Program for Perinatal Mental Health Promotion and Work-Life Balance

INTERVENTION: The MAternal Mental Health in the WORKplace (MAMH@WORK) intervention will address maternal mental health and well‐being protection and promotion during late pregnancy, postpartum and return to work. More specifically, it will target women’s psychosocial adjustment and resilience during this life stage, while promoting several strategic skills: recognition of signals and symptoms of mental disorders; reduction of stigma against mental disorders; coping skills for stressful situations, with a special focus on e‐training of mindfulness; enhancement of help‐seeking efficacy; and strengthening of emotional and cognitive self‐regulation. Health education sessions will be conducted by trained psychologists and psychiatrists experienced in cognitive‐behavioural therapy‐based psychoeducation interventions, prevention and treatment of depression and anxiety disorders. The intervention will be either conducted on‐site (Instituto de Saúde Ambiental da Faculdade de Medicina da Universidade de Lisboa) or live streaming online. The format, setting and contents of the intervention will be fully defined after scoping literature reviews and Delphi technique, which will assure its adequacy as a short‐term and sustainable intervention. Still, the intervention is planned as follows (slight changes are anticipated as a consequence of the scoping literature reviews and Delphi technique for consensus‐building): ‐ Modules: mental health literacy, self‐ and perceived stigma towards mental illness, work‐life balance, early signs of mental disorders, mother‐child interaction and promotion of secure attachment, social support, information about biofeedback (including technical details about the wearable devices), and mindfulness concepts and exercises. ‐ Materials: a standard CONDITION: Anxiety;Postpartum depression;Postpartum blues;Child‐mother attachment;Child emotional self‐regulation;Child cognitive self‐control;Poor sleep;Postpartum bonding; ; Anxiety ; Postpartum depression ; Postpartum blues ; Child‐mother attachment ; Child emotional self‐regulation ; Child cognitive self‐control ; Poor sleep ; Postpartum bonding Mental Health ‐ Anxiety Mental Health ‐ Depression Mental Health ‐ Other mental health disorders Public Health ‐ Health promotion/education Reproductive Health and Childbirth ‐ Childbirth and postnatal care Reproductive Health and Childbirth ‐ Other reproductive health and childbirth disorders PRIMARY OUTCOME: Child attachment security assessed using the Strange Situation Procedure (Ainsworth & Bell, 1970).[12 months postpartum] Postnatal depression, assessed using the Edinburgh Postnatal Depression Scale (Cox et al., 1987) for the three arms.[2 weeks postpartum, 5 months postpartum and 12 months postpartum (primary endpoint)] Postpartum bonding, assessed using the Postpartum Bonding Questionnaire (Brockington et al., 2006) for the three arms.[2 weeks postpartum, 5 months postpartum and 12 months postpartum (primary endpoint)] INCLUSION CRITERIA: Native Portuguese speakers or women living in Portugal for at least 5 years; intended pregnancy; primiparous, singleton pregnant women at the gestational age of 28‐30 weeks; aged 18‐40 years; employed; with access to a smartphone; and have had understood and signed the project’s informed consent form. SECONDARY OUTCOME: Child development assessed using the Schedule of Growing Skills II (Bellman et al, 2012).[5 months postpartum and 12 months postpartum] Participants’ mental health literacy assessed using the Mental Health Literacy Scale (O'Connor & Casey, 2015) at the study close‐out.[Baseline (28‐30 weeks gestation) and 12 months postpartum.] Presenteeism assessed using the World Health Organization’s Heath and Work Performance Questionnaire (Kessler et al, 2003) for the three arms.[12 months postpartum] Resilience assessed using the Connor‐Davidson Resilience Scale (Connor & Davidson, 2003).[Baseline (28‐30 weeks gestation), 29‐31 weeks gestation, 2 weeks postpartum, 5 months postpartum and 12 months postpartum] Sleep quality determined using app data from a wearable device (sleep analyzer). [Baseline (28‐30 weeks gestation), 29‐31 weeks gestation, 2 weeks postpartum, 5 months postpartum and 12 months postpartum]