1299-P: Ecological Momentary Assessment (EMA) of Positive and Negative Affect, Social Context, and Blood Glucose (BG) in Teens with Type 1 Diabetes

Abstract Effective diabetes problem solving requires identification of risk factors for inadequate mealtime self-management. Ecological momentary assessment was used to enhance identification of factors hypothesized to impact self-management. Adolescents with type 1 diabetes participated in a feasibility trial for a mobile app called MyDay. Meals, mealtime insulin, self-monitored blood glucose, and psychosocial and contextual data were obtained for 30 days. Using 1472 assessments, mixed-effects between-subjects analyses showed that social context, location, and mealtime were associated with missed self-monitored blood glucose. Stress, energy, mood, and fatigue were associated with missed insulin. Within-subjects analyses indicated that all factors were associated with both self-management tasks. Intraclass correlations showed within-subjects accounted for the majority of variance. The ecological momentary assessment method provided specific targets for improving self-management problem solving, phenotyping, or integration within just-in-time adaptive interventions.

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Ecological Momentary Assessment (EMA) of Positive and Negative Affect and Associations with Blood Glucose (BG) in Teens with Type 1 Diabetes (T1D)

Journal of Diabetes Science and Technology ◽

10.1177/19322968211035451 ◽

2021 ◽

pp. 193229682110354

Author(s):

Amit Shapira ◽

Lisa K. Volkening ◽

Joshua S. Borus ◽

Lori M. Laffel

Keyword(s):

Type 1 Diabetes ◽

Negative Affect ◽

Handheld Computers ◽

Positive And Negative Affect ◽

Momentary Sampling ◽

Low Glucose ◽

Ecological Momentary ◽

Momentary Assessment ◽

Shed Light

Background: Affect (i.e., emotions) can be associated with diabetes self-care and ambient glucose in teens with type 1 diabetes (T1D). We used momentary sampling to examine associations of daily affectwithblood glucose (BG) monitoring,BG levels,and BG variability in teens with T1D. Method: Over 2 weeks, 32 teens reported positive and negative affect (Positive and Negative Affect Scale) and BG levels on handheld computers 4x/day, coordinated with planned daily BG checks. BG values were classified as: in-range (70-180 mg/dL); low (<70 mg/dL); severe low (<54 mg/dL); high (>180 mg/dL); severe high (>250 mg/dL). Daily BG variability was derived from BG coefficient of variation (BGCV). To determine associations of positive and negative affect with BG checks, BG levels, and BGCV, separate generalized estimating equations were performed, adjusting for demographic and diabetes-related variables, for the overall sample and stratified by HbA1c (≤8%, >8%). Results: Teens (44% male, ages 14-18, 63% pump-treated, HbA1c 8.8 ± 1.4%) reported 51% in-range, 6% low (2% severe low), and 44% high (19% severe high) BG. In teens with HbA1c ≤8%, positive affect was associated with in-range BG (OR = 1.08, 95% CI = 1.04-1.13, P = .0002), reduced odds of very low glucose (OR = 0.35, 95% CI = 0.16-0.74, P = .006), and less daily BGCV (β = −0.9; 95% CI = −1.6, −0.2; P = .01). In teens with HbA1c >8%, negative affect was associated with less likelihood of checking BG (OR = 0.75, 95% CI = 0.64-0.87, P = .0003). Conclusions: Our findings shed light on individual differences in metabolic reactivity based on glycemic levels and the importance of incorporating affect into automated insulin delivery systems.

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A-111 Ecological Momentary Assessment of Mood after Moderate to Severe Traumatic Brain Injury

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.129 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1160-1160

Author(s):

Julianne Wilson ◽

Amanda R Rabinowitz ◽

Tessa Hart

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Negative Affect ◽

Severe Traumatic Brain Injury ◽

Ecological Momentary Assessment ◽

Community Dwelling ◽

Positive And Negative Affect ◽

Environmental Reward ◽

Ecological Momentary ◽

Momentary Assessment

Abstract Objective In persons with moderate–severe traumatic brain injury (msTBI), we compared traditional measures of mood with dynamic measures of affect derived from ecological momentary assessment (EMA), for the purpose of validating the EMA indices and exploring their unique contributions to emotional assessment. Method 23 community-dwelling participants with chronic msTBI were enrolled in a treatment trial for anxiety and/ or depression. At baseline, participants completed the Brief Symptom Inventory-18 Depression and Anxiety subscales (BSI-D, BSI-A) and the Environmental Reward Observation Scale (EROS), a measure of everyday pleasure and reward. EMA data, including the Positive and Negative Affect Scale (PANAS), were collected via smartphone 5 times daily for 7–14 days prior to treatment (M = 8.65; SD = 1.87). Spearman correlations tested associations between baseline BSI-D, BSI-A, and EROS scores with both overall means and temporal variability measures for positive and negative affect (PA, NA). Results Mean PA was significantly correlated with BSI-D (rho −0.60, p < 0.05) and EROS (rho 0.72, p < 0.01). Mean NA and affect variability measures were uncorrelated with baseline scores. NA mean and variability were intercorrelated (rho 0.87, p < 0.001), but this was not the case for PA. Conclusion EMA measures of averaged positive affect showed robust relationships with retrospective measures of depression and environmental reward, providing support for the validity of EMA measures of PA, and for use of the EROS in msTBI. While negative findings must be interpreted with caution, the lack of association of affective variability with retrospective measures suggest a unique role for EMA in examining temporal dynamics of affect.

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