Anxiety: Compliance with ecological momentary assessments and the feasibility of an online training for school staff

Montague, Jessie (2026) Anxiety: Compliance with ecological momentary assessments and the feasibility of an online training for school staff. Doctoral thesis, University of East Anglia.

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Abstract

Background:
Anxiety difficulties require early identification and prevention. This relies on feasible and implementable assessment and intervention methods for individuals in real-world settings. The aims of this thesis were to systematically review the evidence on compliance rates of ecological momentary assessments (EMA) in individuals with anxiety disorders and to conduct a feasibility study of an online training on childhood anxiety for primary school staff.

Methods:
A meta-analysis assessed the pooled compliance rate of EMA in individuals with anxiety disorders and identified whether study design and participant characteristics explained variation in these rates across studies. The feasibility study extended findings from a previous study (Nicola et al., 2024). Immediate post-training and maintenance (follow-up) effects on primary school staff’s knowledge and confidence at theoretically recognising and responding to anxious children were evaluated as well as feasibility, acceptability, and implementation utility factors.

Results:
10 studies were included in the meta-analysis. A high pooled compliance rate (73%) was found. None of the moderating variables significantly explained variation in compliance rates. The empirical study recruited 27 participants (with a 26% dropout rate, yielding 19 participants at follow-up). Findings suggested the training and research process were generally acceptable to staff who completed the study, with some strategies implemented in staff’s work. Some potential barriers were highlighted to implementing the training information. Preliminary evaluation suggested the training shows promise at improving school staff’s theoretical knowledge and confidence in recognising, responding to, and intention to refer children experiencing excessive anxiety for support. Substantial recruitment challenges, limited sample diversity, and lack of objective measurement of behaviour and knowledge change warrants further investigation.

Conclusions:
EMA is a feasible method of assessing individuals with anxiety disorders. The online training shows potential for feasibility, acceptability, implementation utility, and promise at improving outcomes for primary school staff working with anxious children in school settings. Further research is needed in both areas to establish possible facilitators and barriers to engagement with EMA and training methods in real-world settings.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Amy Millward-Doherty
Date Deposited:	13 Nov 2026 16:30
Last Modified:	13 Nov 2026 16:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105121
DOI:

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