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Did you practice today? - Using ecological momentary assessment to explore dosage
Bess, Nevaeh Elman, Carson Hudson, Abbie Hurley, Avery Tackitt, Adelyn Zerr, Sarah
Bess, Nevaeh
Elman, Carson
Hudson, Abbie
Hurley, Avery
Tackitt, Adelyn
Zerr, Sarah
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Bess_2025.pdf
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2025-04-11
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Bess, N., Elman, C., Hudson, A., Hurley, A., Tackitt, A., & Zerr, S. 2025. Did you practice today? - Using ecological momentary assessment to explore dosage. -- In Proceedings: 21st Annual Symposium on Graduate Research and Scholarly Projects. Wichita, KS: Wichita State University
Abstract
INTRODUCTION: Dosage and the factors that influence family behavior for children with disabilities is an important topic in pediatric physical therapy. Caregiver concern is the belief in likelihood in the change of function. The relationship between concern and dosage, as well as the factors that make caregivers more or less likely to use strategies between structured therapy sessions is important for clinicians to understand when making plans of care. Poor caregiver adherence to therapy plans is noted throughout the literature and this study seeks to explore factors related to caregiver concern, dosage, and caregiver integration of strategies between visits in structured therapy using an Ecological Momentary Assessment (EMA), which is repeated sampling of subjects’ current behaviors and experiences in a natural environment to assess the effectiveness and awareness of practice.
PURPOSE: The purpose of this research study is to analyze quantitative data on caregiver action between sessions and to uncover qualitative themes relating to when and how caregivers use strategies learned in physical therapy as well as facilitators and barriers to that practice. This study gathers data about the integration of strategies learned in structured therapy sessions and the dosage between sessions.
METHODS: A dosage survey was developed and distributed via email and QR code, with a follow up EMA survey for interested participants. Our team distributed the survey information to therapy providers with the request to share with families receiving therapy services. Caregivers were prompted to complete the survey daily, providing quantitative data on the dosage of their therapy services and their use of strategies between sessions as well as information on their awareness, integration, and enjoyment related to their child’s development. Caregivers who indicated willingness to complete a follow-up interview were contacted via email to set up a time for a virtual interview session. These interviews were recorded and transcribed. We used a grounded theory approach with constant comparison to find themes in the data and develop a model of the relationship between concern and progress in early intervention.
RESULTS: Quantitatively, we are reporting novel descriptive statistics for caregiver behavior between sessions and have a preliminary regression model to describe factors leading to increased adherence. This model has some obvious holes but will serve as a basis for future studies. We also have descriptive statistical data on facilitators of caregiver action between sessions, which has not been reported quantitatively in the literature. Qualitatively, we discovered themes relating to confidence, action, routines, and supports. Our poster presentation will include a model of these themes. In general, our qualitative findings indicated changes in caregiver routines and actions as a result of fluctuations in confidence resulting from experiences and use of formal and informal supports.
CONCLUSION: Caregivers reported shorter, but more frequent bouts of practice than we hypothesized. The most frequent facilitators to this practice were routines, concern/motivation, education from a therapist, and child and family enjoyment. We discovered that family enjoyment, caregiver education, caregiver work schedules, and anticipated practice amounts were predictors of caregiver action between sessions. Qualitatively, we suspect the strong predictors not accounted for in our model are likely related to locus of control, caregiver concern for child health, and other factors related to these themes.
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Presented to the 21st Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Rhatigan Student Center, Wichita State University, April 11, 2025.
Research completed in the Department of Physical Therapy, College of Health Sciences.
Research completed in the Department of Physical Therapy, College of Health Sciences.
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Wichita State University
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GRASP
v. 21
v. 21