title: Signaling does not adequately improve diary compliance.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Psychiatry & Behavioral Science Stony Brook University, Stony Brook, NY 11794-8790, USA. Joan.Broderick@stonybrook.edu
authors.forename: Joan E
authors.initials: JE
authors.lastname: Broderick
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schwartz
authors.forename: Saul
authors.initials: S
authors.lastname: Shiffman
authors.forename: Michael R
authors.initials: MR
authors.lastname: Hufford
authors.forename: Arthur A
authors.initials: AA
authors.lastname: Stone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001307:Auditory Perception; D003625:Data Collection / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010349:Patient Compliance; D017010:Reminder Systems; D015203:Reproducibility of Results; D014956:Writing