Abstract: Objective To develop and validate a screening pathway for children's mental development suitable for primary care, in order to establish a monitoring platform for children's mental health care at the county, city, and province levels. Methods From January 2019 to March 2020, a stratified cluster sampling study was conducted in nine cities of Fujian province. Relevant items were selected to construct the screening model of children's mental development, and the validity and reliability were verified. Since April 2020, a monitoring platform has been built for routine management of the screening pathway. Results A total of 3 526, 3 568 and 3 553 samples of 0- to 6-year-old children were collected to construct the screening model of intelligence, motor cooperation, social interaction and life ability. The screening models for intelligence, motor coordination, social interaction, and life ability showed AUCs of 0.872 - 0.993, 0.902, and 0.914-0.990, respectively (P<0.05). The Cronbach's α coefficient of three dimensions was 0.731 - 0.938, 0.767 and 0.784 - 0.837, respectively (P<0.05). The construct validity was 0.692 - 0.829, 0.672 - 0.793 and 0.736 - 0.864, respectively (P<0.05). The statistical test showed that the model had good reliability and validity. The sensitivity and specificity were 84.73% and 89.26% for intelligence, 82.77% and 92.16% for motor coordination, and 91.84% and 96.93% for social interaction, respectively. A regional information platform was created to digitize the screening reports. A total of 29 355 children were screened, and 8 513 children tested positive for the initial screening. Among them, 8 183 children were referred to specialists for further treatment, resulting in a high-risk management rate of 96.12%. Conclusion The effective integration of monitoring platform and children's psychological screening technology can improve work efficiency, increase the coverage of children's mental health care, enhance the management rate of high-risk children, promote case closed-loop management and hierarchical diagnosis and treatment, and achieve secondary prevention.

Key words: mental healthcare, screening, regional, monitoring platform

摘要： 目的 研发并验证适合基层使用的儿童心理发育筛查路径,搭建县-市-省儿童心理保健的监测平台。方法 2019年1月—2020年3月,在福建九地市开展分层整群抽样研究,遴选相应条目构建儿童心理发育筛查模式,进行真实性和可靠性验证。2020年4月起,将筛查路径构建监测平台,进行日常管理。结果 分别纳入3 526、3 568、3 553例0~6岁儿童样本用于构建智能、运动协同及社会交往与生活能力的筛查模式。智能、运动协调、社会交往与生活能力筛查模式的AUC分别为0.872~0.993、0.902、0.914~0.990(P<0.05);Cronbach's α系数分别为0.731~0.938、0.767、0.784~0.837(P<0.05);结构效度分别为0.692~0.829、0.672~0.793、0.736~0.864(P<0.05)。经统计学检验,其信效度良好;灵敏度、特异度分别为84.73%、89.26%;82.77%、92.16%;91.84%、96.93%。将筛查模式搭建区域性信息平台,智能化生成筛查报告。共筛查29 355人,发现初筛阳性儿童8 513人,已有8 183例儿童转专科进一步诊疗,高危管理率96.12%。结论 本项目探索出可供基层使用的儿童心理保健路径,监测平台与儿童心理筛查技术有效融合可提升工作效率,可提高儿童心理保健的覆盖面,提升高危儿管理率,促进个案闭环管理及分级诊疗,实现二级预防。

关键词: 心理保健, 筛查, 区域性, 监测平台