Feasibility and Acceptability of a Smartphone and Wearable Assessment Protocol for Adolescents with Depression

Abstract Smartphones and wearables are low–burden tools for assessing real–time mood and behavior. Although these methods have been used with adolescents for behavioral tracking (e.g., activity, sleep), less is known about longer–term use (beyond one week) with adolescents with depression and about mobile sensing for monitoring mood for any adolescent population. This study examined acceptability and feasibility of a one–month EMA, actigraphy, and mobile sensing protocol for adolescents with elevated depressive symptoms. Adolescents aged 12 to 18 ( N = 69; M age = 15.46; 67% assigned female at birth; 42% White; 71% Hispanic or Latine; 38% sexual minority) completed EMA surveys on depressive symptoms, processes, and affect multiple times daily via a smartphone app that also collected passive sensor data (e.g., motion, geolocation). An actigraph measured physical activity and sleep. A feedback interview assessed protocol acceptability. Most participants (91%) completed all components, were willing to participate again (91%), and would recommend participation to peers (93%). EMA response rates improved (mean completion 57% to 66%) after shifting to a semi–personalized schedule with extended response windows. Actigraph wear time was high (> 70%) despite device–related issues. Sensor data availability varied by operating system, and privacy concerns influenced participation. Adherence was correlated within and between modalities, suggesting that individual compliance played a central role in consistent engagement. Findings support the feasibility and acceptability of smartphone and wearable methods for capturing real–world mood and behavior in adolescents, however careful attention to design, engagement, and ethical considerations remains essential.