This study tested whether a one-month combined EMA (ecological momentary assessment), wrist actigraphy, and passive mobile sensing protocol was feasible and acceptable in 69 adolescents (ages 12–18) with elevated depressive symptoms (CES-D ≥16), recruited from a southeastern U.S. community sample.
91% of participants completed all protocol components and were willing to participate again. Overall EMA completion was 60.5%; shifting to a semi-personalized schedule (EARS 2.0) raised feelings-survey completion from ~76.9 to ~94.1 surveys. Actigraph wear averaged 72.4% of the time (~17 hrs/day), with 57% wearing it ≥80% of the period. Passive sensor availability varied widely: accelerometer and motion data captured ~17–18 hrs/day on average, while GPS averaged only ~8.3 hrs/day.
- Multiple protocol changes (app version, compensation, schedule) occurred concurrently, so improved adherence in EARS 2.0 cannot be attributed to any single change. - Sample was geographically restricted to South Florida, predominantly female and Hispanic/Latine, limiting generalizability. - Sensor data availability partly reflected event frequency (e.g., calls, battery events) rather than true adherence, complicating interpretation.
Clinicians and researchers planning digital mental health monitoring in depressed adolescents can expect roughly 60–72% adherence with a one-month multimodal protocol—feasible but lower than adult benchmarks. Semi-personalized EMA schedules, extended response windows, and daily staff check-ins appear to improve engagement and should be built into study or clinical monitoring designs.
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