To personalize the recommendations, we will use statistical models that rely on reinforcement learning (RL), a technique that learns from interactions and prescribes sequences of actions toward a goal (e.g., pain reduction). It has been applied in health research, including tailoring PA recommendations for chronic pain. Our ultimate goal is to develop a mHealth tool for individuals living with endometriosis that focuses on symptom self-management through lifestyle behaviors and modification.
You might be eligible to participate in this study if you:
have a diagnosis of endometriosis or have had related symptoms (chronic pelvic pain, pain during periods, pain during or after sex, painful urination or bowel movements, heavy bleeding during periods or between periods) for at a year
are medically cleared to engage in physical exercise (i.e., no counter-indications or major diseases that would make physical activity dangerous)
are familiar with and engage in some form of physical activity regularly (e.g., 60 minutes of brisk walking per week)
Are willing to track your symptoms and health behaviors daily and follow personalized exercise recommendations for the duration of the study
Participants will receive an activity tracker to use during the study and will be remunerated for taking part in the study.
Common prospective participant questions:
How will you ensure that I can carry out the exercise recommendation generated for me? Upon enrollment, you will have an orientation session with our coordinator. We will gather information from you about your exercise habits, preferences and abilities (e.g., types of activities you feel comfortable doing and activities you prefer to do). This information, along with guidance from our clinical experts on the team, will be used to create the initial tailored exercise list for you. This will ensure that the exercise recommendations are suitable for your health status, exercise ability and access to facilities/equipment. In addition, during this orientation session you will be provided information on exercise safety, how to monitor and track your physical activities within the App.
How long is the study? You will have a warm-up week to get habituated to the study, followed by 8 weeks of intervention during which you will receive exercise recommendations 3 times per week. In total, your participation will consist of 9 weeks (about 2 months).
Do I need to have access to a fitness facility to participate? No, you do not need any facility access or equipment. The recommendations can be tailored accordingly.
How much prior exercise experience do I need? How physically fit do I need to be to participate? To make the most of this study, you need to be familiar with basic activity types (e.g., brisk walking, jogging, bodyweight exercises such as calisthenics and stretching movements). However, no prior experience or expertise in any specific sport or activity is required to participate. To assess whether you have the fitness level required, consider your activity levels in a typical week. Do you engage in at least 1 hour of brisk walking each week? Similarly, think of your activities throughout the day. Are you able to perform typical activities of daily living without assistance and without significant problems (e.g., sitting down on the floor, getting up from a chair or floor to stand up, lying down on the floor)? If yes, then you can safely participate. Finally, make sure that you do not have any counter-indications to engaging in physical activity (e.g., having a major illness or conditions that would make exercising dangerous).
What if I want a specific activity type to be included in the recommendations? This is also taken into consideration. During the orientation meeting with the coordinator, you can provide any particular activities you enjoy and would like to do for the study (e.g., swimming, cycling, yoga, studio/gym class, crossfit, etc.). In this case, the recommender models will additionally consider these from your curated list to tailor the exercises.
What type of exercise recommendations will I receive? You will receive recommendations based on standard, published physical activity guidelines for adults, as well as personalized recommendations tailored based on your individual circumstances. We will develop AI-based models specific for you that will learn from your day-to-day context, including your symptoms (e.g., pain, fatigue, stress, digestive symptoms), health behaviors, how you respond to a given exercise (e.g., pain level after exercise) etc. As the model learns from these interactions, it will update the recommendations to fit your (changing) needs over time.
What happens if I cannot follow a recommendation due to unfavorable symptoms that day? This is completely understandable. Based on the large body of literature on exercise for various populations, exercise is a very safe symptom self-management modality and we do not expect any serious, adverse effects. Nevertheless, there might be (however rare) instances where you are not able to engage in exercise, or that you do not feel like completing a session once you begin. In these instances, you are encouraged follow your intuition and not force yourself to continue exercising. Within the ehive App, you will be asked to track this and give feedback so that your personal recommender model can learn this contextual information. This will allow the model to update its future recommendations for you accordingly.
How much time commitment does participation require?
We anticipate approximately 15 minutes per day of using the ehive App for completing the research tasks (e.g., tracking symptoms, medications, quality of life, exercise feedback etc.). In addition, you can expect up to 3 hours per week spent engaging in some form of exercise. All exercise recommendations will be capped at 1 hour, unless you specifically request a longer duration (e.g., a yoga class at your gym that is scheduled to be 75 minutes). You will receive 3 recommendations per week, so that if you have to skip a day, you can pick up the next day. This way, you are still able to complete the study without day-to-day interruptions.