From Assessment to Intervention: Leveraging Ecological Momentary Assessment (EMA) to Develop a Personalized mobile-health (mHealth) Ecological Momentary Intervention (EMI) for Young Adults With ADHD and High-Risk Alcohol Use

Ecological momentary assessment (EMA) can be a powerful and flexible tool for collecting data on alcohol use, particularly to understand proximal precursors and consequences. EMA can also be leveraged both to inform the development of and to deploy mobile-health (mHealth) interventions. This article describes the development of an mHealth ecological momentary intervention (EMI) for young adults with high-risk alcohol use and attention-deficit/hyperactivity disorder (ADHD). This novel intervention uses EMA as an intervention component to increase self-awareness via symptom monitoring. It also incorporates additional EMI components, including personalized feedback and behavioral strategy suggestions ("tips"), which operate synergistically with EMA questions and are tailored by EMA data. The theoretical underpinnings of this intervention are described, and its distinct relevance for young adults with ADHD who engage in high-risk alcohol use, are discussed. The process of developing this mHealth EMI is detailed, including examining EMA data to generate intervention content, considering participant feedback through iterative pilot testing, and applying human-centered design methods with end users and community partners. Finally, practical considerations of this intervention approach are discussed, including unique benefits, key challenges, and exciting future opportunities.