Perinatal depression, which affects both maternal and child health, is a significant public health issue that requires urgent and effective management. Since 2021, Shenzhen has been promoting city-wide perinatal depression screening and intervention using a mobile healthcare platform.
This study utilises routine data from the Shenzhen perinatal depression screening and intervention programme to assess the impact of the mobile platform on programme implementation and identify the most prominent implementation bottlenecks.
This retrospective study included pregnant and postpartum women who delivered in one of Shenzhen's 82 midwifery institutions across 10 districts between June 2020 and May 2022. Eligible participants were divided into two groups: the routine service group (delivered between June 2020 and May 2021) and the mobile platform group (delivered between June 2021 and May 2022) . Depression screening rates, screening positive rates, referral rates, and intervention rates during early pregnancy, mid-pregnancy, late pregnancy, and postpartum were observe.
A total of 311 719 pregnant and postpartum women were included in the study, of which 166 832 were in the routine service group and 144 887 in the mobile platform group. Screening rates, referral rates, and intervention rates in all stages of pregnancy and postpartum were significantly higher in the mobile platform group than in the routine service group (P<0.05) . Screening positive rates in early and mid-pregnancy were higher in the mobile platform group (P<0.05) , while rates in late pregnancy and postpartum were lower than in the routine service group (P<0.05) .
The mobile platform offers an effective tool for routine perinatal depression management. However, the low intervention rate among screening-positive women represents the most prominent implementation bottleneck. Future research should focus on optimising platform functionality, identifying the most effective combination of intervention measures, enhancing health education, and developing innovative, sustainable, and widely applicable implementation strategies.
China's aging population is expanding rapidly, highlighting the imperative of successful aging as a critical health management goal. Effective menopause management plays a crucial role.
To construct a comprehensive health management evaluation indicator system for menopausal women based on the modified Delphi method.
Between September 2023 and February 2024, a preliminary construction of the comprehensive health management evaluation indicator system for menopausal women was executed via literature review and group discussion. 25 experts in the realms of climacteric health and related fields were selected as conference participants and correspondence subjects. Two rounds of electronic questionnaires using modified Delphi method were conducted, and the survey results were statistically analyzed using SPSS 24.0 software.
The positive coefficients of the two rounds of expert correspondence were 100%, with the authoritative degree of expert opinions were 0.932 and 0.949, respectively. In the initial round, the primary and secondary indicators were assigned mean importance scores ranging from 4.44 to 4.84 and 4.00 to 4.88, respectively, alongside Kendall's W coefficients of concordance at 0.194 (P=0.001) and 0.187 (P<0.001) . The second round yielded mean importance scores for the primary and secondary indicators within the ranges of 4.44 to 4.84 and 3.84 to 4.96, with corresponding Kendall's W coefficients of 0.146 (P=0.006) and 0.326 (P<0.001) , reflecting a notable enhancement in expert agreement for the secondary indicators. The tertiary indicators received mean rationality scores of 4.24 to 4.68 (4.47±0.10) in the first round and 4.08 to 4.72 (4.51±0.15) in the second, with Kendall's W coefficients of 0.063 (P=0.025) and 0.129 (P<0.001) , indicating a trend towards uniformity in expert opinions. The ultimate construction of the comprehensive health management evaluation indicator system for menopausal women encompasses five primary indicators: basic information, lifestyle, symptom assessment, laboratory tests, and key disease screenings. Additionally, it includes 34 secondary indicators such as age, duration since menopause, BMI, and waist circumference, and so on. Each of these secondary indicators is meticulously subdivided and quantified to establish tertiary indicators, thereby providing a granular framework for assessment.
The indicator system, constructed through the modified Delphi method, is endowed with substantial authority and scientific rigor. It offers a holistic assessment of the health status of menopausal women, with a detailed classification and valuation of specific indicators. This systematic approach is conducive to comprehensive and stratified patient management by clinical practitioners, providing a valuable framework for clinical guidance and reference. Nonetheless, the efficacy of its practical application merits ongoing validation through empirical research.
