Abstract

Objectives: Ecological Momentary Assessment (EMA) is a promising methodology for examining the contextual impact of psychosocial functioning on chronic disease management in individuals with type 1 diabetes (T1D). Little is known regarding psychometric properties of EMA of psychosocial functioning in adults with complications related to T1D. The aim of this study is to explore the feasibility, reliability, and validity of EMA psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia in a sample of adult individuals with complications related to T1D.

Methods: Fifty-one participants with T1D completed a 14-day EMA of symptoms of depression, anxiety, diabetes-related distress, and fear of hypoglycemia. Multilevel linear models were used to evaluate the association of EMA psychosocial questions with standard psychosocial measures.

Results: Feasibility was demonstrated via high response rates across the 14-day EMA response period (3 times daily). All 4 EMA measures (depression, anxiety, diabetes-related distress, and fear of hypoglycemia) showed meaningful (i.e. ≥25%) within-person variability (from 28.7% in diabetes-related distress to 46.5% in fear of hypoglycemia). All measures exceeded between-person reliability of 0.8 within 1 to 3 days. None of the measures demonstrated significant diurnal patterns. Convergent validity was established via significant correlations between all aggregate EMA measures with corresponding “gold standard” surveys.

Conclusions: Overall, findings support the psychometric properties (feasibility, reliability, and validity) of EMA of psychosocial measures in an adult cohort with complications related to T1D. This is the first study to date to examine psychometric properties of EMA of psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia simultaneously in an adult population with complications related to T1D.

Document Type

Article

Publication Date

4-16-2026

Publication Title

Canadian Journal of Diabetes

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