No AccessAmerican Journal of AudiologyResearch Article12 Oct 2017

Ecological Momentary Assessment: Feasibility, Construct Validity, and Future Applications


    This research assessed the feasibility and construct validity of ecological momentary assessment in capturing the hearing experiences of adults with mild hearing impairment in natural environments.


    Twenty-nine adults between the ages of 55 and 79 years (M = 69 years) answered multiple surveys on a smartphone app over a 2-week trial. Participants also wore 1 environmental classifier and a streamer allowing bidirectional communication between smartphone and classifier. Surveys were triggered based on defined criteria, or by the participants. A paper-based self-report questionnaire was administered before and after the trial.


    Feasibility was indicated by high compliance rates, with a total of 1,128 surveys completed. Of these, 72% were completed during a listening event, 26% within 1 hr, and only 2% of the surveys more than 1 hr after the listening event. The mean survey completion time was 1 min 40 s. Mean pre- and post-trial self-report scores were not significantly different, indicating no reactivity. Construct validity was indicated by the close agreement between subjective ratings of listening situations and objective data from the hearing aid classifier.


    Ecological momentary assessment is a feasible and valid research methodology for older adults with mild hearing impairment. The methodology has potential as a clinical counseling and outcome tool.


    • Barker, F., MacKenzie, E., Elliott, L., & de Lusignan, S. (2015). Outcome measurement in adult auditory rehabilitation: A scoping review of measures used in randomized controlled trials.Ear and Hearing, 36(5), 567–573.
    • Beach, E. F., Williams, W., & Gilliver, M. (2012). The objective-subjective assessment of noise: Young adults can estimate loudness of events and lifestyle noise.International Journal of Audiology, 51(6), 444–449.
    • Bentler, R. A., & Kramer, S. E. (2000). Guidelines for choosing a self-report outcome measure.Ear and Hearing, 21(Suppl. 4), 37–49.
    • Cronbach, L. J., & Meehl, P. E. (1955). Construct validity in psychological tests.Psychological Bulletin, 52, 281–302.
    • Galvez, G., Turbin, M. B., Thielman, E. J., Istvan, J. A., Andrews, J. A., & Henry, J. A. (2012). Feasibility of ecological momentary assessment of hearing difficulties encountered by hearing aid users.Ear and Hearing, 33(4), 497–507.
    • Garcia-Palacios, A., Herrero, R., Belmonte, M. A., Castilla, D., Guixeres, J., Molinari, G., & Baños, R. M. (2014). Ecological momentary assessment for chronic pain in fibromyalgia using a smartphone: A randomized crossover study.European Journal of Pain, 18(6), 862–872.
    • Goldschmidt, A. B., Wonderlich, S. A., Crosby, R. D., Engel, S. G., Lavender, J. M., Peterson, C. B., … Mitchell, J. E. (2014). Ecological momentary assessment of stressful events and negative affect in bulimia nervosa.Journal of Consulting and Clinical Psychology, 82(1), 30–39.
    • Hasan, S. S., Chipara, O., Wu, Y.-H., & Aksan, N. (2014). Evaluating auditory contexts and their impacts on hearing aid outcomes with mobile phones. Paper presented at the PervasiveHealth 2014: 8th International Conference on Pervasive Computing Technologies for Healthcare, Brussels, Belgium.
    • Hedeker, D., Mermelstein, R. J., & Demirtas, H. (2012). Modeling between- and within-subject variance in ecological momentary assessment (EMA) data using mixed-effects location scale models.Statistics in Medicine, 31(27), 3328–3336.
    • Henry, J. A., Galvez, G., Turbin, M. B., Thielman, E. J., McMillan, G. P., & Istvan, J. A. (2012). Pilot study to evaluate ecological momentary assessment of tinnitus.Ear and Hearing, 32(2), 179–290.
    • Meyer, C., Scarinci, N., Ryan, B., & Hickson, L. (2015). “This is a partnership between all of us”: Audiologists' perceptions of family member involvement in hearing rehabilitation.American Journal of Audiology, 24(4), 536–548.
    • Moore, R. C., Depp, C. A., Wetherell, J. L., & Lenze, E. J. (2016). Ecological momentary assessment versus standard assessment instruments for measuring mindfulness, depressed mood, and anxiety among older adults.Journal of Psychiatric Research, 75, 116–123.
    • Pew Research Center. (2014, April). Older adults and technology use. Retrieved from
    • Piasecki, T. M., Hufford, M. R., Solhan, M., & Trull, T. J. (2007). Assessing clients in their natural environments with electronic diaries: Rationale, benefits, limitations, and barriers.Psychological Assessment, 19(1), 25–43.
    • Poost-Faroosh, L., Jennings, M. B., & Cheesman, M. F. (2015). Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.Journal of the American Academy of Audiology, 26, 247–259.
    • Serre, F., Fatseas, M., Swendsen, J., & Auriacombe, M. (2015). Ecological momentary assessment in the investigation of craving and substance use in daily life: A systematic review.Drug and Alcohol Dependence, 148, 1–20.
    • Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological momentary assessment.Annual Review of Clinical Psychology, 4(1), 1–32.
    • Soulodre, G. A., & Bradley, J. S. (1995). Subjective evaluation of new room acoustic measures.The Journal of the Acoustical Society of America, 98(1), 294–301.
    • StataCorp. (2013). Stata Statistical Software: Release 13. College Station, TX: Author.
    • Stone, A. A., & Shiffman, S. (2002). Capturing momentary, self-report data: A proposal for reporting guidelines.Annals of Behavioral Medicine, 24(3), 236–243.
    • Stone, A. A., Shiffman, S., Schwartz, J. E., Broderick, J. E., & Hufford, M. R. (2002). Patient noncompliance with paper diaries.British Medical Journal (Clinical Research Edition), 324(7347), 1193–1195.
    • Timmer, B. H. B., Hickson, L., & Launer, S. (2015). Adults with mild hearing impairment: Are we meeting the challenge?.International Journal of Audiology, 54(11), 786–795.
    • Trull, T. J., & Ebner-Priemer, U. W. (2009). Using experience sampling methods/ecological momentary assessment (ESM/EMA) in clinical assessment and clinical research: Introduction to the special section.Psychological Assessment, 21(4), 457–462.
    • Ventry, I., & Weinstein, B. (1982). The Hearing Handicap Inventory for the Elderly: A new tool.Ear and Hearing, 3(3), 128–134.
    • Wu, Y.-H., Stangl, E., Zhang, X., & Bentler, R. A. (2015). Construct validity of the ecological momentary assessment in audiology research.Journal of the American Academy of Audiology, 26(10), 872–884.

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