Evaluating the efficacy of an educational app for women with pelvic pain, with or without endometriosis.

Interested participants will be emailed baseline measures to complete before starting the program. They will be asked to complete the Brief Pain Interference (BPI) score weekly for four weeks, and the average score from these four weeks will be used as the baseline BPI measure. If participants complete these baseline measures, they will be provided with access to a smartphone app-based six-week education program designed to be used alongside usual care provided by their primary care team. Following completion of the app, participants will repeat the measures, alongside the revised neurophysiology of pain questionnaire (NPQ). At six and twelve months later, they will complete the same measures again along with two global rating of change scales to evaluate their progress. The digital pain management program uses the same evidence-based content as the PIPPI program, an in-person pain management program specifically developed for women with chronic pelvic pain. The Ella App was built in partnership with the clinicians who designed the PIPPI program. The program is grounded in a Cognitive Behavioural model and covers a range of topics including pain neuroscience education, gentle graded exercises and stretches developed by women’s health physiotherapists, relaxation and mindfulness exercises, sleep and stress management, as well as communication and problem-solving strategies. Pain neuroscience education is delivered through written content. Graded exercises and stretches are provided via short instructional videos, while relaxation and mindfulness sessions are available as audio recordings. Sleep and stress management, communication, and problem-solving are addressed using a cognitive behavioral approach, with written content and worksheets that participants can complete in their own time. Participants are encouraged to engage with the program five days a week for six weeks. New content is "unlocked" daily, and each day's material takes approximately 20 minutes to complete. To monitor adherence to the intervention, app usage data will be analyzed to measure parameters such as the percentage of participants who complete the entire program and their engagement levels throughout. For the purpose of this study, 'standard care' refers to the care typically available to women with chronic pelvic pain in a non-research setting. This includes consultations with general practitioners and gynecologists, the use of hormonal therapies such as the oral contraceptive pill, pain relief medications, physiotherapy, and surgical interventions like diagnostic laparoscopy and/or excision surgery. This standard of care serves as the baseline against which the impact of the education program will be assessed.