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Introduction: There are substantial health disparities in Appalachia partially due to the poor access and utilization of health care. Social support, especially in Appalachia, is consistently linked to the utilization of available health care. The present study aims to identify how on aspect of social support, relationship functioning, are associated with health care utilization for couples in Southern Appalachian. Method: Individual and couple data (N = 147, individuals; n = 76, couples) were collected from participants interested in a brief couple interventions. Individuals and Dyadic Path analyses were conducted in Mplus using methods to account for the dependence in the data. Results: Relational aggression was the only marital factor linked to health care utilization in multivariate analyses while constructive communication was only linked to health care utilization in bivariate correlations, r = .24, p < .05. Dyadic results indicate that men's health care utilization may benefit from partner's relational aggression while women's utilization may be negatively influenced by her own self-reported relational aggression. Discussion: An individual's social context must be considered in order to completely understand barriers to health care utilization. Further, the inclusion of couple/dyadic level interventions should be considered in order to improve health care utilization in the Appalachian region and similarly rural regions. Keywords: health care utilization, relationship functioning, Appalachia, dyadic path analysis, marital quality, There is evidence that the quality of close relationships is linked to the utilization of health care and this may be particularly impactful in communities where there are a cultural [...]

Sexual Minority couples, those who identify as lesbian, gay, bisexual, trans, queer or other (LGBTQ), have voiced a desire for LGBTQ-affirmative couple interventions, and researchers have suggested theoretical adaptations to address this need. However, to date no LGBTQ-affirmative adaptations of general couple interventions have been developed and assessed. The present study assessed the feasibility, acceptability, and effectiveness of an LGBTQ-affirmative adaptation of a preventive, two-session relationship intervention, The Relationship Checkup (RC). In this pilot study, adaptations were made based on recommendations from existing literature, consultation with experts in the field, and conversations with LGBTQ-identified individuals. Data from eighteen couples who completed the intervention suggest that the LGBTQ-RC is feasible and acceptable to participants. Results indicate that the LGBTQ-RC improved both individual and relationship well-being and was viewed by participants as LGBTQ-affirmative. These findings support the effectiveness of utilizing an affirmative stance and addressing LGBTQ-specific issues in couple interventions. [ABSTRACT FROM AUTHOR]

The association between relationship functioning and depressive symptoms is well established. This study examined the effects of the Marriage Checkup, a brief two-session Assessment and Feedback relationship intervention, on depressive symptoms. Two hundred and nine married couples participated in the Marriage Checkup and were randomized into Treatment (N = 108) and Waitlist-Control Conditions (N = 101). Compared to the control condition, intervention participants reported significant improvements in depressive symptoms (d = 0.55), with an even greater effect for those who were reporting more severe baseline depression symptoms (d = 0.67). These outcomes are comparable to those within long-term individual psychotherapy, couple therapy, and pharmacology trials, making this the briefest intervention to date to demonstrate significant improvements in depressive symptoms. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

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Same-gender couples face unique sexual minority stressors that significantly impact individual and relationship health. This impact may be even greater among same-gender couples living in regions where there are pervasive social and legal biases that affect the lesbian, gay, bisexual, transgender, queer and/or questioning, intersex, asexual, two-spirit (LGBTQIA2S+) community (e.g., south central Appalachia). Brief relationship interventions, like the relationship checkup, are effective at improving relationship health and can be widely disseminated due to the brief and flexible nature of the program. Yet, this program was developed for different-gender couples and, as a result, may lack specific intervention for the unique stressors of same-gender couples. While many skills delivered in relationship interventions, including the relationship checkup, are applicable to all couples, untailored interventions for same-gender couples may result in less impactful outcomes. The present study examined whether the relationship checkup, in its original, unadapted format, is as effective for same-gender couples as it is for different-gender couples. Using a subsample from the larger relationship checkup study (N = 656 couples), the present sample included 64 committed couples (same-gender = 32; different-gender = 32). We used propensity score matching to match different-gender participants to the same-gender participants based on racial minority status, poverty status, marital status, and parenting status. Results revealed that same-gender couples presented similarly to different-gender couples on baseline relationship functioning and changed similarly on all relationship functioning outcomes through 1-month postintervention. Same-gender couples also reported similar degrees of satisfaction with and perceived helpfulness of the relationship checkup. The relationship checkup appears to be equally effective and acceptable for same-gender and different-gender couples. [ABSTRACT FROM AUTHOR]