Innovative mobile phone app boosts data collection in adolescent cohort



TYPE Prevention Centre News

The study obtained data over 16 weeks from a hard-to-reach group of nearly 1300 adolescents aged 17 to 19 in Western Sydney.

The young people were recruited through social media and were required to fill in an initial questionnaire followed by regular ‘ecological momentary assessments’ (EMAs) – brief questions sent to their phone at different times of day throughout the week.

Data on their location, movement and screen time were also collected from mobile phone sensors, with participants’ consent.

Study lead, Professor Andrew Page of Western Sydney University, said data were often difficult to obtain from this cohort using traditional methods such as landline or school-based surveys.

“Many people of this age don’t have access to a landline, and by young adulthood we don’t capture them in school-based surveys either. It’s also quite difficult to get them to respond to population health surveys,” Professor Page said.

“In traditional surveys, we usually have one opportunity to ask people a whole lot of questions. But with this mobile phone app, we could ask one or two questions every couple of days over a longer period of time. In combination with the in-built smartphone sensors on movement and location, we could build up quite detailed trajectories of health behaviours over time.”

The Western Sydney Adolescent Health Study was conducted to examine behavioural factors associated with overweight and obesity, as part of a larger Prevention Centre project using big data and dynamic simulation modelling to tackle the problem.

The aims of the pilot study were to test the feasibility of recruiting adolescents in the population catchment of Western Sydney via social media, using mobile phone software to collect health and wellbeing measures in real-time, and to investigate patterns of dietary behaviour, physical activity and other health and wellbeing factors over a 16-week follow-up period.

First, a targeted promotion campaign was developed for Instagram and Facebook and a $30 gift card offered as reimbursement for the time spent participating in the study. A Youth Advisory Group advised on images for the social media campaign.

A total of 1,298 participants joined the pilot study, with greater uptake through Instagram than Facebook. Data were collected through the Ethica Data mobile phone app.

Participants answered questions on health status, happiness, relationships, engagement, achievement, sleep, study, physical activity and diet at baseline and in separate EMAs sent to their phones over 16 weeks. A snapshot of the data collected is available here.

Professor Page said the use of mobile phone apps was particularly suited to younger cohorts, but was useful for any population that used a mobile phone: “It was very easy to set up and use, and I think has wide application in many different contexts.”

Limitations included that the survey sample was predominantly female (81%), and that most participants dropped out during the 16 weeks, with completion rate of the EMAs falling from approximately 25% to 10%.

Recommendations for future research using mobile phones were that partners such as the Youth Advisory Group be embedded in co-design as early as possible; that survey participants be provided with smaller incentives and feedback more often; and that gamification elements in follow-up surveys may help improve retention and adherence rates.

The data collected in this pilot study has also provided insights into the impact of COVID-19 physical distancing measures on the wellbeing and health behaviours of young people in Western Sydney.