Mom's Good Mood: screening and management of perinatal depression within primary healthcare system in China-protocol for an effectiveness-implementation design study

Authors：Mengjuan Lu, Minmin Jiang, Yue Gu, Haiyan Li, Yanyan Hou, Xiayan Yu, Yunxia Cao, Beibei Zhu, Fangbiao Tao

Source：BMJ Open. 2023 May 2;13(5):e063593

DOI: 10.1136/bmjopen-2022-063593

Abstract：

Introduction: The management of perinatal depression (PND) is challenging in China. The Thinking Healthy Programme (THP), developed under the core theory of cognitive-behavioural therapy, is an evidence-based approach that is recommended as a psychosocial intervention for managing PND in low/middle-income countries. Sparse evidence has been generated, however, to assess the effectiveness of THP and guide its implementation in China.

Methods and analysis: A hybrid type II effectiveness-implementation study is ongoing in four cities in Anhui Province, China. A comprehensive online platform, Mom's Good Mood (MGM), has been developed. Perinatal women are screened using the WeChat screening tool (ie, Edinburgh Postnatal Depression Scale embedded as metrics) in clinics. Different intensities of the intervention are delivered through the mobile application for different degrees of depression, according to the stratified care model. The THP WHO treatment manual has been tailored to be the core component of intervention. Guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, process evaluations will be conducted to identify the facilitators and barriers to implementation and to modify the implementation strategy; summative evaluations will be carried out to examine the effectiveness of MGM in the management of PND within the primary healthcare system in China.

Ethics and dissemination: Ethics approval and consent for this programme were obtained from Institutional Review Boards in China: Anhui Medical University, Hefei, People's Republic of China (20170358). Results will be submitted to relevant conferences and peer-reviewed journals.

Trial registration number: ChiCTR1800016844.

Keywords: Depression & mood disorders; Maternal medicine; Public health.

中文摘要：

介绍：围产期抑郁症（PND）的管理在中国具有挑战性。在认知行为疗法的核心理论下制定的健康思维计划（THP）是一种循证方法，被推荐作为低收入/中等收入国家管理PND的社会心理干预措施。然而，评估THP的有效性并指导其在中国的实施的证据很少。

方法和分析：目前正在中国安徽省的四个城市进行混合II型有效性实施研究。一个全面的在线平台，妈妈的好心情（MGM）已经开发出来。围产期妇女在诊所使用微信筛查工具（即爱丁堡产后抑郁量表作为指标嵌入）进行筛查。根据分层护理模型，通过移动应用程序针对不同程度的抑郁症提供不同强度的干预。世卫组织四氢大麻酚治疗手册经过定制，成为干预措施的核心组成部分。在覆盖面、有效性、采用、实施和维护框架的指导下，将进行过程评估，以确定实施的促进因素和障碍，并修改实施战略；将进行总结性评估，以检验美高梅在中国初级医疗系统内管理PND的有效性。

关键字：抑郁症和情绪障碍；妇产科医学；公共卫生。