Assessing Time-Varying Causal Effect Moderation in Mobile Health

In mobile health interventions aimed at behavior change and maintenance, treatments are provided in real time to manage current or impending high-risk situations or promote healthy behaviors in near real time. Currently there is great scientific interest in developing data analysis approaches to guide the development of mobile interventions. In particular data from mobile health studies might be used to examine effect moderatorsindividual characteristics, time-varying context, or past treatment response that moderate the effect of current treatment on a subsequent response. This article introduces a formal definition for moderated effects in terms of potential outcomes, a definition that is particularly suited to mobile interventions, where treatment occasions are numerous, individuals are not always available for treatment, and potential moderators might be influenced by past treatment. Methods for estimating moderated effects are developed and compared. The proposed approach is illustrated using BASICS-Mobile, a smartphone-based intervention designed to curb heavy drinking and smoking among college students. Supplementary materials for this article are available online.