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BACKGROUND

The use of ecological momentary assessment (EMA) designs has been on the rise in mental health epidemiology. However, there is a lack of knowledge of the determinants of participation in and compliance with EMA studies, reliability of measures, and underreporting of methodological details and data quality indicators.

OBJECTIVE

This study aims to evaluate the quality of EMA data in a large sample of university students by estimating participation rate and mean compliance, identifying predictors of individual-level participation and compliance, evaluating between- and within-person reliability of measures of negative and positive affect, and identifying potential careless responding.

METHODS

A total of 1259 university students were invited to participate in a 15-day EMA study on mental health problems. Logistic and Poisson regressions were used to investigate the associations between sociodemographic factors, lifetime adverse experiences, stressful events in the previous 12 months, and mental disorder screens and EMA participation and compliance. Multilevel reliability and intraclass correlation coefficients were obtained for positive and negative affect measures. Careless responders were identified based on low compliance or individual reliability coefficients.

RESULTS

Of those invited, 62.1% (782/1259) participated in the EMA study, with a mean compliance of 76.9% (SD 27.7%). Participation was higher among female individuals (odds ratio [OR] 1.41, 95% CI 1.06-1.87) and lower among those aged ≥30 years (OR 0.20, 95% CI 0.08-0.43 vs those aged 18-21 years) and those who had experienced the death of a friend or family member in the previous 12 months (OR 0.73, 95% CI 0.57-0.94) or had a suicide attempt in the previous 12 months (OR 0.26, 95% CI 0.10-0.64). Compliance was particularly low among those exposed to sexual abuse before the age of 18 years (exponential of β=0.87) or to sexual assault or rape in the previous year (exponential of β=0.80) and among those with 12-month positive alcohol use disorder screens (exponential of β=0.89). Between-person reliability of negative and positive affect was strong (R>0.97), whereas within-person reliability was fair to moderate (R>0.43). Of all answered assessments, 0.86% (291/33,626) were flagged as careless responses because the response time per item was <1 second or the participants gave the same response to all items. Of the participants, 17.5% (137/782) could be considered careless responders due to low compliance (<25/56, 45%) or very low to null individual reliability (raw Cronbach α<0.11) for either negative or positive affect.

CONCLUSIONS

Data quality assessments should be carried out in EMA studies in a standardized manner to provide robust conclusions to advance the field. Future EMA research should implement strategies to mitigate nonresponse bias as well as conduct sensitivity analyses to assess possible exclusion of careless responders.

背景

生态瞬时评估（EMA）设计在心理健康流行病学中的应用日益广泛。然而，对于参与EMA研究及其依从性的决定因素、测量的可靠性，以及方法细节和数据质量指标报告不足等方面，我们了解甚少。

目的

本研究旨在通过估计参与率和平均依从性、确定个体层面参与和依从的预测因素、评估消极和积极情绪测量的个体间和个体内可靠性，以及识别潜在的粗心应答，来评估大量大学生样本中EMA数据的质量。

方法

共邀请1259名大学生参与一项为期15天的关于心理健康问题的EMA研究。采用逻辑回归和泊松回归来研究社会人口学因素、终生不良经历、过去12个月内的应激事件、精神障碍筛查与EMA参与和依从之间的关联。获得了消极和积极情绪测量的多水平可靠性和组内相关系数。根据低依从性或个体可靠性系数识别粗心应答者。

结果

在受邀者中，62.1%（782/1259）参与了EMA研究，平均依从性为76.9%（标准差27.7%）。女性的参与率较高（优势比[OR]1.41，95%置信区间1.06 - 1.87），而年龄≥30岁者（与18 - 21岁者相比，OR 0.20，95%置信区间0.08 - 0.43）、过去12个月内有朋友或家庭成员死亡经历者（OR 0.73，95%置信区间0.57 - 0.94）或过去12个月内有自杀未遂经历者（OR 0.26，95%置信区间0.10 - 0.64）的参与率较低。18岁之前遭受性虐待者（β的指数 = 0.87）或前一年遭受性侵犯或强奸者（β的指数 = 0.80）以及12个月内酒精使用障碍筛查呈阳性者（β的指数 = 0.89）的依从性特别低。消极和积极情绪的个体间可靠性较强（R>0.97），而个体内可靠性为中等（R>0.43）。在所有回答的评估中，0.86%（291/33,626）被标记为粗心应答，因为每个项目的回答时间<1秒或参与者对所有项目给出相同回答。在参与者中，17.5%（137/782）由于消极或积极情绪的依从性低（<25/56，45%）或个体可靠性非常低至零（原始克朗巴哈α<0.11），可被视为粗心应答者。