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

Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.