A Systematic Review of Methods and Procedures Used in Ecological Momentary Assessments of Diet and Physical Activity Research in Youth: An Adapted STROBE Checklist for Reporting EMA Studies (CREMAS)

BACKGROUND: Ecological momentary assessment (EMA) is a method of collecting real-time data based on careful timing, repeated measures, and observations that take place in a participant’s typical environment. Due to methodological advantages and rapid advancement in mobile technologies in recent years, more studies have adopted EMA in addressing topics of nutrition and physical activity in youth. OBJECTIVE: The aim of this systematic review is to describe EMA methodology that has been used in studies addressing nutrition and physical activity in youth and provide a comprehensive checklist for reporting EMA studies. METHODS: Thirteen studies were reviewed and analyzed for the following 5 areas of EMA methodology: (1) sampling and measures, (2) schedule, (3) technology and administration, (4) prompting strategy, and (5) response and compliance. RESULTS: Results of this review showed a wide variability in the design and reporting of EMA studies in nutrition and physical activity among youth. The majority of studies (69%) monitored their participants during one period of time, although the monitoring period ranged from 4 to 14 days, and EMA surveys ranged from 2 to 68 times per day. More than half (54%) of the studies employed some type of electronic technology. Most (85%) of the studies used interval-contingent prompting strategy. For studies that utilized electronic devices with interval-contingent prompting strategy, none reported the actual number of EMA prompts received by participants out of the intended number of prompts. About half (46%) of the studies failed to report information about EMA compliance rates. For those who reported, compliance rates ranged from 44-96%, with an average of 71%. CONCLUSIONS: Findings from this review suggest that in order to identify best practices for EMA methodology in nutrition and physical activity research among youth, more standardized EMA reporting is needed. Missing the key information about EMA design features and participant compliance might lead to misinterpretation of results. Future nutrition and physical activity EMA studies need to be more rigorous and thorough in descriptions of methodology and results. A reporting checklist was developed with the goal of enhancing reliability, efficacy, and overall interpretation of the findings for future studies that use EMAs.