Examining factors that affect engagement with the Experience Sampling Method (ESM) within the AVATAR2 trial. Exploring service users’ experience of using this method.

Experience sampling methodology (ESM) is an assessment method ultilised in psychosis research. Symptom severity and gender may be associated with ESM engagement. Exploring qualitative experiences of using ESM amongst people with psychosis should aid developing more accurate, accessible digital assessments.Data from 207 AVATAR2 trial (ISRCTN55682735) participants were used to evaluate associations between demographic variables, symptom severity and ESM completion rates. Trial participants were purposively sampled to participate in an interview to discuss their experiences of using ESM or to discuss reasons why they chose not to use it. Age, gender, ethnicity and clinical severity were not associated with ESM completion rates. A thematic analysis of 17 participant interviews found three overarching themes. ESM has multiple benefits for people with psychosis including increasing knowledge and awareness of mental health. ESM was straightforward and easy to use, however engaging in other activities, experiencing positive symptoms, little experience using technology and trial involvement impacted engagement. Decisions to use ESM were influenced by concerns about security and privacy. Recommendations are made on how engagement with ESM can be improved, making it easier to use this method with this population.