Table 1_PROMATER: protocol for a randomized controlled trial of a digital self-guided intervention to promote perinatal mental health and reduce self-criticism.docx

Participants will be randomized (1:1 ratio) to either the PROMATER intervention or to an active control group. Participants and data analysts will be blinded to group allocation. PROMATER consists of a 3-week program (6 modules) addressing maternal expectations, self-criticism, perinatal mental health, social support, self-compassion, and mindfulness and mother-infant bonding.

The active control offers a structurally equivalent program covering the same topics, except for the modules specifically targeting these transdiagnostic processes. Primary outcomes are self-compassion, assessed via the compassionate self-responding (CSR) score of the Self-Compassion Scale, and self-criticism, operationalized through the uncompassionate self-responding (USR) score. Secondary outcomes include postpartum depression, anxiety, quality of life, social support, and mother-infant bonding.

Assessments occur at baseline (T1), post-intervention (T2), and 3-month postpartum follow-up (T3). Data will be analyzed using Linear Mixed Models (LMM) following the Intention-to-Treat (ITT) principle.</p>Discussion<p>Evaluating the effectiveness of a brief, accessible, online intervention has the potential to address the need for an evidence-based approach designed to promote maternal well-being during pregnancy and the postpartum period.

The intervention is designed to maximize reach and minimize cost, with the potential to scale up and incorporate in routine perinatal care. The active control condition will allow examination of whether directly targeting self-criticism and self-compassion confers incremental benefit over structured perinatal psychoeducation alone.</p>Systematic review registration<p>ensaiosclinicos.gov.br/, identifier RBR-99tjfz5.</p>