Indiana University, Center for Aging Research, Indianapolis, IN, United States.
Regenstrief Institute, Indianapolis, IN, United States.
JMIR Mhealth Uhealth. 2019 Apr 3;7(4):e10894. doi: 10.2196/10894.
Ecological momentary assessment (EMA) can be a useful tool for collecting real-time behavioral data in studies of health and health behavior. However, EMA administered through mobile technology can be burdensome, and it tends to suffer from suboptimal user engagement, particularly in low health-literacy populations.
This study aimed to report a case study involving the design and evaluation of a mobile EMA tool that supports context-sensitive EMA-reporting of location and social situations accompanying eating and sedentary behavior.
An iterative, user-centered design process with obese, middle-aged women seeking care in a safety-net health system was used to identify the preferred format of self-report measures and the look, feel, and interaction of the mobile EMA tool. A single-arm feasibility field trial with 21 participants receiving 12 prompts each day for momentary self-reports over a 4-week period (336 total prompts per participant) was used to determine user satisfaction with interface quality and user engagement, operationalized as response rate. A second trial among 38 different participants randomized to receive or not to receive a feature designed to improve engagement was conducted.
The feasibility trial results showed high interface satisfaction and engagement, with an average response rate of 50% over 4 weeks. Qualitative feedback pointed to the need for auditory alerts. We settled on 3 alerts at 10-min intervals to accompany each EMA-reporting prompt. The second trial testing this feature showed a statistically significant increase in the response rate between participants randomized to receive repeat auditory alerts versus those who were not (60% vs 40%).
This paper reviews the design research and a set of design constraints that may be considered in the creation of mobile EMA interfaces personalized to users' preferences. Novel aspects of the study include the involvement of low health-literacy adults in design research, the capture of data on time, place, and social context of eating and sedentary behavior, and reporting prompts tailored to an individual's location and schedule.
ClinicalTrials.gov NCT03083964; https://clinicaltrials.gov/ct2/show/NCT03083964.
生态瞬时评估（EMA）可以成为收集健康和健康行为研究中实时行为数据的有用工具。然而，通过移动技术进行的 EMA 可能会带来负担，并且往往存在用户参与度不理想的问题，尤其是在健康素养较低的人群中。
本研究旨在报告一个案例研究，涉及设计和评估一种移动 EMA 工具，该工具支持伴随饮食和久坐行为的位置和社交情况的敏感 EMA 报告。
采用迭代的、以用户为中心的设计过程，对在一个安全网健康系统中寻求治疗的肥胖中年女性进行研究，以确定自我报告措施的首选格式以及移动 EMA 工具的外观、感觉和交互方式。一项为期 4 周的单臂可行性现场试验，共 21 名参与者每天接受 12 次瞬时自我报告提示（每位参与者共 336 次提示），用于确定参与者对界面质量和用户参与度（以响应率衡量）的满意度。随后，对 38 名不同的参与者进行了第二项试验，这些参与者被随机分为接受或不接受旨在提高参与度的功能。
可行性试验结果显示，界面满意度和参与度均很高，4 周内的平均响应率为 50%。定性反馈指出需要听觉警报。我们最终确定每 10 分钟发出 3 次警报，以伴随每次 EMA 报告提示。第二项试验测试了这一功能，结果显示接受重复听觉警报的参与者与未接受的参与者之间的响应率存在统计学显著差异（60%对 40%）。
本文回顾了设计研究和一系列设计约束，这些约束可能在创建针对用户偏好的移动 EMA 界面时考虑。该研究的新颖之处包括让低健康素养成年人参与设计研究、捕捉饮食和久坐行为的时间、地点和社会背景数据，以及根据个人的位置和日程安排定制报告提示。
ClinicalTrials.gov NCT03083964；https://clinicaltrials.gov/ct2/show/NCT03083964。
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