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. 2012 Jun 12:12:75.
doi: 10.1186/1471-2288-12-75.

The feasibility of cell phone based electronic diaries for STI/HIV research

Devon J Hensel  1 , James D Fortenberry, Jaroslaw Harezlak, Dorothy Craig
Affiliations

The feasibility of cell phone based electronic diaries for STI/HIV research

Devon J Hensel et al. BMC Med Res Methodol. .

Abstract

Background: Self-reports of sensitive, socially stigmatized or illegal behavior are common in STI/HIV research, but can raise challenges in terms of data reliability and validity. The use of electronic data collection tools, including ecological momentary assessment (EMA), can increase the accuracy of this information by allowing a participant to self-administer a survey or diary entry, in their own environment, as close to the occurrence of the behavior as possible. In this paper, we evaluate the feasibility of using cell phone-based EMA as a tool for understanding sexual risk and STI among adult men and women.

Methods: As part of a larger prospective clinical study on sexual risk behavior and incident STI in clinically recruited adult men and women, using study-provided cell phones, participants (N = 243) completed thrice-daily EMA diaries monitoring individual and partner-specific emotional attributes, non-sexual activities, non-coital or coital sexual behaviors, and contraceptive behaviors. Using these data, we assess feasibility in terms of participant compliance, behavior reactivity, general method acceptability and method efficacy for capturing behaviors.

Results: Participants were highly compliant with diary entry protocol and schedule: over the entire 12 study weeks, participants submitted 89.7% (54,914/61,236) of the expected diary entries, with an average of 18.86 of the 21 expected diaries (85.7%) each week. Submission did not differ substantially across gender, race/ethnicity and baseline sexually transmitted infection status. A sufficient volume and range of sexual behaviors were captured, with reporting trends in different legal and illegal behaviors showing small variation over time. Participants found the methodology to be acceptable, enjoyed and felt comfortable participating in the study.

Conclusion: Achieving the correct medium of data collection can drastically improve, or degrade, the timeliness and quality of an individual's self-reported sexual risk behavior, which in turn, is a key factor in the success of intervention or education programs relying on this information. Our findings demonstrate that completion of electronic diaries via cellular phone is feasible way to describe STI/HIV risk among clinically recruited adult men and women.

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Figures

Figure 1
Figure 1
Example EMA diary screens: Home Screen for initiating survey and synchronizing data (left) and for selecting sexual behaviors (right).
Figure 2
Figure 2
Trends in participant diary completion.
Figure 3
Figure 3
Trends in reports of vaginal sex, overall and by monogamous sexual relationships.
Figure 4
Figure 4
Trends in individual and partner-based risk behaviors: cocaine/methamphetamine use, marijuana use and alcohol use.
Figure 5
Figure 5
Trends in individual and partner-based neutral behaviors: taking a walk and going to the mall.
See this image and copyright information in PMC

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