Center M Pilot Trial: Integrating Preventive Mental Health Care in Routine Prenatal Care.

A brief group telehealth mindfulness-based cognitive behavioral therapy intervention called Center M, adapted from a longer program for perinatal depression, showed preliminary feasibility and acceptability among 99 pregnant people. Depressive symptoms decreased from before to after the four weekly sessions, and mindfulness capacity increased from before the intervention to six weeks postpartum. Higher mindfulness at six weeks postpartum predicted fewer depressive symptoms at that time point, and reduced maladaptive emotion regulation was linked to lower depression. Qualitative feedback indicated high satisfaction. The authors suggest Center M may be effective but note that further research is needed to confirm these findings and address implementation.

Study at a glance

Abstract

Perinatal depression is a leading cause of preventable US maternal morbidity and mortality. Although Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT-PD) is highly effective, it faces significant scalability challenges. Center M, a brief, group-based, mindfulness-based cognitive behavioral therapy (CBT) intervention, is an adaptation of MBCT-PD designed to overcome these challenges. The purpose of this pilot study was to evaluate Center M's preliminary acceptability, feasibility, mechanisms of action, and efficacy. In this mixed-methods pilot study, data were collected from 99 pregnant people at 3 time points: preintervention, postintervention, and 6-weeks postpartum (Clinical Trials no. NCT06525922). Participants engaged in 4 one-hour, weekly group telehealth Center M sessions facilitated by social workers. Participants strengthened mindfulness CBT skills using home practice materials between group sessions. Data included self-report measures evaluating depressive symptoms, mindfulness skills, and emotion regulation. Satisfaction was assessed via focus groups or surveys. Depressive symptoms significantly decreased preintervention to postintervention (Patient Health Questionnaire-8 score: preintervention mean [SD] 5.02 [3.52], postintervention mean [SD] 4.23 [2.84]; P = .03), and mindfulness capacity significantly increased preintervention to 6 weeks postpartum (Five Facets of Mindfulness Questionnaire score: preintervention mean [SD] 125.56 [18.68], 6 weeks postpartum mean [SD] 130.10 [17.15]; P = .004). Linear regression analyses indicate that higher mindfulness at 6 weeks postpartum significantly predicted fewer depression symptoms at 6 weeks postpartum (β, -0.07; 95% CI, -0.123 to -0.021, R2 = 0.22; P = .006). Reduction in the use of maladaptive emotion regulation was significantly associated with decreased depressive symptoms at 6 weeks postpartum (β, 0.21; 95% CI, 0.048 to 0.376, R2 = .21; P = .012). Qualitative themes indicated high Center M acceptability and appeal. Our findings support the feasibility, acceptability, and appeal of Center M. Results suggest Center M may be effective in reducing depression and enhancing mindfulness skills. Future research must confirm these initial findings to more widely address Center M implementation capacity and sustainability.