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Verbeke J, Matthys C. Experience Sampling as a dietary assessment method: a scoping review towards implementation. Int J Behav Nutr Phys Act 2024; 21:94. [PMID: 39192362 DOI: 10.1186/s12966-024-01643-1] [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: 02/23/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Accurate and feasible assessment of dietary intake remains challenging for research and healthcare. Experience Sampling Methodology (ESM) is a real-time real-life data capturing method with low burden and good feasibility not yet fully explored as alternative dietary assessment method. METHODS This scoping review is the first to explore the implementation of ESM as an alternative to traditional dietary assessment methods by mapping the methodological considerations to apply ESM and formulating recommendations to develop an Experience Sampling-based Dietary Assessment Method (ESDAM). The scoping review methodology framework was followed by searching PubMed (including OVID) and Web of Science from 2012 until 2024. RESULTS Screening of 646 articles resulted in 39 included articles describing 24 studies. ESM was mostly applied for qualitative dietary assessment (i.e. type of consumed foods) (n = 12), next to semi-quantitative dietary assessment (i.e. frequency of consumption, no portion size) (n = 7), and quantitative dietary assessment (i.e. type and portion size of consumed foods) (n = 5). Most studies used ESM to assess the intake of selected foods. Two studies applied ESM as an alternative to traditional dietary assessment methods assessing total dietary intake quantitatively (i.e. all food groups). ESM duration ranged from 4 to 30 days and most studies applied ESM for 7 days (n = 15). Sampling schedules were mostly semi-random (n = 12) or fixed (n = 9) with prompts starting at 8-10 AM and ending at 8-12 PM. ESM questionnaires were adapted from existing questionnaires, based on food consumption data or focus group discussions, and respond options were mostly presented as multiple-choice. Recall period to report dietary intake in ESM prompts varied from 15 min to 3.5 h. CONCLUSIONS Most studies used ESM for 7 days with fixed or semi-random sampling during waking hours and 2-h recall periods. An ESDAM can be developed starting from a food record approach (actual intake) or a validated food frequency questionnaire (long-term or habitual intake). Actual dietary intake can be measured by ESM through short intensive fixed sampling schedules while habitual dietary intake measurement by ESM allows for longer less frequent semi-random sampling schedules. ESM sampling protocols should be developed carefully to optimize feasibility and accuracy of dietary data.
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Affiliation(s)
- Joke Verbeke
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Christophe Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
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Whitton C, Wong YHM, Lau J, Chua XH, Müller AM, Tan CS, van Dam RM, Müller-Riemenschneider F, Rebello SA. Ecological momentary assessment of digital food and beverage marketing exposure and impact in young adults: A feasibility study. Appetite 2024; 197:107338. [PMID: 38579981 DOI: 10.1016/j.appet.2024.107338] [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: 01/11/2024] [Revised: 03/13/2024] [Accepted: 04/02/2024] [Indexed: 04/07/2024]
Abstract
Unhealthy food marketing is contributing to the obesity epidemic, but real-time insights into the mechanisms of this relationship are under-studied. Digital marketing is growing and following food and beverage (F&B) brands on social media is common, but measurement of exposure and impact of such marketing presents novel challenges. Thus, this study aimed to evaluate the feasibility of collecting data on exposure and impact of digital F&B marketing (DFM) using a smartphone-based ecological momentary assessment (EMA) methodology. We hypothesized that DFM-induced food cravings would vary based on whether (or not) participants engaged with F&B brands online. Participants were Singapore residents (n = 95, 21-40 years), recruited via telephone from an existing cohort. Participants were asked to upload screenshots of all sightings of online F&B marketing messages for seven days, and answer in-app contextual questions about sightings including whether any cravings were induced. Participants provided a total of 1310 uploads (median 9 per participant, Q1-Q3: 4-21) of F&B marketing messages, 27% of which were provided on Day 1, significantly more than on other days (P < 0.001). Followers of food/beverage brands on social media encountered 25.6 percentage points (95% CI 11.4, 39.7) more marketing messages that induced cravings than participants who were not followers. University education was also associated with more (18.1 percentage points; 95% CI 3.1, 33.1) encounters with marketing messages that induced cravings. It was practical and acceptable to participants to gather insights into digital F&B marketing exposure and impact using EMA in young adults, although a shorter study period is recommended in future studies. Followers of food and beverage brands on social media appear to be more prone to experience cravings after exposure to digital F&B marketing.
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Affiliation(s)
- Clare Whitton
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Yvonne Hui Min Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jerrald Lau
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xin Hui Chua
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore; Department of Nutrition and Exercise Sciences and Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore; Digital Health Center, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
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Altweck L, Schmidt S, Tomczyk S. Daily Time-Use Patterns and Quality of Life in Parents: Protocol for a Pilot Quasi-Experimental, Nonrandomized Controlled Trial Using Ecological Momentary Assessment. JMIR Res Protoc 2024; 13:e54728. [PMID: 38820576 PMCID: PMC11179039 DOI: 10.2196/54728] [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: 11/20/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The gender gap in time use and its impact on health and well-being are still prevalent. Women work longer hours than men when considering both paid and unpaid (eg, childcare and chores) work, and this gender disparity is particularly visible among parents. Less is known about factors that could potentially mediate or moderate this relationship (eg, work-family conflict and gender role beliefs). Ecological momentary assessment (EMA) allows for the documentation of changes in momentary internal states, such as time use, stress, or mood. It has shown particular validity to measure shorter-term activities (eg, unpaid work) and is thus useful to address gender differences. OBJECTIVE The feasibility of the daily EMA surveys in a parent sample will be examined. The associations between time use, well-being, and stress will be examined, along with potential moderating and mediating factors such as gender, gender role beliefs, and work-family conflict. Finally, the act of monitoring one's own time use, well-being, and stress will be examined in relation to, for example, the quality of life. METHODS We conducted a quasi-experimental, nonrandomized controlled trial with 3 data collection methods, namely, online questionnaires, EMA surveys, and qualitative interviews. The intervention group (n=64) will participate in the online questionnaires and EMA surveys, and a subsample of the intervention group (n=6-17) will also be invited to participate in qualitative interviews. Over a period of 1 week, participants in the intervention group will answer daily EMA surveys (4 times per day). In contrast, the control group (n=17) will only participate in the online questionnaires at baseline and after 1 week. The following constructs were surveyed: sociodemographic background (eg, age, gender, and household composition; baseline questionnaire); mediators and moderators (eg, gender role beliefs and work-family conflict; baseline and follow-up questionnaires); well-being, quality of life, and trait mindfulness (baseline and follow-up questionnaires); momentary activity and well-being, as well as state mindfulness (EMA); and feasibility (baseline and follow-up questionnaires as well as interviews). We anticipate that participants will regard the daily EMA as feasible. Particular daily time-use patterns (eg, high paid and unpaid workload) are expected to be related to lower well-being, higher stress, and health-related quality of life. These associations are expected to be moderated and mediated by factors such as gender, gender role beliefs, work-family conflict, and social support. Participants in the intervention group are expected to show higher values of mindfulness, well-being, health-related quality of life, and lower stress. RESULTS Patient recruitment started in November 2023 and ended in mid April 2024. Data analysis commenced in mid April 2024. CONCLUSIONS This study aims to provide valuable insights into the feasibility of using EMAs and the potential benefits of activity tracking in various aspects of daily life. TRIAL REGISTRATION Open Science Framework 8qj3d; https://osf.io/8qj3d. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54728.
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Affiliation(s)
- Laura Altweck
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Silke Schmidt
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Samuel Tomczyk
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
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Sundquist K, Schwartz JE, Burg MM, Davidson KW, Diaz KM. Use of a Single-Item Ecological Momentary Assessment to Measure Daily Exercise: Agreement with Accelerometer-Measured Exercise. SENSORS (BASEL, SWITZERLAND) 2024; 24:946. [PMID: 38339663 PMCID: PMC10857316 DOI: 10.3390/s24030946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/11/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
Accelerometers have been used to objectively quantify physical activity, but they can pose a high burden. This study was conducted to determine the feasibility of using a single-item smartphone-based ecological momentary assessment (EMA) in lieu of accelerometers in long-term assessment of daily exercise. Data were collected from a randomized controlled trial of intermittently exercising, otherwise healthy adults (N = 79; 57% female, mean age: 31.9 ± 9.5 years) over 365 days. Smartphone-based EMA self-reports of exercise entailed daily end-of-day responses about physical activity; the participants also wore a Fitbit device to measure physical activity. The Kappa statistic was used to quantify the agreement between accelerometer-determined (24 min of moderate-to-vigorous physical activity [MVPA] within 30 min) and self-reported exercise. Possible demographic predictors of agreement were assessed. Participants provided an average of 164 ± 87 days of complete data. The average within-person Kappa was κ = 0.30 ± 0.22 (range: -0.15-0.73). Mean Kappa ranged from 0.16 to 0.30 when the accelerometer-based definition of an exercise bout varied in duration from 15 to 30 min of MVPA within any 30 min period. Among the correlates examined, sex was significantly associated with agreement; mean agreement was higher among women (κ = 0.37) than men (κ = 0.20). Agreement between EMA self-reported and accelerometer-measured exercise was fair, suggesting that long-term exercise monitoring through a single-item EMA may be acceptable.
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Affiliation(s)
| | - Joseph E. Schwartz
- Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, NY 11794, USA;
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY 10032, USA
| | - Matthew M. Burg
- Department of Medicine, Yale University School of Medicine, New Haven, CT 06520, USA;
| | - Karina W. Davidson
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY 11030, USA;
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549, USA
| | - Keith M. Diaz
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY 10032, USA
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Jia SS, Allman-Farinelli M, Roy R, Phongsavan P, Hyun K, Gibson AA, Partridge SR. Using Mobile Ecological Momentary Assessment to Understand Consumption and Context Around Online Food Delivery Use: Pilot Feasibility and Acceptability Study. JMIR Mhealth Uhealth 2023; 11:e49135. [PMID: 38019563 PMCID: PMC10719819 DOI: 10.2196/49135] [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: 05/22/2023] [Revised: 10/18/2023] [Accepted: 11/05/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Mobile ecological momentary assessment (EMA) is a powerful tool for collecting real-time and contextual data from individuals. As our reliance on online technologies to increase convenience accelerates, the way we access food is changing. Online food delivery (OFD) services may further encourage unhealthy food consumption habits, given the high availability of energy-dense, nutrient-poor foods. We used EMA to understand the real-time effects of OFD on individuals' food choices and consumption behaviors. OBJECTIVE The primary aims of this pilot study were to assess the feasibility and acceptability of using EMA in young users of OFD and compare 2 different EMA sampling methods. The secondary aims were to gather data on OFD events and their context and examine any correlations between demographics, lifestyle chronic disease risk factors, and OFD use. METHODS This study used EMA methods via a mobile app (mEMASense, ilumivu Inc). Existing users of OFD services aged 16 to 35 years in Australia who had access to a smartphone were recruited. Participants were randomly assigned to 1 of 2 groups: signal-contingent or event-contingent. The signal-contingent group was monitored over 3 days between 7 AM and 10 PM. They received 5 prompts each day to complete EMA surveys via the smartphone app. In contrast, the event-contingent group was monitored over 7 days and was asked to self-report any instance of OFD. RESULTS A total of 102 participants were analyzed, with 53 participants in the signal-contingent group and 49 participants in the event-contingent group. Compliance rates, indicating the feasibility of signal-contingent and event-contingent protocols, were similar at 72.5% (574/792) and 73.2% (251/343), respectively. Feedback from the participants suggested that the EMA app was not easy to use, which affected their acceptability of the study. Participants in the event-contingent group were 3.53 (95% CI 1.52-8.17) times more likely to have had an OFD event captured during the study. Pizza (23/124, 18.5%) and fried chicken (18/124, 14.5%) comprised a bulk of the 124 OFD orders captured. Most orders were placed at home (98/124, 79%) for 1 person (68/124, 54.8%). Age (incidence rate ratio 0.95, 95% CI 0.91-0.99; P=.03) and dependents (incidence rate ratio 2.01, 95% CI 1.16-3.49; P=.01) were significantly associated with the number of OFD events in a week after adjusting for gender, socioeconomic status, diet quality score, and perceived stress levels. CONCLUSIONS This pilot study showed that EMA using an event-contingent sampling approach may be a better method to capture OFD events and context than signal-contingent sampling. The compliance rates showed that both sampling methods were feasible and acceptable. Although the findings from this study have gathered some insight on the consumption and context of OFD in young people, further studies are required to develop targeted interventions.
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Affiliation(s)
- Si Si Jia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Margaret Allman-Farinelli
- Nutrition and Dietetics, Sydney School of Nursing, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Rajshri Roy
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Karice Hyun
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Concord Hospital, ANZAC Research Institute, The University of Sydney, Sydney, Australia
| | - Alice Anne Gibson
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Stephanie Ruth Partridge
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Dominguez Garcia A, Mullan B, Dorina I. Predicting discretionary food consumption using temporal self-regulation theory and food reward sensitivity. Appetite 2023; 190:107010. [PMID: 37619621 DOI: 10.1016/j.appet.2023.107010] [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: 03/09/2023] [Revised: 07/17/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Discretionary foods account for over a third of the average adult's total daily energy intake. But its excess consumption is a risk factor for obesity, Type 2 diabetes, and other diet-related diseases. This study aimed to use temporal self-regulation theory (intention, past behaviour, habit, self-regulatory capacity) and food reward sensitivity to identify predictors of discretionary food consumption. Two hundred and seventy-three participants aged between 18 and 80 (M = 42.55, SD = 17.07) comprising of mostly females (79.5%) and those residing in Australia (93.4%), completed a two-part online survey, one week apart. Participants completed measures of intention, past behaviour, habit, self-regulatory capacity, food reward sensitivity and demographic information at time one, and discretionary food consumption at time two. Data was analysed using a hierarchical multiple regression analysis. All variables in combination accounted for a significant 40.3% of the variance in discretionary food consumption (R2 = 0.40, p < .001). However, past behaviour and intention were the only unique significant predictors of discretionary food consumption. No significant moderation effects found. Findings offer insight into the motivators of discretionary food consumption, which can inform the development of effective interventions to reduce discretionary food consumption. Past behaviour should be considered, and intention targeted in interventions to reduce discretionary food consumption.
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Affiliation(s)
- Alejandro Dominguez Garcia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Behavioural Science and Health Research Group, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Barbara Mullan
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Behavioural Science and Health Research Group, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Western Australia Cancer Prevention Unit, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Indita Dorina
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Behavioural Science and Health Research Group, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Western Australia Cancer Prevention Unit, EnAble Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Neuser MP, Kühnel A, Kräutlein F, Teckentrup V, Svaldi J, Kroemer NB. Reliability of gamified reinforcement learning in densely sampled longitudinal assessments. PLOS DIGITAL HEALTH 2023; 2:e0000330. [PMID: 37672521 PMCID: PMC10482292 DOI: 10.1371/journal.pdig.0000330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 07/17/2023] [Indexed: 09/08/2023]
Abstract
Reinforcement learning is a core facet of motivation and alterations have been associated with various mental disorders. To build better models of individual learning, repeated measurement of value-based decision-making is crucial. However, the focus on lab-based assessment of reward learning has limited the number of measurements and the test-retest reliability of many decision-related parameters is therefore unknown. In this paper, we present an open-source cross-platform application Influenca that provides a novel reward learning task complemented by ecological momentary assessment (EMA) of current mental and physiological states for repeated assessment over weeks. In this task, players have to identify the most effective medication by integrating reward values with changing probabilities to win (according to random Gaussian walks). Participants can complete up to 31 runs with 150 trials each. To encourage replay, in-game screens provide feedback on the progress. Using an initial validation sample of 384 players (9729 runs), we found that reinforcement learning parameters such as the learning rate and reward sensitivity show poor to fair intra-class correlations (ICC: 0.22-0.53), indicating substantial within- and between-subject variance. Notably, items assessing the psychological state showed comparable ICCs as reinforcement learning parameters. To conclude, our innovative and openly customizable app framework provides a gamified task that optimizes repeated assessments of reward learning to better quantify intra- and inter-individual differences in value-based decision-making over time.
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Affiliation(s)
- Monja P. Neuser
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Anne Kühnel
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
- Department of Translational Psychiatry, Max Planck Institute of Psychiatry and International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Section of Medical Psychology, Department of Psychiatry & Psychotherapy, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Franziska Kräutlein
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Vanessa Teckentrup
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
- School of Psychology & Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Jennifer Svaldi
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
- School of Psychology & Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- German Center for Mental Health, Tübingen, Germany
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Lin TT, Park C, Kapella MC, Martyn-Nemeth P, Tussing-Humphreys L, Rospenda KM, Zenk SN. Shift Work Domains and their Interactions with Empty Calorie Food/Beverage Consumption: A 14-day Intensive Longitudinal Study. Int J Nurs Stud 2023; 141:104490. [PMID: 37004340 DOI: 10.1016/j.ijnurstu.2023.104490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND/OBJECTIVES Shift work has been linked to unhealthy eating behaviors such as imbalanced diet, or increased empty calorie food/beverage consumption. However, most research has focused on the impact of shift timing. The concept of shift work is complex, and it contains several domains such as shift timing, intensity, and speed. Previous studies have suggested that greater shift intensity and quicker shift speed may contribute to adverse health effects. However, evidence regarding associations between other domains of shift work and empty calorie food/beverage consumption has been relatively lacking. Therefore, the purpose of this study was to evaluate how other shift work domains related to empty calorie food/beverage consumption and whether different shift work domains interacted to influence the intake of foods or beverages. DESIGN A 14-day intensive longitudinal study employing ecological momentary assessment. SETTINGS AND PARTICIPANTS Eighty registered nurses working in 24 accredited Taiwanese hospitals (i.e., 9 medical centers, 12 regional hospitals, and 3 district hospitals) were recruited. METHODS During the study period, a convenience sample of 77 participants completed 2444 momentary surveys about empty calorie food/beverage consumption on a smartphone. Three shift work domains (shift timing, intensity, and speed) were evaluated based on registry-based work schedules. To study how these shift work domains influenced empty calorie food/beverage consumption, we employed three-level mixed-effects regression models for data analyses. RESULTS Findings suggested that greater night shift intensity increased the likelihood of sugar-sweetened beverage intake (odds ratio = 1.64, 95% confidence interval [1.01, 2.68]). The impacts of work shift intensity and shift timing on sugar-sweetened beverage consumption varied by shift speed. Among participants assigned a schedule with either medium or rapid shift speed, higher work shift intensity was associated with a higher probability of sugar-sweetened beverage consumption. Compared to day shifts, those who were assigned a quicker shift speed on evening shifts were more likely to consume sugar-sweetened beverages. However, associations between night shift intensity and sugar-sweetened beverage intake did not change by shift speed. Furthermore, shift intensity and shift timing did not interact to affect empty calorie food/beverage consumption. CONCLUSIONS This study demonstrated assignments of shift schedules (i.e., high night shift intensity, more changes in shift timings) might influence workers' consumption of empty calorie foods/beverages. Therefore, identifying and mitigating hazardous shift schedules may help to improve shift workers' eating behaviors and benefit their overall health.
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Chen S, Liu H, Lou VWQ. Monitoring daily well-being and meaning-making tendencies among adult child working dementia caregivers: validating an experience sampling study protocol. BMC Geriatr 2022; 22:714. [PMID: 36038849 PMCID: PMC9421635 DOI: 10.1186/s12877-022-03372-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the experience sampling method offers advantages for gerontological research, it has seldom been applied to examine well-being and meaning-making tendencies among adult children working caregivers of parents with dementia and thus lacks empirical support for such applications. In response, we aimed to validate the proposed protocol's participation status, feasibility, usability, and ecological validity. METHODS For 15 consecutive days, 100 adult child working dementia caregivers participated in our study via web-based assessments on their digital devices. The protocol was first adjusted based on a series of pilot interviews with eight volunteer dementia caregivers. Participants' compliance and preferred times for activities along with the protocol's feasibility, usability, and ecological validity were evaluated in a follow-up session with all participants. RESULTS The protocol was adjusted in light of recruitment details, user interfaces, the reminder mechanism, and reference time for assessments. The general compliance rate was 93.3%. Preference times for assessments of work (10 a.m. to 3 p.m.), care (6-8 p.m.), and personal activities (7-10 p.m.) were identified. The protocol was generally considered to be feasible and easy to use, and ecological validity analysis indicated that the collected data adequately represented real-world data. CONCLUSIONS Our study provides empirical evidence to support an innovative protocol and evaluate its implementation so that future studies using it can better investigate the relationship between meaning-making tendencies and well-being among adult child working caregivers for parents with dementia.
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Affiliation(s)
- Shuangzhou Chen
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Huiying Liu
- Department of Sociology, Central South University, Changsha, China
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China. .,Sau Po Centre on Ageing, University of Hong Kong, Hong Kong, China.
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Zhang D, Su T, Lyu B, Yang Y, Zhuo X. The effects of adolescent physical activity participation on cell phone dependence: The mediating role of self-control. Work 2022; 72:1289-1298. [DOI: 10.3233/wor-210702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The rapid development of science and technology and the swift improvement of people’s material living standards enabled smartphones to be indispensable of people’s daily lives. OBJECTIVE: The purpose of this paper was to examine the influence of self-control in adolescents’ participation in physical activity on cell phone dependence. METHODS: The Physical Activity Rating Scale (PARS-3), the Self-Control Scale, and the Cell Phone Dependence Scale were used to measure the influence of self-control in adolescents’ participation in physical activity on cell phone dependence among 649 adolescents. RESULTS: The results show: (1) There were significant differences (p < 0.01) in the physical activity levels of adolescents under different gender, birthplace, and education background. (2) Each dimensional variable of physical activity was negatively correlated with the cell phone dependence variable, and positively correlated with each variable of self-control, and the self-control variables were negatively correlated with cell phone dependence. (3) Self-control was partially mediating the effects of physical activity on cell phone dependence, with the mediating effect accounting for 39.68%. CONCLUSIONS: Adolescents’ participation in physical exercise activities will improve self-control and ultimately reduce cell phone dependence. Curbing the negative and malignant events of cell phone addiction among adolescents, timely investigation of mobile phone and Internet addiction, pathological formation mechanisms and intervention measures are important measures to reshape the healthy lifestyle of adolescents and have great practical significance for the prosperity and development of families, society, nation and country.
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Affiliation(s)
- Defa Zhang
- Department of Physical Education, Suzhou University, Suzhou, China
- Chinese Graduate School, Panyapiwat Institute of Management, Nonthaburi, Thailand
| | - Tong Su
- Adam Smith Business School and the Glasgow School of Art, University of Glasgow, Glasgow, UK
| | - Bei Lyu
- School of Economics and Management, Huaibei Normal University, Huaibei, China
- Business School, Henan University, Kaifeng, China
- Leeds University Business School, University of Leeds, Leeds, UK
- Chinese Graduate School, Panyapiwat Institute of Management, Nonthaburi, Thailand
| | - Yanchao Yang
- Faculty of Education, University of Macau, Macau, China
- Qinggong College, North China University of Science and Technology, Tangshan, China
| | - Xiangzhi Zhuo
- School of Economics and Management, Huaibei Normal University, Huaibei, China
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11
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Battaglia B, Lee L, Jia SS, Partridge SR, Allman-Farinelli M. The Use of Mobile-Based Ecological Momentary Assessment (mEMA) Methodology to Assess Dietary Intake, Food Consumption Behaviours and Context in Young People: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10071329. [PMID: 35885855 PMCID: PMC9321045 DOI: 10.3390/healthcare10071329] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
Mobile-based ecological momentary assessment (mEMA) offers a novel method for dietary assessment and may reduce recall bias and participant burden. This review evaluated mEMA methodology and the feasibility, acceptability and validity as a dietary assessment method in young people. Five databases were searched from January 2008 to September 2021 for studies including healthy young people aged 16–30 years and used mEMA for obtaining dietary intake data, food consumption behaviours and/or contextual factors. Data on the method used to administer mEMA, compliance with recording and validation were extracted. A total of 46 articles from 39 independent studies were included, demonstrating a wide variation in mEMA methods. Signal-contingent prompting (timed notification to record throughout the day) was used in 26 studies, 9 used event-contingent (food consumption triggered recordings), while 4 used both. Monitoring periods varied and most studies reported a compliance rate of 80% or more. Two studies found mEMA to be burdensome and six reported mEMA as easy to use. Most studies (31/39) reported using previously validated questions. mEMA appears to be a feasible and acceptable methodology to assess dietary intake and food consumption in near real time.
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Affiliation(s)
- Brigitte Battaglia
- Charles Perkins Centre, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia; (B.B.); (L.L.); (M.A.-F.)
| | - Lydia Lee
- Charles Perkins Centre, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia; (B.B.); (L.L.); (M.A.-F.)
| | - Si Si Jia
- Engagement and Co-Design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Correspondence:
| | - Stephanie Ruth Partridge
- Engagement and Co-Design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia; (B.B.); (L.L.); (M.A.-F.)
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12
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Feasibility and Pilot Testing of Mobile Health Apps to Supplement 2 Healthy Lifestyle Interventions in Chronic Traumatic Brain Injury. J Head Trauma Rehabil 2022; 37:162-170. [PMID: 35293364 DOI: 10.1097/htr.0000000000000769] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the feasibility of mobile health (mHealth) apps for enhancing participation of people with chronic traumatic brain injury (TBI) in the Group Lifestyle Balance (GLB-TBI) weight loss intervention and Brain Health Group (BHG-TBI) active control intervention. SETTING Community. PARTICIPANTS n = 56 overweight/obese adults with moderate-severe TBI. DESIGN The GLB-TBI is a 12-month group- and community-based program to promote healthy eating and physical activity. The BHG-TBI is a 12-month group- and community-based program to promote general brain health, designed as an active control condition matched on time, structure, and perceived benefit to the GLB-TBI. In a randomized controlled trial testing the efficacy of the GLB-TBI for weight loss, participants used a group-specific mHealth app providing daily tips customized according to their intervention allocation. MAIN MEASURES Compliance (percentage of daily prompts read and completed) and participant-reported satisfaction and usability. RESULTS In conjunction with relevant stakeholders, we developed the content and structure of the GLB-TBI and BHG-TBI apps based on core curriculum components. We incorporated cognitive strategies (app notifications) to address potential cognitive impairment common after TBI. Both apps delivered brief daily educational and motivational "tips" derived directly from their respective curricula. Daily use of the apps varied greatly across participants, with most participants who used the apps completing 10% to 50% of daily content. Participants found the apps to be easy to use, but only some found them helpful. App use was substantially different for those who participated in the intervention during (2020) versus before (2019) the COVID-19 pandemic. CONCLUSIONS Although enhancing an intensive lifestyle intervention with mHealth technology may be helpful, further refinement is needed to optimize the frequency and delivery methods of mHealth content. Although one might expect remote app use to have been higher during the pandemic, we observed the opposite, potentially due to less hands-on training and ongoing support to use the app and/or general technology fatigue with social distancing.
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13
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Lucassen DA, Brouwer-Brolsma EM, Slotegraaf AI, Kok E, Feskens EJM. DIetary ASSessment (DIASS) Study: Design of an Evaluation Study to Assess Validity, Usability and Perceived Burden of an Innovative Dietary Assessment Methodology. Nutrients 2022; 14:1156. [PMID: 35334813 PMCID: PMC8949267 DOI: 10.3390/nu14061156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 11/26/2022] Open
Abstract
During recent years, the integration of technology has substantially improved self-reported dietary assessment methods, such as food frequency questionnaires (FFQ), food records, and 24-h recalls. To further reduce measurement error, additional innovations are urgently needed. Memory-related measurement error is one of the aspects that warrants attention, which is where new smartphone technologies and ecological momentary assessment (EMA) approaches provide a unique opportunity. In this article, we describe the DIASS study, which was designed to evaluate an innovative 2-h recall (2hR) smartphone-based methodology, against traditional 24-h recalls, FFQ, and biomarkers, to assess both actual and habitual dietary intake. It is hypothesized that a 2-h reporting window decreases reliance on memory and reporting burden, and increases data accuracy. We included 215 men (28%) and women (72%), with a mean ± SD age of 39 ± 19 years and a mean ± SD BMI of 23.8 ± 4.0. Most participants were highly educated (58%). Response rates for the various dietary assessment methods were >90%. Besides the evaluation of the accuracy, usability, and perceived burden of the 2hR methodology, the study set-up also allows for (further) evaluation of the other administrated dietary assessment tools.
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Affiliation(s)
- Desiree A. Lucassen
- Department of Agrotechnology and Food Sciences, Division of Human Nutrition and Health, Wageningen University and Research, 6700 AA Wageningen, The Netherlands; (E.M.B.-B.); (A.I.S.); (E.K.); (E.J.M.F.)
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14
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Barchitta M, Maugeri A, Favara G, Magnano San Lio R, Riela PM, Guarnera L, Battiato S, Agodi A. Development of a Web-App for the Ecological Momentary Assessment of Dietary Habits among College Students: The HEALTHY-UNICT Project. Nutrients 2022; 14:nu14020330. [PMID: 35057511 PMCID: PMC8779738 DOI: 10.3390/nu14020330] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 01/03/2023] Open
Abstract
The transition from adolescence to adulthood is a critical period for the development of healthy behaviors. Yet, it is often characterized by unhealthy food choices. Considering the current pandemic scenario, it is also essential to assess the effects of coronavirus disease-19 (COVID-19) on lifestyles and diet, especially among young people. However, the assessment of dietary habits and their determinants is a complex issue that requires innovative approaches and tools, such as those based on the ecological momentary assessment (EMA). Here, we describe the first phases of the “HEALTHY-UNICT” project, which aimed to develop and validate a web-app for the EMA of dietary data among students from the University of Catania, Italy. The pilot study included 138 students (mean age 24 years, SD = 4.2; 75.4% women), who used the web-app for a week before filling out a food frequency questionnaire with validation purposes. Dietary data obtained through the two tools showed moderate correlations, with the lowest value for butter and margarine and the highest for pizza (Spearman’s correlation coefficients of 0.202 and 0.699, respectively). According to the cross-classification analysis, the percentage of students classified into the same quartile ranged from 36.9% for vegetable oil to 58.1% for pizza. In line with these findings, the weighted-kappa values ranged from 0.15 for vegetable oil to 0.67 for pizza, and most food categories showed values above 0.4. This web-app showed good usability among students, assessed through a 19-item usability scale. Moreover, the web-app also had the potential to evaluate the effect of the COVID-19 pandemic on students’ behaviors and emotions, showing a moderate impact on sedentary activities, level of stress, and depression. These findings, although interesting, might be confirmed by the next phases of the HEALTHY-UNICT project, which aims to characterize lifestyles, dietary habits, and their relationship with anthropometric measures and emotions in a larger sample of students.
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Affiliation(s)
- Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
- Correspondence:
| | - Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
| | - Giuliana Favara
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
| | - Roberta Magnano San Lio
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
| | - Paolo Marco Riela
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy; (P.M.R.); (L.G.); (S.B.)
| | - Luca Guarnera
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy; (P.M.R.); (L.G.); (S.B.)
| | - Sebastiano Battiato
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy; (P.M.R.); (L.G.); (S.B.)
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
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15
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Newton AS, March S, Gehring ND, Rowe AK, Radomski AD. Establishing a Working Definition of User Experience for eHealth Interventions of Self-reported User Experience Measures With eHealth Researchers and Adolescents: Scoping Review. J Med Internet Res 2021; 23:e25012. [PMID: 34860671 PMCID: PMC8686463 DOI: 10.2196/25012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/27/2021] [Accepted: 09/23/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Across eHealth intervention studies involving children, adolescents, and their parents, researchers have measured user experience to assist with intervention development, refinement, and evaluation. To date, no widely accepted definitions or measures of user experience exist to support a standardized approach for evaluation and comparison within or across interventions. OBJECTIVE We conduct a scoping review with subsequent Delphi consultation to identify how user experience is defined and measured in eHealth research studies, characterize the measurement tools used, and establish working definitions for domains of user experience that could be used in future eHealth evaluations. METHODS We systematically searched electronic databases for published and gray literature available from January 1, 2005, to April 11, 2019. We included studies assessing an eHealth intervention that targeted any health condition and was designed for use by children, adolescents, and their parents. eHealth interventions needed to be web-, computer-, or mobile-based, mediated by the internet with some degree of interactivity. We required studies to report the measurement of user experience as first-person experiences, involving cognitive and behavioral factors reported by intervention users. We appraised the quality of user experience measures in included studies using published criteria: well-established, approaching well-established, promising, or not yet established. We conducted a descriptive analysis of how user experience was defined and measured in each study. Review findings subsequently informed the survey questions used in the Delphi consultations with eHealth researchers and adolescent users for how user experience should be defined and measured. RESULTS Of the 8634 articles screened for eligibility, 129 articles and 1 erratum were included in the review. A total of 30 eHealth researchers and 27 adolescents participated in the Delphi consultations. On the basis of the literature and consultations, we proposed working definitions for 6 main user experience domains: acceptability, satisfaction, credibility, usability, user-reported adherence, and perceived impact. Although most studies incorporated a study-specific measure, we identified 10 well-established measures to quantify 5 of the 6 domains of user experience (all except for self-reported adherence). Our adolescent and researcher participants ranked perceived impact as one of the most important domains of user experience and usability as one of the least important domains. Rankings between adolescents and researchers diverged for other domains. CONCLUSIONS Findings highlight the various ways in which user experience has been defined and measured across studies and what aspects are most valued by researchers and adolescent users. We propose incorporating the working definitions and available measures of user experience to support consistent evaluation and reporting of outcomes across studies. Future studies can refine the definitions and measurement of user experience, explore how user experience relates to other eHealth outcomes, and inform the design and use of human-centered eHealth interventions.
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Affiliation(s)
- Amanda S Newton
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Sonja March
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Nicole D Gehring
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Arlen K Rowe
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Ashley D Radomski
- Knowledge Institute for Child and Youth Mental Health and Addictions, Ottawa, ON, Canada.,CHEO (Children's Hospital of Eastern Ontario) Research Institute, Ottawa, ON, Canada
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16
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Woolf TB, Goheer A, Holzhauer K, Martinez J, Coughlin JW, Martin L, Zhao D, Song S, Ahmad Y, Sokolinskyi K, Remayeva T, Clark JM, Bennett W, Lehmann H. Development of a Mobile App for Ecological Momentary Assessment of Circadian Data: Design Considerations and Usability Testing. JMIR Form Res 2021; 5:e26297. [PMID: 34296999 PMCID: PMC8367152 DOI: 10.2196/26297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/12/2021] [Accepted: 04/04/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Collecting data on daily habits across a population of individuals is challenging. Mobile-based circadian ecological momentary assessment (cEMA) is a powerful frame for observing the impact of daily living on long-term health. OBJECTIVE In this paper, we (1) describe the design, testing, and rationale for specifications of a mobile-based cEMA app to collect timing of eating and sleeping data and (2) compare cEMA and survey data collected as part of a 6-month observational cohort study. The ultimate goal of this paper is to summarize our experience and lessons learned with the Daily24 mobile app and to highlight the pros and cons of this data collection modality. METHODS Design specifications for the Daily24 app were drafted by the study team based on the research questions and target audience for the cohort study. The associated backend was optimized to provide real-time data to the study team for participant monitoring and engagement. An external 8-member advisory board was consulted throughout the development process, and additional test users recruited as part of a qualitative study provided feedback through in-depth interviews. RESULTS After ≥4 days of at-home use, 37 qualitative study participants provided feedback on the app. The app generally received positive feedback from test users for being fast and easy to use. Test users identified several bugs and areas where modifications were necessary to in-app text and instructions and also provided feedback on the engagement strategy. Data collected through the mobile app captured more variability in eating windows than data collected through a one-time survey, though at a significant cost. CONCLUSIONS Researchers should consider the potential uses of a mobile app beyond the initial data collection when deciding whether the time and monetary expenditure are advisable for their situation and goals.
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Affiliation(s)
- Thomas B Woolf
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Attia Goheer
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Katherine Holzhauer
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jonathan Martinez
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Janelle W Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lindsay Martin
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Di Zhao
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Shanshan Song
- Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yanif Ahmad
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, United States
| | | | | | - Jeanne M Clark
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Wendy Bennett
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Harold Lehmann
- Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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17
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Ruf A, Koch ED, Ebner-Priemer U, Knopf M, Reif A, Matura S. Studying Microtemporal, Within-Person Processes of Diet, Physical Activity, and Related Factors Using the APPetite-Mobile-App: Feasibility, Usability, and Validation Study. J Med Internet Res 2021; 23:e25850. [PMID: 34342268 PMCID: PMC8406112 DOI: 10.2196/25850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/12/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Background Diet and physical activity (PA) have a major impact on physical and mental health. However, there is a lack of effective strategies for sustaining these health-protective behaviors. A shift to a microtemporal, within-person approach is needed to capture dynamic processes underlying eating behavior and PA, as they change rapidly across minutes or hours and differ among individuals. However, a tool that captures these microtemporal, within-person processes in daily life is currently not present. Objective The APPetite-mobile-app is developed for the ecological momentary assessment of microtemporal, within-person processes of complex dietary intake, objectively recorded PA, and related factors. This study aims to evaluate the feasibility and usability of the APPetite-mobile-app and the validity of the incorporated APPetite-food record. Methods The APPetite-mobile-app captures dietary intake event-contingently through a food record, captures PA continuously through accelerometers, and captures related factors (eg, stress) signal-contingently through 8 prompts per day. Empirical data on feasibility (n=157), usability (n=84), and validity (n=44) were collected within the Eat2beNICE-APPetite-study. Feasibility and usability were examined in healthy participants and psychiatric patients. The relative validity of the APPetite-food record was assessed with a subgroup of healthy participants by using a counterbalanced crossover design. The reference method was a 24-hour recall. In addition, the energy intake was compared with the total energy expenditure estimated from accelerometry. Results Good feasibility, with compliance rates above 80% for prompts and the accelerometer, as well as reasonable average response and recording durations (prompt: 2.04 min; food record per day: 17.66 min) and latencies (prompts: 3.16 min; food record: 58.35 min) were found. Usability was rated as moderate, with a score of 61.9 of 100 on the System Usability Scale. The evaluation of validity identified large differences in energy and macronutrient intake between the two methods at the group and individual levels. The APPetite-food record captured higher dietary intakes, indicating a lower level of underreporting, compared with the 24-hour recall. Energy intake was assessed fairly accurately by the APPetite-food record at the group level on 2 of 3 days when compared with total energy expenditure. The comparison with mean total energy expenditure (2417.8 kcal, SD 410) showed that the 24-hour recall (1909.2 kcal, SD 478.8) underestimated habitual energy intake to a larger degree than the APPetite-food record (2146.4 kcal, SD 574.5). Conclusions The APPetite-mobile-app is a promising tool for capturing microtemporal, within-person processes of diet, PA, and related factors in real time or near real time and is, to the best of our knowledge, the first of its kind. First evidence supports the good feasibility and moderate usability of the APPetite-mobile-app and the validity of the APPetite-food record. Future findings in this context will build the foundation for the development of personalized lifestyle modification interventions, such as just-in-time adaptive interventions.
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Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Elena Doris Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Monika Knopf
- Department of Developmental Psychology, Goethe University, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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18
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Characterizing Breakthrough Cancer Pain Using Ecological Momentary Assessment with a Smartphone App: Feasibility and Clinical Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115991. [PMID: 34204871 PMCID: PMC8199778 DOI: 10.3390/ijerph18115991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND mobile applications (apps) facilitate cancer pain ecological momentary assessment (EMA) and provide more reliable data than retrospective monitoring. The aims of this study are (a) to describe the status of persons with cancer pain when assessed ecologically, (b) to analyze the utility of clinical alarms integrated into the app, and (c) to test the feasibility of implementing an app for daily oncological pain monitoring. METHODS in this feasibility study, 21 patients (mean age = 56.95 years, SD = 10.53, 81.0% men) responded to an app-based evaluation of physical status (baseline and breakthrough cancer pain (BTcP)) and mental health variables (fatigue, mood, and coping) daily during 30 days. RESULTS cancer pain characterization with the app was similar to data from the literature using retrospective assessments in terms of BTcP duration and perceived medication effectiveness. However, BTcP was less frequent when evaluated ecologically. Pain, fatigue, and mood were comparable in the morning and evening. Passive coping strategies were the most employed daily. Clinical alarms appear to be useful to detect and address adverse events. App implementation was feasible and acceptable. CONCLUSION apps reduce recall bias and facilitate a rapid response to adverse events in oncological care. Future efforts should be addressed to integrate EMA and ecological momentary interventions to facilitate pain self-management via apps.
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19
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Spencer-Bonilla G, Serrano V, Gao C, Sanchez M, Carroll K, Gionfriddo MR, Behnken EM, Hargraves I, Boehmer K, May C, Montori VM. Patient Work and Treatment Burden in Type 2 Diabetes: A Mixed-Methods Study. Mayo Clin Proc Innov Qual Outcomes 2021; 5:359-367. [PMID: 33997635 PMCID: PMC8105508 DOI: 10.1016/j.mayocpiqo.2021.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective To use quantitative and qualitative methods to characterize the work patients with type 2 diabetes mellitus (T2DM) enact and explore the interactions between illness, treatment, and life. Patients and Methods In this mixed-methods, descriptive study, adult patients with T2DM seen at the outpatient diabetes clinic at Mayo Clinic in Rochester, Minnesota, from February 1, 2016, through March 31, 2017, were invited to participate. The study had 3 phases. In phase 1, the Patient Experience with Treatment and Self-management (PETS) scale was used to quantify treatment burden. In phase 2, a convenience sample of patients used a smartphone application to describe, in real time, time spent completing diabetes self-management tasks and to upload descriptive digital photographs. In phase 3, these data were explored in qualitative interviews that were analyed by 2 investigators using deductive analysis. Results Of 162 participants recruited, 160 returned the survey (phase 1); of the 50 participants who used the smartphone application (phase 2), we interviewed 17 (phase 3). The areas in which patients reported highest treatment burden were difficulty with negotiating health services (eg, coordinating medical appointments), medical expenses, and mental/physical exhaustion with self-care. Participants reported that medical appointments required about 2.5 hours per day, and completing administrative tasks related to health care required about 45 minutes. Time spent on health behaviors varied widely—from 2 to 60 minutes in a given 3-hour period. Patients’ experience of a task’s burden did not always correlate with the time spent on that task. Conclusion The most burdensome tasks to patients with T2DM included negotiating health care services, affording medications, and completing administrative tasks even though they were not the most time-consuming activities. To be minimally disruptive, diabetes care should minimize the delegation of administrative tasks to patients.
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Affiliation(s)
| | - Valentina Serrano
- Department of Nutrition, Diabetes and Metabolism, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catherine Gao
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN.,Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN
| | - Manuel Sanchez
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Katherine Carroll
- School of Sociology, College of Arts and Social Sciences, Australian National University, Canberra, Australia
| | | | - Emma M Behnken
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Ian Hargraves
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Kasey Boehmer
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Carl May
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Victor M Montori
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN
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20
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Hensher M, Cooper P, Dona SWA, Angeles MR, Nguyen D, Heynsbergh N, Chatterton ML, Peeters A. Scoping review: Development and assessment of evaluation frameworks of mobile health apps for recommendations to consumers. J Am Med Inform Assoc 2021; 28:1318-1329. [PMID: 33787894 PMCID: PMC8263081 DOI: 10.1093/jamia/ocab041] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/12/2021] [Accepted: 03/03/2021] [Indexed: 02/06/2023] Open
Abstract
Objective The study sought to review the different assessment items that have been used within existing health app evaluation frameworks aimed at individual, clinician, or organizational users, and to analyze the scoring and evaluation methods used in these frameworks. Materials and Methods We searched multiple bibliographic databases and conducted backward searches of reference lists, using search terms that were synonyms of “health apps,” “evaluation,” and “frameworks.” The review covered publications from 2011 to April 2020. Studies on health app evaluation frameworks and studies that elaborated on the scaling and scoring mechanisms applied in such frameworks were included. Results Ten common domains were identified across general health app evaluation frameworks. A list of 430 assessment criteria was compiled across 97 identified studies. The most frequently used scaling mechanism was a 5-point Likert scale. Most studies have adopted summary statistics to generate the total scoring of each app, and the most popular approach taken was the calculation of mean or average scores. Other frameworks did not use any scaling or scoring mechanism and adopted criteria-based, pictorial, or descriptive approaches, or “threshold” filter. Discussion There is wide variance in the approaches to evaluating health apps within published frameworks, and this variance leads to ongoing uncertainty in how to evaluate health apps. Conclusions A new evaluation framework is needed that can integrate the full range of evaluative criteria within one structure, and provide summative guidance on health app rating, to support individual app users, clinicians, and health organizations in choosing or recommending the best health app.
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Affiliation(s)
- Martin Hensher
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Paul Cooper
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Sithara Wanni Arachchige Dona
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Mary Rose Angeles
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Dieu Nguyen
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Natalie Heynsbergh
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Mary Lou Chatterton
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Anna Peeters
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Williams MT, Lewthwaite H, Fraysse F, Gajewska A, Ignatavicius J, Ferrar K. Compliance With Mobile Ecological Momentary Assessment of Self-Reported Health-Related Behaviors and Psychological Constructs in Adults: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e17023. [PMID: 33656451 PMCID: PMC7970161 DOI: 10.2196/17023] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/01/2020] [Accepted: 10/31/2020] [Indexed: 01/08/2023] Open
Abstract
Background Mobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. Objective This study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical samples of adults. Methods In total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults (>18 years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance (P≤.05) assessed differences between nonclinical and clinical data sets. Results Of the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets; secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%); median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I2>90%), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. Conclusions In this 10-year sample of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
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Affiliation(s)
- Marie T Williams
- Innovation, Implementation And Clinical Translation in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Hayley Lewthwaite
- Innovation, Implementation And Clinical Translation in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montreal, QC, Canada
| | - François Fraysse
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Alexandra Gajewska
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Jordan Ignatavicius
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Katia Ferrar
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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22
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Fischer F, Kleen S. Possibilities, Problems, and Perspectives of Data Collection by Mobile Apps in Longitudinal Epidemiological Studies: Scoping Review. J Med Internet Res 2021; 23:e17691. [PMID: 33480850 PMCID: PMC7864774 DOI: 10.2196/17691] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 11/06/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background The broad availability of smartphones and the number of health apps in app stores have risen in recent years. Health apps have benefits for individuals (eg, the ability to monitor one’s health) as well as for researchers (eg, the ability to collect data in population-based, clinical, and observational studies). Although the number of health apps on the global app market is huge and the associated potential seems to be great, app-based questionnaires for collecting patient-related data have not played an important role in epidemiological studies so far. Objective This study aims to provide an overview of studies that have collected patient data using an app-based approach, with a particular focus on longitudinal studies. This literature review describes the current extent to which smartphones have been used for collecting (patient) data for research purposes, and the potential benefits and challenges associated with this approach. Methods We conducted a scoping review of studies that used data collection via apps. PubMed was used to identify studies describing the use of smartphone app questionnaires for collecting data over time. Overall, 17 articles were included in the summary. Results Based on the results of this scoping review, there are only a few studies that integrate smartphone apps into data-collection approaches. Studies dealing with the collection of health-related data via smartphone apps have mainly been developed with regard to psychosomatic, neurodegenerative, respiratory, and cardiovascular diseases, as well as malign neoplasm. Among the identified studies, the duration of data collection ranged from 4 weeks to 12 months, and the participants’ mean ages ranged from 7 to 69 years.
Potential can be seen for real-time information transfer, fast data synchronization (which saves time and increases effectivity), and the possibility of tracking responses longitudinally. Furthermore, smartphone-based data-collection techniques might prevent biases, such as reminder bias or mistakes occurring during manual data transfers. In chronic diseases, real-time communication with physicians and early detection of symptoms enables rapid modifications in disease management. Conclusions The results indicate that using mobile technologies can help to overcome challenges linked with data collection in epidemiological research. However, further feasibility studies need to be conducted in the near future to test the applicability and acceptance of these mobile apps for epidemiological research in various subpopulations.
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Affiliation(s)
- Florian Fischer
- Institut of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany.,Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Sina Kleen
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
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23
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Eisele G, Vachon H, Lafit G, Kuppens P, Houben M, Myin-Germeys I, Viechtbauer W. The Effects of Sampling Frequency and Questionnaire Length on Perceived Burden, Compliance, and Careless Responding in Experience Sampling Data in a Student Population. Assessment 2020; 29:136-151. [DOI: 10.1177/1073191120957102] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Currently, little is known about the association between assessment intensity, burden, data quantity, and data quality in experience sampling method (ESM) studies. Researchers therefore have insufficient information to make informed decisions about the design of their ESM study. Our aim was to investigate the effects of different sampling frequencies and questionnaire lengths on burden, compliance, and careless responding. Students ( n = 163) received either a 30- or 60-item questionnaire three, six, or nine times per day for 14 days. Preregistered multilevel regression analyses and analyses of variance were used to analyze the effect of design condition on momentary outcomes, changes in those outcomes over time, and retrospective outcomes. Our findings offer support for increased burden and compromised data quantity and quality with longer questionnaires, but not with increased sampling frequency. We therefore advise against the use of long ESM questionnaires, while high-sampling frequencies do not seem to be associated with negative consequences.
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Affiliation(s)
| | | | | | | | | | | | - Wolfgang Viechtbauer
- KU Leuven, Leuven, Belgium
- Maastricht University, Maastricht, Limburg, Netherlands
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24
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Promotion of Healthy Lifestyles to Teenagers with Mobile Devices: A Case Study in Portugal. Healthcare (Basel) 2020; 8:healthcare8030315. [PMID: 32887251 PMCID: PMC7551168 DOI: 10.3390/healthcare8030315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
Educating teenagers about nutrition and promoting active lifestyles is essential in reducing the long-term health risks and one idea to achieve this is by using mobile applications. Previous studies showed that the existing mobile applications have similar functionalities, such as intervention with questionnaires, and the use of gamification techniques to improve interactiveness. However, unlike our study, some studies are not validated and verified by healthcare professionals. Additionally, this study intends to promote the interaction between the teenagers and the medical communities. In this study, we analyze the benefits of the proposed mobile application, which features monitoring of physical activity, daily tips and curiosities, questionnaires, and gamification through earning points. Most of the teenagers were satisfied with the physical activity monitoring and found the tips, curiosities, and weekly questionnaires useful. The study started with 26 teenagers from two schools in the center of Portugal that would use the mobile application for five weeks. Still, at the end of the study, only 7 teenagers finalized the study. The decreasing number of teenagers in the study was affected by the lack of social interaction caused by the pandemic situation. During the period, the mobile application would engage the users with notifications on nutrition and physical activity, challenges concerning the number of steps and calories they would have to spend, and questionnaires related to the curiosities and suggestions from the previous week. We used Fisher’s test to investigate the relationship between the assessment obtained in the responses to the questionnaires, and the adoption of healthier eating and sports practices. In summary, participants were satisfied with the mobile application and experienced some improvements in diet and habits.
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25
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Concordance of children's intake of selected food groups as reported by parents via 24-h dietary recall and ecological momentary assessment. Public Health Nutr 2020; 24:22-33. [PMID: 32576304 DOI: 10.1017/s1368980020001111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To understand how dietary intake data collected via a brief ecological momentary assessment (EMA) measure compares to that of data collected via interviewer-administered 24-h dietary recalls, and explore differences in level of concordance between these two assessment types by individual- and meal-level characteristics. DESIGN Parents completed three 24-h dietary recalls and 8 d of brief EMA surveys on behalf of their child; in total, there were 185 d where dietary intake data from both EMA and 24-h recall were available. The EMA measure asked parents to indicate whether (yes/no) their child had consumed any of the nine total food items (e.g. fruit, vegetable, etc.) at eating occasions where both the child and parent were present. SETTING Twenty-four-hour dietary recalls were completed in person in the study participant's home; participants completed EMA surveys using a study provided in iPad or their personal cell phone. PARTICIPANTS A diverse, population-based sample of parent-child dyads (n 150). RESULTS Among meals reported in both the EMA and dietary recalls, concordance of reporting of specific types of food ranged from moderate agreement for meat (kappa = 0·55); fair agreement for sweets (kappa = 0·38), beans/nuts (kappa = 0·37), dairy (kappa = 0·31), fruit (kappa = 0·31) and vegetables (kappa = 0·27); and little to no agreement for refined grains, whole grains and sweetened beverages (73 % overall agreement; kappa = 0·14). Concordance of reporting was highest for breakfast and snacks, as compared with other eating occasions. Higher concordance was observed between the two measures if the meal occurred at home. CONCLUSIONS Data suggest that among meals reported in both the EMA and dietary recalls, concordance in reporting was reasonably good for some types of food but only fair or poor for others.
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26
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Enkema MC, Hallgren KA, Larimer ME. Craving is impermanent and it matters: Investigating craving and cannabis use among young adults with problematic use interested in reducing use. Drug Alcohol Depend 2020; 210:107957. [PMID: 32200158 PMCID: PMC7360486 DOI: 10.1016/j.drugalcdep.2020.107957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 03/07/2020] [Accepted: 03/10/2020] [Indexed: 11/18/2022]
Abstract
Rates of problematic cannabis use have nearly doubled over the last decade, and peak onset for cannabis use disorders occurs during young adulthood. Craving for cannabis is hypothesized to be an important factor that maintains cannabis use among people who desire to stop or reduce their use, including many young adults. Previous studies that used single timepoint assessment methods to demonstrate a link between craving and cannabis use have found mixed predictive utility of measurements. The impermanent, or time-varying nature of craving may be responsible for mixed findings, leading to inaccuracies in retrospective recall and greater difficulty measuring craving and detecting its association with cannabis use. The current study compared intensive longitudinal assessments and single timepoint assessments predicting cannabis use among young adults with problematic cannabis use who reported a desire to reduce their use. Participants (N = 80) completed a baseline craving questionnaire and intensive longitudinal assessments of momentary craving and cannabis use up to four times per day for 14 days. Results suggested that averaged momentary craving predicted cannabis use above-and-beyond craving measured at baseline. An increase of one SD above the sample-mean for averaged momentary craving increased the probability of cannabis use by 367 %, while a one SD increase in baseline craving was only associated with a 49 % increase. Findings suggest that asking young adults who want to cut back on their cannabis use about their craving at a single timepoint may not be as clinically useful as tracking cravings repeatedly in near real-time and in ecologically valid contexts.
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Affiliation(s)
- Matthew C Enkema
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 354944, 1100 NE 45th St, Suite 300, Seattle, WA 98105, United States.
| | - Kevin A Hallgren
- Behavioral Research in Technology and Engineering (BRiTE) Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 356560, Seattle, WA 98195, United States.
| | - Mary E Larimer
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 354944, 1100 NE 45th St, Suite 300, Seattle, WA 98105, United States.
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Abstract
BACKGROUND The Striving to be Strong study tested the efficacy of a multifaceted, theory-based, complex osteoporosis prevention smartphone application (app). We hypothesized use of the app would improve bone mineral density and trabecular bone scores. METHODS The study was a three-group, prospective, repeated-measure, longitudinal randomized trial. Baseline sample consisted of 290 healthy women between 40 and 60 years of age. Participants were randomly assigned to one of three groups: "Striving," a dynamically tailored, person-centered app; "Boning Up," a standardized osteoporosis-education e-book; and "Wait List," a participant's choice of intervention in the final 3 months of the 12-month study. Participants had or were provided a smart phone. Bone mineral density and trabecular bone scores were measured using dual-energy X-ray absorptiometry at baseline and 12 months. To assess engagement in health behavior change processes, ecological momentary assessments were administered via text messaging during the 12 months participants actively used the app. RESULTS The final sample reflects an 89.6% retention rate. There were decreases in bone mineral density over time but not among the three groups. The percentage of bone density lost over 12 months was lower than expected. Trabecular bone scores were not different over time or by group but improved across all three groups. DISCUSSION Small but positive results were observed across all groups, suggesting one or more aspects of participation might have affected outcomes, including dissemination of the intervention across groups, retention without participation, ecological momentary assessments functioning as both an intervention and measure, and selective engagement in research-based recommendations.
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Affiliation(s)
- Polly Ryan
- Polly Ryan, PhD, RN, ACNS, FAAN, is Research Scientist, School of Nursing University of Wisconsin-Madison. Roger L. Brown, MS, PhD, is Professor of Research Methodology and Medical Statistics, Director of Research Design and Statistics Unit, Schools of Nursing and Medicine and Public Health, University of Wisconsin-Madison. Mary Ellen Csuka, MD, is Professor, Department of Rheumatology, Medical College of Wisconsin, Milwaukee. Paula Papanek, PhD, MpT, LAT/ATC, FACSM, is Associate Professor and Department Chair, Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin
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28
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Zapata-Lamana R, Lalanza JF, Losilla JM, Parrado E, Capdevila L. mHealth technology for ecological momentary assessment in physical activity research: a systematic review. PeerJ 2020; 8:e8848. [PMID: 32257648 PMCID: PMC7103204 DOI: 10.7717/peerj.8848] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/03/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To systematically review the publications on ecological momentary assessment (EMA) relating to physical activity (PA) behavior in order to classify the methodologies, and to identify the main mHealth technology-based tools and procedures that have been applied during the first 10 years since the emergence of smartphones. As a result of this review, we want to ask if there is enough evidence to propose the use of the term "mEMA" (mobile-based EMA). DESIGN A systematic review according to PRISMA Statement (PROSPERO registration: CRD42018088136). METHOD Four databases (PsycINFO, CINALH, Medline and Web of Science Core Collection) were searched electronically from 2008 to February 2018. RESULTS A total of 76 studies from 297 potential articles on the use of EMA and PA were included in this review. It was found that 71% of studies specifically used "EMA" for assessing PA behaviors but the rest used other terminology that also adjusted to the inclusion criteria. Just over half (51.3%) of studies (39) used mHealth technology, mainly smartphones, for collecting EMA data. The majority (79.5%) of these studies (31 out of 39) were published during the last 4 years. On the other hand, 58.8% of studies that only used paper-and-pencil were published during the first 3 years of the 10-year period analyzed. An accelerometer was the main built-in sensor used for collecting PA behavior by means of mHealth (69%). Most of the studies were carried out on young-adult samples, with only three studies in older adults. Women were included in 60% of studies, and healthy people in 82%. The studies lasted between 1 and 7 days in 57.9%, and between three and seven assessments per day were carried out in 37%. The most popular topics evaluated together with PA were psychological state and social and environmental context. CONCLUSIONS We have classified the EMA methodologies used for assessing PA behaviors. A total of 71% of studies used the term "EMA" and 51.3% used mHealth technology. Accelerometers have been the main built-in sensor used for collecting PA. The change of trend in the use of tools for EMA in PA coincides with the technological advances of the last decade due to the emergence of smartphones and mHealth technology. There is enough evidence to use the term mEMA when mHealth technology is being used for monitoring real-time lifestyle behaviors in natural situations. We define mEMA as the use of mobile computing and communication technologies for the EMA of health and lifestyle behaviors. It is clear that the use of mHealth is increasing, but there is still a lot to be gained from taking advantage of all the capabilities of this technology in order to apply EMA to PA behavior. Thus, mEMA methodology can help in the monitoring of healthy lifestyles under both subjective and objective perspectives. The tendency for future research should be the automatic recognition of the PA of the user without interrupting their behavior. The ecological information could be completed with voice messages, image captures or brief text selections on the touch screen made in real time, all managed through smartphone apps. This methodology could be extended when EMA combined with mHealth are used to evaluate other lifestyle behaviors.
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Affiliation(s)
| | - Jaume F. Lalanza
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Josep-Maria Losilla
- Department of Psychobiology and Methodology of Health Science, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Eva Parrado
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Lluis Capdevila
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
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29
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Degroote L, DeSmet A, De Bourdeaudhuij I, Van Dyck D, Crombez G. Content validity and methodological considerations in ecological momentary assessment studies on physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act 2020; 17:35. [PMID: 32151251 PMCID: PMC7063739 DOI: 10.1186/s12966-020-00932-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/14/2020] [Indexed: 01/06/2023] Open
Abstract
Background Ecological momentary assessment (EMA) is a method of collecting real-time data based on repeated measures and observations that take place in participant’s daily environment. EMA has many advantages over more traditional, retrospective questionnaires. However, EMA faces some challenges to reach its full potential. The aims of this systematic review are to (1) investigate whether and how content validity of the items (i.e. the specific questions that are part of a larger EMA questionnaire) used in EMA studies on physical activity and sedentary behaviour was assessed, and (2) provide an overview of important methodological considerations of EMA in measuring physical activity and sedentary behaviour. Methods Thirty papers (twenty unique studies) were systematically reviewed and variables were coded and analysed within the following 4 domains: (1) Content validity, (2) Sampling approach, (3) Data input modalities and (4) Degree of EMA completion. Results Only about half of the studies reported the specific items (n = 12) and the source of the items (n = 11). None of the studies specifically assessed the content validity of the items used. Only a minority (n = 5) of the studies reported any training, and one tested the comprehensibility of the EMA items. A wide variability was found in the design and methodology of the EMA. A minority of the studies (n = 7) reported a rationale for the used prompt frequency, time selection, and monitoring period. Retrospective assessment periods varied from ‘now’ to ‘in the last 3.5 hours’. In some studies there was a possibility to delay (n = 6) or deactivate (n = 10) the prompt, and some provided reminders after the first prompt (n = 9). Conclusions Almost no EMA studies reported the content validation of the items used. We recommend using the COSMIN checklist (COnsensus-based Standards for the selection of health Measurement INstruments) to report on the content validity of EMA items. Furthermore, as often no rationale was provided for several methodological decisions, the following three recommendations are made. First, provide a rationale for choosing the sampling modalities. Second, to ensure assessment ‘in the moment’, think carefully about the retrospective assessment period, reminders, and deactivation of the prompt. Third, as high completion rates are important for representativeness of the data and generalizability of the findings, report completion rates. Trial registration This review is registered in PROSPERO, the International prospective register of systematic reviews (registration number: CRD42017077996).
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Affiliation(s)
- L Degroote
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders, Brussels, Belgium. .,Department of Clinical-Experimental Health Psychology, Ghent University, Ghent, Belgium.
| | - A DeSmet
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium.,Faculty of Psychology and Educational Sciences, Free University of Brussels, Brussels, Belgium
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - D Van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - G Crombez
- Department of Clinical-Experimental Health Psychology, Ghent University, Ghent, Belgium
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30
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Promotion of Healthy Nutrition and Physical Activity Lifestyles for Teenagers: A Systematic Literature Review of The Current Methodologies. J Pers Med 2020; 10:jpm10010012. [PMID: 32121555 PMCID: PMC7151579 DOI: 10.3390/jpm10010012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/12/2020] [Accepted: 02/25/2020] [Indexed: 11/17/2022] Open
Abstract
Amid obesity problems in the young population and apparent trends of spending a significant amount of time in a stationary position, promoting healthy nutrition and physical activities to teenagers is becoming increasingly important. It can rely on different methodologies, including a paper diary and mobile applications. However, the widespread use of mobile applications by teenagers suggests that they could be a more suitable tool for this purpose. This paper reviews the methodologies for promoting physical activities to healthy teenagers explored in different studies, excluding the analysis of different diseases. We found only nine studies working with teenagers and mobile applications to promote active lifestyles, including the focus on nutrition and physical activity. Studies report using different techniques to captivate the teenagers, including questionnaires and gamification techniques. We identified the common features used in different studies, which are: paper diary, diet diary, exercise diary, notifications, diet plan, physical activity registration, gamification, smoking cessation, pictures, game, and SMS, among others.
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31
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Vekaria KM, O'Connell K, Rhoads SA, Brethel-Haurwitz KM, Cardinale EM, Robertson EL, Walitt B, VanMeter JW, Marsh AA. Activation in bed nucleus of the stria terminalis (BNST) corresponds to everyday helping. Cortex 2020; 127:67-77. [PMID: 32169677 DOI: 10.1016/j.cortex.2020.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 09/30/2019] [Accepted: 02/05/2020] [Indexed: 01/01/2023]
Abstract
Everyday prosociality includes helping behaviors such as holding doors or giving directions that are spontaneous and low-cost and are performed frequently by the average person. Such behaviors promote a wide array of positive outcomes that include increased well-being, trust, and social capital, but the cognitive and neural mechanisms that support these behaviors are not yet well understood. Whereas costly altruistic responding to others' distress is associated with elevated reactivity in the amygdala, we hypothesized that everyday prosociality would be more closely associated with activation in the bed nucleus of the stria terminalis (BNST), a region of the extended amygdala known for its roles in maintaining vigilance for relevant socio-affective environmental cues and in supporting parental care. One previous study of the neural correlates of everyday prosociality highlighted a functional cluster identified as the septal area but which overlapped with established coordinates of BNST. We used an anatomical mask of BNST (Torrisi et al., 2015) to evaluate the association of BNST activation and daily helping in a sample of 25 adults recruited from the community as well as 23 adults who had engaged in acts of extraordinary altruism. Results found that activation in left BNST during an empathy task predicted everyday helping over a subsequent 14-day period in both samples. BNST activation most strongly predicted helping strangers and proactive helping. We conclude that beyond facilitating care for offspring, activation in BNST may provide a basis for the motivation to engage in a broad array of everyday helping behaviors.
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Affiliation(s)
- Kruti M Vekaria
- Department of Psychology, Georgetown University, Washington, DC, USA.
| | - Katherine O'Connell
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, USA
| | - Shawn A Rhoads
- Department of Psychology, Georgetown University, Washington, DC, USA
| | | | - Elise M Cardinale
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Emily L Robertson
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Brian Walitt
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - John W VanMeter
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA
| | - Abigail A Marsh
- Department of Psychology, Georgetown University, Washington, DC, USA
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Azad-Khaneghah P, Neubauer N, Miguel Cruz A, Liu L. Mobile health app usability and quality rating scales: a systematic review. Disabil Rehabil Assist Technol 2020; 16:712-721. [PMID: 31910687 DOI: 10.1080/17483107.2019.1701103] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To review the rating scales used to evaluate usability and quality of mobile health applications, and to compare their purpose, content, and intended target users (i.e., patients, caregivers, or researchers). MATERIAL AND METHODS We conducted a systematic review of the literature in accordance with the PRISMA statement on Medline, CINAHL, PsycINFO, IEEE Explore databases, as well as a review of the grey literature to identify rating scales used to evaluate usability and quality of mobile health applications (m-health apps), between January 1, 2000 and July 31, 2018. Two researchers screened the titles and abstracts of articles that met inclusion criteria, and retrieved usability and quality rating scales from the articles. RESULTS We identified 24 usability scales and 25 quality rating scales in 87 peer-reviewed articles. We identified only one quality rating scale designed for non-expert users (i.e., patients or caregivers). None of the studies used a theoretical framework for app evaluation to support the scales. The validity of existing quality rating scales is yet to be investigated. CONCLUSION Existing usability and quality rating scales are targeted at professionals, not end users who are patients or caregivers. Rating scales that are usable by all end-users would make mobile health apps accessible and meaningful to consumers.Implications for rehabilitationThe number of mobile health applications on app stores that can be used for rehabilitation is increasing.Most healthcare providers lack the training to identify m-health apps with high quality to be used in rehabilitation.This study has reviewed the current rating scales that can help clinicians and care providers rate the quality of m-health apps and identify the ones that are most appropriate for their practice.
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Affiliation(s)
| | - Noelannah Neubauer
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Antonio Miguel Cruz
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lili Liu
- Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada
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McKinney TL, Euler MJ, Butner JE. It’s about time: The role of temporal variability in improving assessment of executive functioning. Clin Neuropsychol 2019; 34:619-642. [DOI: 10.1080/13854046.2019.1704434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Ty L. McKinney
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Matthew J. Euler
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Barnett I, Torous J, Staples P, Keshavan M, Onnela JP. Beyond smartphones and sensors: choosing appropriate statistical methods for the analysis of longitudinal data. J Am Med Inform Assoc 2019; 25:1669-1674. [PMID: 30272176 DOI: 10.1093/jamia/ocy121] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/23/2018] [Indexed: 01/18/2023] Open
Abstract
Objectives As smartphones and sensors become more prominently used in mobile health, the methods used to analyze the resulting data must also be carefully considered. The advantages of smartphone-based studies, including large quantities of temporally dense longitudinally captured data, must be matched with the appropriate statistical methods in order draw valid conclusions. In this paper, we review and provide recommendations in 3 critical domains of analysis for these types of temporally dense longitudinal data and highlight how misleading results can arise from improper use of these methods. Target Audience Clinicians, biostatisticians, and data analysts who have digital phenotyping data or are interested in performing a digital phenotyping study or any other type of longitudinal study with frequent measurements taken over an extended period of time. Scope We cover the following topics: 1) statistical models using longitudinal repeated measures, 2) multiple comparisons of correlated tests, and 3) dimension reduction for correlated behavioral covariates. While these 3 classes of methods are frequently used in digital phenotyping data analysis, we demonstrate via actual clinical studies data that they may sometimes not perform as expected when applied to novel digital data.
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Affiliation(s)
- Ian Barnett
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Division of Clinical Informatics, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Patrick Staples
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Silva AG, Simões P, Santos R, Queirós A, Rocha NP, Rodrigues M. A Scale to Assess the Methodological Quality of Studies Assessing Usability of Electronic Health Products and Services: Delphi Study Followed by Validity and Reliability Testing. J Med Internet Res 2019; 21:e14829. [PMID: 31730036 PMCID: PMC6884719 DOI: 10.2196/14829] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/26/2019] [Accepted: 08/13/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The usability of electronic health (eHealth) and mobile health apps is of paramount importance as it impacts the quality of care. Methodological quality assessment is a common practice in the field of health for different designs and types of studies. However, we were unable to find a scale to assess the methodological quality of studies on the usability of eHealth products or services. OBJECTIVE This study aimed to develop a scale to assess the methodological quality of studies assessing usability of mobile apps and to perform a preliminary analysis of of the scale's feasibility, reliability, and construct validity on studies assessing usability of mobile apps, measuring aspects of physical activity. METHODS A 3-round Delphi panel was used to generate a pool of items considered important when assessing the quality of studies on the usability of mobile apps. These items were used to write the scale and the guide to assist its use. The scale was then used to assess the quality of studies on usability of mobile apps for physical activity, and it assessed in terms of feasibility, interrater reliability, and construct validity. RESULTS A total of 25 experts participated in the Delphi panel, and a 15-item scale was developed. This scale was shown to be feasible (time of application mean 13.10 [SD 2.59] min), reliable (intraclass correlation coefficient=0.81; 95% CI 0.55-0.93), and able to discriminate between low- and high-quality studies (high quality: mean 9.22 [SD 0.36]; low quality: mean 6.86 [SD 0.80]; P=.01). CONCLUSIONS The scale that was developed can be used both to assess the methodological quality of usability studies and to inform its planning.
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Affiliation(s)
- Anabela G Silva
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Patrícia Simões
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Rita Santos
- Higher School of Technology and Management of Águeda, Aveiro, Portugal
| | | | - Nelson P Rocha
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Mário Rodrigues
- Higher School of Technology and Management of Águeda, Aveiro, Portugal
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Maugeri A, Barchitta M. A Systematic Review of Ecological Momentary Assessment of Diet: Implications and Perspectives for Nutritional Epidemiology. Nutrients 2019; 11:nu11112696. [PMID: 31703374 PMCID: PMC6893429 DOI: 10.3390/nu11112696] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/18/2022] Open
Abstract
The ecological momentary assessment (EMA) of eating behaviors represents an innovative, detailed and valid approach to capture the complexity of food intake and to overcome limitations of traditional dietary assessment methods. Moreover, EMA studies might generate a large variety of data (e.g., dietary, behavioral, physical, sociopsychological, and contextual information), thereby enabling to examine concurrent exposures and events. Due to the increasing number of studies in this field of research, here we systematically reviewed EMA methods for the assessment of dietary intake in epidemiological studies, and discussed implications and perspectives for future research. Our study summarized several protocols and platforms that may be applied to assess diet in terms of eating frequency, choices, and habits. Nearly 38% of studies used an event-contingent strategy by asking participants to report foods and beverages consumed in real-time at each eating occasion. Instead, approximately 55% of studies used a signal-contingent prompting approach that notified the participants to record their dietary consumption. The remaining studies used a combination of event- and signal-contingent protocols to compare their accuracy or to improve the assessment of dietary data. Although both approaches might improve the accuracy and ecological validity of dietary assessment—also reducing the burden for participants—some limitations should nevertheless be considered. Despite these limitations, our systematic review pointed out that EMA can be applied in various fields of nutritional epidemiology, from the identification of determinants of dietary habits in healthy people to the management of patients with eating or metabolic disorders. However, more efforts should be encouraged to improve the validity and the reliability of EMA and to provide further technological innovations for public health research and interventions.
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Sufrinko AM, Howie EK, Charek DB, Elbin RJ, Collins MW, Kontos AP. Mobile Ecological Momentary Assessment of Postconcussion Symptoms and Recovery Outcomes. J Head Trauma Rehabil 2019; 34:E40-E48. [DOI: 10.1097/htr.0000000000000474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Validity, Reliability, Feasibility, and Usefulness of Pain Monitor: A Multidimensional Smartphone App for Daily Monitoring of Adults With Heterogenous Chronic Pain. Clin J Pain 2019; 34:900-908. [PMID: 29659375 DOI: 10.1097/ajp.0000000000000618] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Ecological momentary assessment has been recommended in the management of chronic pain. Smartphone apps might be a useful tool for that purpose. This goal of this study was to develop and test a multidimensional smartphone app for adults with chronic pain. A multidisciplinary team developed the app content after a series of meetings, considering clinical guidelines for pain measurement. The content included pain intensity and interference, fatigue, mood, perceived health status, activity level, side effects of the medication, use of rescue medication, and pain-related sychological constructs (catastrophizing, acceptance, fear, and coping). METHODS Thirty-eight participants (21 to 59 y) used the app, called Pain Monitor, twice a day during 30 consecutive days. Patients completed a set of well-established measures at the beginning and end of the study via paper-and-pencil. Weekly phone assessments were also made for pain intensity, pain interference, fatigue, and mood. RESULTS Construct validity was revealed by moderate-to-strong correlations between app content and traditional measures. Feasibility was supported by high compliance (between 70% and 82%) and high acceptability and ease of use. Both side effects of the medication and use of rescue medication were found to be useful tools to guide treatment. DISCUSSION The new assessment protocol in the app allows for an easy and rapid multidimensional assessment of chronic pain patients.
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Liu H, Lou VWQ. Developing a smartphone-based ecological momentary assessment protocol to collect biopsychosocial data with community-dwelling late-middle-aged and older adults. Transl Behav Med 2019; 9:711-719. [PMID: 30395340 DOI: 10.1093/tbm/iby096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Although ecological momentary assessment (EMA) has been used in youth and adult populations, very few of the studies provided evidence of the feasibility and utility of smartphone-based EMA protocols to collect biopsychosocial data from aging populations. This study aimed to describe the design and implementation of a smartphone-based EMA protocol, and to evaluate the feasibility and utility of this EMA protocol among community-dwelling late-middle-aged and older Chinese. A sample of 78 community-dwelling Chinese aged between 50 and 70 years was trained to participate in a 1-week EMA data collection, during which each participant carried an Android smartphone loaded with a researcher-developed EMA application and a smartphone-based electrocardiogram (ECG) monitor to provide psychosocial (e.g., daily activities, social interaction, affect) data and ECG recordings six times daily. Adherence was demonstrated with a total response rate of 91.5% of all scheduled assessments (n = 3,822) and a moderately high level of perceived feasibility. Female participants reported higher compliance to the study and rated the overall experience as more pleasant and interesting than male participants. Our study provided the first evidence of the feasibility and utility of smartphone-based EMA protocols among late-middle-aged and older Chinese. Key areas for improvement in future design and implementation of mobile-based EMA include the incorporation of usable technology, adequate and training, and timely assistance.
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Affiliation(s)
- Huiying Liu
- Department of Social Work & Social Administration, University of Hong Kong, Hong Kong, China
| | - Vivian W Q Lou
- Department of Social Work & Social Administration, University of Hong Kong, Hong Kong, China.,Department of Social Work & Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, China
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40
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Schembre SM, Liao Y, O'Connor SG, Hingle MD, Shen SE, Hamoy KG, Huh J, Dunton GF, Weiss R, Thomson CA, Boushey CJ. Mobile Ecological Momentary Diet Assessment Methods for Behavioral Research: Systematic Review. JMIR Mhealth Uhealth 2018; 6:e11170. [PMID: 30459148 PMCID: PMC6280032 DOI: 10.2196/11170] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/03/2018] [Accepted: 10/10/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND New methods for assessing diet in research are being developed to address the limitations of traditional dietary assessment methods. Mobile device-assisted ecological momentary diet assessment (mEMDA) is a new dietary assessment method that has not yet been optimized and has the potential to minimize recall biases and participant burden while maximizing ecological validity. There have been limited efforts to characterize the use of mEMDA in behavioral research settings. OBJECTIVE The aims of this study were to summarize mEMDA protocols used in research to date, to characterize key aspects of these assessment approaches, and to discuss the advantages and disadvantages of mEMDA compared with the traditional dietary assessment methods as well as implications for future mEMDA research. METHODS Studies that used mobile devices and described mEMDA protocols to assess dietary intake were included. Data were extracted according to Preferred Reporting of Systematic Reviews and Meta-Analyses and Cochrane guidelines and then synthesized narratively. RESULTS The review included 20 studies with unique mEMDA protocols. Of these, 50% (10/20) used participant-initiated reports of intake at eating events (event-contingent mEMDA), and 50% (10/20) used researcher-initiated prompts requesting that participants report recent dietary intake (signal-contingent mEMDA). A majority of the study protocols (60%, 12/20) enabled participants to use mobile phones to report dietary data. Event-contingent mEMDA protocols most commonly assessed diet in real time, used dietary records for data collection (60%, 6/10), and provided estimates of energy and nutrient intake (60%, 6/10). All signal-contingent mEMDA protocols used a near real-time recall approach with unannounced (ie, random) abbreviated diet surveys. Most signal-contingent protocols (70%, 7/10) assessed the frequency with which (targeted) foods or food groups were consumed. Relatively few (30%, 6/20) studies compared mEMDA with the traditional dietary assessment methods. CONCLUSIONS This review demonstrates that mEMDA has the potential to reduce participant burden and recall bias, thus advancing the field beyond current dietary assessment methods while maximizing ecological validity.
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Affiliation(s)
- Susan M Schembre
- Department of Behavioral Science, Division of Cancer Control and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Family and Community Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ, United States
| | - Yue Liao
- Department of Behavioral Science, Division of Cancer Control and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sydney G O'Connor
- Institute for Health Promotion & Disease Prevention, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture & Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Shu-En Shen
- Department of Kinesiology, Wiess School of Natural Sciences, Rice University, Houston, TX, United States
| | - Katarina G Hamoy
- Department of Health and Human Performance, College of Liberal Arts and Social Sciences, University of Houston, Houston, TX, United States
| | - Jimi Huh
- Institute for Health Promotion & Disease Prevention, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Genevieve F Dunton
- Institute for Health Promotion & Disease Prevention, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Rick Weiss
- Viocare, Inc, Princeton, NJ, United States
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States
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Comulada WS, Swendeman D, Rezai R, Ramanathan N. Time Series Visualizations of Mobile Phone-Based Daily Diary Reports of Stress, Physical Activity, and Diet Quality in Mostly Ethnic Minority Mothers: Feasibility Study. JMIR Form Res 2018; 2:e11062. [PMID: 30684407 PMCID: PMC6334694 DOI: 10.2196/11062] [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: 05/16/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 11/18/2022] Open
Abstract
Background Health behavior patterns reported through daily diary data are important to understand and intervene upon at the individual level in N-of-1 trials and related study designs. There is often interest in relationships between multiple outcomes, such as stress and health behavior. However, analyses often utilize regressions that evaluate aggregate effects across individuals, and standard analyses target single outcomes. Objective This paper aims to illustrate how individuals’ daily reports of stress and health behavior (time series) can be explored using visualization tools. Methods Secondary analysis was conducted on 6 months of daily diary reports of stress and health behavior (physical activity and diet quality) from mostly ethnic minority mothers who pilot-tested a self-monitoring mobile health app. Time series with minimal missing data from 14 of the 44 mothers were analyzed. Correlations between stress and health behavior within each time series were reported as a preliminary step. Stress and health behavior time series patterns were visualized by plotting moving averages and time points where mean shifts in the data occurred (changepoints). Results Median correlation was small and negative for associations of stress with physical activity (r=−.14) and diet quality (r=−.08). Moving averages and changepoints for stress and health behavior were aligned for some participants but not for others. A third subset of participants exhibited little variation in stress and health behavior reports. Conclusions Median correlations in this study corroborate prior findings. In addition, time series visualizations highlighted variations in stress and health behavior across individuals and time points, which are difficult to capture through correlations and regression-based summary measures.
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Affiliation(s)
- W Scott Comulada
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Dallas Swendeman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roxana Rezai
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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Spruijt-Metz D, Wen CKF, Bell BM, Intille S, Huang JS, Baranowski T. Advances and Controversies in Diet and Physical Activity Measurement in Youth. Am J Prev Med 2018; 55:e81-e91. [PMID: 30135037 PMCID: PMC6151143 DOI: 10.1016/j.amepre.2018.06.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/09/2018] [Accepted: 06/15/2018] [Indexed: 11/16/2022]
Abstract
Technological advancements in the past decades have improved dietary intake and physical activity measurements. This report reviews current developments in dietary intake and physical activity assessment in youth. Dietary intake assessment has relied predominantly on self-report or image-based methods to measure key aspects of dietary intake (e.g., food types, portion size, eating occasion), which are prone to notable methodologic (e.g., recall bias) and logistic (e.g., participant and researcher burden) challenges. Although there have been improvements in automatic eating detection, artificial intelligence, and sensor-based technologies, participant input is often needed to verify food categories and portions. Current physical activity assessment methods, including self-report, direct observation, and wearable devices, provide researchers with reliable estimations for energy expenditure and bodily movement. Recent developments in algorithms that incorporate signals from multiple sensors and technology-augmented self-reporting methods have shown preliminary efficacy in measuring specific types of activity patterns and relevant contextual information. However, challenges in detecting resistance (e.g., in resistance training, weight lifting), prolonged physical activity monitoring, and algorithm (non)equivalence remain to be addressed. In summary, although dietary intake assessment methods have yet to achieve the same validity and reliability as physical activity measurement, recent developments in wearable technologies in both arenas have the potential to improve current assessment methods. THEME INFORMATION This article is part of a theme issue entitled Innovative Tools for Assessing Diet and Physical Activity for Health Promotion, which is sponsored by the North American branch of the International Life Sciences Institute.
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Affiliation(s)
- Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, Los Angeles, California; Department of Psychology, University of Southern California, Los Angeles, California; Department of Preventive Medicine, University of Southern California, Los Angeles, California.
| | - Cheng K Fred Wen
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Brooke M Bell
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Stephen Intille
- College of Computer and Information Science, Northeastern University, Boston, Massachusetts; Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Jeannie S Huang
- Department of Pediatrics, School of Medicine, University of California at San Diego, San Diego, California; Rady Children's Hospital, San Diego, California
| | - Tom Baranowski
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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Self-monitoring physical activity with a smartphone application in cancer patients: a randomized feasibility study (SMART-trial). Support Care Cancer 2018; 26:3915-3923. [PMID: 29785635 PMCID: PMC6182373 DOI: 10.1007/s00520-018-4263-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/10/2018] [Indexed: 01/11/2023]
Abstract
Purpose Evidence accumulates that an active lifestyle positively influences cancer treatment outcome. A “smartphone application” (app) such as “RunKeeper,” to self-monitor physical activity (PA) might be helpful. This study aimed to examine whether using RunKeeper to increase self-reported PA is feasible in cancer patients and to evaluate patients’ opinion about using RunKeeper in a 12-week program. Methods Adult patients (n = 32), diagnosed with cancer, were randomized between usual care (n = 16) or a 12-week intervention with instructions to self-monitor PA with RunKeeper (n = 16). Changes in PA were determined with the Physical Activity Scale for the Elderly (PASE) at baseline (T0), 6 weeks (T1), and 12 weeks (T2). Usability and patients’ experiences were tested at T2 with the System Usability Scale (SUS) and a semi-structured interview. Results Patient mean age was 33.6 years. Between T0 and T1, an increase in PA of 51% (medium estimated effect size r = 0.40) was found in PASE sum score in the intervention group compared with usual care. In addition, total minutes of PA increased with 46% (r = 0.37). These effects decreased over time (T2). Sedentary time decreased with 19% between T0 and T1 and 27% between T0 and T2. Usability was rated “good” and most patients found RunKeeper use helpful to improve PA. Conclusions Self-monitoring PA with RunKeeper was safe and feasible in cancer patients. The RunKeeper use resulted in an increase in PA after 6 weeks. RunKeeper usability was rated good and can be used to study PA in cancer patients. Trial registration NCT02391454 Electronic supplementary material The online version of this article (10.1007/s00520-018-4263-5) contains supplementary material, which is available to authorized users.
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Abstract
OBJECTIVE To assess the level of agreement between children and their parents when reporting a child's food consumption. DESIGN Cross-sectional study in which children and parents independently completed 7 d food diaries describing the foods and drinks the child consumed at every meal and snack. The association between child and parent reporting was assessed for nineteen food groups using Kendall's tau-b non-parametric correlations, Spearman's rank correlations, kappa coefficients and Lin's concordance measure of agreement. Results were also stratified by gender of the child and his/her grade at school. SETTING Households in Ticino, Switzerland, April-June 2014. SUBJECTS Two hundred and ninety-nine children aged 6-12 years and one of their parents participated, with 264 providing complete data (35 % completion rate). RESULTS Results showed a high level of agreement between child and parent reporting. Spearman correlations ranged from 0·55 (sauces) and 0·57 (fatty meat) to 0·80 (fruit), 0·83 (starchy foods) and 0·84 (pastries). All nineteen Spearman correlations were significant at the 0·001 level. Kendall's tau-b correlations ranged from 0·44 (fat meat) to 0·81 (puff pastry). Kappa values showed low to high levels of agreement, ranging from 0·15 (sweets) to 0·77 (puff pastry). Lin's concordance correlation coefficients ranged from 0·39 (whole grains) to 0·86 (puff pastry). CONCLUSIONS When assessing the eating behaviour of children using a 7 d food diary, children's reports might be as reliable as their parents'.
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Serafica R, Lukkahatai N, Morris BT, Webber K. The Use of Social Media and mEMA Technology in Comparing Compliance Rate Among Users. Asian Pac Isl Nurs J 2018; 3:168-176. [PMID: 31037265 PMCID: PMC6484148 DOI: 10.31372/20180304.1019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Compliance can be defined as the extent to which a person’s behavior corresponds with agreed recommendations. Within the context of lifestyle intervention, this may refer to physical activity, diet modifications, or lifestyle intervention program attendance or attrition. For lifestyle intervention programs to be successful (as measured against a variety of health and lifestyle markers), it is crucial for individuals to comply as best they can to the recommendations or instructions provided by the researchers. Those who disengage prematurely are likely to have poorer treatment outcomes. Hence, a better understanding and an added component, such as engagement, is vital to the development of successful compliance rates. Technology, such as the mobile-based Ecological Momentary Assessment (mEMA), has been used by researchers to collect data on participants through their smartphones. Studies have also used social media and mEMA in the past for topics such as chronic conditions, physical activity, weight management, and dietary behaviors. This article reports the results of two approaches to dietary monitoring using social media and mEMA technology and the lessons learned from the two studies for improving participant compliance.
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Affiliation(s)
- Reimund Serafica
- University of Nevada, Las Vegas, School of Nursing, Las Vegas, NV, USA
| | - Nada Lukkahatai
- Johns Hopkins University, School of Nursing, Baltimore, MD, USA
| | - Brendan Tran Morris
- Department of Electrical and Computer Engineering, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Kelly Webber
- University of Nevada Cooperative Extension, Reno, NV, USA
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van der Ploeg HP, Hillsdon M. Is sedentary behaviour just physical inactivity by another name? Int J Behav Nutr Phys Act 2017; 14:142. [PMID: 29058587 PMCID: PMC5651642 DOI: 10.1186/s12966-017-0601-0] [Citation(s) in RCA: 170] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/16/2017] [Indexed: 12/19/2022] Open
Abstract
The relationship between sedentary behaviour and physical activity and their role in the development of health conditions is an ongoing topic of research. This debate paper presents arguments in favour and against the statement: "Is sedentary behaviour just physical inactivity by another name?" The paper finishes with recommendations for future research in the field of sedentary behaviour, physical activity and public health.
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Affiliation(s)
- Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, van der Boechorststraat 7, NL-1081, BT, Amsterdam, the Netherlands. .,Sydney School of Public Health, University of Sydney, Camperdown, Australia.
| | - Melvyn Hillsdon
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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The promise of wearable sensors and ecological momentary assessment measures for dynamical systems modeling in adolescents: a feasibility and acceptability study. Transl Behav Med 2017; 6:558-565. [PMID: 27678501 DOI: 10.1007/s13142-016-0442-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Intervention development can be accelerated by using wearable sensors and ecological momentary assessment (EMA) to study how behaviors change within a person. The purpose of this study was to determine the feasibility and acceptability of a novel, intensive EMA method for assessing physiology, behavior, and psychosocial variables utilizing two objective sensors and a mobile application (app). Adolescents (n = 20) enrolled in a 20-day EMA protocol. Participants wore a physiological monitor and an accelerometer that measured sleep and physical activity and completed four surveys per day on an app. Participants provided approximately 81 % of the expected survey data. Participants were compliant to the wrist-worn accelerometer (75.3 %), which is a feasible measurement of physical activity/sleep (74.1 % complete data). The data capture (47.8 %) and compliance (70.28 %) with the physiological monitor were lower than other study variables. The findings support the use of an intensive assessment protocol to study real-time relationships between biopsychosocial variables and health behaviors.
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Nemati E, Batteate C, Jerrett M. Opportunistic Environmental Sensing with Smartphones: a Critical Review of Current Literature and Applications. Curr Environ Health Rep 2017; 4:306-318. [PMID: 28879432 DOI: 10.1007/s40572-017-0158-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW This review sought to summarize recent literature and applications of passive, or opportunistic, mobile sensing in the fields of exposure science in built environment settings; highlight innovative opportunistic sensing systems; and analyze their functionality, significant features, and limitations. RECENT FINDINGS Fifty-two papers related to opportunistic environmental sensing from 2009 or later were related to this review, of which 27 were included. An array of applications have emerged in environmental monitoring, employing anywhere from one to six of the phone's on-board sensors. The viability of an application is determined by several key factors: the number and quality of sensors on-board the smartphone; power and processing demand; algorithm complexity; data security; mobile network coverage; reliance on external data sources; minimum number of users required; and degree of user burden when using the application. Some factors are universal, while others are more context-specific. Future research should assess sensing applications based on these factors.
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Affiliation(s)
- Ebrahim Nemati
- Department of Electrical Engineering, UCLA ER Lab, Los Angeles, CA, USA
| | - Christina Batteate
- UCLA Center for Occupational and Environmental Health, Los Angeles, CA, USA
| | - Michael Jerrett
- UCLA Center for Occupational and Environmental Health, Los Angeles, CA, USA.
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South 56-060 CHS, Los Angeles, CA, 90095, USA.
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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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