Alabama Community Healthy Marriage Initiative Evaluation Project for Couples

Study Overview
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Brief Summary
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The Alabama Healthy Marriage and Relationship Education Initiative (AHMREI), a large-scale partnership among Auburn University and 9 additional implementation partners at Family Resource Centers, implements multiple program activities that respond to family needs and integrate comprehensive services to promote healthy marriages and relationships, as authorized by the Claims Resolution Act of 2010 (Pub. L. 111-291). The purpose of this study is to evaluate the efficacy of two selected couples education curricula- Elevate and Couples Connecting Mindfully. The programs are intended to improve the well-being of individuals, couples, and families in domains such as couple well-being, parenting skills, individual skills, and economic stability.

Detailed Description
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In 2015, Congress provided funding for grants to provide healthy marriage and relationship services to help interested couples enhance or improve adult and family relationships. The Administration for Children and Families (ACF), within the Department of Health and Human Services (HHS), oversees these grants and provides supports to assist grantees in meeting their goals and objectives. To learn about the implementation and effects of these programs, Dr. Francesca Adler-Baeder at Auburn University was awarded a contract to conduct a local impact evaluation study. The evaluation includes impact and process studies for couples education curricula. Couples who are eligible for the programs and agree to be in the study are randomly assigned to either one of two program groups (Elevate or Couples Connecting Mindfully) or a no-program control group. Program group members are offered program services; control group members are not offered those services. The impact study will examine whether the programs improve outcomes for individuals in couples and the children of the participants in the program group compared to outcomes of those in the control group. Members of both program and control groups are surveyed five times over 2 years: before they are randomly assigned, immediately after the curricula have been implemented (approximately 8 weeks later), and 6 months, 1 year, and 2 years after baseline. All surveys are administered via an online survey system, Qualtrics. The survey covers a range of questions related to couple relationships and interactions, individual functioning, parent-child interactions, co-parenting quality, and economic stability. The process aspect of the study will examine multiple aspects of the implementation and operation of the programs. Specifically, program attendance or dose, participant characteristics, facilitator-participant relationship, attitudes towards the program, and mechanisms of change will be considered in the process evaluation. Information for the process evaluation is obtained through the respondents' online surveys and facilitator/educator surveys.

Official Title
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The Alabama Healthy Marriage and Relationship Education Initiative

Conditions
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Healthy Marriage, Healthy Relationship

Intervention / Treatment
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* Behavioral: Couples Connecting Mindfully
* Behavioral: ELEVATE


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: To be eligible for the AHRMEI Couples Evaluation Project, the applicant must be part of a couple (as defined by the couple) in which both couple members are applying to the program and that: both members of the couple are 19 years of age or older, both members of the couple can attend the majority of the class offerings. Exclusion Criteria: Does not meet the inclusion criteria.

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Couples Connecting Mindfully Curriculum<br>Receives the Couples Connecting Mindfully curriculum over a 6 week period. | Behavioral: Couples Connecting Mindfully<br> <br> * Other names: CCM;|
| Experimental: ELEVATE Curriculum<br>Receives the ELEVATE curriculum over a 6 week period. | Behavioral: ELEVATE<br> <br> |
| No Intervention: Control<br>No programming is offered. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Couple Satisfaction Index | Couple satisfaction was measured using an abbreviated version of the Couple Satisfaction Index utilized in previously published studies. The 3 items (rated from 1 [Not at all] to 6 [Completely]) are: I have a warm and comfortable relationship with my partner, How rewarding is your relationship with your partner? and In general, how satisfied are you with your relationship? Mean composites were calculated, and the total scale ranges from 1 to 6. Higher scores indicate higher couple satisfaction. | 6 months | 
| The Couple Relationship Skills Inventory | Couple relationship skills were measured using 32 items from the Couple Relationship Skills Inventory (CRSI). This measure was constructed to match the core relationship skills and predictors of couple quality emphasized in the HMRE programs provided. Items were taken from established and validated social science measures assessing commitment, intimate partner knowledge, friendship, caring behaviors, conflict management, and external support. Example items include, I commit effort every day to making my relationship work, I know my partner's current life stresses, When things 'get heated' I suggest we take a break to calm down, and I initiate physical affection with my partner. Items ranged from 1 (Very strongly disagree) to 7 (Very strongly agree). Composite sum scores were created at the individual level and the total scale ranges from 1-224 (i.e., 32*7 = 224). Higher scores indicate greater couple relationship skills. | 8 weeks | 
| Individual Mental Health | Individual mental health was measured using the SF-12 Mental Component Summary score assessing anxiety, depression, sense of wellbeing, and social/emotional functioning. Per the measure's design, items were asked on differing scales (e.g., 1 to 3 or 1 to 5) with different anchor responses (e.g., all of the time to none of the time, or not at all to extremely). Example items include, During the past month how much of the time have you accomplished less than you would like or During the past month how often have you felt downhearted and depressed? The SF-12 Mental Component Summary score has shown scale reliability and validity in empirical studies. Scores range from 0 to 100 with a mean of 50 and SD of 10 in the general U.S. population. Higher scores indicate better individual mental health. | 6 months |