Tailoring the fit: co-designed recommendation for a community, evidence-based lifestyle programs for polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common endocrine condition (1) associated with an increased risk of developing type 2 diabetes (T2D) and cardiovascular disease. Healthy lifestyle habits are critical in the management of PCOS (1) , however, the public health system provides limited support for the lifestyle management of PCOS. Diabetes Victoria delivers a free program, ‘ Life! ’, to Victorian Residents at high risk of developing T2D, including those with PCOS. Life! is currently designed to meet general high-risk population needs, not specifically designed with PCOS in mind. This study aimed to evaluate the current Life! Program’s design, content and delivery against the needs of those with PCOS through co-design workshops with previous Life! participants who have PCOS (n = 14) and program facilitators (n = 5). A series of mixed-methods workshops were used to assess the current program, design an ideal program and prioritise unmet needs. Co-design was informed by the Linking and Amplifying User-Cantered Networks through Connected Health (LAUNCH) Roadmap (2) and the TiDiER checklist (3) . Online worksheets, polls, open-ended questions and annotation of current material were used to aid participation and input. Four workshops (WS) were conducted online: two 3-hr (WS 1) and two 2-hr (WS 2). All were audio recorded and transcribed. Data was thematically synthesised using template analysis and findings from WS 1 were used to inform WS 2. Those with PCOS participated in the Life! program between 2018 and 2023, were aged between 24 and 52 years and the majority (93%) had a BMI greater than 25kg/m 2 . Program facilitators included dietitians, diabetes educators and a physiotherapist with 80% having more than 10 years’ experience. Overall participants wanted less generic and more PCOS-centric topics, less of an emphasis placed on weight loss with an equal focus on a range of health outcomes. Recommended topics included PCOS-centric lifestyle advice across diet, physical activity, sleep and mental health with an emphasis on how (practical strategies) and why (mechanistic understanding) healthy lifestyle behaviours should be applied. Participants desired the tone and sentiment used in the program’s language and imagery to be inclusive, gentle, non-stigmatising and positive. Participants desired a flexible approach to program delivery (a mix of in-person, online, one-on-one and group). One-on-one sessions were desired when receiving individualised advice and discussing sensitive topics, while group sessions were preferred for peer support, learning activities and reflections. People with PCOS desire a PCOS-centric lifestyle program with a focus on meaningful health outcomes, reducing the focus on weight loss, blended delivery, tailored and practical strategies with long-term support. Results will inform the development of a tailored lifestyle program that aims to better engage those with PCOS. Future community-based PCOS programs and clinicians are strongly recommended to incorporate these findings to improve engagement and consumer satisfaction.