关键词: 抑郁症, 产后；阶梯式医疗模型；心理干预；妇幼保健服务；移动健康；德尔菲法

Abstract: Background Postpartum depression prevention and treatment is an important public health issue. However，in China，the psychological intervention rate among women with positive depression screening results remains low，posing a key bottleneck for prevention efforts. In 2022，the World Health Organization proposed the Stepped Care Model as a theoretical framework for integrating perinatal mental health services into maternal and child health care systems. However，empirical research on its applicability and effectiveness in China remains limited and requires further validation. Objective To develop a stepped-care intervention program for postpartum depression that is applicable to maternal and child health institutions in China and fully leverages a mobile health platform，based on the Shenzhen Postpartum Depression Screening and Intervention Program. Methods Using a community-based participatory research approach，this study conducted multi-stakeholder qualitative interviews，one focus group discussion，and a supplementary literature review from February to October 2024. Multiple sources of qualitative evidence were synthesized to draft a preliminary intervention framework. From October 2024 to January 2025，a two-round Delphi consultation was conducted with 15 experts. Indicators of expert engagement（response rate and proportion providing specific suggestions），authority coefficient（Cr），and coefficients of variation（CV） for the scientific soundness and feasibility of each item were calculated. The intervention program was iteratively refined based on item screening criteria and expert feedback. Results The synthesized evidence included 25 stakeholder interviews，one focus group discussion，five policy documents，five clinical guidelines，three systematic reviews，five randomized controlled trials，and one mixed-methods study. The initial program comprised four intervention stages（first-level items），ten intervention contents （second-level items），and twelve specific measures（third-level items）. Both Delphi rounds achieved a 100.0% response rate；93.3% and 73.3% of experts provided specific suggestions in the first and second rounds，respectively. The Cr values were 0.86 and 0.87. In the first round，CVs for importance ranged from 0 to 0.16 and for feasibility from 0.05 to 0.27；in the second round，CVs for importance ranged from 0 to 0.13 and for feasibility from 0 to 0.21. The final intervention program consisted of four intervention stages，14 intervention contents，and 35 specific measures. Conclusion This study developed a scientifically robust and feasible stepped-care intervention program for postpartum depression，supported by a mobile health platform. The program offers theoretical and methodological guidance for maternal and child health institutions in optimizing postpartum depression prevention and intervention efforts.

Key words: Depression, postpartum；Stepped care model；Psychological intervention；Maternal-child health services；Mobile health；Delphi