Signaling does not adequately improve diary compliance

Ann Behav Med. 2003 Oct;26(2):139-48. doi: 10.1207/S15324796ABM2602_06.


Hypothesis: Compliance with a paper diary protocol would be improved by using auditory signaling.

Background: Prior research has demonstrated that compliance with the reporting schedule in paper diary protocols is poor.

Methods: Adults with chronic pain (N = 27) were recruited from the community to participate in a 24-day experience sampling protocol of 3 pain assessments per day (10:00 a.m., 4:00 p.m., 8:00 p.m.). Diaries were instrumented to record openings and closings, thereby permitting determination of date and time when the participant could have made diary entries. Participants were signaled with a programmed wristwatch at the onset of each 30-min assessment window. Two compliance windows were defined: -/+ 15 min and -/+ 45 min of the targeted assessment time.

Results: Self-reported compliance based on participants' paper diaries was 85% and 91% for the 30- and 90-min windows. Verified compliance was 29% and 39% for the two windows. Signaling produced a significant increment in verified compliance when compared with an identical trial without signaling. A significant eroding of verified compliance was observed across the 3 weeks of the study.

Conclusions: Self-report dating of diary entries may be misleading investigators about compliance with diary protocols. Although auditory signaling enhances compliance, the result is still unsatisfactory.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Auditory Perception
  • Data Collection / standards*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement*
  • Patient Compliance*
  • Reminder Systems*
  • Reproducibility of Results
  • Writing