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Objective: To determine the relationships of self-management strategies and physical activity (PA) and diet quality in women with PCOS., Methods: An online cross-sectional study involving women (n = 501), 18-45 years in the general Australian community with a self-reported PCOS diagnosis. The self-management and lifestyle behaviour questionnaires were completed between August 2017 and March 2018., Results: Implementation of PA related self-management strategies increased the odds of meeting PA recommendations [Odds ratio (OR): 2.929 (95%CI: 2.172, 3.951), p < 0.001] but had no association with body mass index (BMI) [OR: 0.-0.984 (95%CI: -1.010, 0.959), p = 0.217] nor perception of self weight [OR: 1.382 (95% CI: 0.700, 2.725), p = 0.352]. Nutrition related self-management strategies were inversely associated with BMI [OR: - 0.115 (95%CI: -7.159, -0.980), p = 0.010] but had no association with diet quality [OR: 0.183 (95%CI: -2.328, 2.800), p = 0.855], energy intake [OR: - 0.092 (95%CI: -1204.443, 527.496) p = 0.438] or weight [OR: - 0.034 (95%CI: -4.020, 1.930), p = 0.491]., Conclusions: PA self-management strategies were associated with meeting PA recommendations. Nutrition strategies were associated with lower BMI but not diet quality, energy intake or weight in women with PCOS., Practice Implications: Other behaviour change determinants (e.g. education, skills and self-efficacy) should be considered when designing a PCOS lifestyle programme in conjunction with self-management strategies., Competing Interests: Conflict of interest Authors declare no conflicts of interest., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The 2018 Evidence-Based Polycystic Ovary Syndrome (PCOS) Clinical Guidelines recommend lifestyle management as first-line treatment for PCOS, yet implementation of PCOS lifestyle programs into practice is not well understood., Objective: To complete systematic intervention mapping by identifying the facilitators and barriers to lifestyle management in women with PCOS using the theoretical domains framework (TDF) and the Capacity, Opportunity, Motivation and Behaviour model (COM-B)., Patient Involvement: Women (N = 20) in Australian with PCOS were interviewed., Methods: Telephone semi-structured interviews., Results: Nine themes mapped onto seven TDF domains and the COM-B. Capability: psychological co-morbidities, knowledge and awareness of lifestyle change and ability to identify and resolve barriers. Opportunity: presence of other medical conditions, access to practical resources and availability of social support., Motivation: outcomes expectancies of lifestyle behaviour, personal values, enjoyment and readiness to change and the impact of stress on lifestyle choices., Discussion: This is the first study to explore barriers and facilitators to lifestyle change from the perspectives of women with PCOS using the TDF and COM-B. Addressing these themes will facilitate patient-centred care and long-term behaviour change., Practical Implications: May increase the efficacy and effectiveness of PCOS lifestyle programs and reduce the risk of PCOS-associated disease in this population., Competing Interests: Declaration of Competing Interest The authors report no declarations of interest., (Copyright © 2021 Elsevier B.V. All rights reserved.)