TY  - JOUR
AU  - Khalifa, Aleya
AU  - Beres, Laura K
AU  - Anok, Aggrey
AU  - Mbabali, Ismail
AU  - Katabalwa, Charles
AU  - Mulamba, Jeremiah
AU  - Thomas, Alvin G
AU  - Bugos, Eva
AU  - Nakigozi, Gertrude
AU  - Chang, Larry W
AU  - Grabowski, M Kate
PY  - 2024
DA  - 2024/6/10
TI  - Leveraging Ecological Momentary Assessment Data to Characterize Individual Mobility: Exploratory Pilot Study in Rural Uganda
JO  - JMIR Form Res
SP  - e54207
VL  - 8
KW  - ecological momentary assessment
KW  - spatial analysis
KW  - geographic mobility
KW  - global positioning system
KW  - health behaviors
KW  - Uganda
KW  - mobility
KW  - pilot study
KW  - smartphone
KW  - alcohol
KW  - cigarette
KW  - smoking
KW  - promoting
KW  - promotion
KW  - alcohol use
KW  - cigarette smoking
KW  - mobile phone
AB  - Background: The geographical environments within which individuals conduct their daily activities may influence health behaviors, yet little is known about individual-level geographic mobility and specific, linked behaviors in rural low- and middle-income settings. Objective: Nested in a 3-month ecological momentary assessment intervention pilot trial, this study aims to leverage mobile health app user GPS data to examine activity space through individual spatial mobility and locations of reported health behaviors in relation to their homes. Methods: Pilot trial participants were recruited from the Rakai Community Cohort Study—an ongoing population-based cohort study in rural south-central Uganda. Participants used a smartphone app that logged their GPS coordinates every 1-2 hours for approximately 90 days. They also reported specific health behaviors (alcohol use, cigarette smoking, and having condomless sex with a non–long-term partner) via the app that were both location and time stamped. In this substudy, we characterized participant mobility using 3 measures: average distance (kilometers) traveled per week, number of unique locations visited (deduplicated points within 25 m of one another), and the percentage of GPS points recorded away from home. The latter measure was calculated using home buffer regions of 100 m, 400 m, and 800 m. We also evaluated the number of unique locations visited for each specific health behavior, and whether those locations were within or outside the home buffer regions. Sociodemographic information, mobility measures, and locations of health behaviors were summarized across the sample using descriptive statistics. Results: Of the 46 participants with complete GPS data, 24 (52%) participants were men, 30 (65%) participants were younger than 35 years, and 33 (72%) participants were in the top 2 socioeconomic status quartiles. On median, participants traveled 303 (IQR 152-585) km per week. Over the study period, participants on median recorded 1292 (IQR 963-2137) GPS points—76% (IQR 58%-86%) of which were outside their 400-m home buffer regions. Of the participants reporting drinking alcohol, cigarette smoking, and engaging in condomless sex, respectively, 19 (83%), 8 (89%), and 12 (86%) reported that behavior at least once outside their 400-m home neighborhood and across a median of 3.0 (IQR 1.5-5.5), 3.0 (IQR 1.0-3.0), and 3.5 (IQR 1.0-7.0) unique locations, respectively. Conclusions: Among residents in rural Uganda, an ecological momentary assessment app successfully captured high mobility and health-related behaviors across multiple locations. Our findings suggest that future mobile health interventions in similar settings can benefit from integrating spatial data collection using the GPS technology in mobile phones. Leveraging such individual-level GPS data can inform place-based strategies within these interventions for promoting healthy behavior change. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2024/1/e54207
UR  - https://doi.org/10.2196/54207
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38857493
DO  - 10.2196/54207
ID  - info:doi/10.2196/54207
ER  -