Compliance with mobile ecological momentary assessment protocols in children and adolescents: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Mobile device-based ecological momentary assessment (mobile-EMA) is increasingly used to collect participants' data in real-time and in context. Although EMA offers methodological advantages, these advantages can be diminished by participant noncompliance. However, evidence on how well participants comply with mobile-EMA protocols and how study design factors associated with participant compliance is limited, especially in the youth literature. OBJECTIVE: To systematically and meta-analytically examine youth's compliance to mobile-EMA protocols and moderators of participant compliance in clinical and nonclinical settings. METHODS: Studies using mobile devices to collect EMA data among youth (age ≤18 years old) were identified. A systematic review was conducted to describe the characteristics of mobile-EMA protocols and author-reported factors associated with compliance. Random effects meta-analyses were conducted to estimate the overall compliance across studies and to explore factors associated with differences in youths' compliance. RESULTS: This review included 42 unique studies that assessed behaviors, subjective experiences, and contextual information. Mobile phones were used as the primary mode of EMA data collection in 48% (20/42) of the reviewed studies. In total, 12% (5/42) of the studies used wearable devices in addition to the EMA data collection platforms. About half of the studies (62%, 24/42) recruited youth from nonclinical settings. Most (98%, 41/42) studies used a time-based sampling protocol. Among these studies, most (95%, 39/41) prompted youth 2-9 times daily, for a study length ranging from 2-42 days. Sampling frequency and study length did not differ between studies with participants from clinical versus nonclinical settings. Most (88%, 36/41) studies with a time-based sampling protocol defined compliance as the proportion of prompts to which participants responded. In these studies, the weighted average compliance rate was 78.3%. The average compliance rates were not different between studies with clinical (76.9%) and nonclinical (79.2%; P=.29) and studies that used only a mobile-EMA platform (77.4%) and mobile platform plus additional wearable devices (73.0%, P=.36). Among clinical studies, the mean compliance rate was significantly lower in studies that prompted participants 2-3 times (73.5%) or 4-5 times (66.9%) compared with studies with a higher sampling frequency (6+ times: 89.3%). Among nonclinical studies, a higher average compliance rate was observed in studies that prompted participants 2-3 times daily (91.7%) compared with those that prompted participants more frequently (4-5 times: 77.4%; 6+ times: 75.0%). The reported compliance rates did not differ by duration of EMA period among studies from either clinical or nonclinical settings. CONCLUSIONS: The compliance rate among mobile-EMA studies in youth is moderate but suboptimal. Study design may affect protocol compliance differently between clinical and nonclinical participants; including additional wearable devices did not affect participant compliance. A more consistent compliance-related result reporting practices can facilitate understanding and improvement of participant compliance with EMA data collection among youth.
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More frequent assessments may not reduce compliance, or may even increase compliance, as long as questionnaires are kept brief.
“It has also previously been reported that more frequent assessments may not reduce compliance (106), or may even increase compliance (107), as long as questionnaires are kept brief (108).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [107]
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“Fourth, there may have also been reactivity to EMAs [52] similar to a Hawthorne Effect—HIV health risk behaviors went down over time in both groups, potentially because participants were thinking about their health more due to the EMAs and the generic health messages.”
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Alexithymia – Not autism – is associated with frequency of social interactions in adults
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A collaborative realist review of remote measurement technologies for depression in young people
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- Authors
- Wen, C. K. F., Schneider, S., Stone, A. A., & Spruijt-Metz, D.
- Affiliations
- University of Southern California (US)
- Corresponding author
- Wen, Cheng K Fred
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2017-04-26
- Volume
- 19
- Issue
- 4
- Pages
- e132
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC5425774
- OpenAlex
- W2609643912
- Cited by
- 350
- References
- 58
- Citations by year
- 2026: 49 · 2025: 37 · 2024: 43 · 2023: 40 · 2022: 40 · 2021: 52 · 2020: 33 · 2019: 28 · 2018: 26 · 2017: 1
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Science Foundation (1521722)
- University of Southern California
- National Institutes of Health (U24OD023176)
- Directorate for Computer and Information Science and Engineering
- National Institute on Aging (R01AG042407)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR066200)
- National Center for Complementary and Integrative Health (R01AT008330)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- participant compliance, youth, children and adolescents, mobile phone data collection, wearable devices, sampling frequency, informed consent
- MeSH terms
- Ecological Momentary Assessment, Adolescent, Child, Data Collection, Humans, Patient Compliance, Research Design, Cell Phone
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