A discrete choice experiment was conducted among 698 women at high risk for postpartum depression. The study utilized home visits by healthcare providers and a comprehensive mobile app questionnaire to assess referral preferences. Seven distinct referral attributes were evaluated, including accompaniment by a family member, access to psychiatric clinics, face-to-face consultations, costs, and waiting times. These attributes served as the intervention exposure, compared against other referral options.
The analysis revealed that all assessed attributes, except for accompaniment, were important determinants of participant preference. Participants generally preferred referrals to psychiatric clinics, face-to-face consultations, lower costs, and shorter waiting times. Latent class analysis categorized participants into four distinct groups based on their specific preferences. Within these groups, treatment cost and waiting times emerged as the most decisive factors influencing referral choices.
No adverse events or discontinuations were reported, as this study assessed preferences rather than clinical outcomes. A key limitation noted is the remaining gap in quantitative analysis. The findings suggest that developing flexible and personalized referral programs that cater to these specific preferences is crucial for optimizing care delivery in this population.
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Despite the global prevalence of postpartum depression (PPD), current referral uptake rates are far from satisfactory. While some qualitative studies have investigated factors affecting PPD referrals, a gap in quantitative analysis remains. Addressing this, our study utilized a discrete choice experiment (DCE) to understand the procedural elements influencing PPD referral uptake among diagnosed women. The DCE was conducted via home visits by healthcare providers and a comprehensive mobile app questionnaire. We constructed seven distinct referral attributes to explore participants preferences, analyzed using mixed logit models and latent class analysis. This analysis identified key determinants and revealed the heterogeneities in referral preferences. A total of 698 individuals completed the DCE questionnaire. All assessed attributes, except for Accompaniment (going to clinic with a family member), were important determinants of preference. Participants generally preferred referrals to psychiatric clinics, face-to-face consultations, lower costs, and shorter waiting times. Significantly, participants personal and socio-demographic characteristics also played a critical role in their referral preferences. Latent class analysis categorized participants into four distinct groups based on their preferences, with treatment cost and waiting times being the most decisive factors. In conclusion, the preference for PPD referrals is predominantly driven by convenience and access to specialist care. To enhance referral uptake, developing flexible and personalized referral programs that cater to these preferences is crucial.