The study is a randomized control trial (RCT) with two parallel arms, 1) an intervention
arm: Center M added to treatment as usual (TAU), defined as standard prenatal care, and
2) a control arm: TAU, again defined as standard prenatal care. As both groups will be
obtaining services through the Center for Women's Health at OHSU, offered standard
prenatal care is expected to be similar in both arms. The study will be masked to the PI,
Co-I's, consultants, and anyone directly collecting or analyzing study data. Primary
prenatal care providers will also be masked to subject assignment. Participant and
interventionist masking is not possible due to the nature of the intervention arm. The
research coordinator(s), research assistants needing to communicate with research
participants about group activities (e.g., responding to logistical emails), and
volunteers who support the research coordinator or research assistants with
communications regarding groups will also be unmasked. Participants will be randomized by
the research coordinator or designated research assistant after eligibility determination
and study consent.

The Center M intervention proceeds sequentially with weekly one-hour group sessions led
by a trained, masters-level (or equivalent) therapist. Each group will include 3-6
participants. These sessions are conducted digitally via WebEx. Center M session
structure aligns with mindfulness based cognitive therapy by including: 1) introduction
of a core theme and rationale for how this theme relates to mental well-being (i.e.,
psychoeducation); 2) teaching core mindfulness (including an emphasis on self-compassion)
and CBT skills; 3) facilitating in-session practice of skills (i.e., experiential
learning); and 4) reviewing home practice of skills as well as barriers to practice.
Sessions are focused on skill development, both through active engagement in practice
during group sessions and individual home practice. Center M content teaches skills that
increase capability for effectively navigating general life stress and the unique
stresses of pregnancy and parenting. It is further designed to increase awareness of
early warning signs of perinatal depression to allow for identification of the need for
additional resources (including more intensive preventive intervention). The curriculum
is designed to be a 'light touch', or minimum necessary intervention that still retains
the capacity to prevent perinatal depression. Examples and summaries of the curriculum
and accompanying handouts and homework are outlined below and full curriculum, handouts,
and homework are available in the IRB documents. The Center M curriculum, handouts and
homework follows the parent model MBCT curriculum, with alterations made in direct
communication with Sona Dimidjian, PhD, and Sherryl Goodman, PhD, the developers of the
parent model. The Center M adaptation has been accomplished with the support and
involvement of Drs. Dimidjian and Goodman.