Date of this Version

8-1-2025

Document Type

DNP Project

Abstract

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age and is closely associated with insulin resistance (IR). Primary care clinicians (PCCs) are well-positioned to identify and manage IR—one of the core pathophysiological features of PCOS that affects a significant percentage of women—through the implementation of evidence-based lifestyle interventions. IR significantly contributes to the development and progression of PCOS and its related comorbidities, including Type 2 diabetes and cardiovascular disease (Zhao et al., 2023). To adequately support patients with PCOS, PCCs require current knowledge of diagnostic criteria, treatment protocols, and lifestyle-based strategies, along with a foundational understanding of the condition and the ability to provide patient-centered care (Pirotta et al., 2021). Given that PCCs often serve as the first point of contact, they must be equipped to recognize early signs of PCOS and guide patients toward appropriate management. Following a structured literature review, ten (n = 10) Level I evidence studies (systematic reviews or meta-analyses) were selected. These studies emphasized the efficacy of lifestyle medicine interventions, specifically nutrition, exercise, sleep, and stress reduction, in improving insulin sensitivity, hormonal regulation, and overall quality of life in women with PCOS. The literature also revealed gaps in PCCs’ knowledge, attitudes, and clinical practice behaviors, which contribute to delayed diagnoses, inconsistent treatment, and fragmented care delivery.

To address these challenges, a quality improvement (QI) project was implemented at a women’s health primary care clinic in South Florida. The project aimed to enhance clinicians’ knowledge, confidence, and practice behaviors related to IR management in PCOS. Clinicians were provided with evidence-based lifestyle approaches grounded in scientific research and supported by the Six Pillars of Lifestyle Medicine: nutrition, physical activity, restorative sleep, stress management, avoidance of risky substances, and social connection. An educational intervention was delivered in person via a PowerPoint presentation during a lunchtime session. A total of 29 clinicians participated. Pre- and post-intervention surveys were administered and analyzed using a paired samples t-test. The results demonstrated measurable improvements across all domains: knowledge scores increased by 36.1% (pre-intervention mean = 3.05; post-intervention mean = 4.15), attitude scores improved by 40.0% (pre-mean = 3.19; post mean = 4.47), and practice behavior scores improved by 67.9% (pre-mean = 2.79; post mean = 4.68). A paired, two-tailed t-test revealed statistical significance (p = 0.014), supporting the rejection of the null hypothesis. These findings suggest that targeted, evidence-based education can significantly improve PCCs’ knowledge, attitudes, and practice behaviors in managing IR in women with PCOS. Ongoing education and integration of lifestyle medicine principles into clinical practice are recommended to improve long-term outcomes for this population.

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