Education/Health/Career

4:00 PM - 4:15 PM JST(7:00 AM - 7:15 AM UTC)

[aQrq5kgV-02] Effects of mHealth Intervention on Stress, Anxiety, and Depression Among Patients with Polycystic Ovary Syndrome: A Randomized Controlled Trial in Rural Bangladesh

*Sadia Akter¹, Farkhanda Mahjebin², Mohammad Delwer Hossain Hawlader^3,4, Md Moshiur Rahman⁵, Sanmei Chen⁵, Saori Kashima^6,7, Sheuly Akter², Shamit Dasgupta⁸, Yoko Shimpuku^1,5  (1. Graduate School of Innovation and practice for smart society, Hiroshima University (Japan), 2. Khwaja Yunus Ali Medical College and Hospital (Bangladesh), 3. Department of Public Health, North South University (Bangladesh), 4. NSU Global Health Institute, NGHI, North South University (Bangladesh), 5. Graduate School of Biomedical and Health Sciences, Hiroshima University (Japan), 6. Center for Planetary Health and Innovation Science, The IDEC Institute, Hiroshima University (Japan), 7. Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Hiroshima University (Japan), 8. Ministry of Health, Government of British Columbia (Canada))

Keywords:

PCOS,mHealth,app-based health education.

Background: Polycystic ovary syndrome (PCOS) is a complex endocrine, metabolic, and reproductive condition affecting 6–20% of women of reproductive age.  The condition has both physical and mental health outcomes. While the physical symptoms are often expressed and diagnosed, the mental health outcomes are ignored and undiagnosed. In Bangladesh, research exploring the impact of digital health interventions on the mental health burden is scarce. Objective: The study aims to explore the effect of mHealth education on the stress, anxiety, and depression levels among PCOS patients in Bangladesh. Methods: A single-blinded, randomized controlled trial was conducted at Khwaja Yunus Ali Medical College and Hospital, Sirajganj, Bangladesh. A total of 212 participants were randomly assigned and divided to 106 to either the intervention group or the control group in the study. The intervention group received PCOS-related health education via a smartphone app reinforced with app notifications and bi-monthly phone calls from the researcher. The primary outcome was psychological distress measured by the DASS-21 total score. Secondary outcomes included serum cortisol, total testosterone, BMI, and PCOS knowledge. Results: DID analysis showed a greater reduction in psychological distress in the intervention group, with an estimated effect of −13.64 points on DASS-21 total score. Total testosterone also decreased more in the intervention group, with a DID estimate of −0.42 nmol/L. Intention-to-treat analysis showed significant group-by-time effects for psychological distress (p = 0.003) and testosterone (p = <0.001). ANCOVA showed significantly lower endline testosterone in the intervention group (β = −0.14, p = 0.023), while the adjusted DASS-21 difference favored the intervention but was not statistically significant (β = −2.99, p = 0.226). BMI and cortisol showed variable effects. Qualitative findings revealed that participants found the app easy to understand and useful for improving awareness. However, household responsibilities, fatigue, irregular app use, and limited personal smartphone access affected engagement. Conclusion: A culturally adapted mHealth education intervention improved psychological well-being among women with PCOS.