The ILHBN: challenges, opportunities, and solutions from harmonizing data under heterogeneous study designs, target populations, and measurement protocols.

The ILHBN is funded by the National Institutes of Health to collaboratively study the interactive dynamics of behavior, health, and the environment using Intensive Longitudinal Data (ILD) to (a) understand and intervene on behavior and health and (b) develop new analytic methods to innovate behavioral theories and interventions. The heterogenous study designs, populations, and measurement protocols adopted by the seven studies within the ILHBN created practical challenges, but also unprecedented opportunities to capitalize on data harmonization to provide comparable views of data from different studies, enhance the quality and utility of expensive and hard-won ILD, and amplify scientific yield. The purpose of this article is to provide a brief report of the challenges, opportunities, and solutions from some of the ILHBN's cross-study data harmonization efforts. We review the process through which harmonization challenges and opportunities motivated the development of tools and collection of metadata within the ILHBN. A variety of strategies have been adopted within the ILHBN to facilitate harmonization of ecological momentary assessment, location, accelerometer, and participant engagement data while preserving theory-driven heterogeneity and data privacy considerations. Several tools have been developed by the ILHBN to resolve challenges in integrating ILD across multiple data streams and time scales both within and across studies. Harmonization of distinct longitudinal measures, measurement tools, and sampling rates across studies is challenging, but also opens up new opportunities to address cross-cutting scientific themes of interest.

Health behavior changes, such as prevention of suicidal thoughts and behaviors, smoking, drug use, and alcohol use; and the promotion of mental health, sleep, and physical activities, and decreases in sedentary behavior, are difficult to sustain. The ILHBN is a cooperative agreement network funded jointly by seven participating units within the National Institutes of Health to collaboratively study how factors that occur in individuals' everyday life and in their natural environment influence the success of positive health behavior changes. This article discusses how information collected using smartphones, wearables, and other devices can provide helpful active and passive reflections of the participants' extent of risk and resources at the moment for an extended period of time. However, successful engagement and retention of participants also require tailored adaptations of study designs, measurement tools, measurement intervals, study span, and device choices that create hurdles in integrating (harmonizing) data from multiple studies. We describe some of the challenges, opportunities, and solutions that emerged from harmonizing intensive longitudinal data under heterogeneous study and participant characteristics within the ILHBN, and share some tools and recommendations to facilitate future data harmonization efforts.

Effectiveness and Utility of Mobile Device Assessment of Subjective Craving during Residential Opioid Dependence Treatment.

Background: Craving is a dynamic state that is both theoretically and empirically linked to relapse in addiction. Static measures cannot adequately capture the dynamic nature of craving, and research has shown that these measures are limited in their capacity to link craving to treatment outcomes. Methods: The current study reports on assessments of craving collected 4x-day across 12 days from 73 patients in residential treatment for opioid dependence. Analyses investigated whether the within-person assessments yielded expected across- and within-day variability, whether levels of craving changed across and within days, and, finally, whether individual differences in craving variability predicted post-residential treatment relapse. Results: Preliminary analyses found acceptable levels of data entry compliance and reliability. Consistent with expectations, craving varied both between (46%) and within persons, with most within-person variance (over 40%) existing within days. Other patterns that emerged indicated that, on average, craving declined across the 12-days of assessment, and was generally strongest at mid-day. Analyses also found that patients' person-level craving variability predicted post-treatment relapse, above and beyond their mean levels of craving. Conclusion: Analyses support the reliability, sensitivity, and potential utility of the 4x-day, 12-day assessment protocol for measuring craving during residential treatment.

Ecological momentary assessment of using food to soothe during infancy in the INSIGHT trial.

BACKGROUND: Use of food to soothe infant distress has been linked to greater weight in observational studies. We used ecological momentary assessment to capture detailed patterns of food to soothe and evaluate if a responsive parenting intervention reduced parents' use of food to soothe. METHODS: Primiparous mother-newborn dyads were randomized to a responsive parenting intervention designed for obesity prevention or a safety control group. Responsive parenting curriculum included guidance on using alternative soothing strategies (e.g., swaddling), rather than feeding, as the first response to infant fussiness. After the initial intervention visit 3 weeks after delivery, mothers (n = 157) were surveyed for two 5-8 day bursts at infant ages 3 and 8 weeks. Surveys were sent via text message every 4 h between 10:00 AM-10:00 PM, with 2 surveys sent at 8:00 AM asking about nighttime hours. Infant fusses and feeds were reported for each 4-h interval. Food to soothe was defined as "Fed First" and "Not Fed First" in response to a fussy event. Use of food to soothe was modeled using random-intercept logistic regression. RESULTS: The control group had greater odds of having Fed First, compared to the responsive parenting group at ages 3 and 8 weeks (3 weeks: OR = 1.9; 95% CI = 1.4-2.7; p < 0.01; 8 weeks: OR = 1.4; 95% CI = 1.0-2.1; p = 0.053). More responsive parenting mothers reported using a responsive parenting intervention strategy first, before feeding, than controls at ages 3 and 8 weeks (3 weeks: 58.1% vs. 41.9%; 8 weeks: 57.1% vs. 42.9%, respectively; p < 0.01 for both). At both ages combined, fewer fusses from responsive parenting infants were soothed best by feeding compared to controls (49.5% vs. 61.0%, respectively; p < 0.01). For both study groups combined, parents had greater odds of having Fed First during the nighttime compared to the daytime at both ages (3 weeks: OR = 1.6, 95% CI = 1.4-1.8; p < 0.01; 8 weeks: OR = 2.1; 95% CI = 1.7-2.6; p < 0.01). CONCLUSIONS: INSIGHT's responsive parenting intervention reduced use of food to soothe and increased use of alternative soothing strategies in response to infant fussiness. Education on responsive parenting behaviors around fussing and feeding during early infancy has the potential to improve later self-regulation and weight gain trajectory. TRIAL REGISTRATION: NCT01167270 . Registered July 21, 2010.