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Ulm C, Chen S, Fleshman B, Benson L, Kendzor DE, Frank-Pearce S, Neil JM, Vidrine D, Businelle MS. Smartphone-Based Survey and Message Compliance in Adults Initially Unready to Quit Smoking: Secondary Analysis of a Randomized Controlled Trial. JMIR Form Res 2024; 8:e56003. [PMID: 38848557 PMCID: PMC11193076 DOI: 10.2196/56003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/04/2024] [Accepted: 04/29/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Efficacy of smartphone-based interventions depends on intervention content quality and level of exposure to that content. Smartphone-based survey completion rates tend to decline over time; however, few studies have identified variables that predict this decline over longer-term interventions (eg, 26 weeks). OBJECTIVE This study aims to identify predictors of survey completion and message viewing over time within a 26-week smoking cessation trial. METHODS This study examined data from a 3-group pilot randomized controlled trial of adults who smoke (N=152) and were not ready to quit smoking within the next 30 days. For 182 days, two intervention groups received smartphone-based morning and evening messages based on current readiness to quit smoking. The control group received 2 daily messages unrelated to smoking. All participants were prompted to complete 26 weekly smartphone-based surveys that assessed smoking behavior, quit attempts, and readiness to quit. Compliance was operationalized as percentages of weekly surveys completed and daily messages viewed. Linear regression and mixed-effects models were used to identify predictors (eg, intervention group, age, and sex) of weekly survey completion and daily message viewing and decline in compliance over time. RESULTS The sample (mean age 50, SD 12.5, range 19-75 years; mean years of education 13.3, SD 1.6, range 10-20 years) was 67.8% (n=103) female, 74.3% (n=113) White, 77% (n=117) urban, and 52.6% (n=80) unemployed, and 61.2% (n=93) had mental health diagnoses. On average, participants completed 18.3 (71.8%) out of 25.5 prompted weekly surveys and viewed 207.3 (60.6%) out of 345.1 presented messages (31,503/52,460 total). Age was positively associated with overall weekly survey completion (P=.003) and daily message viewing (P=.02). Mixed-effects models indicated a decline in survey completion from 77% (114/148) in the first week of the intervention to 56% (84/150) in the last week of the intervention (P<.001), which was significantly moderated by age, sex, ethnicity, municipality (ie, rural/urban), and employment status. Similarly, message viewing declined from 72.3% (1533/2120) in the first week of the intervention to 44.6% (868/1946) in the last week of the intervention (P<.001). This decline in message viewing was significantly moderated by age, sex, municipality, employment status, and education. CONCLUSIONS This study demonstrated the feasibility of a 26-week smartphone-based smoking cessation intervention. Study results identified subgroups that displayed accelerated rates in the decline of survey completion and message viewing. Future research should identify ways to maintain high levels of interaction with mobile health interventions that span long intervention periods, especially among subgroups that have demonstrated declining rates of intervention engagement over time. TRIAL REGISTRATION ClinicalTrials.gov NCT03405129; https://clinicaltrials.gov/ct2/show/NCT03405129.
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Affiliation(s)
- Clayton Ulm
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Heatlh Sciences Center, Oklahoma City, OK, United States
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Brianna Fleshman
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Heatlh Sciences Center, Oklahoma City, OK, United States
| | - Lizbeth Benson
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Heatlh Sciences Center, Oklahoma City, OK, United States
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Heatlh Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Summer Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Heatlh Sciences Center, Oklahoma City, OK, United States
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jordan M Neil
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Heatlh Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Damon Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Michael S Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Heatlh Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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Sun Y, Kargarandehkordi A, Slade C, Jaiswal A, Busch G, Guerrero A, Phillips KT, Washington P. Personalized Deep Learning for Substance Use in Hawaii: Protocol for a Passive Sensing and Ecological Momentary Assessment Study. JMIR Res Protoc 2024; 13:e46493. [PMID: 38324375 PMCID: PMC10882478 DOI: 10.2196/46493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Artificial intelligence (AI)-powered digital therapies that detect methamphetamine cravings via consumer devices have the potential to reduce health care disparities by providing remote and accessible care solutions to communities with limited care solutions, such as Native Hawaiian, Filipino, and Pacific Islander communities. However, Native Hawaiian, Filipino, and Pacific Islander communities are understudied with respect to digital therapeutics and AI health sensing despite using technology at the same rates as other racial groups. OBJECTIVE In this study, we aimed to understand the feasibility of continuous remote digital monitoring and ecological momentary assessments in Native Hawaiian, Filipino, and Pacific Islander communities in Hawaii by curating a novel data set of longitudinal Fitbit (Fitbit Inc) biosignals with the corresponding craving and substance use labels. We also aimed to develop personalized AI models that predict methamphetamine craving events in real time using wearable sensor data. METHODS We will develop personalized AI and machine learning models for methamphetamine use and craving prediction in 40 individuals from Native Hawaiian, Filipino, and Pacific Islander communities by curating a novel data set of real-time Fitbit biosensor readings and the corresponding participant annotations (ie, raw self-reported substance use data) of their methamphetamine use and cravings. In the process of collecting this data set, we will gain insights into cultural and other human factors that can challenge the proper acquisition of precise annotations. With the resulting data set, we will use self-supervised learning AI approaches, which are a new family of machine learning methods that allows a neural network to be trained without labels by being optimized to make predictions about the data. The inputs to the proposed AI models are Fitbit biosensor readings, and the outputs are predictions of methamphetamine use or craving. This paradigm is gaining increased attention in AI for health care. RESULTS To date, more than 40 individuals have expressed interest in participating in the study, and we have successfully recruited our first 5 participants with minimal logistical challenges and proper compliance. Several logistical challenges that the research team has encountered so far and the related implications are discussed. CONCLUSIONS We expect to develop models that significantly outperform traditional supervised methods by finetuning according to the data of a participant. Such methods will enable AI solutions that work with the limited data available from Native Hawaiian, Filipino, and Pacific Islander populations and that are inherently unbiased owing to their personalized nature. Such models can support future AI-powered digital therapeutics for substance abuse. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46493.
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Affiliation(s)
- Yinan Sun
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Ali Kargarandehkordi
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Christopher Slade
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Aditi Jaiswal
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Gerald Busch
- Department of Psychiatry, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Anthony Guerrero
- Department of Psychiatry, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Kristina T Phillips
- Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu, HI, United States
| | - Peter Washington
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
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Beckham JC, Calhoun PS, Chen Z, Dennis MF, Kirby AC, Treis ET, Hertzberg JS, Hair LP, Mann AJ, Budney AJ, Kimbrel NA. Development of Mobile Contingency Management for Cannabis Use Reduction. Behav Ther 2024; 55:1-13. [PMID: 38216224 PMCID: PMC10787157 DOI: 10.1016/j.beth.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 01/14/2024]
Abstract
Many interventions for cannabis use disorder (CUD) are associated with decreases in frequency and quantity of use but fail to increase overall rates of sustained abstinence. It is currently unknown whether reductions in use (in the absence of sustained abstinence) result in clinically significant improvements in functioning. The objective of this study was to refine a mobile contingency management approach to reduce cannabis use to ultimately evaluate whether reductions in frequency and quantity of cannabis are related to improvements in functional and mental health status. Three cohorts of participants (n = 18 total, n = 10 women) were enrolled and completed 2 weeks of ecological momentary assessment (EMA) during a baseline ad lib cannabis use period, followed by a 6-week reduction period. Participants completed EMA assessments multiple times per day and were prompted to provide videotaped saliva cannabis testing 2-3 times daily. Data from participants who were at least 80% adherent to all EMA prompts were analyzed (13 out of 18). During the ad lib phase, participants were using cannabis on 94% of the days and reported using a mean of 1.42 grams daily. The intervention was a mobile application that participants used to record cannabis use by saliva tests to bioverify abstinence and participants completed electronic diaries to report their grams used. During the 6-week intervention phase, participants reported reducing their use days to 47% of the days with a reported mean of .61 grams daily. In the last cohort, at least 50% of the heavy users were able to reduce their cannabis use by at least 50%. The effect of cannabis reduction (versus abstinence) is largely unknown. Observations suggest that it is possible to develop a mobile intervention to reduce cannabis use among heavy users, and this paradigm can be utilized in future work to evaluate whether reductions in cannabis use among heavy users will result in improvements in functional and mental health status.
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Affiliation(s)
- Jean C Beckham
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine.
| | - Patrick S Calhoun
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Center of Innovation to Accelerate Discovery and Practice Transformation; Duke University School of Medicine
| | | | - Michelle F Dennis
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine
| | - Angela C Kirby
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine
| | | | | | - Lauren P Hair
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine
| | | | | | - Nathan A Kimbrel
- Durham Veterans Affairs Health Care System; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Health Care System; Duke University School of Medicine
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Washington P. Personalized Machine Learning using Passive Sensing and Ecological Momentary Assessments for Meth Users in Hawaii: A Research Protocol. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.24.23294587. [PMID: 37662253 PMCID: PMC10473804 DOI: 10.1101/2023.08.24.23294587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Background Artificial intelligence (AI)-powered digital therapies which detect meth cravings delivered on consumer devices have the potential to reduce these disparities by providing remote and accessible care solutions to Native Hawaiians, Filipinos, and Pacific Islanders (NHFPI) communities with limited care solutions. However, NHFPI are fully understudied with respect to digital therapeutics and AI health sensing despite using technology at the same rates as other races. Objective We seek to fulfill two research aims: (1) Understand the feasibility of continuous remote digital monitoring and ecological momentary assessments (EMAs) in NHFPI in Hawaii by curating a novel dataset of longitudinal FitBit biosignals with corresponding craving and substance use labels. (2) Develop personalized AI models which predict meth craving events in real time using wearable sensor data. Methods We will develop personalized AI/ML (artificial intelligence/machine learning) models for meth use and craving prediction in 40 NHFPI individuals by curating a novel dataset of real-time FitBit biosensor readings and corresponding participant annotations (i.e., raw self-reported substance use data) of their meth use and cravings. In the process of collecting this dataset, we will glean insights about cultural and other human factors which can challenge the proper acquisition of precise annotations. With the resulting dataset, we will employ self-supervised learning (SSL) AI approaches, which are a new family of ML methods that allow a neural network to be trained without labels by being optimized to make predictions about the data itself. The inputs to the proposed AI models are FitBit biosensor readings and the outputs are predictions of meth use or craving. This paradigm is gaining increased attention in AI for healthcare. Conclusions We expect to develop models which significantly outperform traditional supervised methods by fine-tuning to an individual subject's data. Such methods will enable AI solutions which work with the limited data available from NHFPI populations and which are inherently unbiased due to their personalized nature. Such models can support future AI-powered digital therapeutics for substance abuse.
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Tonkin S, Gass J, Wray J, Maguin E, Mahoney M, Colder C, Tiffany S, Hawk LW. Evaluating Declines in Compliance With Ecological Momentary Assessment in Longitudinal Health Behavior Research: Analyses From a Clinical Trial. J Med Internet Res 2023; 25:e43826. [PMID: 37347538 PMCID: PMC10337346 DOI: 10.2196/43826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/15/2023] [Accepted: 04/20/2023] [Indexed: 06/23/2023] Open
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 This 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-using adults. METHODS A total of 257 daily cigarette-using adults participating in a randomized controlled trial for smoking cessation completed daily smartphone EMA assessments, including 1 scheduled morning assessment and 4 random assessments per day. Weekly EMA compliance was calculated and multilevel modeling assessed the rate of change in compliance over the 9-week assessment period. 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%) than for random assessments (58%) at the beginning of the EMA period (P<.001). EMA compliance declined linearly across weeks, and the rate of decline was greater for morning assessments (2% per week) than for random assessments (1% per week; P<.001). Declines in compliance were stronger for younger participants (P<.001), participants who were employed full-time (P=.03), and participants who subsequently dropped out of the study (P<.001). Overall compliance was higher among White participants compared to Black or African American participants (P=.001). CONCLUSIONS This study suggests that 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 subgroups of participants and investigate the extent to which rapid declines in EMA compliance might prove useful for triggering interventions to prevent study dropout. TRIAL REGISTRATION ClinicalTrials.gov NCT03262662; https://clinicaltrials.gov/ct2/show/NCT03262662.
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Affiliation(s)
- Sarah Tonkin
- Stephenson Cancer Center, Tobacco Settlement Endowment Trust Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Julie Gass
- Department of Veterans Affairs Center for Integrated Healthcare, VA Western NY Healthcare System at Buffalo, Buffalo, NY, United States
- Department of Psychology, The State University of New York: University at Buffalo, Buffalo, NY, United States
| | - Jennifer Wray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H Johnson VA Healthcare System, Charleston, SC, United States
| | - Eugene Maguin
- Department of Psychology, The State University of New York: University at Buffalo, Buffalo, NY, United States
| | - Martin Mahoney
- Departments of Internal Medicine and Health Behavior, Roswell Park Cancer Comprehensive Cancer Center, Buffalo, NY, United States
| | - Craig Colder
- Department of Psychology, The State University of New York: University at Buffalo, Buffalo, NY, United States
| | - Stephen Tiffany
- Department of Psychology, The State University of New York: University at Buffalo, Buffalo, NY, United States
| | - Larry W Hawk
- Department of Psychology, The State University of New York: University at Buffalo, Buffalo, NY, United States
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Sheck I, Tilchin C, Wagner J, Epstein DH, Burgess-Hull A, Jennings JM. Acceptability and Feasibility of Geographically Explicit Ecological Momentary Assessment Among Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2429-2436. [PMID: 34779979 PMCID: PMC9294007 DOI: 10.1007/s10508-021-02159-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Syphilis among men who have sex with men (MSM) has increased greatly in the past twenty years in the U.S. Geographically explicit ecological momentary assessment (GEMA), in which behaviors are geotagged and contextualized in time and space, may contribute to a greater understanding of transmission risk. The objective was to determine the acceptability and feasibility of GEMA for assessing HIV and syphilis transmission risk behaviors among a sample of MSM. Participants responded to a brief survey five times a day for two weeks. Feasibility was measured by participant recruitment, enrollment, prompts received and answered, geotagged prompts, and technical interference with data collection. Acceptability was measured by ratings of enjoyment and willingness for future participation. Summaries of five behavioral measures from the brief survey were calculated. Among the 83 participants contacted, 67.5% (56) expressed interest, 98% (55) were scheduled, and 81.8% (45) were enrolled. Participants answered 78.3% (2,277) of prompts received and 87.7% (1,998) of answered prompts were geotagged. Overall, 70.5% (31) enjoyed participating and 91.1% (41) were willing to participate in the future. Among prompts answered, missingness was low for five behavioral measures (range 0.2% (4) to 0.7% (16)). Feasibility and acceptability were high and missingness was low on behavioral measures in this MSM study population. Most participants reported that they would participate again. Future work should focus on whether GEMA improves our understanding of syphilis and HIV transmission risk.
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Affiliation(s)
- Isabelle Sheck
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, The Johns Hopkins University Bayview Medical Center, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4200, Baltimore, MD, 21224, USA
| | - Carla Tilchin
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, The Johns Hopkins University Bayview Medical Center, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4200, Baltimore, MD, 21224, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jessica Wagner
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, The Johns Hopkins University Bayview Medical Center, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4200, Baltimore, MD, 21224, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David H Epstein
- Intramural Research Program, National Institute on Drug Abuse, The Johns Hopkins University Bayview Medical Center, Baltimore, MD, USA
| | - Albert Burgess-Hull
- Intramural Research Program, National Institute on Drug Abuse, The Johns Hopkins University Bayview Medical Center, Baltimore, MD, USA
| | - Jacky M Jennings
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, The Johns Hopkins University Bayview Medical Center, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4200, Baltimore, MD, 21224, USA.
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Tang W, Gunn HJ, Kwok S, Comulada WS, Arnold EM, Swendeman D, Fernández MI. Response Patterns to Weekly Short Message Service Health Surveys Among Diverse Youth at High Risk for Acquiring HIV. AIDS Behav 2022; 26:2229-2241. [PMID: 35018546 DOI: 10.1007/s10461-021-03569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2021] [Indexed: 11/30/2022]
Abstract
HIV researchers use short messaging service (SMS)-based surveys to monitor health behaviors more closely than what would be possible with in-person assessment. Benefits are tempered by nonresponse to completing surveys. Understanding response patterns and their associated study participant characteristics would guide more tailored use of SMS-based surveys for HIV studies. We examined response to weekly 7-item SMS surveys administered as part of an HIV prevention trial. Using Mixture hidden Markov models (MHMM), we identified the underlying response patterns shared by subgroups of participants over time and quantified the association between these response patterns and participant characteristics. Three underlying response patterns were identified; responders, responders with phone-related errors, and non-responders. Non-responders versus responders were more likely to be younger, male, cis-gender, Black and Latinx participants with histories of homelessness, incarceration, and social support service utilization. Responders with phone-related errors compared to non-responders were more likely to be Black, Latinx, female, students, and have a history of incarceration and social support service utilization. More nuanced results from MHMM analyses better inform what strategies to use for increasing SMS response rates, including assisting in securing phone ownership/service for responders with phone-related errors and identifying alternative strategies for non-responders. Actively collecting and monitoring non-delivery notification data available from SMS gateway service companies offers another opportunity to identify and connect with participants when they are willing but unable to respond during follow-up.
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Affiliation(s)
- Wenze Tang
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Stephen Kwok
- UCLA Center for Community Health, Los Angeles, CA, USA
| | - W Scott Comulada
- UCLA Center for Community Health, 10920 Wilshire Blvd Suite 350, Los Angeles, CA, 90024, USA.
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Nelson LA, Spieker AJ, Kripalani S, Rothman RL, Roumie CL, Coco J, Fabbri D, Levy P, Collins SP, McNaughton CD. User preferences for and engagement with text messages to support antihypertensive medication adherence: Findings from a pilot study evaluating an emergency department-based behavioral intervention. PATIENT EDUCATION AND COUNSELING 2022; 105:1606-1613. [PMID: 34690012 PMCID: PMC9001748 DOI: 10.1016/j.pec.2021.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/22/2021] [Accepted: 10/08/2021] [Indexed: 05/07/2023]
Abstract
OBJECTIVE We examined users' preferences for and engagement with text messages delivered as part of an emergency department (ED)-based intervention to improve antihypertensive medication adherence. METHODS We recruited ED patients with elevated blood pressure for a pilot randomized trial evaluating a medication adherence intervention with text messages. Intervention participants chose text content and frequency, received texts for 45 days, and completed a feedback survey. We defined engagement via responses to texts. We examined participant characteristics associated with text preferences, engagement, and feedback. RESULTS Participants (N = 101) were 57% female and 46% non-White. Most participants (71%) chose to receive both reminder and informational texts; 94% chose reminder texts once per day and 97% chose informational texts three times per week. Median text message response rate was 56% (IQR 26-80%). Participants who were Black (p < 0.01), had lower income (p = 0.03), or had lower medication adherence (p < 0.01) rated the program as more helpful and wanted additional functionalities for adherence support. CONCLUSIONS AND PRACTICE IMPLICATIONS While overall engagement was modest, participants at risk of worse health outcomes expressed more value and interest in the program. Findings inform the design of text messaging interventions for antihypertensive medication adherence and support targeting vulnerable patients to reduce health disparities. CLINICAL TRIALS REGISTRATION NCT02672787.
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Affiliation(s)
- Lyndsay A Nelson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, USA.
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, USA
| | - Sunil Kripalani
- Department of Medicine, Vanderbilt University Medical Center, Nashville, USA; Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, USA
| | - Russell L Rothman
- Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, USA
| | - Christianne L Roumie
- Department of Medicine, Vanderbilt University Medical Center, Nashville, USA; Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, USA; Geriatric Research Education Clinical Center, Tennessee Valley Healthcare System VA Medical Center, Nashville, USA
| | - Joseph Coco
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, USA
| | - Daniel Fabbri
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, USA
| | - Phillip Levy
- Department of Emergency Medicine, Wayne State University, Detroit, USA
| | - Sean P Collins
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA; Geriatric Research Education Clinical Center, Tennessee Valley Healthcare System VA Medical Center, Nashville, USA
| | - Candace D McNaughton
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA; Geriatric Research Education Clinical Center, Tennessee Valley Healthcare System VA Medical Center, Nashville, USA
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Markowski KL, Smith JA, Gauthier GR, Harcey SR. Patterns of Missing Data With Ecological Momentary Assessment Among People Who Use Drugs: Feasibility Study Using Pilot Study Data. JMIR Form Res 2021; 5:e31421. [PMID: 34464327 PMCID: PMC8501406 DOI: 10.2196/31421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/15/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ecological momentary assessment (EMA) is a set of research methods that capture events, feelings, and behaviors as they unfold in their real-world setting. Capturing data in the moment reduces important sources of measurement error but also generates challenges for noncompliance (ie, missing data). To date, EMA research has only examined the overall rates of noncompliance. OBJECTIVE In this study, we identify four types of noncompliance among people who use drugs and aim to examine the factors associated with the most common types. METHODS Data were obtained from a recent pilot study of 28 Nebraskan people who use drugs who answered EMA questions for 2 weeks. We examined questions that were not answered because they were skipped, they expired, the phone was switched off, or the phone died after receiving them. RESULTS We found that the phone being switched off and questions expiring comprised 93.34% (1739/1863 missing question-instances) of our missing data. Generalized structural equation model results show that participant-level factors, including age (relative risk ratio [RRR]=0.93; P=.005), gender (RRR=0.08; P=.006), homelessness (RRR=3.80; P=.04), personal device ownership (RRR=0.14; P=.008), and network size (RRR=0.57; P=.001), are important for predicting off missingness, whereas only question-level factors, including time of day (ie, morning compared with afternoon, RRR=0.55; P<.001) and day of week (ie, Tuesday-Saturday compared with Sunday, RRR=0.70, P=.02; RRR=0.64, P=.005; RRR=0.58, P=.001; RRR=0.55, P<.001; and RRR=0.66, P=.008, respectively) are important for predicting expired missingness. The week of study is important for both (ie, week 2 compared with week 1, RRR=1.21, P=.03, for off missingness and RRR=1.98, P<.001, for expired missingness). CONCLUSIONS We suggest a three-pronged strategy to preempt missing EMA data with high-risk populations: first, provide additional resources for participants likely to experience phone charging problems (eg, people experiencing homelessness); second, ask questions when participants are not likely to experience competing demands (eg, morning); and third, incentivize continued compliance as the study progresses. Attending to these issues can help researchers ensure maximal data quality.
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Affiliation(s)
- Kelly L Markowski
- Rural Drug Addiction Research Center, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Jeffrey A Smith
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - G Robin Gauthier
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Sela R Harcey
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States
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10
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Clark V, Kim SJ. Ecological Momentary Assessment and mHealth Interventions Among Men Who Have Sex With Men: Scoping Review. J Med Internet Res 2021; 23:e27751. [PMID: 34342585 PMCID: PMC8371491 DOI: 10.2196/27751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/07/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ecological momentary assessment (EMA) is a research design that allows for the measurement of nearly instantaneous experiences within the participant's natural environment. Using EMA can help improve recall bias, ecological validity, and patient engagement while enhancing personalization and the ubiquity of interventions. People that can benefit from the use of EMA are men who have sex with men (MSM). Previous EMA studies have been successful in capturing patterns of depression, anxiety, substance use, and risky sexual behavior. These findings are directly relevant to MSM, who have high rates of each of these psychological and behavioral outcomes. Although there is a driving force behind the growing literature surrounding EMAs among MSM, no synthesizing reviews yet exist. OBJECTIVE The aims of this study were to (1) synthesize the literature across fields on how EMA methods have been used among MSM, (2) better understand the feasibility and acceptability of EMA interventions among MSM, and (3) inform designs for future research studies on best evidence-based practices for EMA interventions. METHODS Based on 4 library databases, we conducted a scoping review of EMAs used within interventions among MSM. The eligibility criteria included peer-reviewed studies conducted in the United States and the use of EMA methodology in an intervention for MSM. Modeling after the Centers for Disease Control and Prevention's Compendium of Evidence-Based Interventions as the framework, we applied a typology that used 8 distinct review criteria, for example, sample size, design of the intervention, random assignment, design of the follow-up investigation, rate of retention, and rate of engagement. RESULTS Our results (k=15, N=952) indicated a range of sample sizes; the smallest sample size was 12, while the largest sample size was 120. Of the 15 studies, 7 (47%) focused on outcomes related to substance use or outcomes related to psychological experiences. Of the 15 studies, 5 (33%) implemented an EMA intervention across 30 days. Of the 15 studies, 2 studies (13%) used random assignment, and 2 studies (13%) had quasi-experimental designs. Of the 15 studies, 10 studies (67%) reported acceptable retention rates greater than 70%. The outcomes that had event-contingent prompts (ie, prompts after engaging in substance use) were not as effective in engaging participants, with overall engagement rates as low as 37%. CONCLUSIONS Our systematic scoping review indicates strong evidence that the EMA methodology is both feasible and acceptable at high rates among MSM, especially, when examining psychological and behavioral outcomes such as negative or positive affect, risky sexual behavior, or substance use. Further research on optimal designs of EMA interventions for MSM is warranted.
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Affiliation(s)
- Viktor Clark
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Sunny Jung Kim
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
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11
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Turner CM, Trujillo D, Le V, Wilson EC, Arayasirikul S. Event-Level Association Between Daily Alcohol Use and Same-Day Nonadherence to Antiretroviral Therapy Among Young Men Who Have Sex With Men and Trans Women Living With HIV: Intensive Longitudinal Study. JMIR Mhealth Uhealth 2020; 8:e22733. [PMID: 33055070 PMCID: PMC7596651 DOI: 10.2196/22733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Young trans women (TW) and men who have sex with men (MSM) are disproportionately impacted by HIV. Optimizing adherence to antiretroviral therapy (ART) is one mechanism by which public health experts aim to achieve favorable HIV health outcomes while reducing disease transmission. However, alcohol use is prevalent among young TW and MSM and threatens optimal adherence. In addition, the daily variations in alcohol use and ART adherence and their association with each other are poorly understood, warranting more appropriate methodological approaches, such as analysis of ecological momentary assessment (EMA) data. OBJECTIVE The aim of this analysis is to characterize the association between daily alcohol use and same-day ART nonadherence captured by an EMA study of young MSM and TW living with HIV in San Francisco. METHODS Young MSM and TW enrolled in the Health eNav digital HIV care navigation intervention were included in the analytic sample (N=113). Data on alcohol and ART use were collected by daily EMA surveys administered via text messaging and were analyzed over 30 days of follow-up. A multivariable mixed-effects logistic regression model adjusting for baseline sociodemographic characteristics was specified to investigate whether daily alcohol use was associated with same-day ART nonuse. RESULTS Daily alcohol use was associated with higher same-day ART nonuse. On average, participants drank alcohol on 15.20 (SD 8.93) days and used ART on 15.19 (SD 10.16) days out of 30 days. Daily alcohol use was associated with 1.89 (95% CI 1.14-3.15) times the adjusted odds of same-day ART nonuse for each participant. CONCLUSIONS Results are consistent with other analyses of daily alcohol and ART use and underscore the importance of individually targeted interventions that are sensitive to each participant's dynamic risk environment. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/16406.
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Affiliation(s)
- Caitlin Marie Turner
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,Doctoral Program in Epidemiology & Translational Science, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States
| | - Dillon Trujillo
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Victory Le
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,California School of Professional Psychology, Alliant International University, San Francisco, CA, United States
| | - Erin C Wilson
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States
| | - Sean Arayasirikul
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,Department of Pediatrics, School of Medicine, University of California, San Francisco, CA, United States
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12
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Hsiang E, Offer C, Prescott M, Rodriguez A, Behar E, Matheson T, Santa Maria D, Santos GM. Bridging the Digital Divide Among Racial and Ethnic Minority Men Who Have Sex With Men to Reduce Substance Use and HIV Risk: Mixed Methods Feasibility Study. JMIR Mhealth Uhealth 2020; 8:e15282. [PMID: 32347807 PMCID: PMC7221651 DOI: 10.2196/15282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 01/25/2020] [Accepted: 02/04/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ecological momentary assessment (EMA) is a promising data collection tool for mobile health interventions targeting episodic health behaviors. For substance-using men who have sex with men (SUMSM), EMA is becoming more widely utilized in efforts to characterize substance use and sexual risk factors for HIV transmission. However, recent literature demonstrates emerging concerns over compliance and lower EMA engagement and data concordance among racial and ethnic minority SUMSM. OBJECTIVE This study aimed to provide a qualitative evaluation of the barriers and facilitators of EMA as a data collection tool among racial and ethnic minority SUMSM. METHODS Between October and November 2017, 45 racial and ethnic minority SUMSM were recruited from a list of prior research participants at the San Francisco Department of Public Health to participate in daily EMA surveys on their substance use and sexual health behaviors for 1 week, followed by in-person focus groups (FGs). A total of 4 FGs explored the participants' experiences with the surveys, issues regarding privacy and confidentiality, and suggestions for improvement. Qualitative analysis was performed using content analysis. Descriptive statistics and Fisher exact tests were used to assess the associations between demographics or substance use behaviors and EMA completion. RESULTS Overall, 93.9% (295/314) of all delivered surveys were initiated, and of those, 98.0% (289/295) were completed. Neither participant demographics, including race (P=.65) or age (P=.43), nor substance use behaviors, including the frequency of alcohol (P=.40) or methamphetamine (P=.91) use or any cocaine (P=.28), crack (P=.99), or polysubstance use (P=.24), were found to be associated with survey completion. Overall, participants were receptive to the text message-based EMA surveys. Facilitators included survey timing, user-friendly survey design, survey-stimulated self-reflection, coding of sensitive phrases, and other privacy benefits of a mobile survey. Barriers included an inability to correct texting errors and participants' perception of judgment or stigmatization related to questions about condomless sex. To improve EMA compliance and uptake, participants suggested adding response confirmations, clarifying survey language, and continuing to diversify the study audience. CONCLUSIONS EMA appears to be feasible and acceptable among this sample of racial and ethnic minority SUMSM. Close attention to EMA study design and the development of nonjudgmental, contextualized questions regarding stigmatized health behaviors may be critical to further improve EMA compliance.
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Affiliation(s)
- Elaine Hsiang
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Claudine Offer
- Substance Use Research Unit, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Maximo Prescott
- Substance Use Research Unit, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Amy Rodriguez
- Substance Use Research Unit, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Emily Behar
- Substance Use Research Unit, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Tim Matheson
- Substance Use Research Unit, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Diane Santa Maria
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Glenn-Milo Santos
- Substance Use Research Unit, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, United States
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13
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Shimoni N, Nippita S, Castaño PM. Best practices for collecting repeated measures data using text messages. BMC Med Res Methodol 2020; 20:2. [PMID: 31900108 PMCID: PMC6942258 DOI: 10.1186/s12874-019-0891-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 12/23/2019] [Indexed: 12/15/2022] Open
Abstract
Background Researchers and clinicians use text messages to collect data with the advantage of real time capture when compared with standard data collection methods. This article reviews project setup and management for successfully collecting patient-reported data through text messages. Methods We review our experience enrolling over 2600 participants in six clinical trials that used text messages to relay information or collect data. We also reviewed the literature on text messages used for repeated data collection. We classify recommendations according to common themes: the text message, the data submitted and the phone used. Results We present lessons learned and discuss how to create text message content, select a data collection platform with practical features, manage the data thoughtfully and consistently, and work with patients, participants and their phones to protect privacy. Researchers and clinicians should design text messages to include short, simple prompts and answer choices. They should decide whether and when to send reminders if participants do not respond and set parameters regarding when and how often to contact patients for missing data. Data collection platforms send, receive, and store messages. They can validate responses and send error messages. Researchers should develop a protocol to append and correct data in order to improve consistency with data handling. At the time of enrollment, researchers should ensure that participants can receive and respond to messages. Researchers should address privacy concerns and plan for service interruptions by obtaining alternate participant contact information and providing participants with a backup data collection method. Conclusions Careful planning and execution can reward clinicians and investigators with complete, timely and accurate data sets.
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Affiliation(s)
- Noa'a Shimoni
- Department of Family Medicine, Rutgers New Jersey Medical School, 183 South Orange Avenue, E1562, Newark, NJ, 07103, USA.
| | - Siripanth Nippita
- Department of Obstetrics and Gynecology, New York University-Langone Medical Center, New York, USA
| | - Paula M Castaño
- Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, USA
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14
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Turner CM, Arayasirikul S, Trujillo D, Lê V, Wilson EC. Social Inequity and Structural Barriers to Completion of Ecological Momentary Assessments for Young Men Who Have Sex With Men and Trans Women Living With HIV in San Francisco. JMIR Mhealth Uhealth 2019; 7:e13241. [PMID: 31066714 PMCID: PMC6530262 DOI: 10.2196/13241] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/25/2019] [Accepted: 03/29/2019] [Indexed: 01/15/2023] Open
Abstract
Background Ecological momentary assessments (EMAs) administered via text messaging facilitate real-time data collection. With widespread cell phone access, EMAs are becoming more available to even the most disenfranchised communities, such as those living with HIV. However, structural barriers disproportionately burden young men who have sex with men (MSM) and trans women (TW) living with HIV and threaten participation in HIV research. Objective We aim to identify structural barriers to completing EMA text surveys nested within a digital HIV care intervention for young MSM and TW living with HIV in San Francisco. Methods A total of 10,800 EMA text messages were delivered daily over 90 days to 120 participants enrolled in the Health eNav intervention (2017-2018) at the San Francisco Department of Public Health. EMA surveys inquired about participants’ daily affect, sexual behaviors, substance use, and treatment adherence. Survey completion was calculated after 30, 60, and 90 days of follow-up. We described characteristics of nonstarters (those who provided less than four complete responses to the first seven EMA surveys) and analyzed structural correlates of days to first weeklong or more EMA survey noncompletion using multivariable Cox proportional hazards regression. Qualitative interviews were used to evaluate the acceptability of EMA surveys. Results Participants completed 4384 of 10,800 (40.59%) EMA surveys. Completion of 70% or more of EMA surveys was attained by 56 of 120 participants (46.7%) at 30 days of follow-up, 40/120 (33.3%) at 60 days of follow-up, and 30/120 (25.0%) by the end of the 90-day study period. Twenty-eight participants (23.3%) were identified as nonstarters, and were more likely to be recently incarcerated (prevalence ratio [PR] 2.3, 95% CI 1.3-4.4), forego basic needs for HIV medications (PR 2.4, 95% CI 1.3-4.5), and be diagnosed with HIV in the last year (PR 2.2, 95% CI 1.1-4.1). Adjusting for nonstarters, young MSM and TW living in temporary/transitional housing (adjusted hazard ratio [aHR] 1.8, 95% CI 1.1-3.0), foregoing HIV medications to afford basic needs (aHR 1.7, 95% CI 1.1-2.7), and having less than a college education (aHR 3.5, 95% CI 1.4-9.0) had greater hazard of weeklong or more EMA survey noncompletion. Overall, there was high acceptability of the EMA surveys. Conclusions Although access to and use of technology is increasingly ubiquitous, this analysis demonstrates persisting gaps in EMA completion by socioeconomic factors such as incarceration, education level, housing, and competing needs for young MSM and TW living with HIV in San Francisco. Moreover, those recently diagnosed with HIV were more likely to experience an immediate drop-off in completing EMA surveys. EMAs are feasible for individuals not experiencing social inequity and structural barriers. HIV prevention technologies addressing these barriers and leveraging similar methodology may prove effective for young MSM and TW living with HIV.
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Affiliation(s)
- Caitlin M Turner
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Sean Arayasirikul
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Dillon Trujillo
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Victory Lê
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Erin C Wilson
- San Francisco Department of Public Health, San Francisco, CA, United States
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15
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Jones A, Remmerswaal D, Verveer I, Robinson E, Franken IHA, Wen CKF, Field M. Compliance with ecological momentary assessment protocols in substance users: a meta-analysis. Addiction 2019; 114:609-619. [PMID: 30461120 PMCID: PMC6492133 DOI: 10.1111/add.14503] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/30/2018] [Accepted: 11/02/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS While there are considerable benefits to Ecological Momentary Assessment (EMA), poor compliance with assessment protocols has been identified as a limitation, particularly in substance users. Our aim was to identify the pooled compliance rate of EMA studies in substance users and examine variables that may influence compliance with EMA protocols, such as the length and frequency of assessments. DESIGN A meta-analysis and meta-regression of all possible studies (randomized controlled trials and longitudinal) which incorporated EMA protocols, examining substance use. SETTING Studies took place from 1998 to 2017, in numerous countries world-wide. PARTICIPANTS One hundred and twenty-six studies were identified, contributing a total of 19 431 participants (52.32% male, mean age = 28.86). MEASUREMENTS Compliance data, the proportion of responses to the study protocol, were extracted from each study alongside prompt frequency, total length of assessment period, substance use population and device used to administer EMA prompts. FINDINGS The pooled compliance rate across all studies was 75.06% [95% confidence interval (CI) = 72.37%, 77.65%]. There was no evidence that compliance rates were significantly associated with prompt frequency [Q(3) = 7.35, P = 0.061], length of assessment period [Q(2) = 2.40, P = 0.301], substance type [Q(3) = 6.30, P = 0.098] or device administration [Q(4) = 4.28, P = 0.369]. However, dependent samples (69.80%) had lower compliance rates than non-dependent samples [76.02%; Q(1) = 4.13, P = 0.042]. CONCLUSIONS The pooled compliance rate for Ecological Momentary Assessment studies in substance-using populations from 1998 to 2017 was lower than the recommended rate of 80%, and was not associated with frequency or duration of assessments.
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Affiliation(s)
- Andrew Jones
- Psychological SciencesUniversity of LiverpoolUK,UK Centre for Tobacco and Alcohol Studies (UKCTAS), LiverpoolUK
| | - Danielle Remmerswaal
- Department of Psychology, Education and Child StudiesErasmus UniversityRotterdamthe Netherlands
| | - Ilse Verveer
- Department of Psychology, Education and Child StudiesErasmus UniversityRotterdamthe Netherlands
| | - Eric Robinson
- Psychological SciencesUniversity of LiverpoolUK,UK Centre for Tobacco and Alcohol Studies (UKCTAS), LiverpoolUK
| | - Ingmar H. A. Franken
- Department of Psychology, Education and Child StudiesErasmus UniversityRotterdamthe Netherlands
| | - Cheng K. Fred Wen
- Center for Self‐Report ScienceUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Matt Field
- Psychological SciencesUniversity of LiverpoolUK,UK Centre for Tobacco and Alcohol Studies (UKCTAS), LiverpoolUK
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16
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Duncan DT, Kapadia F, Kirchner TR, Goedel WC, Brady WJ, Halkitis PN. Acceptability of Ecological Momentary Assessment Among Young Men Who Have Sex with Men. JOURNAL OF LGBT YOUTH 2017; 14:436-444. [PMID: 29988981 PMCID: PMC6034697 DOI: 10.1080/19361653.2017.1365038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The study evaluated the acceptability of text message- and voice-based ecological momentary assessment (EMA) methods among a sample (n=74) of young men who have sex with men (MSM). We assessed the acceptability of text message- and voice-based EMA methods. Almost all participants (96%) reported that they would be willing to accept texts on their smartphone to answer questions about their current mood, surroundings, or feelings. A large majority (89%) also reported being willing to accept phone calls to answer these questions. This work suggests that different EMA methods are acceptable for use among young MSM.
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Affiliation(s)
- Dustin T. Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY
| | - Farzana Kapadia
- College of Global Public Health, New York University, New York, NY
- Population Center, College of Arts and Science, New York University, New York, NY
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY
- Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, New York, NY
| | - Thomas R. Kirchner
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, New York, NY
| | - William C. Goedel
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
| | - William J. Brady
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY
- Department of Psychology, Graduate School of Arts and Science, New York University, New York, NY
| | - Perry N. Halkitis
- College of Global Public Health, New York University, New York, NY
- Population Center, College of Arts and Science, New York University, New York, NY
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY
- Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, New York, NY
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