Variability of the Behavioral Assessment Screening Tool for Mobile Health Using Ecological Momentary Assessment in Chronic Traumatic Brain Injury

Abstract

Objective

To describe the variability of self-reported behavioral symptoms over a 2-week period in 44 individuals with chronic traumatic brain injury (TBI) using subscale scores from the Behavioral Assessment Screening Tool for Mobile Health (BAST_mHealth) collected in a prior feasibility study.

Design

Secondary analysis of data collected from a prospective, high-frequency, in situ, repeated-measures design feasibility study of the BAST_mHealth.

Setting

Community.

Participants

Forty-four (N=44) community-dwelling adults with a lifetime TBI history who completed at least 2 assessments. The sample had an average age of 43 years (SD, 14.4), consisted primarily of women (69.2%), and had an average time since the last TBI of 8.6 years (SD, 10).

Interventions

Not applicable.

Main Outcome Measures

Self-reported behavioral symptoms measured with the BAST_mHealth.

Results

We found that the Every Other Day Scheduled prompts captured the most between-day variability in self-reported behavioral symptoms compared with the Daily Random and Daily Scheduled prompts, while all 3 prompting schedules captured within-person variability over a 14-day period. We identified 3 clusters of symptom reporters, which we labeled psychiatric, cognitive, and steady symptoms.

Conclusions

We were able to capture and evaluate variability in self-reported emotional and behavioral symptoms within and between individuals. Understanding individual symptom fluctuations may guide and evaluate treatment interventions. Thus, our results indicate that BAST_mHealth may be a valuable, evidence-based tool and clinical monitoring system for evaluating post-TBI symptoms in both clinical and pragmatic trials.