Pressurizing or encouraging: Health behaviors among long-distance couples.

Couples in long-distance relationships face unique challenges that affect their health outcomes and relationship dynamics in ways that are different from couples in close proximal relationships (PR). The results of previous literature analyzing health outcomes for long-distance relationship (LDR) couples have been mixed, and factors such as couple satisfaction and gender of the individuals contribute to the variance. This study examined the good health practices of couples in LDRs, the ways in which partners influence each other's health, and the health outcomes of these couples as compared to couples in PRs. Multilevel multivariate analysis showed that couples in LDRs had better health practices than those in PRs, and men overall had poorer health practices than women. There was no main effect seen for LDRs when we examined strategies used for influencing health. There was a main effect for gender, though, and we found that women tend to use more collaborative and pressurizing strategies for influencing their partner's health. On health indices, we found that LDR couples tended to have lower levels of fatigue and sleep disturbance as compared to PR couples. In the adjusted model with covariates, which included age, income, couple satisfaction, and married or unmarried couples, we found that lower couple satisfaction and lower income significantly predicted poorer health on all health indices. These results are discussed in light of unequal gender roles, social control, and positive aspects of LDRs on health in an attempt to understand LDRs better and destigmatize the narrative of these relationships as 'less than' PRs. Implications for health and mental health practitioners are also discussed.

What, why, and for whom: couples interventions: a deconstruction approach.

This paper provides a commentary on the special series on universal processes and common factors in couple therapy (Halford & Snyder, this issue). The authors in this section share their insights, from varying perspectives, about what it is in couples therapy and relationship education programs that work, why they work, and for whom they work best. In so doing, these articles address specific elements of couples interventions--in effect, taking a couples approach apart in order to understand it better. However, as a collection, this section takes this approach to understanding one step further. It puts the elements back together again, making the process of couples therapy/relationship education more accessible and easier to customize based upon the couple, the presenting complaints, the therapist, and the context. The term "deconstruction" is used to describe how the specific elements of couples interventions are understood and reassembled in new, theoretical, and empirically validated ways. It is argued here that once it is understood that a couples intervention works, why it works, and for whom it works, we are able to individualize our approach to specific couples in an effort to make couples therapy better at improving relationships and keeping them improved.

Challenges and opportunities in public health perspectives on family interventions: introduction to the special section.

This introduction to the special section frames the idea of a public health approach to couple and family interventions as focusing upon the impact of interventions on outcomes at the population level. It notes the importance of looking at how evidence-based interventions can be used more effectively at the population level. It also stresses that the goals for population-level studies are different from randomized clinical trials. Public health interventions need evidence that the interventions can be used in widespread practice, that the interventions are cost effective when used as designed, and that monitoring and evaluation tools are available for adopting agencies. Finally, this introduction introduces the three articles of the series.