Advancing a better understanding of influences on relational health: A prevention science approach

Abstract

One of the strongest predictors of optimal health, well-being, and life satisfaction is having stable and supportive relationships (Pinker, 2014). Yet as evidenced by high rates of relationship dissolution, maintaining healthy and stable romantic relationships can be difficult (Rodrigues, Hall, & Fincham, 2005). Thus, there has been a significant amount of focus on predictors of successful romantic relationships. This two-study dissertation takes a prevention science approach to focus on advancing empirical research focused on individuals’ and couples’ relationship health and the design of psychoeducational programs. Both basic and applied research questions were explored.

The first study sought to investigate the effects of a newly developed couple relationship education curriculum, ELEVATE: Taking Your Relationship to the Next Level. It addressed several critical gaps in the CRE evaluation literature (e.g., the assessment of the effects of a specific curriculum, the use of multiple time points, the use of a large group of diverse participants and comparisons, a focus on several key individual and contextual moderators of change, and the assessment of a wider range of outcomes). The first study compares change over six months between participants (N = 184) and non-participants (N = 116) using propensity score adjustments and multi-level growth curve modeling. We found partial support for the effectiveness of ELEVATE in five of the nine target outcomes related to program content and individual and couple functioning over a six month period (intimate knowledge of partner, connection to sources of support, conflict management strategies, couple quality, and depressive symptoms). These findings provide initial support to move ELEVATE towards an emerging evidence-based program. A prevention science framework suggests universal interventions may have differential effects on individuals, depending on the level of risk. Thus we also explored variations in outcomes based on several demographic characteristics. Income moderated the change in two of the nine outcomes, such that those with higher levels of income experienced greater change in developing a couple identity and connection to sources of support. Family harmony moderated change in five of the nine outcomes (intentionality, developing a couple identity, caring behaviors, couple quality, and depressive symptoms), indicating those experiencing more stressful family contexts at baseline experience a greater amount of change. Additionally, relationship length moderated the amount of change in two of the nine outcomes (conflict management skills and overall relationship quality); specifically, those in more established relationships experienced greater change. Our study contributes to efforts to assess the efficacy of a specific curriculum offered to a diverse population through community-based programming and efforts considering the effects of CRE programming beyond the “average” experience. Overall, this type of nuanced approach to CRE evaluation helps to inform practitioners, researchers, and curriculum developers and provides information relevant to the development of best practices for CRE in diverse communities.

The second study serves to advance the empirical research on predictors of relationship quality by examining the role of trait mindfulness in combination with well-established empirical links including, the negative influence of stress and the positive influence of positive relationship behaviors on relationship quality. In a sample of 157 women and 124 men in romantic relationships, multi-group structural equation models were fit to test a conceptual model built on the extant literature, the vulnerability-stress-adaptation model, and family stress theory. Specifically, the conceptual model assessed predictors of relationship quality by examining the role of trait mindfulness and exploring its influence directly and indirectly, through stress and positive behaviors. The results of the current study indicate a robust connection between trait mindfulness and relationship quality for women in our study and a trend towards an established link for men, while considering the independent influence of stress and positive behaviors. Positive relationship behaviors appear to be the most potent predictor of relationship quality for both men and women in our sample. For men, this link is direct; however, for women, the most potent predictive pathway is from stress to positive relationship behaviors to relationship quality. Overall, the study provides evidence that mindfulness can be considered a unique predictor of relationship quality, particularly for women; however, actual behaviors in relationships remain a key factor in predicting relationship quality for both men and women and may not necessarily stem from higher trait mindfulness. It appears warranted to suggest an emphasis on all three areas of skill development in interventions in order to enhance a romantic relationship, particularly for women.

Historically, prevention scientists have focused on public health issues; however, there has been a movement in prevention science research to focus on issues related to human development and family life. This movement has highlighted the need to assess psychoeducational programs from a prevention science framework and utilize basic science to guide the development and refinement of curricula and programs. Continued efforts to integrate multiple areas of research relevant to individual and family functioning and broaden the definition of health and well-being to include relational and social dimensions is necessary. Finally, moving the research focused on successful and healthy romantic relationships forward in a collaborative and clarifying way is central to the refinement of programs that can promote resiliency for diverse couples and families.