Exploring Proof of Concept for a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome: Multi-Method Study

Polycystic ovary syndrome (PCOS) is a common chronic hormonal condition affecting 8-13% of women and individuals assigned female at birth. Symptoms may include subfertility, menstrual, skin and metabolic problems, with long-term health risks including diabetes and cardiovascular disease. PCOS has a significant negative impact on mental health, quality of life and wellbeing. We explored proof of concept for a web-based self-management support intervention 'Hope PCOS' designed to reduce anxiety and depression and increase positive wellbeing for women living with PCOS. To pilot the intervention to test feasibility for web-based recruitment and delivery, acceptability and potential to reduce anxiety and depression and increase positive wellbeing. Women with PCOS were recruited via social media with support from a patient advocacy charity and offered places on a six-session cohort of the intervention. In a pre-post design participants reported depression (PHQ-9), anxiety (GAD-7), wellbeing (Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)), hope (State Hope Scale (SHS)) and gratitude (Gratitude Questionnaire (GQ-6)) at baseline and six weeks. All participants who accessed 3 or more sessions were invited to a follow-up qualitative interview to explore user experience. Data from 8 interviews were thematically analysed and pre-post data explored with descriptive statistics. Sixty-three eligible women responded and were given access to the intervention. Three withdrew, leaving a baseline sample of N=60, aged 20-58 (median 30) years. Forty-eight of the 60 started, of whom 44% (22/48) completed at least three sessions and 27% (14/48) completed all six. Eight women (aged 25-38, median 29) years who completed all sessions reported acceptability and experiences in exit interviews, including prioritising self-care, developing a self-management mindset, setting motivating goals, improved mental health, self-compassion, reduced shame, openness about PCOS, preparedness for future health concerns, and continuing practice to consolidate behaviour change. Eleven women aged 25-43 (median 31) years, who completed 1-6 sessions (median 6), completed pre-and post-intervention outcomes. Descriptive quantitative analysis indicated decreases in anxiety and depression and increases in hope agency, hope pathways and gratitude. There was a meaningful (≥3 points) increase in wellbeing. Among patients with baseline and follow-up data, 73% (8/11) met clinical caseness for depression at baseline and 36% (4/11) post intervention. We explored proof of concept. Recruitment and delivery online was feasible. We detected early signs of acceptability and potential benefits for anxiety, depression, and positive wellbeing that warrant testing in a controlled trial. Future research should assess feasibility of a randomised controlled trial to evaluate effectiveness, acceptability and cost-effectiveness. Not applicable as this was an exploratory proof of concept study.