An ecological momentary sampling tool for movement patterns and psychiatric symptom variability: A pilot study

Purpose In this report, we describe the development of an Ecological Momentary Sampling (EMS) application (app) for smart devices (EMS-Tool) to collect movement and mental health information from older adults with bipolar disorder. Participants are randomly prompted within self-specified windows of general availability and asked about important events of that day, medication adherence, sleep quality, and symptom levels at that moment. Up to three prompts are received twice daily at Time 1, 20 min, and 25 min after Time 1 if no questionnaire is submitted. Voluntary EMS questionnaires can also be submitted outside of these 30-minute windows. We also measure global positioning system (GPS) data every six minutes. Methods We outline three non-linear (iterative) main activities of the development process: (i) requirements elicitation and analysis, (ii) high-level and detailed design, and (iii) implementation and testing. In a pilot study, participants were prompted to complete am and pm versions of our brief EMS questionnaire over two weeks. They were also asked to complete identical printed-page versions and indicate their location. Results All questionnaire responses submitted via our app were recorded with near perfect reliability when responses were immediately transmitted and when temporarily stored by the device until back in 4G LTE or WiFi range. Discussion Beyond its initial development for our BADAS (Bipolar Affective Disorder and older Adults) Study, there is an array of research and clinical applications for this EMS-Tool. This includes data collection over extended periods to populate online self-care and care-management tools intended to foster symptom awareness and health enhancing behaviors.