Reliability and validity of daily self-monitoring by smartphone application for health-related quality-of-life, antiretroviral adherence, substance use, and sexual behaviors among people living with HIV

Abstract

This paper examines inter-method reliability and validity of daily self-reports by smartphone application compared to 14-day recall web-surveys repeated over 6 weeks with people living with HIV (PLH). A participatory sensing framework guided participant-centered design prioritizing external validity of methods for potential applications in both research and self-management interventions. Inter-method reliability correlations were consistent with prior research for physical and mental health quality-of-life (r = 0.26-0.61), antiretroviral adherence (r = 0.70-0.73), and substance use (r = 0.65-0.92) but not for detailed sexual encounter surveys (r = 0.15-0.61). Concordant and discordant pairwise comparisons show potential trends in reporting biases, for example, lower recall reports of unprotected sex or alcohol use, and rounding up errors for frequent events. Event-based reporting likely compensated for modest response rates to daily time-based prompts, particularly for sexual and drug use behaviors that may not occur daily. Recommendations are discussed for future continuous assessment designs and analyses.

Conflict of interest statement

Conflict of interest The authors declare that they have no competing interests.

Figures

Fig. 1

Plots of exemplar domains showing daily and recall pairwise comparisons for counts and proportions of days reported, and corresponding Spearman’s rho correlations shown for 14-day periods including zero reports (r1) and excluding zero reports (r2)

Fig. 2

Plots of exemplar domains showing correlations of the differences between daily and recall reports by the number of days without daily reports. Solid dots represent zero-reports for both daily and recall reports (e.g. abstinent). Pearson correlation coefficients shown for 14-day periods including zero reports (r1) and excluding zero reports (r2)

Fig. 3

Key Recommendations for mHealth Self-monitoring Assessment for PLH