Ecological Momentary Assessment in Eating Disorders Research: A Qualitative Examination of Participant Experience and Recommendations for Future Studies

Abstract

Objective: Ecological momentary assessment (EMA) is a widely-used research method for investigating temporal relationships among eating disorder (ED) symptoms. Though EMA has many methodological advantages (e.g., reducing retrospective recall bias), little is known about the experience and effects of participating in this type of study from the perspective of individuals with EDs. The present study aimed to examine the experience of participants with EDs after completing an EMA study, with the goal of elucidating potential positive and negative effects of EMA methodology. Method: A heterogeneous sample of participants with EDs (N = 192) completed clinical interviews, questionnaires, and an EMA protocol (five surveys/day for 14 days). A subsample of these participants (n = 16) completed a qualitative interview exploring their experience participating in the study. A reflexive thematic analysis was conducted using Nvivo software. Results: The following themes were identified: (1) Self-awareness, mindfulness, and reflection; (2) Behavioral change; (3) Rewarding aspects of the study; (4) Challenging aspects of the study; (5) Study design (including facilitators and barriers to participating); and (6) Suggestions for future studies. Discussion: Although participants reported some challenging aspects of the study, most described their experience as positive (or at least neutral), and many noted direct benefits of participating. Future EMA research may benefit from integrating the perspectives of those with lived experience into study design, potentially reducing participant burden, improving the quantity and quality of data collected, and increasing benefits for participants.