Ecological momentary assessments to measure substance use and associated behaviours: A systematic review.

Abstract

Background: Substance use behaviours tend to be episodic, contextual and event or time contingent. Previously, substance use measurement has relied on retrospective recall, which is not suitable to investigate dynamic changes in behaviour that occur over time and across contexts. One method to overcome these limitations is Ecological Momentary Assessment (EMA). EMA methods repeatedly sample participant behaviours and experiences in real time, in the context in which they occur. These methods aim to maximise ecological validity and allow for the investigation of microprocesses that influence behaviour in real-world contexts. To date there is significant methodological variation across EMA studies for the assessment of substance use and related behaviours. Therefore, this review aims to provide a comprehensive overview of EMA methods that have been used to measure substance use and to identify personal, social and environmental factors influencing substance use.   Methods: Researchers conducted a systematic review of the literature by searching PubMed, MEDLINE, EMBASE, and PsycINFO via Ovid from database inception to 1 October 2022. Studies were screened by two independent reviewers, using a title and abstract first only method. Studies using EMA methods to collect original data on substance use were identified. The key data for extraction included: participant characteristics, type of EMA methodology, substance use measures, related behaviours, statistical analysis, and findings.   Results: After title/abstract and full-text screening, 274 studies were deemed eligible. An overview of study characteristics will be provided. Where possible, findings will be synthesised according to drug class, revealing the association between substance use and any moderating factors, including personal, social and/or environmental factors.   Conclusion: The use of EMA methods vastly improves our understanding of the reciprocal relationship between substance use and related behaviours. This will undoubtedly inform the delivery of more effective clinical interventions.