EMA questionnaires

Some parameters relevant to assess an individual’s occupational exposome have a more qualitative nature and cannot be measured by sensors or passive samplers. Traditionally these parameters are assessed by questionnaires that are completed once or twice a year. Examples of qualitative parameters are experienced stress level or quality of sleep or general well-being. Questionnaires can be either digitally or on paper.  It is also possible to use questionnaires in a more real time manner. This is called Ecological Momentary Assessment. By presenting the questionnaires daily to participants online, changes in these parameters can be monitored in high(er) resolution over time. Also, the data from the questionnaires may be made available for further processing directly after completion and can be combined in (near) real time with more quantitative measurements.  Besides for more qualitative parameters, EMA can also be used for real time collection of contextual data that can assist the interpretation of exposure measurement (sensor) data, like time-activity profiles, information on working conditions or control measures. 

In the context of EPHOR we are studying two occupational  case studies. Both studies include a long-term component based on on-going occupational cohort studies, and a short-term component, where the internal and external exposome will be measured.

These case studies study the following topics: 

1. Evaluation of the impact of the working-life exposome on respiratory health. 
   The short-term part of this case study investigates whether aspects of the working-life exposome measured in EPHOR affect lung function decline, severity in symptoms and the level of inflammatory markers across a work week. This will be linked to understanding their relationship to the longer-term respiratory outcomes of interest. 
2. Evaluation of how the disruption of endogenous circadian rhythms, as a result of night shift work, impacts health. 
   The case study will examine how the long- and short-term external working-life exposome among night shift workers affects key body functions and ageing in relation to the development of non-communicable diseases (NCDs) and investigate if this is influenced by chronotype, age or gender. 

In the context of EPHOR, the EMA questionnaires were implemented in TNO’s HowAmI app. This personalized smart phone app offers the possibility for each study participant to be notified to complete the questionnaire daily at a chosen time. The study is protected by a study code, user name and password. The answers are stored online in a protected personal datastore and thereby in real time available for further (automised) analysis or data processing. Besides the sensors and passive samplers, EMA is used to understand how daily activities related to work might impact health. For these two case studies 2 EMA questionnaires were developed which can be downloaded below.