Table 2.
Mamma Mia determinants, methods, and strategies for use.
| Determinants | Methods | Strategies for use |
| Knowledge | Consciousness raising (TTMa) | Psychoeducation, guidelines, and recommendations are often followed by, for example, reflective questions intended to raise awareness about certain counterproductive expectancies or attitudes (eg, “I can’t ask anybody for help, I should be able to take care of my own baby”) |
| Active learning (ELMb and SCTc) | Psychoeducational information, cognitive and behavioral assignments, brief and many learning moments with repeated content over time to provide opportunities for rehearsal. | |
| Elaboration (ELMb) | Information should be relevant, easily understandable, and rewarding to follow. Aligned with the chronology of the physiological and psychological processes during pregnancy and postpartum. | |
| Expectancies and attitudes | Goals/personal standards (SRTd) | Promote acceptance of a lesser need for detailed planning and rigorous control (eg, unexpected events may occur during birth). |
| Normalization (NSIe) | Normalize mixed feelings, potential failure to breast-feed, and feeling low on energy, which can assist with relaxation. | |
| Self- and environmental re-evaluation (TTMa) | Stimulate appraisal to self-assess depressive symptoms, reinforce partner involvement, reinforce early parent-child bonding (eg, fantasy baby). | |
| Verbal persuasion (SCTc) | Communicate optimism about users’ parenting abilities, benefit of participating in Mamma Mia, and support-seeking behavior. | |
| Attachment, emotion regulation, and help-seeking | Newborn Behavioral Observation | Video demonstrations of infant sleep-wake cycles and social interactive skills, homework assignments. |
| Circle of security | Illustrated graphics to help parents understand their baby’s needs and activate appropriate attachment behaviors. | |
| Positive psychotherapy (PPTf) | Provide concrete tasks that focus users’ attention on all the good things in life to enhance positive emotions, engagement, and a sense of meaning (eg, gratitude exercises); homework assignments. | |
| Mindfulness (PPTf) | Audio-taped instructions that foster being in the moment, which are provided as downloadable audio files for personal use; homework assignments. | |
| Behavioral activation (PPTf) | Recommendations for physical activity during pregnancy and after childbirth. Compile a list of pleasant activities and schedule pleasant activities over the course of the intervention. | |
| Stress and coping social support theory/relational regulation | Edinburgh Postnatal Depression Scale to assess depressive symptoms, encourage asking for partner support and/or general physician, provide a phone number to a mental health hotline. | |
| Metacognitive therapy | Audio-guided instructions and exercises (eg, attention training technique) to induce a state of awareness of internal events (eg, excessive worry) without responding cognitively, emotionally, or behaviorally; homework assignments. | |
| Relationship satisfaction and communication skills | Gottman’s method (couples therapy) | Couple exercises and homework to build closeness with partner, create a supportive relationship, and learn to manage conflicts (eg, softening technique); homework assignments. |
| Prevention and relationship enhancement program | Video demonstrations of communication and problem-solving skills (eg, speaker-listener technique); homework assignments. | |
| Nonviolent communication | Practice distinguishing observations from interpretation of actions, identifying and expressing one’s feelings and needs in a nondemanding way, and be given performance feedback. |
aTTM = transtheoretical model
bELM = elaboration likelihood model
cSCT = social cognitive theory
dSRT = self-regulation theory
eNSI = normative social influence
fPPT = positive psychotherapy