# Educational Intervention to Improve Sexual Health and Quality of Life in Survivors of Breast and Gynecological Cancer: Protocol for a Mixed Methods Feasibility Study

## TL;DR

This study tests a new educational program to improve sexual health and quality of life for cancer survivors in Colombia.

## Contribution

The study introduces a culturally adapted, mixed-methods psychosexual intervention co-designed with survivors in a low- and middle-income setting.

## Key findings

- The intervention includes workshops, interviews, and counseling to address sexual health and well-being.
- Pilot testing led to shorter sessions and hybrid delivery to improve adherence and acceptability.
- Results will guide future implementation and effectiveness studies in low- and middle-income settings.

## Abstract

Sexual health is often underaddressed in cancer care, especially among survivors of breast and gynecological cancer. In Colombia, treatment side effects, cultural stigma, and limited training among health care providers affect well-being. Although international guidelines promote patient-centered and culturally sensitive approaches, few interventions have been implemented in low- and middle-income settings.

This study aimed to describe the feasibility and acceptability of an educational psychosexual intervention for survivors of breast and gynecological cancer, including design, integration of qualitative and quantitative methods, core components, measurement time points, and a prespecified analysis plan.

This is a prospective, single-group feasibility study at a university hospital in Colombia. Participants are adult women who completed treatment for breast or gynecological cancer at least 2 years before enrollment. The intervention combines tiered educational workshops, semistructured group interviews, and optional individualized counseling. Qualitative data will explore perceptions, barriers, and facilitators related to sexual health and well-being. Quantitative outcomes include the Female Sexual Function Index and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 before and after the intervention to estimate change. Pre- and postintervention scores will be compared with paired tests and CIs. Qualitative data will undergo reflexive thematic analysis. Mixed findings will inform feasibility, acceptability, and practical recommendations. The intervention was co-designed with survivors and a multidisciplinary team, refined by expert review and a manual, and pilot-tested to optimize acceptability, logistics, and fidelity.

The study was funded in December 2024 and approved by the Comité de Ética en Investigación Biomédica of Fundación Valle del Lili. Recruitment began in March 2025 and is expected to end in September 2025. As of July 2025, 13 participants had enrolled (n=2, 15.4% survivors of breast cancer; n=11, 84.6% survivors of gynecological cancer). Based on pretrial piloting, shorter session blocks and optional hybrid delivery were made available to support adherence while preserving core content and objectives. Final analysis is planned for October 2025, with results expected in December 2025.

This protocol evaluates the feasibility and acceptability of a codesigned, context-adapted psychosexual education model. Findings will guide implementation refinements and the design of a future comparative study of effectiveness and longer-term outcomes and may inform sustainable integration of sexual health into survivorship care in low- and middle-income settings. The model is intended to be replicable and scalable across oncology and other chronic disease contexts.