Feasibility and acceptability of 7-day smartphone-based, activity-triggered Ecological Momentary Assessment among low-income older adults

Background and Objectives
Smartphone-based Ecological Momentary Assessment (EMA) is increasingly used to collect real-time data on physical activity behaviour. However, no activity-triggered EMA studies have been conducted among low-income older adults. We aim to assess the feasibility and acceptability of activity-triggered EMA in low-income older adults.

Research Design and Methods
Researchers partnered with community organisations and provided technical support to facilitate the recruitment and retention of low-income older adults. For 7 days, 39 older adults (76.4 ± 8.5 years; 76% earning below £25,000/year) received EMA surveys when they surpassed a predefined activity/inactivity threshold, or when two hours elapsed between prompts. Participants wore a Move 4 activity sensor to measure their steps. A post-study questionnaire assessed perceptions of acceptability.

Results
Participants completed 84% of the EMA surveys they received. EMA compliance did not appear to differ as a function of age, biological sex, time of day, day of week, or concurrent physical activity. Responses to the post-study questionnaire revealed that the most enjoyable aspects of participating in the study were making a worthwhile contribution to science and becoming more self-aware of their feelings and/or activities. The least enjoyable aspects included the frequency or timing of EMA prompts, the interruption of activities to complete an EMA survey, and limited or inadequate response options for certain EMA items.

Discussion and Implications
Smartphone-based, activity-triggered EMA is feasible and acceptable among low-income older adults. Fostering community partnerships, managing participant resource constraints, and providing technical support are crucial strategies for engaging and retaining this population in mobile health research.