Examining Reactivity to Intensive Longitudinal Ecological Momentary Assessment: 12-month Prospective Study

Abstract

Abstract Purpose To examine the association between intensive, longitudinal ecological momentary assessment (EMA) and self-reported eating behaviors. Methods Secondary analysis of the EMPOWER study—a 12-month observational study that examined the microprocesses of relapse following intentional weight loss using smartphone-administered EMA—was conducted. Participants were asked to complete four types of EMA surveys using a mobile app. For this analysis, only the number of completed random EMA surveys was used. Using linear mixed-effects modeling, we analyzed whether the number of completed random EMA surveys was associated with changes in self-reported dietary restraint, dietary disinhibition, and susceptibility to hunger measured using the Three-Factor Eating Questionnaire (TFEQ). Results During the 12-month study, participants completed a mean of 1,062 random EMA surveys (range: 673-1,362). The number of completed random EMA surveys was not significantly associated with TFEQ scores. However, there was a marginally significant main effect of the number of EMA surveys on disinhibition (p = 0.08) and an interaction between study interval and the number of EMA surveys on restraint (p = 0.08). Conclusions Intensive longitudinal EMA did not influence self-reported eating behaviors. The findings suggest that EMA can be used to frequently assess real-world eating behaviors with minimal concern about assessment reactivity. Nonetheless, care must be taken when designing EMA surveys—particularly when using self-reported outcome measures. Level of evidence: Level III, prospective observational study