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. 2017 Mar 24;5(3):e37.
doi: 10.2196/mhealth.6496.

Cloudy with a Chance of Pain: Engagement and Subsequent Attrition of Daily Data Entry in a Smartphone Pilot Study Tracking Weather, Disease Severity, and Physical Activity in Patients With Rheumatoid Arthritis

Samuel Reade  1   2 , Karen Spencer  2 , Jamie C Sergeant  2   3 , Matthew Sperrin  4 , David M Schultz  5 , John Ainsworth  3 , Rashmi Lakshminarayana  6 , Bruce Hellman  6 , Ben James  6 , John McBeth  2 , Caroline Sanders  7 , William G Dixon  2   4   8
Affiliations

Cloudy with a Chance of Pain: Engagement and Subsequent Attrition of Daily Data Entry in a Smartphone Pilot Study Tracking Weather, Disease Severity, and Physical Activity in Patients With Rheumatoid Arthritis

Samuel Reade et al. JMIR Mhealth Uhealth. .

Abstract

Background: The increasing ownership of smartphones provides major opportunities for epidemiological research through self-reported and passively collected data.

Objective: This pilot study aimed to codesign a smartphone app to assess associations between weather and joint pain in patients with rheumatoid arthritis (RA) and to study the success of daily self-reported data entry over a 60-day period and the enablers of and barriers to data collection.

Methods: A patient and public involvement group (n=5) and 2 focus groups of patients with RA (n=9) supported the codesign of the app collecting self-reported symptoms. A separate "capture app" was designed to collect global positioning system (GPS) and continuous raw accelerometer data, with the GPS-linking providing local weather data. A total of 20 patients with RA were then recruited to collect daily data for 60 days, with entry and exit interviews. Of these, 17 were loaned an Android smartphone, whereas 3 used their own Android smartphones.

Results: Of the 20 patients, 6 (30%) withdrew from the study: 4 because of technical challenges and 2 for health reasons. The mean completion of daily entries was 68% over 2 months. Patients entered data at least five times per week 65% of the time. Reasons for successful engagement included a simple graphical user interface, automated reminders, visualization of data, and eagerness to contribute to this easily understood research question. The main barrier to continuing engagement was impaired battery life due to the accelerometer data capture app. For some, successful engagement required ongoing support in using the smartphones.

Conclusions: This successful pilot study has demonstrated that daily data collection using smartphones for health research is feasible and achievable with high levels of ongoing engagement over 2 months. This result opens important opportunities for large-scale longitudinal epidemiological research.

Keywords: arthritis; attrition; mHealth; smartphone; weather.

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Conflict of interest statement

Conflicts of Interest: RL, BH, and BJ work for uMotif, the company that provided the software application. All analyses were performed at the University of Manchester, independent from these 3 authors. The remaining authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Screenshot of uMotif app and list of data items. Each segment of the motif represents 1 of the 10 questions listed in the box. Participants slide the segment to score their response to the question stem with each question having 5 possible ordinal responses. In the example shown, the participant is responding to the question “How severe was your fatigue today?” with a response of “Moderate fatigue,” selected from options of no fatigue, mild fatigue, moderate fatigue, severe fatigue, and very severe fatigue. RA: rheumatoid arthritis.
Figure 2
Figure 2
Data flow. API: application program interface; GPS: global positioning system.
Figure 3
Figure 3
Number of days providing data, by week, for eligible participants.
Figure 4
Figure 4
Example of self-reported symptom data and weather data from Global Positioning System–derived Met Office data (pain and temperature).
See this image and copyright information in PMC

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