sample of young and older adults with BD and their cohabiting partners where available. Both participants and partners downloaded separate apps onto their respective smartphones. Within self-specified “windows of general availability,” participants with BD were randomly prompted to briefly report symptoms of depression and hypo/mania (ie, BDSx), positive and negative mood (ie, POMS-15; partners), and any important events of the day (both). The partner app was yoked to the participant app so that the former was prompted roughly 30 minutes after the participant with BD or the next morning if outside the partner’s specified availability. Results Four couples provided 312 matched BD symptom and partner mood responses over an average of 123 days (range 65-221 days). Both were GPS- and time-stamped (mean 3:11 hrs between questionnaires, SD 4:51 hrs). Total depression had a small but significant association with positive (r=–.14; P=.02) and negative partner affect (r=.15; P=.01]. Yet total hypo/mania appeared to have no association with positive partner affect (r=–.01; P=.87); instead, negative partner affect was significantly correlated with total hypo/mania (r=.26; P=.01). However, when we look specifically at BD factors, we see that negative partner affect is associated only with affrontive symptoms of hypo/mania (r=.38; P=.01); elation or loss of insight appears unrelated to either positive (r=.10; P=.09) or negative partner affect (r=.02; P=.71). Yet affrontive symptoms of hypo/mania were significantly correlated with negative affect, but only when couples were together (r=.41; P=.01), not when apart (r=.22; P=.12). That is, these angry interpersonal symptoms of hypo/mania appear to be experienced most negatively by spouses when couples are together. Conclusions These initial findings demonstrate the utility of in vivo ambulatory data collection in longitudinal mental health research. Preliminary analyses suggest different BD symptoms are associated with negative and positive partner mood. These negative effects appear greater for hypo/mania than depressive symptoms, but proximity to the person with BD is important.


2021 ◽  
Author(s):  
Mor Yerushalmi ◽  
Andrew Sixsmith ◽  
Ariel Pollock Star ◽  
David B King ◽  
Norm O'Rourke

BACKGROUND The World Health Organization ranks bipolar disorder (BD) as the 7th leading cause of disability. Although the effects on those with BD are well described, less is reported on the impact of BD on cohabiting partners or any interactions between the two; this requires in vivo data collection measured each day over several months. OBJECTIVE We set out to demonstrate the utility of ecological momentary assessment with BD couples measured using yoked smartphone apps. When randomly prompted over time, we assumed distinct patterns of association would emerge between BD symptoms (both depression and hypo/mania) and partner mood (positive and negative affect). METHODS For this pilot study, we recruited an international sample of young and older adults with BD and their cohabiting partners where available. Both participants and partners downloaded separate apps onto their respective smartphones. Within self-specified “windows of general availability,” participants with BD were randomly prompted to briefly report symptoms of depression and hypo/mania (ie, BDS<sub>x</sub>), positive and negative mood (ie, POMS-15; partners), and any important events of the day (both). The partner app was yoked to the participant app so that the former was prompted roughly 30 minutes after the participant with BD or the next morning if outside the partner’s specified availability. RESULTS Four couples provided 312 matched BD symptom and partner mood responses over an average of 123 days (range 65-221 days). Both were GPS- and time-stamped (mean 3:11 hrs between questionnaires, SD 4:51 hrs). Total depression had a small but significant association with positive (r=–.14; <i>P</i>=.02) and negative partner affect (r=.15; <i>P</i>=.01]. Yet total hypo/mania appeared to have no association with positive partner affect (r=–.01; <i>P</i>=.87); instead, negative partner affect was significantly correlated with total hypo/mania (r=.26; <i>P</i>=.01). However, when we look specifically at BD factors, we see that negative partner affect is associated only with affrontive symptoms of hypo/mania (r=.38; <i>P</i>=.01); elation or loss of insight appears unrelated to either positive (r=.10; <i>P</i>=.09) or negative partner affect (r=.02; <i>P</i>=.71). Yet affrontive symptoms of hypo/mania were significantly correlated with negative affect, but only when couples were together (r=.41; <i>P</i>=.01), not when apart (r=.22; <i>P</i>=.12). That is, these angry interpersonal symptoms of hypo/mania appear to be experienced most negatively by spouses when couples are together. CONCLUSIONS These initial findings demonstrate the utility of in vivo ambulatory data collection in longitudinal mental health research. Preliminary analyses suggest different BD symptoms are associated with negative and positive partner mood. These negative effects appear greater for hypo/mania than depressive symptoms, but proximity to the person with BD is important.


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