Evaluating Declines in Compliance With Ecological Momentary Assessment in Longitudinal Health Behavior Research: Analyses From a Clinical Trial.

Publisher: JMIR Publications Country of Publication: Canada NLM ID: 100959882 Publication Model: Electronic Cited Medium: Internet ISSN: 1438-8871 (Electronic) Linking ISSN: 14388871 NLM ISO Abbreviation: J Med Internet Res Subsets: MEDLINE

Publication: <2011- > : Toronto : JMIR Publications
Original Publication: [Pittsburgh, PA? : s.n., 1999-

Ecological Momentary Assessment* ; Health Behavior*/ethnology ; Smoking Cessation*/methods; Adult ; Humans ; Black or African American/statistics & numerical data ; Smartphone ; White/statistics & numerical data ; United States/epidemiology

Background: Ecological momentary assessment (EMA) is increasingly used to evaluate behavioral health processes over extended time periods. The validity of EMA for providing representative, real-world data with high temporal precision is threatened to the extent that EMA compliance drops over time.
Objective: This research builds on prior short-term studies by evaluating the time course of EMA compliance over 9 weeks and examines predictors of weekly compliance rates among cigarette-using adults.
Methods: A total of 257 daily cigarette-using adults participating in a randomized controlled trial for smoking cessation completed daily smartphone EMA assessments, including 1 scheduled morning assessment and 4 random assessments per day. Weekly EMA compliance was calculated and multilevel modeling assessed the rate of change in compliance over the 9-week assessment period. Participant and study characteristics were examined as predictors of overall compliance and changes in compliance rates over time.
Results: Compliance was higher for scheduled morning assessments (86%) than for random assessments (58%) at the beginning of the EMA period (P<.001). EMA compliance declined linearly across weeks, and the rate of decline was greater for morning assessments (2% per week) than for random assessments (1% per week; P<.001). Declines in compliance were stronger for younger participants (P<.001), participants who were employed full-time (P=.03), and participants who subsequently dropped out of the study (P<.001). Overall compliance was higher among White participants compared to Black or African American participants (P=.001).
Conclusions: This study suggests that EMA compliance declines linearly but modestly across lengthy EMA protocols. In general, these data support the validity of EMA for tracking health behavior and hypothesized treatment mechanisms over the course of several months. Future work should target improving compliance among subgroups of participants and investigate the extent to which rapid declines in EMA compliance might prove useful for triggering interventions to prevent study dropout.
Trial Registration: ClinicalTrials.gov NCT03262662; https://clinicaltrials.gov/ct2/show/NCT03262662.
(©Sarah Tonkin, Julie Gass, Jennifer Wray, Eugene Maguin, Martin Mahoney, Craig Colder, Stephen Tiffany, Larry W Hawk Jr. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.06.2023.)

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Keywords: RCT; adherence; cessation; cigar; compliance; dropout; ecological momentary assessment; health behavior; longitudinal; methodology; quit; retention; smoker; smoking

ClinicalTrials.gov NCT03262662

Date Created: 20230622 Date Completed: 20230701 Latest Revision: 20231124

20250114

PMC10337346

10.2196/43826

37347538