Lightning Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

Expert evaluation of a new smartphone‑based ecological momentary assessment survey for stroke rehabilitation (139139)

Katrina Kenah 1 2 , Felicity Bright 3 , Dana Wong 4 , Natalie Fini 5 , Jessica Kolic 1 , Andrea Elliott 1 2 , Valentina Maric 1 , Meave McCann 1 , Phoebe Hoogeveen 1 , Julia Gilmartin-Thomas 1 2
  1. Bayside Health, Melbourne, Victoria, Australia
  2. School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
  3. Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
  4. School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
  5. Physiotherapy Department, University of Melbourne, Parkville, Victoria, Australia

Aim: Existing patient‑reported outcome measures may be insensitive to day-to-day experiences that impact wellbeing during stroke rehabilitation. Ecological momentary assessment (EMA) offers a real‑time approach to address this gap. This study evaluated the quality of items in a new smartphone‑based EMA survey systematically developed from literature and existing EMA tools to measure daily activities and wellbeing in stroke survivors and carers during sub‑acute rehabilitation.

Methods: Stroke rehabilitation experts from Australia and New Zealand with relevant content and accessible design expertise for EMA item development were invited via email to participate. Participants rated 23 proposed items assessing momentary wellbeing (e.g. boredom, perceived control) and context (e.g. location, activity, people present). Items were evaluated against 13 quality criteria selected from the ESM‑Q1, assessing item clarity, appropriateness and suitability for six-times daily sampling, and refined through researcher and stakeholder advisory group (n=9) discussion.

Results: Of 25 invited experts, 13 completed the review. Participants represented physiotherapy (n=5), occupational therapy (n=2), speech pathology (n=3), and psychology (n=3), with two reporting prior EMA experience. Ten items demonstrated significant issues (<70% agreement on ≥1 criterion). Most concerns related to ambiguity, ease of understanding and response option coverage. Minor wording changes were made to 22 items. One item was revised from “sense of progress” to “helpful for stroke recovery” following concerns about construct suitability for high-frequency sampling.

Conclusion: Expert review improved clarity, comprehension and response option coverage of a new smartphone‑based EMA survey for stroke rehabilitation. Further refinement will occur through cognitive interviews with stroke survivors and carers.

  1. Eisele G, Hiekkaranta A, Kunkels YK, et al. ESM-Q: A consensus-based quality assessment tool for experience sampling method items. Behav Res Methods. 2025;57(4):124.