Balancing burden and resolution: Effects of EMA survey schedule on compliance and study evaluation in suicide-focused...

Ecological momentary assessment (EMA) enables fine-grained, real-time prediction and monitoring of suicidal ideation and related experiences, but participant burden and declining compliance pose challenges. This study examined how EMA survey schedules influence EMA compliance, response likelihood, and participant burden.

Participants (N = 137) with recent suicidal ideation completed 28 days of EMA under one of three schedules: fixed (six surveys/day), 4+burst (four/day with one week of 10/day), or randomly varying (3-15 surveys/day). Bayesian mixed-effects and logistic regression models examined the effects of schedule type and time on overall and momentary compliance. Associations between compliance and schedule type with perceived burden, emotional reactions, and satisfaction were examined.

Schedule type was not associated with overall compliance; however, time-by-schedule interactions showed that 4+burst and randomly varying conditions exhibited less decline over time than the fixed condition. Prior survey completion increased momentary response likelihood, while time in study decreased the likelihood of responding. Higher compliance was associated with fewer perceived drawbacks; no other effects of compliance or study schedule were found.

Although overall compliance did not differ across schedules, those that incorporated some variability in survey frequency showed more sustained compliance over time. Responding to the previous survey increased response likelihood, indicating a momentum effect, whereas longer study participation reduced momentary compliance, consistent with cumulative survey fatigue.

Incorporating variability in survey frequency sustained greater compliance over time without increasing perceived burden, suggesting that varying EMA schedules may help mitigate study fatigue.