TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
J Med Internet Res. 2024 Aug 12;26:e50275. doi: 10.2196/50275.
Ecological momentary assessment (EMA) is a measurement methodology that involves the repeated collection of real-time data on participants' behavior and experience in their natural environment. While EMA allows researchers to gain valuable insights into dynamic behavioral processes, the need for frequent self-reporting can be burdensome and disruptive. Compliance with EMA protocols is important for accurate, unbiased sampling; yet, there is no "gold standard" for EMA study design to promote compliance.
The purpose of this study was to use a factorial design to identify optimal study design factors, or combinations of factors, for achieving the highest completion rates for smartphone-based EMAs.
Participants recruited from across the United States were randomized to 1 of 2 levels on each of 5 design factors in a 2×2×2×2×2 design (32 conditions): factor 1-number of questions per EMA survey (15 vs 25); factor 2-number of EMAs per day (2 vs 4); factor 3-EMA prompting schedule (random vs fixed times); factor 4-payment type (US $1 paid per EMA vs payment based on the percentage of EMAs completed); and factor 5-EMA response scale type (ie, slider-type response scale vs Likert-type response scale; this is the only within-person factor; each participant was randomized to complete slider- or Likert-type questions for the first 14 days or second 14 days of the study period). All participants were asked to complete prompted EMAs for 28 days. The effect of each factor on EMA completion was examined, as well as the effects of factor interactions on EMA completion. Finally, relations between demographic and socioenvironmental factors and EMA completion were examined.
Participants (N=411) were aged 48.4 (SD 12.1) years; 75.7% (311/411) were female, 72.5% (298/411) were White, 18.0% (74/411) were Black or African American, 2.7% (11/411) were Asian, 1.5% (6/411) were American Indian or Alaska Native, 5.4% (22/411) belonged to more than one race, and 9.6% (38/396) were Hispanic/Latino. On average, participants completed 83.8% (28,948/34,552) of scheduled EMAs, and 96.6% (397/411) of participants completed the follow-up survey. Results indicated that there were no significant main effects of the design factors on compliance and no significant interactions. Analyses also indicated that older adults, those without a history of substance use problems, and those without current depression tended to complete more EMAs than their counterparts. No other demographic or socioenvironmental factors were related to EMA completion rates. Finally, the app was well liked (ie, system usability scale score=82.7), and there was a statistically significant positive association between liking the app and EMA compliance.
Study results have broad implications for developing best practices guidelines for future studies that use EMA methodologies.
ClinicalTrials.gov number NCT05194228; https://clinicaltrials.gov/study/NCT05194228.
生态瞬时评估（EMA）是一种测量方法，涉及在参与者的自然环境中重复收集关于他们的行为和体验的实时数据。虽然 EMA 使研究人员能够深入了解动态行为过程，但频繁的自我报告可能会带来负担和干扰。遵守 EMA 协议对于准确、无偏采样很重要；然而，没有“黄金标准”的 EMA 研究设计来促进遵守。
本研究旨在使用析因设计来确定最佳的研究设计因素，或组合因素，以实现基于智能手机的 EMA 的最高完成率。
从美国各地招募的参与者被随机分配到 5 个设计因素中的每个因素的 2 个水平（2×2×2×2×2 设计：32 种条件）：因素 1-每个 EMA 调查的问题数量（15 与 25）；因素 2-每天的 EMA 数量（2 与 4）；因素 3-EMA 提示时间表（随机与固定时间）；因素 4-支付类型（每完成一个 EMA 支付 1 美元与根据完成的 EMA 百分比支付；这是唯一的个体内因素；每个参与者被随机分配在研究期间的前 14 天或后 14 天完成滑块或李克特类型的问题）；因素 5-EMA 响应量表类型（即，滑块类型响应量表与李克特类型响应量表；这是唯一的个体内因素；每个参与者在研究期间的前 14 天或后 14 天被随机分配完成滑块或李克特类型的问题）。所有参与者都被要求在 28 天内完成提示 EMA。研究考察了每个因素对 EMA 完成的影响，以及因素相互作用对 EMA 完成的影响。最后，研究考察了人口统计学和社会环境因素与 EMA 完成的关系。
参与者（N=411）年龄为 48.4（SD 12.1）岁；75.7%（311/411）为女性，72.5%（298/411）为白人，18.0%（74/411）为黑人和非裔美国人，2.7%（11/411）为亚洲人，1.5%（6/411）为美洲印第安人或阿拉斯加原住民，5.4%（22/411）属于多个种族，9.6%（38/396）为西班牙裔或拉丁裔。平均而言，参与者完成了计划 EMA 的 83.8%（28，948/34，552），96.6%（397/411）的参与者完成了后续调查。结果表明，设计因素对合规性没有显著的主要影响，也没有显著的相互作用。分析还表明，年龄较大、没有药物使用问题史且没有当前抑郁的参与者比他们的同龄人更有可能完成更多的 EMA。没有其他人口统计学或社会环境因素与 EMA 完成率相关。最后，该应用程序很受欢迎（即，系统可用性量表得分=82.7），并且对应用程序的喜爱与 EMA 合规性呈正相关。
研究结果对未来使用 EMA 方法的研究制定最佳实践指南具有广泛的意义。
ClinicalTrials.gov 编号 NCT05194228；https://clinicaltrials.gov/study/NCT05194228。
