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Published on: February 3, 2022
A mobile device-based ecological momentary assessment in adolescents and young adults with diabetes: a systematic
Amit Shapira1, Margaret C Penman1, Stefan Schneider2
1Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
Aims:
Mobile ecological momentary assessment (mobile-EMA) enables real-time contextualization of glucose excursions, yet compliance rates in adolescents and young adults (AYA) with diabetes has not been estimated. This systematic review and meta-analysis evaluated mobile-EMA protocols and participant compliance in this population.
Methods:
Ovid MEDLINE, Embase, Web of Science Core Collection, and CINAHL were searched through November 7, 2024. Eligible studies included English-language publications of AYA with type 1 or type 2 diabetes (T1D or T2D) using mobile-EMA. Three reviewers extracted data on protocols and compliance. Of 991 abstracts screened, 57 underwent full-text review and 9 met inclusion criteria. Protocol characteristics and quality reporting were evaluated using the Checklist for Reporting EMA Studies.
Results:
Across nine studies (N = 703), most used participants' personal smartphones (67%). Common measures included glucose, diabetes self-care, and psychosocial. Nearly all studies used time-based sampling over 4-30 days. The random-effects pooled estimate of compliance was 70% (95% CI: 60-79%). Higher prompting was associated with greater compliance (β = 0.0701, SE = 0.0183, p = 0.009), whereas study length and participant burden were not.
Conclusions:
Evidence on mobile-EMA in AYA with diabetes remains limited. Protocol variability and moderate compliance underscore the need to optimize EMA sampling strategies.