Symposia
Telehealth/m-Health
Brittany Stevenson, Ph.D. (she/her/hers)
Minneapolis VAMC
Minneapolis, Minnesota
Maria Sciortino, MA (she/her/hers)
Health Science Specialist
Minneapolis VAMC
Minneapolis, Minnesota
Heather Herrmann (she/her/hers)
Health Science Specialist
Minneapolis VAMC
Minneapolis, Minnesota
Background: Ecological momentary assessment (EMA) continues to increase in popularity among researchers and is beginning to grow in VA. EMA has several benefits, including improved accuracy for recalled items, improved ecological validity over retrospective questionnaires, repeated measurements for longitudinal analysis, and ability to conduct individual-level (idiographic) analyses. However, because participants completing EMA protocols are not in a dedicated research setting and surveys are frequent, EMA protocols need to be very brief, routinely evaluated for acceptability, and carefully screened for poor quality responding styles.
Method: Veterans attending treatment for substance use disorders (SUD) completed personalized EMA protocols four times per day for four weeks measuring mood, comorbid symptoms (e.g., anxiety, depression, PTSD), SUD symptoms, and personalized items. Individual-level models were estimated using causal discovery algorithms and structural equation modeling which showed the connections between all of the measured symptoms. Models were delivered to Veterans following EMA. Veterans were asked to provide feedback both during the EMA protocol and an individual interview following the study to help us improve the acceptability, feasibility, and relevance of the EMA procedures and personalized models.
Results: Of those who participated, EMA response rates were good ( >75%), but around 80% of Veterans who were contacted by the research team declined to participate in the study. Veteran feedback suggested ways to improve the feasibility and acceptability of the protocol, including increasing compensation and reducing survey frequency. For those who did participate, models revealed heterogeneous connections between comorbid and SUD symptoms between individuals, suggesting individual-level analyses are important for revealing unique structures of psychopathology.
Conclusion: EMA reveals inter-individual heterogeneity at a level of detail that is difficult to detect using one-time surveys, but studies including EMA protocols are perceived as burdensome by the majority of Veterans participating in SUD treatment. Reducing survey frequency and increasing compensation were suggested to improve acceptability.