Diversity, equity, and inclusivity in observational ambulatory assessment: Recommendations from two decades of Electronically Activated Recorder (EAR) research.

Ambient audio sampling methods such as the Electronically Activated Recorder (EAR) have become increasingly prominent in clinical and social sciences research. These methods record snippets of naturalistically assessed audio from participants' daily lives, enabling novel observational research about the daily social interactions, identities, environments, behaviors, and speech of populations of interest. In practice, these scientific opportunities are equaled by methodological challenges: researchers' own cultural backgrounds and identities can easily and unknowingly permeate the collection, coding, analysis, and interpretation of social data from daily life. Ambient audio sampling poses unique and significant challenges to cultural humility, diversity, equity, and inclusivity (DEI) in scientific research that require systematized attention. Motivated by this observation, an international consortium of 21 researchers who have used ambient audio sampling methodologies created a workgroup with the aim of improving upon existing published guidelines. We pooled formally and informally documented challenges pertaining to DEI in ambient audio sampling from our collective experience on 40+ studies (most of which used the EAR app) in clinical and healthy populations ranging from children to older adults. This article presents our resultant recommendations and argues for the incorporation of community-engaged research methods in observational ambulatory assessment designs looking forward. We provide concrete recommendations across each stage typical of an ambient audio sampling study (recruiting and enrolling participants, developing coding systems, training coders, handling multi-linguistic participants, data analysis and interpretation, and dissemination of results) as well as guiding questions that can be used to adapt these recommendations to project-specific constraints and needs.

Listening to Family Life After Serious Pediatric Injury: A Study of Four Cases.

Following a serious child injury, the entire family can be affected. Gaining an understanding of family support, interactions, and stress levels can help clinicians tailor treatment. Presently, these factors are assessed mainly via self-reports and structured observations. We aimed to explore the value of naturalistic observation of postinjury parent-child interactions, in order to highlight how clinicians might use these data in their practice. Our qualitative study involved an in-depth analysis of four cases from the Ear for Recovery project, against the backdrop of the larger sample's characteristics. Children who had been hospitalized with a serious injury wore the Electronically Activated Recorder (EAR). Over a two-day period postdischarge, the EAR recorded 30-second audio "snippets" every 5 minutes. Families also completed self-report measures on family functioning, child stress and social support, parent stress, optimism, and self-efficacy. For each case, two coders independently used an ethnographic method, integrating self-report measures, family and injury characteristics, audio recordings, and transcripts to mimic integration of information within clinical practice. The coders then reached consensus on the main themes for each case through discussion. Families showed substantial variation in their communication in terms of content, tone, and frequency, including moments of conflict, humor, and injury-related conversations. We explored how these recorded interactions converged with and diverged from the self-report data. The EAR provided an opportunity for rich descriptions of individual families' communication and activities, yielding potential clinical information that may be otherwise difficult or impractical to obtain.

Después de una lesión pediátrica grave, toda la familia puede quedar afectada. Llegar a comprender el apoyo, las interacciones y los niveles de estrés de la familia puede ayudar a los profesionales a personalizar el tratamiento. Actualmente, estos factores se evalúan principalmente mediante autoinformes y observaciones estructuradas. Nuestra finalidad fue analizar el valor de la observación naturalista de las interacciones entre padres e hijos después de una lesión pediátrica a fin de destacar cómo los profesionales podrían usar estos datos en su práctica. Nuestro estudio cualitativo implicó un análisis profundo de cuatro casos del proyecto Ear for Recovery en el marco de las características de la muestra más grande. Los niños que habían sido hospitalizados con una lesión grave usaron la grabadora activada electrónicamente (Electronically Activated Recorder, EAR). Durante un periodo de dos días posteriores al alta, la EAR grabó fragmentos de audio de 30 segundos cada 5 minutos. Las familias también completaron medidas de autoinforme sobre funcionamiento familiar, estrés infantil y apoyo social, estrés de los padres, optimismo y autoeficacia. Para cada caso, dos codificadores usaron independientemente un método etnográfico, integrando medidas de autoinforme, características de la familia y la lesión, grabaciones de audio y transcripciones para imitar la integración de la información dentro de la práctica clínica. Los codificadores luego se pusieron de acuerdo sobre los temas principales de cada caso mediante una charla. Las familias demostraron una variación considerable en su comunicación en cuanto al contenido, al tono y a la frecuencia, incluidos los momentos de conflicto, de humor y las conversaciones relacionadas con la lesión. Analizamos cómo estas interacciones grabadas coincidieron y se diferenciaron de los datos autoinformados. La EAR brindó la oportunidad de obtener descripciones detalladas de la comunicación y las actividades de cada familia en particular, y facilitó posible información clínica que de lo contrario puede ser difícil o impráctico obtener.

Can children predict psychological recovery after injury?

While children's voice is core to paediatric care, their own assessment of future psychological needs is underexplored. We conducted a prospective observational study among children hospitalised for injury in Melbourne, Australia. Their expectations of psychological recovery at baseline (in hospital) were significant and substantial predictors of their quality of life and post-traumatic stress 6 weeks later, suggesting potential diagnostic value.

How Do Mothers and Fathers Interact With Their Children After An Injury? Exploring the Role of Parental Acute Stress, Optimism, and Self-Efficacy.

OBJECTIVE: In the aftermath of a child injury, children and parents can jointly experience acute stress symptoms. Optimism and self-efficacy might buffer against post-traumatic stress disorder. Knowing that children are innately receptive to parent modeling, we were interested in exploring how parent acute stress, optimism, and self-efficacy might transpire in parent-child interactions and whether any differences existed between mothers and fathers. METHODS: We recruited 71 families of seriously injured children who were hospitalized for at least 24 hr. Parents completed self-report measures of acute stress, optimism, and self-efficacy. Children wore the Electronically Activated Recorder (EAR(2)); Mehl, M. R. [2017]. The electronically activated recorder (EAR): A method for the naturalistic observation of daily social behavior. Current Directions in Psychological Science, 26, 184-190) for a 2-day period postdischarge. The EAR recorded ambient sounds for 30 s every 5 min. The audio recordings were transcribed and coded. We derived a percentage of time spent with each parent (interaction time), and average ratings of the emotional tone of voice for each speaker. RESULTS: Overall, parental acute stress and self-efficacy were not associated with interaction time or emotional tone, and parents generally spent less time with older children. Compared to fathers, mothers spent significantly more time with their child, particularly for daughters, but mothers did not differ from fathers in emotional tone, acute stress, optimism, or self-efficacy. For mothers, optimism may be associated with greater interaction time and more positive emotional tone. CONCLUSIONS: The present study highlighted parent gender differences in time spent with children and enabled the inclusion of more fathers using a naturalistic observational tool.