Understanding health behaviours in context: A systematic review and meta-analysis of Ecological Momentary Assessment studies of five key health behaviours

Olga Perski* (Corresponding Author), Jan Keller, Dimitra Kale, Bernard Yeboah-Asiamah Asare, Verena Schneider, Daniel Powell, Felix Naughton, Gill Ten Hoor, Peter Verboon, Dominika Kwasnicka

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)
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Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psychological and contextual predictors) and methodological aspects (e.g., study characteristics, EMA adherence). We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science until February 2021. We included studies focused on any of the aforementioned health behaviours in adult, non-clinical populations that assessed ≥1 psychological/contextual predictor and reported a predictor-behaviour association. A narrative synthesis and random-effects meta-analyses of EMA adherence were conducted. We included 633 studies. The median study duration was 14 days. The most frequently assessed predictors were 'negative feeling states' (21%) and 'motivation and goals' (16.5%). The pooled percentage of EMA adherence was high at 81.4% (95% CI = 80.0%, 82.8%, k=348) and did not differ by target behaviour but was somewhat higher in student (vs. general) samples, when EMAs were delivered via mobile phones (vs. handheld devices), and when event contingent (vs. fixed) sampling was used. This review showcases how the EMA method has been applied to improve understanding and prediction of health behaviours in context.

Original languageEnglish
Pages (from-to)576-601
Number of pages26
JournalHealth Psychology Review
Issue number4
Early online date15 Sept 2022
Publication statusPublished - 2022

Bibliographical note

The review team would like to thank Dr. David Simons for his help with the R code, as well as Dr. Pierre Gerain, Sally Di Maio, Rike Panse, Noemi Lorbeer, Malte Stollwerck, Dr. Paul Gellert, and Dr. Ann DeSmet for their contributions to the data extraction.
Olga Perski and Dimitra Kale receive salary support from Cancer Research UK (C1417/A22962). Daniel Powell is funded by the Scottish Government’s Rural and Environment Science and Analytical Services (RESAS) and by the School of Medicine, Medical Sciences, and Nutrition (SMMSN) at the University of Aberdeen. Felix Naughton’s salary is covered by the Faculty of Medicine and Health Sciences at the University of East Anglia. Dominika Kwasnicka’s work is carried out within the HOMING program of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund (grant number POIR.04.04.00-00-5CF3/18-00; HOMING 5/2018) and she is also funded by the NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Australia.


  • ambulatory assessment
  • ecological momentary assessment
  • experience sampling
  • health psychology
  • systematic review
  • metaanalysis


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