Children and adolescents undergo rapid physical and psychological development, a period during which chronic physical conditions and psychological or behavioral problems may interact and co-occur as physical and mental comorbidity. Current prevention and control strategies remain largely disease-specific, and local evidence to inform priority setting and integrated governance is limited.

To identify priority areas of physical and mental comorbidity in children and adolescents in Zhejiang Province by developing an integrated approach that combines expert opinion with artificial intelligence, and to inform policy development and future empirical research in child and adolescent health.

In May 2025, experts from health and education systems across 11 prefecture-level cities in Zhejiang Province were recruited by convenience sampling. Data were collected using expert questionnaires and large language models to construct a text corpus. Grounded theory was applied to this corpus, using open, axial, and selective coding to inductively derive priority areas of physical and mental comorbidity in children and adolescents.

Based on inputs from 77 experts in the health, education, and related sectors in Zhejiang Province, together with outputs from three large language models, this study identified several priority areas in physical and mental comorbidity among children and adolescents in Zhejiang Province. Mental health problems and overall psychosomatic health emerged as central concerns. Multilevel determinants, including social support systems, school and family environments, and individual behavioral factors, also warrant attention. In prevention and management, policy support, early identification, and comprehensive intervention were identified as key priorities.

Prevention and control of physical and mental comorbidity among children and adolescents in Zhejiang Province should prioritize integrated physical-mental development and mental health promotion. Comprehensive prevention and control should be advanced at multiple levels, including policy support, school and family environments, social support, and individual behaviors, with strengthened efforts in early identification, coordinated intervention, continuous management, and outcome evaluation. This study represents the first systematic identification of priority areas on physical and mental comorbidity in children and adolescents in Zhejiang Province. The findings provide guidance for research funding allocation, policy development, and the translation of evidence into coordinated multisectoral practice within the province.