Preferences of Chinese Women for Perinatal Depression Screening: A Discrete Choice Experiment

Perinatal depression affects 17.7% of women globally, with prevalence reaching 20-30% in China and higher in low-income regions. It poses severe risks, including adverse pregnancy outcomes, maternal suicide, and infanticide. Despite its high prevalence, many cases go undiagnosed due to low screening participation. Screening is cost-effective and reduces depression risk by 2.1-9.1%, yet current strategies often fail to align with patient preferences. In this study, a discrete choice experiment was utilized to assess women's preferences for postpartum depression screening characteristics, and to quantify trade-offs and preference heterogeneity, providing information for a more patient-centered approach.

We identified six key screening attributes through literature review, interviews, and focus groups. A D-efficiency design approach was implemented to create 36 choice sets and randomly divide them into 3 blocks. A mixed logit model was applied to analyze participants' preferences, assess the relative importance of attributes, and predict the choice probabilities of participants for screening situations.

There are 291 respondents were included in analysis. Healthcare provider type emerged as the most important screening characteristic (27% relative importance), with strongest preference for doctor-led screenings. Women consistently preferred shorter screening duration (15 minutes). Younger women (18-34 years) preferred online screening, while Postpartum women showed stronger preferences for telephone screenings. The most preferred scenario-online by a physician, lasted 15 minutes, occurred every three months, and provided as a rouhad a 0.270 predicted choice probability. These findings highlight the need for tailored screening approaches based on age and pregnancy status.

This study identified a preference for brief, physician-led screening with follow-up. To enhance implementation in primary care, particularly in resource-limited settings, we recommend integrating short screenings into routine visits and utilizing trained non-specialists with digital support. These strategies can improve screening accessibility and long-term management.