Autor: Stefan Hey

Ambulatory Assessment

A short summary of the current methodologies

Studying people in their natural habitat is no longer exclusively the domain of anthropologists in the wild. The jungle and the savannah no longer resemble the day to day experiences of modern urban dwelling homo-sapiens. However the legacy of our past is still locked within our psyche, and unravelling our psychological nature involves researchers utilizing new methods to delve deeper in to our minds and bodies.

The overarching ‘umbrella’ for all of the following research methods is Ambulatory Assessment. Whether you’re performing an Ecological Momentary Assessment or Experience Sampling study, they fall within the scope of Ambulatory Assessment.

The core idea of Ambulatory Assessment is to track parameters outside of the laboratory or clinic. Using electronic diaries and/or physiological sensors, researchers can cast aside the inaccuracy of patient reporting and gain valid real time or near real time data. Data not contaminated by the fallibility of participant recollection or miss reporting, and this allowed researchers a purer glimpse of the “… rich information about the daily lives of individuals who may be studied or treated by clinical scientists and mental health professionals.” (Trull & Ebner-Priemer, 2013)

The best and most concise definition of Ambulatory Assessment comes from the Society for Ambulatory Assessment website:

“Ambulatory Assessment comprises the use of field methods to assess the ongoing behavior, physiology, experience and environmental aspects of people in naturalistic or unconstrained settings. Ambulatory Assessment uses ecologically-valid tools to understand biopsychosocial processes as they unfold naturally in time and in context.”

Whilst Experience Sampling and Ecological Momentary Assessment and Daily Diary Studies are components of Ambulatory Assessment, this term often conjures Physiological Monitoring to mind. Research papers that cite Ambulatory Assessment in their keywords often utilize accelerometers, ECG, and other physiological parameters as the core data in their study.

So that brings us on to Ecological Momentary Assessment and Experience Sampling, two of the key components of Ambulatory Assessment, and just like Ambulatory Assessment, Ecological Momentary Assessment doesn’t really sound that catchy. Now, there’s a subtle difference between EMA and Experience Sampling. First I’ll pass it over to Reed Larson and Mihaly Csikszentmihalyi to recite the abstract from their 1983 article that defined the Experience Sampling Method:

“…the Experience Sampling Method (ESM), a research procedure that consists of asking individuals to provide systematic self-reports at random occasions during the waking hours of a normal week....The ESM obtains information about the private as well as the public aspects of individuals' lives, secures data about behavioral and intrapsychic aspects of daily activity, and obtains reports about people's experiences as they occur, thereby minimizing the effects of reliance on memory and reconstruction.”

Whilst gathering information from people during their daily lives is the primary role of Experience Sampling, the term has become used to describe gathering subjective data over time even within the laboratory or clinical setting. Now, let’s get back to Ecological Momentary Assessment. To perform great craftsmanship, a tradesman requires good tools, and for the researcher Ecological Momentary Assessment (EMA) is an incredibly powerful longitudinal study tool for harnessing subjective data in day to day life. The subtle difference between EMA and ESM (experience sampling methodology) lies in the origins of the two methods. EMA emerged out of the field of behavioral medicine, and as a result often includes physiological parameters or health related questions, and is primarily performed in a person’s day to day normal environment.

In the next part of this series, we’ll delve in to the advantages and drawbacks of Ambulatory Assessment, and discuss the impact of developing technology.