RESUMO
The federal government, through the Administration for Children and Families (ACF), has funded community-based relationship education programs for couples, individuals, and families, with a strong focus on serving economically disadvantaged and racially diverse families. This study evaluated the impact of a 36-hour, workshop-based couple relationship education program that was funded by ACF using a randomized controlled trial (RCT) design and intent-to-treat (ITT) analyses. Participants were 1320 couples who were either expecting a baby or had a baby within the past 3 months, at the time of enrollment. Follow-up surveys were administered 12 months later. Analyses evaluated program impacts on relationship stability, constructive communication, and destructive conflict compared to a no-treatment control group. Analyses showed a statistically significant impact of the program on destructive conflict (d = 0.10) but not on constructive communication (d = 0.06) or stability (dCox = 0.10). Based on findings from previous evaluations, we also examined whether participants' levels of sociodemographic disadvantage moderated these effects. There was significant moderation by sociodemographic disadvantage on constructive communication and destructive conflict, but not on stability. Effects were observed for those at higher levels of sociodemographic disadvantage.
Assuntos
Comunicação , Motivação , Criança , Humanos , Avaliação de Programas e Projetos de SaúdeRESUMO
The field of relationship science has called for more research on the impact of relationship education on child outcomes, yet studies in this area remain sparse, particularly regarding maternal and infant health at birth. Research on group prenatal care demonstrates that individual-oriented group interventions have a positive impact on infant birth outcomes, suggesting the need to consider the impacts of other forms of group programming for women. The current study examined the impact of MotherWise, an individual-oriented relationship education and brief case management/coaching program for minority and low-income pregnant women, on birth outcomes. The study sample included 136 women who enrolled in a larger randomized controlled trial of MotherWise during early pregnancy. Although statistical power was limited due to the sample size and the effects were not outright significant at p < 0.05, results indicated that the effects of MotherWise on birth outcomes were small to moderate in size (0.23 for birthweight, 0.46 for preterm birth) and suggest important avenues for future tests of relationship education programs and their impacts on maternal and infant health. The current study suggests that relationship education during pregnancy could directly impact women's and infant's health.
Assuntos
Escolaridade , Cuidado Pré-Natal , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Nascimento Prematuro , Cuidado Pré-Natal/métodosRESUMO
Low-income couples are at increased risk for relationship instability and divorce. In response, online relationship education programs such as ePREP and OurRelationship have been developed to more easily reach this population. A previous trial indicated that these programs promote relationship functioning (Doss et al., 2020) and individual well-being (Roddy et al., 2020a). However, given that these effects were notably larger than previous studies of in-person relationship education and approached effect sizes observed in couple therapy, it is possible that the magnitude of these effects was somewhat spurious; therefore, these findings need replication. The current manuscript seeks to replicate these programs' previous effects on relationship functioning and determine whether these effects are stable. Using a sample of 671 low-income couples seeking relationship help (N = 1337 individuals) and Bayesian estimation, the current study replicated previous findings that the OurRelationship and ePREP programs offered with four coaching calls produced reliable improvements in relationship functioning relative to a 6-month waitlist control group. There were no statistically reliable differences between the two active interventions. Bayesian analyses indicated that the effects of the two online programs were larger than the average effects of in-person relationship education for low-income couples reported in previous studies, roughly equivalent to efficacy studies of in-person relationship education reported in previous studies, smaller than those that resulted from the OurRelationship program delivered to distressed couples without an income requirement and smaller than couple therapy.
Las parejas de bajos recursos tienen mayor riesgo de inestabilidad en las relaciones y de divorcio. En respuesta a esto, se han desarrollado programas de educación sobre las relaciones, como ePREP y OurRelationship, con el fin de llegar más fácilmente a esta población. Un ensayo previo indicó que estos programas promueven el funcionamiento de las relaciones (Doss et al., 2020) y el bienestar individual (Roddy et al., 2020a). Sin embargo, teniendo en cuenta que estos efectos fueron notablemente mayores que los de estudios previos de la educación presencial sobre las relaciones y que abordaron tamaños del efecto observados en la terapia de pareja, es posible que la magnitud de estos efectos fuera de alguna manera falsa, por lo tanto, estos resultados necesitan repetirse. En el presente manuscrito se busca reproducir los efectos previos de estos programas en el funcionamiento de la relación y determinar si estos efectos son estables. Utilizando una muestra de 671 parejas de bajos recursos que buscaban ayuda para las relaciones (N = 1337 personas) y el cálculo bayesiano, el presente estudio reprodujo los resultados anteriores que ofrecieron los programas OurRelationship y ePREP con cuatro llamados de capacitación, generando mejoras fiables en el funcionamiento de la relación respecto de un grupo de referencia en lista de espera de seis meses. No hubo diferencias estadísticamente fiables entre las dos intervenciones activas. Los análisis bayesianos indicaron que los efectos de los dos programas virtuales fueron mayores que los efectos promedio de la educación presencial sobre las relaciones para parejas de bajos recursos informados en estudios previos, aproximadamente equivalentes a los de los estudios de eficacia de la educación presencial sobre las relaciones informados en estudios previos, menores que los obtenidos del programa OurRelationship impartido a parejas con distrés sin requisitos de ingresos, y menores que los de la terapia de pareja.
Assuntos
Terapia de Casal , Teorema de Bayes , Terapia de Casal/métodos , Divórcio , Emoções , Humanos , PobrezaRESUMO
Prenatal depression is a significant health issue associated with increased risk for poor mental and physical health outcomes among for both parents and their children. Having a history of childhood maltreatment is associated with increased risk for prenatal depression. Although research suggests that romantic relationship functioning likely plays a role in the links between childhood maltreatment and prenatal depression, it remains to be tested which aspects of relationship functioning modulate these associations. Using an actor-partner interdependence model framework (Kenny et al., 2006), the present study examined how specific aspects of romantic relationship functioning-relationship commitment, perceived partner support, constructive communication, and destructive conflict-moderated the links between mothers' and fathers' childhood maltreatment and depression during pregnancy. Participants included a subset of 1,135 low-income heterosexual couples (2,270 individuals) who enrolled in a randomized controlled trial of a relationship education program during pregnancy. Baseline, pretreatment data were used. Results indicated significant actor and partner effects of childhood maltreatment on prenatal depression. Further, these effects were moderated by specific indices of relationship functioning, such that the effect of one's own maltreatment on their prenatal depression was mitigated by high emotional support from partner and high constructive communication and was exacerbated by destructive conflict. Findings demonstrate that high relationship functioning can act as a protective factor, and low relationship functioning as a risk factor, in the link between one's own childhood maltreatment and their prenatal depression among both mothers and fathers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).