JMIR Publications

ABSTRACT

Background:

Mobile Ecological Momentary Assessment (mEMA) permits real-time capture of self-reported participant behaviours and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of child/youth and specific clinical populations of adults.

Objective:

In studies of nonclinical and clinical samples of adults, describe: 1) use of mEMA for self-reported behaviours and psychological constructs; 2) mEMA protocol and compliance reporting; and 3) associations between key components of mEMA protocols and compliance.

Methods:

Nine electronic databases were searched (2006 to 2016) for observational studies reporting compliance to mEMA for health-related data from adults (>18 years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency/schedule, device type, training, incentives and burden score). Random effects ANOVA (P ≤ .05) assessed differences between nonclinical and clinical datasets.

Results:

Of 168 eligible studies, 97 (58%) reported compliance in 105 unique datasets (nonclinical = 64, clinical = 41). The commonest self-report mEMA target was affect (primary target 31/105 datasets; secondary target 50/105 datasets). Median mEMA protocol duration was 7 days (nonclinical 7, clinical 12). The majority of protocols used a single time-based (random or interval) prompt type (n = 69, 66%); median prompt frequency was 5/d. The median number of items per prompt was similar for nonclinical (8) and clinical datasets (10). Over half the datasets reported mEMA training (n = 84, 80%) and provision of participant incentives (n = 66, 63%). Less than half reported number of prompts delivered (n = 22, 21%), answered (n = 43, 41%), criterion for ‘valid’ mEMA data (n = 37, 35%) or response latency (n = 38, 36%). Meta-analysis (nonclinical = 41, clinical = 27) estimated overall compliance of 81.9% (95%CI 79.1%, 84.4%), with no significant difference between nonclinical and clinical datasets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical datasets. While widespread heterogeneity existed across analysis (I2 > 90%), no compelling relationship was identified between key features of mEMA protocols representing ‘burden’ and mEMA compliance.

Conclusions:

In this 10-year sample of studies using mEMA of self-reported health-related behaviours and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts, health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance. Clinical Trial: International Prospective Register of Systematic Reviews (PROSPERO 2016:CRD42016051726).