Piloting real-time assessment of movement behaviors in adults with mobility disabilities: a feasibility study

Adults with mobility disabilities (MD) experience significant health disparities, including high rates of obesity and low levels of physical activity, due to a range of persistent barriers. Addressing these challenges requires innovative strategies that capture real-world behaviors and contexts to inform tailored interventions.

This pilot study evaluated the feasibility and acceptability of ecological momentary assessment (EMA) to assess movement behaviors in adults with overweight or obesity and a MD.

Twenty-four adults with overweight or obesity (body mass index >25 kg/m²) and a permanent MD participated in a 5-week observational study. The EMA protocol included two 7-day assessment periods separated by a 3-week no-contact interval. Participants completed four EMA surveys/day (morning, evening, and two signal-contingent) via smartphone. Demographics and anthropometrics were self-reported at baseline. Movement behaviors were assessed via wrist-worn accelerometer. Feasibility of the EMA protocol was defined as completion of >75% of prompts and a mean feasibility questionnaire score of ≥4.0 on a 5.0-point scale. Acceptability was measured via questionnaire on a 5.0-point scale.

Participants (∼55.2 ± 13.3 years, 79% female) completed 303 morning, 586 signal-contingent, and 303 evening surveys. Mean moderate-to-vigorous physical activity was 36.6 ± 27.3 min/day; total physical activity was 147.4 ± 76.3 min/day. EMA compliance was 91.6%, exceeding feasibility criteria. Questionnaire results indicated high feasibility (4.6 ± 0.4) and acceptability (4.5 ± 0.5).

EMA of movement behaviors is feasible and acceptable in adults with MD and overweight or obesity. These findings support the use of EMA in future behavioral interventions targeting movement and health outcomes in this underserved population.