Patterns of Missing Data With Ecological Momentary Assessment Among People Who Use Drugs: Feasibility Study Using Pilot Study Data

Abstract

Background Ecological momentary assessment (EMA) is a set of research methods that capture events, feelings, and behaviors as they unfold in their real-world setting. Capturing data in the moment reduces important sources of measurement error but also generates challenges for noncompliance (ie, missing data). To date, EMA research has only examined the overall rates of noncompliance. Objective In this study, we identify four types of noncompliance among people who use drugs and aim to examine the factors associated with the most common types. Methods Data were obtained from a recent pilot study of 28 Nebraskan people who use drugs who answered EMA questions for 2 weeks. We examined questions that were not answered because they were skipped, they expired, the phone was switched off, or the phone died after receiving them. Results We found that the phone being switched off and questions expiring comprised 93.34% (1739/1863 missing question-instances) of our missing data. Generalized structural equation model results show that participant-level factors, including age (relative risk ratio [RRR]=0.93; P=.005), gender (RRR=0.08; P=.006), homelessness (RRR=3.80; P=.04), personal device ownership (RRR=0.14; P=.008), and network size (RRR=0.57; P=.001), are important for predicting off missingness, whereas only question-level factors, including time of day (ie, morning compared with afternoon, RRR=0.55; P<.001) and day of week (ie, Tuesday-Saturday compared with Sunday, RRR=0.70, P=.02; RRR=0.64, P=.005; RRR=0.58, P=.001; RRR=0.55, P<.001; and RRR=0.66, P=.008, respectively) are important for predicting expired missingness. The week of study is important for both (ie, week 2 compared with week 1, RRR=1.21, P=.03, for off missingness and RRR=1.98, P<.001, for expired missingness). Conclusions We suggest a three-pronged strategy to preempt missing EMA data with high-risk populations: first, provide additional resources for participants likely to experience phone charging problems (eg, people experiencing homelessness); second, ask questions when participants are not likely to experience competing demands (eg, morning); and third, incentivize continued compliance as the study progresses. Attending to these issues can help researchers ensure maximal data quality.

Identifying factors impacting missingness within smartphone-based research: Implications for intensive longitudinal studies of adolescent suicidal thoughts and behaviors.

“…Yet, missingness can occur both due to participant noncompliance (or nonadherence) with study protocols, or due to “technical” failures, including failed prompt delivery/upload, incompatibility of phone operating system, device malfunction, or insufficient service or battery (Heron et al, 2017). Some factors driving missingness in ESM research in youth may be beyond participants’ control; for example, lack of stable cell service or data plan, and smartphone usage restrictions (e.g., parents, school) can drive missingness (Markowski et al, 2021; Santa Maria et al, 2018). In these contexts, missingness should not be characterized as “noncompliance,” and for this reason, we use the umbrella terms “missingness” or “missing data” to capture instances for which data are not available.…”

Ecological Momentary Assessments in Sociology

“…Although these assessments typically require only a few minutes to complete, participants may nevertheless be unlikely to complete the assessments if they are occupied by a demanding task or activity. Indeed, missing data is a real concern with EMA studies (Markowski et al 2021a). Prospective EMA researchers should therefore carefully consider how many assessments per day they need from each participant.…”

“…Indeed, one of the key strengths of the EMA approach lies in its ability to link longstanding sociological theories with methodologically innovative data. Although the increasing profusion of smartphone technology has dramatically increased the feasibility of conducting EMA studies, this approach has rarely been adopted by sociologists due perhaps to the financial and logistical burdens that are associated with the methodology (Keusch and Conrad 2022; Markowski et al 2021a). In this article, I argue that these barriers to entry undersell the relevance of ecological momentary assessments for sociological study.…”

Finding a home in or through mobile phones: Access and usage patterns among homeless women in shelter-homes of India

“…The major focus of this body of research in the global West has been on various health-based interventions, ranging from drug abuse to mental health and even diabetes (Asgary et al, 2023; Karadzhov, 2023; Markowski et al, 2021). In a study conducted on homeless individuals in the United States, it was found that consistent access to smartphone technology and transportation empowered participants to meet the requirements for the attainment of social needs (Thurman et al, 2021).…”