Using Mobile-Technology-Based Ecological Momentary Assessment (EMA) Methods With Youth: A Systematic Review and Recommendations

Abstract

Ecological momentary assessment (EMA) methods are increasingly used in social and health sciences, but the feasibility and best practices for using EMA with youth are not yet clear. We conducted a systematic review of studies that used self-report EMA methods with youth; the goal was to identify common approaches and challenges to implementation and develop recommendations for future research. We examined 54 peer-reviewed papers that reported on 24 unique studies. Papers were evaluated using a standardized, three-dimensional coding scheme focused on the following: (1) sample characteristics; (2) EMA data collection methods (sampling duration, frequency, hardware/software); (3) study implementation methods (technical/logistical challenges, training participants, compliance). Overall, the research suggests EMA can be successfully implemented with youth (age ∼ ≥7) from diverse backgrounds, but protocol adaptations may be necessary for younger children. Study design and implementation challenges and recommendations for research on youth are provided.

Annual Research Review: Ecological momentary assessment studies in child psychology and psychiatry

“…Many EMA studies have been conducted with children and adolescents, summarized in two recent systematic reviews (Heron, Everhart, McHale, & Smyth, ; Wen, Schneider, Stone, & Spruijt‐Metz, ). Most EMA studies with children and adolescents have ranged in length from 2 to 42 days, involved two to nine survey prompts daily, used digital technology to collect self‐reports, provided monetary incentives to encourage compliance, and trained young participants to operate EMA devices and/or respond to EMA survey questions before going into the field (Heron et al, ; Wen et al, ). The use of EMA is supported with children and adolescents as young as 7 years of age, as youth of different genders, racial/ethnic groups, nationalities, socioeconomic backgrounds, and mental or physical health conditions all have effectively and compliantly participated in EMA research (Heron et al, ).…”

“…Most EMA studies with children and adolescents have ranged in length from 2 to 42 days, involved two to nine survey prompts daily, used digital technology to collect self‐reports, provided monetary incentives to encourage compliance, and trained young participants to operate EMA devices and/or respond to EMA survey questions before going into the field (Heron et al, ; Wen et al, ). The use of EMA is supported with children and adolescents as young as 7 years of age, as youth of different genders, racial/ethnic groups, nationalities, socioeconomic backgrounds, and mental or physical health conditions all have effectively and compliantly participated in EMA research (Heron et al, ). Heron et al () reported average EMA compliance rates – the proportion of prompts to which participants responded – of 76% across their selected studies, which is consistent with the 80% guideline offered in EMA studies with adults (Stone & Shiffman, ).…”

“…The use of EMA is supported with children and adolescents as young as 7 years of age, as youth of different genders, racial/ethnic groups, nationalities, socioeconomic backgrounds, and mental or physical health conditions all have effectively and compliantly participated in EMA research (Heron et al, ). Heron et al () reported average EMA compliance rates – the proportion of prompts to which participants responded – of 76% across their selected studies, which is consistent with the 80% guideline offered in EMA studies with adults (Stone & Shiffman, ). Similarly, Wen et al () identified an average compliance rate of 78.3% across 42 studies using EMA with youth, noting no significant differences in compliance between clinical and non‐clinical samples of youth (76.9% vs. 79.2%, respectively, p = .29), nor when using EMA with a mobile survey platform only (77.4%) versus a mobile survey platform plus a wearable device (73.0%, p = .36), nor when comparing studies 2+ weeks in duration versus 1 week or less for both clinical ( p = .85) and non‐clinical samples ( p = .27).…”

“…Next, we review the international body of literature reporting on the use of EMA to examine mental and behavioral health in the day‐to‐day lives of children and adolescents. Articles for the current review were selected from the references of previously published reviews (Baltasar‐Tello, Miguélez‐Fernández, Peñuelas‐Calvo, & Carballo, ; Heron et al, ; Wen et al, ) and an updated literature search (from December 2017 to January 31, 2019) using PubMed and Google Scholar. Our review is not exhaustive; it is a narrative review in which we provide examples of how EMA may enhance discovery and individualized treatment of mental and behavioral health problems in youth.…”

“…These issues are especially important when working with marginalized, at‐risk, or under‐resourced youth (Simonich et al, ; Tyler, Olson, & Ray, ). Studies may benefit by tailoring assessment protocols to align with day‐to‐day lives to enhance compliance (Heron et al, ; Wen et al, ). Moreover, creative incentivization strategies may keep high‐risk children and adolescents engaged.…”