Mobile survey engagement by older adults is high during multiple phases of the COVID-19 pandemic and is predicted by baseline and structural factors

Abstract

Digital surveys, such as mobile phone ecological momentary assessment (EMA), bear the potential to assess and target individual wellbeing in a personalized, real-time approach and allow for interaction in situations when in-person contact is not possible, such as during the coronavirus pandemic. While the use of digital technology might especially benefit research in older adults who find themselves in circumstances of reduced mobility, little is known about their barriers to adherence. We investigated baseline and structural factors that predict study withdrawal and adherence from daily smartphone EMA self-report surveys in the StayWELL Study. The StayWELL study is a longitudinal, observational study on the relationship between social restrictions during the coronavirus pandemic and mental well-being in 95 community-dwelling older aged adults (67–87 years) who were participants in a randomized clinical trial using EMA. Withdrawal was associated with less research staff changes and less likely in participants that reached the study mid-point. No baseline characteristics predicted withdrawal. Main reasons for withdrawal were communication issues, i.e. staff not being able to contact participants. We found an adherence rate of 82% and no fatigue effects. Adherence was predicted by education status, study participation duration, reaching the study midpoint and time between study start and enrollment. COVID infections or supporting people in the household was not related to adherence. To conclude, it is feasible to conduct an EMA study in older people without impacting engagement during a pandemic. Furthermore, personal characteristics and smartphone operating system (Android vs. iOS) used did not relate to engagement, allowing for a broad distribution of digital health technologies. Our study adds information on single predictive variables relevant for adherence and withdrawal from EMA smartphone surveys in older people that can inform the design of future digital EMA research to maximize engagement and reliability of study results.

Evaluating a New Digital App–Based Program for Heart Health: Feasibility and Acceptability Pilot Study

“…In addition, the withdrawal rate for the study was low: only 20 (3.9%) of the 509 participants withdrew after enrollment. Withdrawal rates for digital health apps with frequent survey content range from 15% to 51% [48]. It is important to note that the retention rates reported here should be interpreted as research study retention rates; study retention rates are typically higher than retention rates in programs that are commercially released to real-world populations.…”

COVID-19 experiences of social isolation and loneliness among older adults in Africa: a scoping review

“…Thus, the inability of older adults to receive adequate physical, emotional, and material support from families and friends during the pandemic was a significant cause of strain on their social and mental health ( 22 ). During the pandemic, in many countries with more developed infrastructures, the use of technology, such as phone and other low-tech communicative devices, have been shown to be beneficial in reducing SI/L and supporting some older adults to stay socially connected ( 23 , 24 ). The uptake of information and communication technology appeared to increase among older adults in some countries, but particularly in places where there was technology uptake prior to the pandemic ( 24 , 25 ).…”