Using Activity Tracking and Just-In-Time Messaging to Improve Adaptive Pacing: A Pragmatic Randomised Control Trial

Long-COVID symptoms change regularly, often getting worse after activity. Adaptive pacing (AP) is a way for people who experience these symptoms to better manage their day-to-day activity. AP needs people to continuously track their daily activities and balance what they plan to do with how much energy they feel they have. However, this is not always easy because the amount of activity that will cause symptoms to get worse is different for everyone. Also, individuals must keep track of their activity (perhaps for several days) which can also be challenging, particularly if poor memory is a symptom. With help from people with long-COVID, we have designed a project to make AP easier for people with long-COVID to use. We will track activity for them and send alerts if they risk doing too much. The aim is to help individuals better plan their day-to-day activities and prevent periods where symptoms become worse. We will recruit two groups; one will follow the standard AP advice, and the other will try our modified AP approach. We will ask this group to wear a Fitbit activity monitor and download a mobile phone app designed by us. We will use the information from the Fitbit to keep track of each participants activity level. We will then send alert messages if it looks like they might do too much. This way, each person has their own AP plan. The activity and messaging support will last for three months. Afterwards, we will review how effective it was by comparing them to the usual care group. If this approach works, we will see if the tracking and messages can be improved and offer this to the control group so they can also benefit. We will also look for ways to scale up the process to help more people.