The Acceptability and Compliance of Ambulatory Assessment: A Large-Scale Investigation on 2792 Individuals

Background: Despite the popularity of Ambulatory Assessment (AA), few studies have investigated how participants experience and perceive their participation, including the burdensomeness and utility of AA. This is important, as participants’ experience in the measurement process can directly impact participants’ wellbeing and data quality. Methods: In a 40-day diary study involving 2792 individuals, participants reported their experience of the measurement process (AA acceptability) with six self-report items. We analyzed the percentage of subjects who perceived benefits from the participation vs. those who did not and investigated whether this could be related to participant demographics using Seemingly Unrelated Regression (SUR) and logistic regression. We explored how compliance (the number of participation days) was related to AA acceptability and participant demographics using multiple Poisson regression. Results: Most participants found AA to be beneficial in general (74.6%), specifically, for their self-understanding (59.9%), and self-reflection and experience sharing (68.5%). Most participants expressed willingness to participate in AA research again (83.9%). A minority of participants (11.7%) reported they felt AA participation worsened their problems, while twice as many (21.7%) participants reported that AA participation helped alleviate their mental health problems. Demographic predictors were predominant insignificant, reflecting that the high acceptability of AA was relatively stable across different populations. Participation was perceived to be more beneficial by females, younger adults, and those who were receiving psychological treatment. The high acceptability of AA also improved participants’ compliance in the study, with perceived utility predicting more participation days. Conclusions: Adults across different population subgroups predominantly find participation in AA research to be beneficial for their mental health, with the majority of adults expressing re-participation interest. One in five participants experienced improvement in their psychiatric symptoms related to participation, while a minority of individuals expressed mental deterioration, presenting a critical avenue for future research to identify the characteristics of individuals who are more or less likely to benefit from AA research. The finding that AA was perceived to be more beneficial by recipients of psychological treatment highlights the potential of AA methods to serve as a complementary tool to provide feedback and facilitate patient-clinician interactions toward improving treatment outcomes in psychotherapy.