Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 25, 2022
Date Accepted: Apr 20, 2023
Evaluating Declines in Compliance with Ecological Momentary Assessment in Longitudinal Health Behavior Research
ABSTRACT
Background:
Ecological momentary assessment (EMA) is increasingly used to evaluate behavioral health processes over extended time periods. The validity of EMA for providing representative, real-world data with high temporal precision is threatened to the extent that EMA compliance drops over time.
Objective:
The present research builds on prior short-term studies by evaluating the time course of EMA compliance over 9 weeks and examines predictors of weekly compliance rates among cigarette users.
Methods:
257 daily cigarette using adults enrolled in a randomized controlled trial for smoking cessation completed daily smartphone EMA assessments, including one scheduled morning assessment and four random assessments per day. Weekly EMA compliance was calculated and multilevel modeling assessed the rate of change in compliance. Participant and study characteristics were examined as predictors of overall compliance and changes in compliance rates over time.
Results:
Compliance was higher for scheduled morning assessments (86%) compared to random assessments (58%) at the beginning of the assessment period. EMA compliance declined linearly across weeks, and the rate of decline was greater for morning assessments (2%/week) than for random assessments (1%/week). Declines in compliance were larger for younger participants, participants employed full-time, and participants who subsequently dropped out of the study. Overall compliance was higher among White participants.
Conclusions:
The present study suggests EMA compliance declines linearly, but modestly, across lengthy EMA protocols. In general, these data support the validity of EMA for tracking health behavior and hypothesized treatment mechanisms over the course of several months. Future work should target improving compliance among sub-groups of participants and investigate the extent to which rapid declines in EMA compliance might prove useful for triggering interventions to prevent study drop out. Clinical Trial: clinicaltrials.gov; identifier: NCT03262662; https://clinicaltrials.gov/ct2/show/NCT03262662
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.