Purpose
Overview of geographically explicit momentary assessment research, applied to the study of mental health and well-being, which allows for cross-validation, extension, and enrichment of ...research on place and health.
Methods
Building on the historical foundations of both ecological momentary assessment and geographic momentary assessment research, this review explores their emerging synergy into a more generalized and powerful research framework.
Results
Geographically explicit momentary assessment methods are rapidly advancing across a number of complimentary literatures that intersect but have not yet converged. Key contributions from these areas reveal tremendous potential for transdisciplinary and translational science.
Conclusions
Mobile communication devices are revolutionizing research on mental health and well-being by physically linking momentary experience sampling to objective measures of socio-ecological context in time and place. Methodological standards are not well-established and will be required for transdisciplinary collaboration and scientific inference moving forward.
Objective: This article presents an experimental design, the microrandomized trial, developed to support optimization of just-in-time adaptive interventions (JITAIs). JITAIs are mHealth technologies ...that aim to deliver the right intervention components at the right times and locations to optimally support individuals' health behaviors. Microrandomized trials offer a way to optimize such interventions by enabling modeling of causal effects and time-varying effect moderation for individual intervention components within a JITAI. Method: The article describes the microrandomized trial design, enumerates research questions that this experimental design can help answer, and provides an overview of the data analyses that can be used to assess the causal effects of studied intervention components and investigate time-varying moderation of those effects. Results: Microrandomized trials enable causal modeling of proximal effects of the randomized intervention components and assessment of time-varying moderation of those effects. Conclusion: Microrandomized trials can help researchers understand whether their interventions are having intended effects, when and for whom they are effective, and what factors moderate the interventions' effects, enabling creation of more effective JITAIs.
Rationale
One third of US smokers are intermittent smokers (ITS) who do not smoke daily. Unlike daily smokers (DS), whose smoking is negatively reinforced by withdrawal relief, ITS may be motivated ...by immediate positive reinforcement. In contrast, incentive salience theory posits hypothesis that “liking” of drug effects fades in established users, such as DS.
Objective
This study aims to compare ITS’ and DS’ hedonic responses to smoking.
Methods
Participants were 109 ITS (smoking 4–27 days/month) and 52 DS (smoking daily 5–25 cigarettes/day), aged ≥21, smoking ≥3 years, and not quitting smoking. For 3 weeks, participants engaged in ecological momentary assessment, carrying an electronic diary that asked them to rate their most recent smoking experience on 0–100 visual analog scales (satisfaction, enjoyment averaged as “pleasure”, feeling sick, feeling a “rush,” enjoying upper respiratory sensations, and immediate craving relief). Hierarchical random effect regression analyzed 4476 ratings.
Results
ITS found smoking pleasurable (mean = 69.7 ± 1.7 SE) but significantly less so than DS did (77.6 ± 2.3;
p
< 0.006). ITS also reported more aversive response (ITS 18.2 ± 1.4, DS 11.6 ± 2.0;
p
< 0.007). Even though ITS are more likely to smoke at bars/restaurants, when drinking alcohol, or when others were present, they did not report more pleasure in these settings (compared to DS). More extensive smoking experience was unrelated to craving or smoking effects among DS, but predicted greater craving, greater pleasure, and less aversion among ITS.
Conclusions
The findings were largely inconsistent with incentive-salience models of drug use.
Ecological momentary assessment Shiffman, Saul; Stone, Arthur A; Hufford, Michael R
Annual review of clinical psychology,
01/2008, Letnik:
4
Journal Article
Recenzirano
Assessment in clinical psychology typically relies on global retrospective self-reports collected at research or clinic visits, which are limited by recall bias and are not well suited to address how ...behavior changes over time and across contexts. Ecological momentary assessment (EMA) involves repeated sampling of subjects' current behaviors and experiences in real time, in subjects' natural environments. EMA aims to minimize recall bias, maximize ecological validity, and allow study of microprocesses that influence behavior in real-world contexts. EMA studies assess particular events in subjects' lives or assess subjects at periodic intervals, often by random time sampling, using technologies ranging from written diaries and telephones to electronic diaries and physiological sensors. We discuss the rationale for EMA, EMA designs, methodological and practical issues, and comparisons of EMA and recall data. EMA holds unique promise to advance the science and practice of clinical psychology by shedding light on the dynamics of behavior in real-world settings.
Abstract Objectives Patient-reported outcomes (PROs; self-report assessments) are increasingly important in evaluating medical care and treatment efficacy. Electronic administration of PROs via ...computer is becoming widespread. This article reviews the literature addressing whether computer-administered tests are equivalent to their paper-and-pencil forms. Methods Meta-analysis was used to synthesize 65 studies that directly assessed the equivalence of computer versus paper versions of PROs used in clinical trials. A total of 46 unique studies, evaluating 278 scales, provided sufficient detail to allow quantitative analysis. Results Among 233 direct comparisons, the average mean difference between modes averaged 0.2% of the scale range (e.g., 0.02 points on a 10-point scale), and 93% were within ±5% of the scale range. Among 207 correlation coefficients between paper and computer instruments (typically intraclass correlation coefficients), the average weighted correlation was 0.90; 94% of correlations were at least 0.75. Because the cross-mode correlation (paper vs. computer) is also a test–retest correlation, with potential variation because of retest, we compared it to the within-mode (paper vs. paper) test–retest correlation. In four comparisons that evaluated both, the average cross-mode paper-to-computer correlation was almost identical to the within-mode correlation for readministration of a paper measure (0.88 vs. 0.91). Conclusions Extensive evidence indicates that paper- and computer-administered PROs are equivalent.
Ecological momentary assessment (EMA) is particularly suitable for studying substance use, because use is episodic and thought to be related to mood and context. This article reviews EMA methods in ...substance use research, focusing on tobacco and alcohol use and relapse, where EMA has been most applied. Common EMA designs combine event-based reports of substance use with time-based assessments. Approaches to data organization and analysis have been very diverse, particularly regarding their treatment of time. Compliance with signaled assessments is often high. Compliance with recording of substance use appears good but is harder to validate. Treatment applications of EMA are emerging. EMA captures substance use patterns not measured by questionnaires or retrospective data and holds promise for substance use research.
Abstract Craving to smoke is often conceptualized and measured as a tonic, slowly changing state induced by abstinence. In this article, we review the literature on the existence, causes, and ...treatment of cue-induced cravings: intense, episodic cravings typically provoked by situational cues associated with drug use. In laboratory research, smokers exposed to smoking-related cues demonstrate increased craving as well as distinct patterns of brain activation. Observational field studies indicate that such cue-induced cravings are substantially responsible for relapse to smoking but that smoking can often be averted by coping responses. The effects of pharmacological interventions are mixed. Steady-state medications (bupropion, varenicline, nicotine patch) do not appear to protect smokers from cue-induced cravings. However, acutely administered nicotine medications (such as nicotine gum and lozenge), used after cue exposure as “rescue medications,” can help a smoker's recovery from cue-induced cravings. Cue-induced craving plays an important role in smoking and relapse and likely in other addictions as well. Treatments to mitigate the effect of cue-induced craving are both important and needed.
Abstract
Background
Studies have suggested that some US adult smokers are switching away from smoking to e-cigarette use. Nationally representative data may reflect such changes in smoking by ...assessing trends in cigarette and e-cigarette prevalence. The objective of this study is to assess whether and how much smoking prevalence differs from expectations since the introduction of e-cigarettes.
Methods
Annual estimates of smoking and e-cigarette use in US adults varying in age, race/ethnicity, and sex were derived from the National Health Interview Survey. Regression models were fitted to smoking prevalence trends before e-cigarettes became widely available (1999–2009) and trends were extrapolated to 2019 (counterfactual model). Smoking prevalence discrepancies, defined as the difference between projected and actual smoking prevalence from 2010 to 2019, were calculated, to evaluate whether actual smoking prevalence differed from those expected from counterfactual projections. The correlation between smoking discrepancies and e-cigarette use prevalence was investigated.
Results
Actual overall smoking prevalence from 2010 to 2019 was significantly lower than counterfactual predictions. The discrepancy was significantly larger as e-cigarette use prevalence increased. In subgroup analyses, discrepancies in smoking prevalence were more pronounced for cohorts with greater e-cigarette use prevalence, namely adults ages 18–34, adult males, and non-Hispanic White adults.
Conclusion
Population-level data suggest that smoking prevalence has dropped faster than expected, in ways correlated with increased e-cigarette use. This population movement has potential public health implications.
Use of Smoking-Cessation Treatments in the United States Shiffman, Saul, PhD; Brockwell, Sarah E., PhD; Pillitteri, Janine L., PhD ...
American journal of preventive medicine,
02/2008, Letnik:
34, Številka:
2
Journal Article
Recenzirano
Background Health promotion efforts encourage smokers to quit and to use effective cessation treatments. Randomized controlled trials demonstrate that medications and behavioral treatments improve ...cessation rates, but retrospective surveys have been inconsistent. This study assessed frequency of quit attempts, use of treatments for cessation, and abstinence rates among treatment users and non-users. Methods Data were analyzed from the 2003 Tobacco Use Special Cessation Supplement to the Current Population Survey. Participants included 29,537 U.S. smokers aged ≥18 years who smoked daily 12 months before the survey. Outcome measures included past-year quit attempts; use of behavioral, pharmacologic, and alternative treatments; receipt of social support; and abstinence for ≥4 weeks at time of survey. Results Approximately 43.5% of smokers reported a quit attempt in the preceding year: 64.2% of attempters used no cessation treatments; 8.8% used behavioral treatment; 32.2% used medication; and 14.1% used more than one treatment. Social support was reported to have been received by 24.1%. More nicotine-dependent smokers were more likely to use medications (OR=3.58; 95% CI=3.04–4.20). At the time of the survey, 19.3% of attempters were abstinent ≥4 weeks. Smokers who sought treatment were less likely to be abstinent (OR=0.75; 95% CI=0.67–0.84), and those who sought multiple treatments were even less likely to be abstinent. Conclusions Many U.S. smokers make quit attempts, but most do not use behavioral or pharmacologic treatments. More nicotine-dependent smokers were more likely to seek treatment. Smokers who sought treatment were less likely to report abstinence, probably due to biased self-selection and recall. Retrospective survey data are not well-suited to assess the effectiveness of treatment.
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