Feasibility, Acceptability and Preliminary Effectiveness of WeChat-Based Supportive Care Microinterventions for Co-occurring Psychological Distress and Sleep Disturbance in Adolescents and Young Adults with Gynecologic Cancer: A Pilot Randomized Controlled Trial

<title>Abstract</title> <p> <bold>Background</bold> Psychological distress and sleep disturbance frequently co-occur among adolescents and young adults (AYAs) with gynecologic cancer and are associated with poorer quality of life and treatment experiences. However, access to low-burden psychosocial and sleep-related supportive care remains limited, highlighting the need for accessible interventions. <bold>Objective</bold> To evaluate the feasibility, acceptability, and preliminary effects of WeChat-Based supportive care microinterventions designed to address co-occurring psychological distress and sleep disturbance among AYAs with gynecologic cancer. <bold>Methods</bold> A two-arm, parallel-group randomized controlled trial was conducted between November 2025 and March 2026 in two tertiary hospitals. Participants were randomly assigned 1:1 to the intervention group (n = 10) or control group (n = 10). Both groups received routine care plus disease-related health education via the same WeChat platform. In addition, the intervention group received a 4-week trained research interventionist-assisted WeChat-based microintervention program. Feasibility outcomes (eligibility rate, enrollment rate, consent rate, retention rate, attrition rate, adherence indicators, and perceived feasibility) and acceptability (perceived acceptability and appropriateness, backend usage data and brief interview) and preliminary effectiveness outcomes were assessed. Assessments were conducted at baseline (T0), post-intervention (T1), 1-month follow-up (T2), and 2-month follow-up (T3). Generalized estimating equations were used to examine preliminary intervention effects. Participants and interventionists were not blinded because of the nature of the intervention. Data analysts were blinded to group allocation. No adverse events or harms were reported. <bold>Results</bold> Of 77 patients screened, 35 were eligible and 20 were randomized. The eligibility, enrollment, consent and retention rate were 45.5%, 26.1%, 57.1% and 100% respectively. In the intervention group (n = 10), the overall intervention completion rate was 80%, and 90% of participants completed at least 75% of the intervention content. Mean scores for perceived feasibility, acceptability, and appropriateness were high at 16.40 ± 1.90, 16.60 ± 1.90, and 16.80 ± 1.69, respectively. Backend usage data indicated high adherence to the psychological distress support package and the sleep behavioral regulation module. Brief post-intervention feedback indicated that the microinterventions were practical, easy to use, and low burden. Compared with the control group (n = 10), the intervention group had lower psychological distress scores than the control group at T1, T2, and T3, with adjusted between-group differences of − 2.22, − 2.12, and − 2.12, respectively. Sleep disturbance scores were lower in the intervention group at T1 and T2, with adjusted differences of − 3.49 and − 1.99, respectively. Anxiety symptoms showed exploratory between-group differences at T2 and T3, with adjusted differences of − 0.80 and − 3.20, respectively. No significant between-group differences in depressive symptoms were observed at post-baseline time points. <bold>Conclusions</bold> The WeChat-Based Supportive Care Microinterventions microinterventions demonstrated high feasibility and acceptability among adolescents and young adults with gynecologic cancer. Preliminary findings suggest potential short-term benefits for reducing psychological distress and improving sleep disturbance and anxiety symptoms. Further adequately powered trials with longer follow-up are needed to confirm these effects. <bold>Clinical trial number</bold> : not applicable. </p>