Systematic review of ecological momentary assessment for assessing mental health among sexual and gender minorities

Sexual and gender minority (SGM) populations experience disproportionately high rates of depression, anxiety, stress, and suicidal thoughts and behaviors (STBs). Ecological momentary assessment (EMA) offers a promising method for capturing real-time fluctuations in these psychological states. This systematic review evaluated the feasibility, acceptability, and predictive utility of EMA for assessing mental health in SGM. We searched PubMed, PsycINFO, Scopus, CINAHL, and Cochrane Library databases and identified 11 studies from 815 records. Most studies reported high feasibility and moderate-to-high acceptability, although concerns about participant burden and privacy were noted. Studies identified dynamic predictors of poor mental health, such as discrimination, affective instability, and interpersonal conflict, as well as protective factors, including social support and gender affirmation. Three studies used predictive modeling, and two incorporated EMA into just-in-time adaptive interventions (JITAIs). These findings suggest that EMA is feasible, with untapped potential for delivering responsive mental health care to SGM individuals.