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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Nov 26, 2024
Date Accepted: Jul 16, 2025

The final, peer-reviewed published version of this preprint can be found here:

Ecological Momentary Assessment as a Measure of Intervention Change: Evaluation in 4 Digital Mental Health Trials

Webb C, Hilt L, Swords C, Bolt D, Fisher H, Goldberg S

Ecological Momentary Assessment as a Measure of Intervention Change: Evaluation in 4 Digital Mental Health Trials

J Med Internet Res 2025;27:e69297

DOI: 10.2196/69297

PMID: 40924996

PMCID: 12457869

Are ecological momentary assessment measures of intervention change worth the trouble?: Evaluation in four digital mental health trials

  • Christian Webb; 
  • Lori Hilt; 
  • Caroline Swords; 
  • Daniel Bolt; 
  • Hadar Fisher; 
  • Simon Goldberg

ABSTRACT

Ecological momentary assessment (EMA) is increasingly being incorporated into intervention studies to acquire a more fine-grained and ecologically valid assessment of change. The added utility of including relatively burdensome EMA measures in a clinical trial hinges on several psychometric assumptions, including that these measure are: (1) reliable, (2) related but not redundant with conventional self-report measures (convergent and discriminant validity), (3) sensitive to intervention-related change, and (4) associated with a clinically-relevant criterion of improvement (criterion validity) above conventional self-report measures (incremental validity). Using data from 4 app-based meditation trials (N = 412), we examined the reliability, validity, and sensitivity to change of conventional self-report and EMA measures of improvement in rumination. Conventional self-report and EMA measures of rumination were only modestly correlated, particularly with regards to change over time, which may be due to their lower reliability. Changes in rumination were larger for conventional self-report than EMA. Notably, change in both self-report and EMA rumination each accounted for unique variance in depressive symptom improvement, demonstrating incremental predictive validity. Conventional self-report and EMA measures of rumination provide distinct and clinically meaningful information. Researchers using EMA should consider the psychometric properties of their measures and the precise construct they intend to capture.


 Citation

Please cite as:

Webb C, Hilt L, Swords C, Bolt D, Fisher H, Goldberg S

Ecological Momentary Assessment as a Measure of Intervention Change: Evaluation in 4 Digital Mental Health Trials

J Med Internet Res 2025;27:e69297

DOI: 10.2196/69297

PMID: 40924996

PMCID: 12457869

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