How do participant preferences, expectancies, and perceptions of ecological momentary assessment impact adherence? A mixed-methods analysis.

Clinical researchers using ecological momentary assessment (EMA) methods design study protocols to optimize adherence. These decisions can sacrifice the scope, temporal granularity, and observational power of resultant data and are often based on limited empirical evidence. The present mixed-methods study queried participant preferences on EMA design and expectancies regarding a hypothetical EMA protocol (Sample 1, N = 1,495). We used a concurrent triangulation approach to analyze quantitative survey and qualitative interview data assessing implementation outcomes from a subset of Sample 1 individuals (a majority of whom reported clinical levels of anxiety/stress or frequent alcohol use) who enrolled and completed at least 2 weeks EMA (Sample 2; n = 59). Participants completed three EMA surveys for up to 112 days (M = 76.8 days, SD = 37.88) with an average within-person compliance of 73.8% (SD = 17.18). Descriptive statistics and a hybrid inductive-deductive coding approach were used to analyze quantitative and qualitative data, respectively, to understand factors that influence adherence. Participants perceived daily variability in most health-related domains (e.g., mental health symptoms, rest) and frequently reported positive expectations for EMA (e.g., anticipated increased awareness). Most participants reported that EMA helped increase awareness of their daily patterns (n = 37, 62.7%) but that study protocols were long and burdensome (n = 44, 74.6%). Qualitative themes were related to deductive implementation outcomes with significant inductive nuances that varied by level of adherence. Results help to guide EMA protocol decisions to improve adherence based on participant preferences, expectations, and experiences during EMA. (PsycInfo Database Record (c) 2025 APA, all rights reserved).