# Presentation: 119684

## The Supporting Healthy Marriage Evaluation 

- Design, Early Lessons, and Progress to Date
- Barbara Goldman, MDRC
- ACF/OPRE 10th Annual Welfare Research and Evaluation Conference June 4-6, 2007

**Notes:**
-- As Phil said, I’m the project director for the Supporting Healthy Marriage evaluation.   
-- I would love to come back when we are further along and have some findings to share.  But for now I’m happy to be here, to introduce you to the project and where it stands right now.   
-- For those of you who are not familiar with MDRC :
--  a non-profit, non-partisan research group based in New York and Oakland. 
-- have been conducting social policy research since 1974
--  best known for conducting large-scale random assignment tests of new social policies 
-- with the mission of learning what works to improve the well-being of low-income people.

## What is the Supporting Healthy Marriage (SHM) Evaluation?

- Random assignment study in multiple sites around the country
- Interventions aimed at healthy marriage among low-income married couples
- Created and funded by Administration for Children and Families, U.S. Department of Health and Human Services
- Conducted by MDRC, Abt Associates, Child Trends, Optimal Solutions Group, with many additional experts and consultants

**Notes:**
-- The target group is one feature that distinguishes this study from some other work that is going on right now.  There are other studies and efforts being conducted under the federal healthy marriage initiative, such as the Building Strong Families project, that are aimed at unmarried couples, particularly those who have a child together.  

-- The Supporting Healthy Marriage evaluation is aimed instead at couples who are already married and is looking at how to strengthen those existing marriages.

-- This project is funded by the Administration for Children and Families at HHS.  And while MDRC is the lead research firm, we have several important partners, including Abt Associates, Child Trends, Optimal Solutions Group, and we have been fortunate enough to work closely with several academics who are leaders in this field, like Phil and Carolyn Cowan.

## Why Marriage Education for Low-income Married Couples?

- Strategy for improving well-being of low-income children through improving parents’ relationships
- Children whose parents are married and in low-conflict relationships tend to do better on many outcomes
- Low-income couples’ marriages are more likely to end in separation or divorce, so their children are less likely to experience these benefits

**Notes:**
Before we talk about the specifics of the project, I just want to mention the underlying rationale for this study.  Why should we test whether marriage education is a helpful service for low-income married couples?  Well, MDRC is interested because we see it as a potential strategy for improving the well-being of low-income children by improving their parents’ relationships. We have conducted some other studies of the child support system and efforts to help non-resident fathers remain more involved with their children, and these programs were very limited in their ability to improve family relationships.  It seems worthwhile to take a more preventive approach, to see if there is anything we can do to help couples, who are trying to raise a child together, to develop relationship skills that might help them stay together in a healthy relationship while their child is growing up.  

-- We know from non-experimental research that children whose parents are married and in low-conflict relationships tend to do better on many outcomes.  And we know that low-income couples’ marriages are more likely to end in separately or divorce, so that their children are less likely to experience the benefits of a low-conflict two-parent family.
- But these are primarily findings from well-done correlational studies.  What we can learn in SHM is the causal question of whether intervening to strengthen parents’ relationship can actually CHANGE outcomes for their children.

## What Do We Know from Existing Research?

- Marriage education programs can bring about improvements in couple relationships
- Limitations of prior research:
- Small studies
- Mostly middle-class, white couples
- Often short-term follow-up studies; when long-term, impacts fade over time
- We know little about their effectiveness for low-income couples

**Notes:**
-- We also know that in studies of primarily middle class couples, marriage education programs that teach relationship skills can bring about improvements in couple relationships.  So this suggests that a preventive approach might be useful.  
-- But most prior studies had limitations.  They tend to have small samples so that we can’t learn much about how they work for different types of couples. Their participants tend to be middle-class white couples.  They often have very short-term follow-up, and when there is long-term follow-up, the benefits to couples tend to fade over time.  They also tend to look at a very limited set of outcomes, such as marital satisfaction, but not levels of conflict or separation and divorce.  Only a few researchers like the Cowans have looked at how these interventions might ultimately affect children.  
-- And finally, we know little about the effectiveness of these kinds of programs for low-income couples.   
-- For example, will low-income couples face so many challenges to even showing up for a program that meets for several weeks that it’s hard for them to benefit?  And if they do attend, do past problems or current circumstances that undermine their family relationships overwhelm the benefits they might derive from learning better communication or conflict resolution skills?  

-- These are all things that we are hoping to learn more about in this study.

## Important Principles Guiding SHM

- Reliance on research to shape intervention
- Skills-based approach (not therapy or marital counseling)
- Voluntary participation
- Focus on couples, fathers as well as mothers
- Emphasis on *healthy *marriage and relationships
- Alertness about domestic violence

**Notes:**
There are some other important principles that underlie our approach to this project.  

-- We’ve already talked some about how existing research has influenced our decisions – in particular, it has pointed us to a program model that is more intensive and comprehensive than most marriage education programs that are out there.  

-- We are testing a skills-based approach, a psycho-educational and preventive approach to behavior change.  This is not couples therapy or marital counseling for people in very distressed relationships. 

-- Another principle is voluntary participation – this is to me the most important characteristic of these programs.  The sites are going to have to design their programs so that couples find them useful and fun to participate in, or they simply won’t come.

-- The focus on couples is very important – part of what these programs might do, I think, is move organizations who implement them closer to working with the whole family, not just one parent, which in our social service system in the past has typically been the mother.

-- The emphasis on healthy marriage and relationships is also crucial – these programs are not about telling couples who should stay together and who shouldn’t, or telling them that they should stay together no matter what problems they are having.  The programs provide them with skills to communicate more effectively, to make decisions together, to help keep conflict from spinning out of control, but they make their own decisions about their relationships. The staff in every site are developing domestic violence protocols with local domestic violence partners, including how to make sure the program gives opportunities for safe disclosure of domestic violence and what to do if a disclosure occurs. 

## Who will an SHM program serve?

- Married, adult couples with children
- Both spouses must volunteer
- Low to moderate income families
- Families without serious family violence issues

## What does an SHM Program Look Like? 

- Services delivered over 12 months
- SHM program components:
**Core Marriage Education Curriculum **(~3 to 5 months)
- Multi-sessions, groups, 30+ hours
- Common set of topics (e.g., managing conflict and stress)
- Four curricula: Within Our Reach, Becoming Parents Program, PAIRS, Loving Couples/Loving Children

## Program Components (cont’d)

**Extended Marriage Education Activities** (~7-9 months)
- Booster sessions, peer mentoring, coaching, group social events, date nights, family activities
**Family Support and Supplemental Services** (Ongoing)
- Support participation and reinforce skills
- Identify family needs and link couples with supplemental services (e.g., child care, transportation, emergency assistance, employment, mental health, etc.)
- Encourage safe disclosure of domestic violence and link to appropriate services

## Program Implementation

- Identification
- Of
- Pilot Sites

## SHM Pilot Sites

## SHM Pilot Sites: Variety of Settings

- University-based
**Orlando, Florida**:  University of Central Florida:  Operates a family and marriage clinic and research institute
**Seattle, Washington**: Becoming Parents Program:  Formerly university-based, now a private curriculum developer / service provider – target expectant married couples
- Mental health HMO
**Bronx, New York**: University Behavioral Associates:  behavioral management services organization part of Montefiore Medical Center accessing medical, mental health and substance abuse care – target clinics

## SHM Pilot Sites

- Non-profit community organizations
**Kansas **(two locations): Catholic Charities – (Kansas City and Wichita); faith-based, working in conjunction with Kansas Healthy Marriage Initiative
- Multi-service family centers:
**Shoreline, Washington**: Center for Human Services; several family support centers providing parenting, youth, counseling services
**Pennsylvania** (three locations):  Community Prevention Partnership (Reading), Family Answers (Bethlehem), Family Service Partners (Harrisburg)** **
**Texas** (two locations):  San Antonio Family Service Association; marriage education added to existing counseling services. Texas HHSC in lead

## SHM Pilots

- Head Start/Children’s services:
**Texas:  **El Paso Children’s Center. Working with entire family (parents and children)
- For-Profit Organizations
**Oklahoma:**  Public Strategies, Inc.  Operating Building Strong Families program, now targeting married expectant couples

## Update on SHM Activities

- 8 sites starting pilots beginning May through September 2007
- Develop operational plan and budget
- Hire  and train staff
- Providing technical assistance; continuing to develop programs
- Operational benchmarks
- Pilot assessments
- Pilot survey to assess service differential between SHM and control groups
- Begin sample build-up for full evaluation sample (2007 – 2010)

## Research Design

- Implementation Study and
- Impact Study

## Implementation Study

**Key Questions **
- What did the program “look” like?  What was the operating environment?
- Who was served? What strategies were used to recruit, engage, and retain couples?
- What challenges did staff face in designing and implementing the program?
**Data Sources**
- Field visits - observations, interviews, focus groups
- Program participation records (from MIS)
- Surveys

##  Impact Study

- Key Questions
- What were the effects on marital quality and stability? Mental health of each partner? Parenting / co-parenting? Child outcomes?
- What were the effects for different subgroups?
- Random Assignment Design
- Data Sources
- Baseline Data
- Surveys (12, 36, possibly 60 months)
- Videotaped observations of couple interactions

## Assessing Program Operations

- Operational Benchmarks
- and
- Management Information Systems

## Key Challenges in Early SHM Program Operations

- Recruit steady and adequate flow of couples
- Involve both husbands and wives
- Assure strong program (high participation, on-going contact, high quality)
- Assure strong test (large differential in SHM-type services received between SHM program and control group couples)

## Multiple Users of the SHM MIS

- Program managers
- Track sample build-up from recruitment and referral through intake
- Track program services and activities
- Track marriage education groups (frequency)
- Program staff
- Day-to-day management of their caseloads
- SHM site team
- Monitor operational benchmarks
- Researchers
- Describe sample
- Inform implementation and impact research

## MIS Central Tool to Manage New Program

- Intake and Eligibility
- Recruitment and referral through random assignment
- Real-time random assignment
- SHM Program Services
- Marriage education groups and attendance
- Extended marriage activities
- Contacts with spouses/couples
- Referrals, supplemental services, and incentives
- Reporting Functions

## Key Features of MIS

- Track couples and each spouse (both husband and wife)
- User friendly – encourage intake and program staff to direct enter information into system
- Accessibility to information – create reporting functions so information can be easily retrieved by program managers and staff
- Staff need to find it helpful in doing their jobs – electronic case notes, tickler systems
- Set a few important benchmarks, collect information, share with managers and staff, and use information to improve program operations

**Notes:**
Good MIS system and reports are key.  Staff also have to put in the information needed, or you won’t know what’s going on.  
 Example of management against first goal : Where are couples being recruited from? Are we more successful sending outreach staff to other organizations or are our referral partners sending us appropriate couples themselves? How can we adjust our staff’s daily activities to maximize recruitment?

Why are couples being screened out / not eligible?  Will require looking closely at information gathered before or during intake.

## Using benchmarks to manage a new program  

- Examples of simple benchmarks :
- Overall level of recruitment: # of couples referred to program
*Productive* recruitment (not just couples, but couples who are eligible and interested):  # couples randomly assigned/enrolled
- Timely engagement into services:  % of enrolled couples attending at least one marriage education class within two months of enrollment
- Ensuring that the full multi-component program is being implemented:
- % of enrolled couples meeting with Family Support Worker at least once within two months of enrollment
- % of enrolled couples attending at least one extended marriage activity

**Notes:**
Good MIS system and reports are key.  Staff also have to put in the information needed, or you won’t know what’s going on.  
 Example of management against first goal : Where are couples being recruited from? Are we more successful sending outreach staff to other organizations or are our referral partners sending us appropriate couples themselves? How can we adjust our staff’s daily activities to maximize recruitment?

Why are couples being screened out / not eligible?  Will require looking closely at information gathered before or during intake.

## For more information:

- _[www.supportinghealthymarriage.org](http://www.supportinghealthymarriage.org/)_
- _[www.mdrc.org](http://www.mdrc.org/)_
- b_[arbara.goldman@mdrc.org](mailto:Barbara.goldman@mdrc.org)_