Synthesis of evidence on the use of ecological momentary assessments to monitor health outcomes after traumatic injury: rapid systematic review

Abstract

Background With the increasing use of mobile technology, ecological momentary assessments (EMAs) may enable routine monitoring of patient health outcomes and patient experiences of care by health agencies. This rapid review aims to synthesise the evidence on the use of EMAs to monitor health outcomes after traumatic unintentional injury. Method A rapid systematic review of nine databases (MEDLINE, Web of Science, Embase, CINAHL, Academic Search Premier, PsychINFO, Psychology and Behavioural Sciences Collection, Scopus, SportDiscus) for English-language articles from January 2010–September 2021 was conducted. Abstracts and full-text were screened by two reviewers and each article critically appraised. Key information was extracted by population characteristics, age and sample size, follow-up time period(s), type of EMA tools, physical health or pain outcome(s), psychological health outcome(s), general health or social outcome(s), and facilitators or barriers of EMA methods. Narrative synthesis was undertaken to identify key EMA facilitator and barrier themes. Results There were 29 articles using data from 25 unique studies. Almost all (84.0%) were prospective cohort studies and 11 (44.0%) were EMA feasibility trials with an injured cohort. Traumatic and acquired brain injuries and concussion (64.0%) were the most common injuries examined. The most common EMA type was interval (40.0%). There were 10 key facilitator themes (e.g. feasibility, ecological validity, compliance) and 10 key barrier themes (e.g. complex technology, response consistency, ability to capture a participant’s full experience, compliance decline) identified in studies using EMA to examine health outcomes post-injury. Conclusions This review highlighted the usefulness of EMA to capture ecologically valid participant responses of their experiences post-injury. EMAs have the potential to assist in routine follow-up of the health outcomes of patients post-injury and their use should be further explored.

Traditional surveys versus ecological momentary assessments: Digital citizen science approaches to improve ethical physical activity surveillance among youth

“…Evidence also indicates that EMAs provide ecological validity of whether associations are significant in relation to typical settings of everyday life [ 67 , 68 ]. PA measurement using EMAs provide context, improves data validity through reduction of recall bias and data entry errors as participants are not required to retrospectively recall their behaviours [ 69 , 70 ]. EMAs reduce participant burden by using digital reminders/ nudges that can be triggered on participants’ phones based on predefined time and location [ 69 , 71 ].…”

“…PA measurement using EMAs provide context, improves data validity through reduction of recall bias and data entry errors as participants are not required to retrospectively recall their behaviours [ 69 , 70 ]. EMAs reduce participant burden by using digital reminders/ nudges that can be triggered on participants’ phones based on predefined time and location [ 69 , 71 ]. In addition, EMAs can also be self-triggered by participants, which allows them some level of personalization to their needs [ 69 , 72 ].…”

“…EMAs reduce participant burden by using digital reminders/ nudges that can be triggered on participants’ phones based on predefined time and location [ 69 , 71 ]. In addition, EMAs can also be self-triggered by participants, which allows them some level of personalization to their needs [ 69 , 72 ]. One clear indication is that in the digital age, where smartphone usage is almost universal [ 73 , 74 ], it is critical to further explore usage of digital EMAs to capture PA across populations.…”

Ecological Momentary Assessment with REDCap: Methods, Feasibility, and User Behaviour in a Parent and Child Study

“…Moreover, participants took less time to respond to survey notifications received by text message than email. Most existing EMA studies have not reported completion rates by notification method (email vs. text message), have not provided participants with different notification options [16], [44], [45], or have used mobile applications with built-in prompts for participants to take assessments at appropriate intervals [46], [47]. However, our results are consistent with one previous study on drug use among adults in non-urban areas, in which EMA completion rates were higher when notifications were sent via text message compared to email [48].…”

Exploring the usability of a smartphone application to monitor fatigue and activity for people with acquired brain injury

“…However, EMA is not without its limitations. Mitchell et al's rapid review of EMA in monitoring outcomes following traumatic injury highlights how the type of technology used to deliver EMAs affects the quality of data, that EMA completion rates tend to reduce over time, and that intensive self-monitoring may affect participants behaviour and responses, a phenomenon known as reactivity (Mitchell et al, 2022). Optimising the usability of EMAs is therefore essential in optimising data quality and exploring users experiences of EMA may help to understand the potential effects of intensive self-monitoring.…”