Logs, diaries, checklists and other self-monitoring tools are an ubiquitous part of nearly all research. Paper-based self-monitoring tools have been used to assess a range of subject behaviors including substance use, medication use, medical symptoms, and physical activity. Essentially any behavior, thought, or emotion has been self-monitored for research purposes.
To improve accuracy, reduce retrospective recording, and address the compliance difficulties of pencil-and-paper self-monitoring procedures, a range of technologies have been applied to self-monitoring methods. Csikszentmihalyi & Larson (1987) developed the Experience Sampling Method (ESM) in which a pager or other timing device prompts the subject to observe and record the presence or absence of the target behaviors. The prompt to record improves subject compliance with the field protocol while also reducing monitoring burden since the behaviors are sampled instead of being continuously monitored. Shiffman, Stone, and colleagues (Shiffman, 1993) developed the Ecological Momentary Assessment (EMA) method which delivers the self-monitoring procedure on handheld data collection computers, such as Personal Digital Assistants (PDAs). Since that time, EMA has been used to self-monitor a range of smoking associated variables including coping responses to cravings (O'Connell, Gerkovich, Cook, Shiffman, Hickcox, & Kakolewski, 1998), alcohol use (Collins, Morsheimer, Shiffman, Paty, Gnys, & Papandonatos, 1998) and eating disorder behaviors (Wegner, Smyth, Crosby, Wittrock, Wonderlich, & Mitchell, 2002). As work using EMA technologies expands, standards for analyzing (Schwartz & Stone, 1998) and reporting (Stone & Shiffman, 2002) EMA data are being increasingly standardized and accepted.
Foster and colleagues (Foster, Layerty-Finch, Gizzo, & Ostantowski, 1999) have noted that computer-administered methods offer a number of advantages over pencil and paper diaries including: a) automated scheduled prompts for recording (similar to the ESM method), b) automated date and time recording to assess and control the elapsed time from prompt to actual entry, c) ability to prevent subjects viewing previous responses to minimize the influence of prior entries, d) greater recording method flexibility, e) portability while also being sufficiently intrusive to serve as a recording cue, and f) elimination of manual entry of log or diary responses to a database, saving time and eliminating transcription errors. Stone, Kessler & Haythornthwaite (1991) also noted that computerized programs offer the potential for greater complexity of the monitoring procedure (e.g. branching logic) since the computer guides the administration. Compliance rates to prompted self-monitoring, especially computerized prompting and recording, have generally been high, typically exceeding 90% (Foster et al, 1999). Some studies have found lower completion rates of computerized vs. pencil-and-paper systems resulting from the inability of subjects to use computers to complete entries retrospectively. (Hank & Schwenkmezger, 1996; Collins, Kashdan, & Gollnisch, 2003).
A disadvantage noted by Foster et al. (1999) of computerized self-monitoring systems is that the systems are costly to develop. Collins and Graham (2002) have argued that, although EMA is promising, it is too costly to be utilized for many research questions. With EMA, there are considerable programming costs required to develop and test the screen displays, the input and output functions, navigation, scheduled prompting functions, database integrity, and the conduit functions for uploading and downloading of information regarding the field protocol. These programming efforts must be undertaken for each study in which a different self-monitoring procedure is used. Even with recent commercial efforts to address the issues of programming costs and expertise for researchers desiring a computerized self-monitoring system, these programming costs remain prohibitive for all but the largest and most well-funded research organizations. In clinical settings in which the monitoring system must be flexible enough to be tailored to each client or patient, such frequent reprogramming is not a viable option, effectively excluding computerized self-monitoring from small clinical trials.