A Health-Related Digital Ecological Momentary Assessment in Children (Aged 5- 11 Years): Systematic Review

Area of Science:

• Pediatric Health Research
• Digital Health Technologies
• Behavioral Science

Background:

• Digital ecological momentary assessment (EMA) captures real-time experiences, vital for pediatric health research.
• Preadolescents (5-11 years) have unique developmental needs impacting EMA engagement.
• Existing reviews lack focus on EMA protocol acceptability and feasibility for this age group.

Purpose of the Study:

• To examine digital EMA protocols used with children aged 5-11 years across health domains.
• To assess the characteristics, acceptability, and feasibility of these EMA protocols.
• To identify factors associated with high versus low response rates in pediatric EMA.

Main Methods:

• Systematic review of 10 databases up to October 2025.
• Included peer-reviewed studies using digital EMA with children aged 5-11 years for health data collection.
• Narrative synthesis of findings from 17 identified EMA protocols.

Main Results:

• Seventeen EMA protocols were identified, mostly for nonclinical populations using handheld devices over 3-28 days.
• Response rates varied (48%-92%), with facilitators including engaging technology and caregiver involvement.
• Barriers included device burden and insufficient caregiver support; high-response protocols often used incentives and fixed schedules.

Conclusions:

• This review is the first systematic synthesis on EMA for preadolescents, highlighting developmental appropriateness and reporting gaps.
• Digital EMA for preadolescents needs child-centered design for better acceptability and adherence.
• Improved reporting standards and tailored protocols are crucial for effective pediatric health monitoring using EMA.