Couple relationship education program “Living as Partners”: evaluation of effects on marital quality and conflict

Neumann, Angélica Paula; Wagner, Adriana; Remor, Eduardo

doi:10.1186/s41155-018-0106-z

Angélica Paula Neumann ^** Correspondence: angelicaneumann@gmail.com

APN is a doctorate in Psychology with CAPES scholarship (Universidade Federal do Rio Grande do Sul-UFRGS), a member of the Research Group in Family Relations Dynamics (UFRGS), and a professor at the Universidade Regional Integrada do Alto Uruguai e das Missões, Campus of Erechim.

Universidade Regional Integrada do Alto Uruguai e das Missões, 1621 Sete de Setembro Avenue, Erechim, RS 99709-250, Brazil.

https://orcid.org/0000-0001-5888-0360

Adriana Wagner

AW is a doctorate in Social Psychology (Universidad Autónoma de Madrid), an adjunct professor of the Instituto de Psicologia at the Universidade Federal do Rio Grande do Sul, and a coordinator of the Research Group in Family Relations Dynamics (UFRGS). She received a CNPq researcher grant (Level 1B).

Universidade Federal do Rio Grande do Sul, 2600 Ramiro Barcelos Street, Office 126, Porto Alegre, RS 90035-003, Brazil.

Eduardo Remor

ER is a doctorate in Health Psychology (Universidad Autónoma de Madrid), a professor at the Universidade Federal do Rio Grande do Sul, and a coordinator of the Research Group in Health Psychology. He received a CNPq researcher grant (Level 1D).

Universidade Federal do Rio Grande do Sul, 2600 Ramiro Barcelos Street, Office 126, Porto Alegre, RS 90035-003, Brazil.

* Correspondence: angelicaneumann@gmail.com

Authors' contributions

The first author (APN) collected the data. All authors collaborate with the data analysis and article writing. All authors read and approved the final manuscript.

Competing interests

The first (APN) and second (AW) authors are authors of the Psychoeducational program for couples “Living as Partners”. The other author declares that he has no competing interests.

Item number	Item
	BRIEF NAME
1.	Living as Partners: Turning Challenges into Opportunities
	WHY
2.	Marital conflicts are inherent in love relationships. However, when they happen frequent and intensely, and when they are not solved satisfactorily, they can negatively affect the relationship. Couple relationship education programs can promote better marital quality and conflict management between spouses. The relationship education program “Living as Partners: Turning Challenges into Opportunities' seeks to promote the couples' learning of conflict resolution strategies and better quality levels in the relationship.
	WHAT
3.	Materials: The program is a curriculum-based skills training approach, delivered in six workshops that are conducted weekly in groups of couples. The manual of the program is available for sale in Portuguese (https://goo.gl/xjNDHr) and Spanish (https://goo.gl/uJ2opR), and it is in the process of translation to English. All the materials used in the interventions are attached to the manual. In the Portuguese version, the materials are available in a password area of the website. In the Spanish version, the materials are available in a CD-ROM attached to the manual. The materials are six PowerPoint presentations, each one corresponding to one workshop, two video and several cards destined either to guide the practical activities or to provide psychoeducational information.
4.	Procedures: The detailed activities and procedures can be found in ^{Additional file 1} Additional file 1 Table S1. Description of the workshops' objectives and activities. (DOCX 18 kb) .
	WHO PROVIDED
5.	The workshops were provided by ten teams formed by three professionals working in the areas of Health and Social Service. Each group was led by a moderator, with the assistance of an auxiliary. An observer accompanied the workshops on the spot without intervening in the process. All the moderators had a university degree. Nine were psychologists and one was a pedagogue. Nine of them held a degree or were taking a post-graduate program. The auxiliaries and observers held a higher education degree (57.8%, n =11) or were undergraduate students (42.1%, n = 8) in psychology, social service, nursing and public management. Further information on the coordinating teams is available in Neumann (2017)Neumann, A. P. (2017). “Viver a dois: Compartilhando esse desafio”: Avaliação de um programa psicoeducativo para casais [“Living as partners: Turning challenges into opportunities”: Evaluation of a couple relationship education program]. Doctoral Thesis. Post-Graduation Program in Psychology at the Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.. The teams were selected by the authors of the intervention. They received 10 hours of training, coordinated by the authors of the intervention and their collaborators.
	HOW
6.	The program was delivered in six face-to-face workshops conducted weekly in groups of couples. The total hour load ranged from nine hours (9 h) for groups with three to five couples to 12 (12 h) for groups with six to eight couples.
	WHERE
7.	The intervention occurred in different places. Four group interventions were performed in public health services contexts, five group interventions were performed in universities and one group intervention was performed in a couples and family training center. The infrastructure of all the places included a private meeting room, chairs, individual desks or clipboards, computer, speakers and projector
	WHEN and HOW MUCH
8.	The intervention was composed of six weekly workshops. The duration of each workshop ranged from one and a half hours for groups of three to five couples and two hours for groups of six to eight couples. The workshops took place at different times, according to the team's availability. One group intervention occurred Saturday mornings (9:00 a.m. to 11:00 a.m.); one group intervention occurred Wednesday afternoons (14:00 p.m. to 15:30 p.m.); one group intervention occurred Monday evenings (17:00 p.m. to 19:00 p.m.); and seven group interventions occurred during the night (ranging from 19:00 p.m. to 22:00 p.m.), on different weekdays. Further, the couples participated in an introductory information meeting about the program, which occurred before the first workshop. In this meeting, participants answered the pre-test. After the sixth workshop, couples participated in two extra meetings based on the application of the post-test and the five months' follow-up. The intervention was offered free of charge.
	TAILORING
9.	The intervention was not personalized, titrated, or adapted.
	MODIFICATIONS
10.	The intervention was not modified during the course of the study.
	HOW WELL
11.	Planned: Based on the Living as Partners program manual, a checklist was prepared containing all the procedures expected in each workshop. Two judges, psychologists and individual observers knowledgeable on the program scored how well the procedures described in the checklist corresponded to the instructions given in the manual of the program using a Likert scale from one to six. The judges' average grade was 5.5, indicating that the checklist corresponded satisfactorily to the instructions provided in the manual. After each workshop, moderators and assistants answered the checklist in an online questionnaire on the Google Forms platform. The observers scored the questionnaire on paper during the workshop. Each expected procedure was evaluated on a four-point Likert scale in which 1 represents that the moderator did not execute the expected procedure, 2 represents that the procedure was done quite incompletely, 3 indicates that it was done almost completely and 4 suggests that it was done in a complete way. Descriptive analyses were applied to check the reliability to the manual according to the moderators, assistants and observers.
12.	Actual: High fidelity scores to the program manual were found for the development of the workshops. The checklist was scored on a Likert scale ranging from 1 to 4, in which 1 represented that the moderator did not perform the expected procedure and 4 that it was performed completely. The lowest fidelity score found was M = 3.67 (DP = 0.23) in the first workshop, according to the moderators' assessment. The highest fidelity score found was M = 3.93 (DP = 0.06 for assistants and 0.08 for observers) in the sixth workshop, according to the assistants' and the observers' assessment. Detailed results are available in Table 3.

Variables		Men	Women
		M (SD)	M (SD)
Age		37.93 (11.56)	36.54 (11.31)
Length of relationship		13, 32 (11,16)	13, 32 (11,16)
Variables		Men % (n)	Women % (n)
Situation of the relationship
	Cohabitating (not married)	31.7 (13)	31.7 (13)
	Married	51.2 (21)	51.2 (21)
	Dating	17.1 (7)	17.1 (7)
Has children
	Yes	65.9 (27)	68.3 (28)
	No	34.1 (14)	29.3 (12)
Education
	Finished or unfinished primary	14.6 (6)	9.8 (4)
	Finished or unfinished secondary	29.3 (12)	26.8 (11)
	Unfinished higher	17.1 (7)	19.5 (8)
	Finished higher and graduation	39 (16)	43.9 (18)
Works
	Yes	80.5 (33)	78 (32)
	No	19.5 (8)	22 (9)
Personal income per month
	No income	22 (9)	14.6 (6)
	Until R$ 2640.00	48.8 (20)	58.5 (24)
	Between R$ 2641.00 and R$ 5280.00	9.8 (4)	17.1 (7)
	Between R$ 5281.00 and R$ 8800.00	9.8 (4)	2.4 (1)
	More than R$ 8801.00	9.8 (4)	7.3 (3)

	Moderators	Assistants	Observers
	M (SD)	M (SD)	M (SD)
Workshop 1	3.67 (0.23)	3.85 (0.17)	3.87 (0.08)
Workshop 2	3.80 (0.17)	3.81 (0.20)	3.85 (0.08)
Workshop 3	3.78 (0.13)	3.85 (0.15)	3.76 (0.18)
Workshop 4	3.75 (0.14)	3.86 (0.11)	3.86 (0.12)
Workshop 5	3.85 (0.13)	3.91 (0.12)	3.83 (0.16)
Workshop 6	3.78 (0.12)	3.93 (0.06)	3.93 (0.08)

		Pre-test	Post-test	Student's t (df)		Effect size Cohen's d
		M (SD)	M (SD)
Marital quality¹ 1 Lower scores represent better marital quality indices		Husbands	31.62 (8.55)	28.65 (7.49)	3.062 (39)^ p <0.01	0.46
		Wives	29.93 (11.33)	28.59 (10.43)	1.189 (40)	0.13
Conflict frequency		Husbands	2.17 (0.56)	2.05 (0.64)	1.036 (40)	0.19
		Wives	2.21 (0.60)	1.91 (0.53)	4.152 (40)^* * p <0.001,	0.63
Conflict resolution
	Positive resolution	Husbands	3.26 (0.62)	3.60 (0.65)	– 3.116 (39)^ p <0.01	0.51
		Wives	3.34 (0.67)	3.70 (0.56)	– 3.904 (40)^* * p <0.001,	0.57
	Conflict engagement	Husbands	2.38 (0.68)	1.77 (0.59)	4.528 (39)^* * p <0.001,	0.67
		Wives	2.57 (0.75)	1.77 (0.62)	6.750 (40)^* * p <0.001,	0.98
	Withdrawal	Husbands	2.84 (0.75)	2.17 (0.73)	5.263 (39)^* * p <0.001,	0.81
		Wives	2.69 (0.79)	2.15 (0.73)	5.412(40)^* * p <0.001,	0.81
	Compliance	Husbands	2.36 (0.75)	2.19 (0.75)	1.472(39)	0.24
		Wives	2.29 (0.70)	1.94 (0.69)	3.019(40)^ p <0.01	0.47

			ANOVA F	df	Effect size partial η_p²
Marital quality¹ 1 Lower scores represent better marital quality indices
	Time		2.358	2	0.069
	Gender		0.003	1	0.000
	Time x gender		0.908	1.575	0.028
Conflict frequency
	Time		7.323^* * p <0.001,	2	0.182
	Gender		0.012	1	0.000
	Time x gender		1.167	1.700	0.034
Conflict resolution
	Positive resolution
		Time	10.583^* * p <0.001,	1.480	0.255
		Gender	0.444	14	0.014
		Time x gender	0.366	2	0.012
	Conflict engagement
		Time	23.950^* * p <0.001,	2	0.436
		Gender	0.298	1	0.010
		Time x gender	1.703	2	0.052
	Withdrawal
		Time	29.515^* * p <0.001,	2	0.488
		Gender	1.103	1	0.034
		Time x gender	0.199	2	0.006
	Compliance
		Time	4.6705^ p <0.05	2	0.132
		Gender	0.003	1	0.000
		Time x gender	0.516	1.592	0.016

			Pre-test M (SD)	Post-test M (SD)	Follow-up M (SD)
Marital quality¹ 1 Lower scores represent better marital quality indices		Husbands (n = 33)	31.03 (8.9)	27.88 (7.33)	28.94 (10.23)
		Wives (n = 33)	29.88 (12.28)	29.15 (10.987)	29.00 (11.51)
Conflict frequency		Husbands (n = 33)	2.13 (0.57)	1.97 (0.57)	2.00 (0.68)
		Wives (n = 33)	2.24 (0.63)	1.92 (0.55)	1.92 (0.69)
Conflict resolution
	Positive resolution	Husbands (n = 33)	3.27 (0.66)	3.68 (0.67)	3.63 (0.76)
		Wives (n = 33)	3.40 (0.67)	3.73 (0.53)	3.65 (0.61)
	Conflict engagement	Husbands (n = 33)	2.31 (0.72)	1.76 (0.60)	1.93 (0.60)
		Wives (n = 33)	2.52 (0.74)	1.68 (0.54)	1.95 (0.71)
	Withdrawal	Husbands (n = 33)	2.92 (0.75)	2.15 (0.73)	2.50 (0.85)
		Wives (n = 33)	2.74 (0.81)	2.08 (0.71)	2.33 (0.72)
	Compliance	Husbands (n = 33)	2.30 (0.78)	2.08 (0.76)	2.17 (0.82)
		Wives (n = 33)	2.39 (0.66)	2.00 (0.70)	2.15 (0.64)

[1] * Correspondence: angelicaneumann@gmail.com

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Couple relationship education program “Living as Partners”: evaluation of effects on marital quality and conflict

Abstract