Marriage Checkup in Integrated Primary Care: A Randomized Controlled Trial With Active-Duty Military Couples.

Objective: This study assessed the efficacy of the marriage checkup, as adapted to integrated primary care settings and active-duty military couples, for improving relationship health and depressive symptoms. Method: Married couples (N = 244, Mage = 32.4, 67.6% Caucasian) in which at least one member was active-duty Air Force were recruited from bases across the U.S. via online advertisement, emails sent from medical clinics to enrolled beneficiaries, social media posts, and flyers, and randomly assigned to active treatment or waitlist control. Treatment and control couples were linked in pairs sequentially and pairs completed nine sets of questionnaires at baseline, 1-, and 6-month posttreatment. Outcome measures included the Couples Satisfaction Index, Intimate Safety Questionnaire, Responsive Attention Scale, Partner Compassion Scale, Communication Skills Test, and the Center for Epidemiologic Studies Depression Scale. Results: A three-level multilevel model indicated, after adjustment for multiple comparisons, treatment couples experienced statistically significant small-to-moderate improvements compared to the control group (Cohen's d from 0.21 to 0.55) at 1 month that were sustained at 6 months for relationship satisfaction, responsive attention, compassion toward their partners, communication skills, intimate safety, and depressive symptoms. Conclusions: A longitudinal randomized control trial of the MC supports the hypothesis that the MC significantly improves relationship satisfaction, intimacy, communication, partner compassion, responsive attention, and depressive symptoms. Implications for theory, treatment, and dissemination are discussed. What is the public health significance of this article?: Poor marital relationship quality is positively associated with a multitude of negative health outcomes. Effective tertiary couple therapies exist but are underutilized and have limited reach into the population. We adapted a brief prevention and early intervention relationship health protocol for use with military couples in integrated primary care. The marriage checkup attracted couples across the continuum of relationship health and significantly improved relationship quality compared to a control condition. Brief preventative interventions lower barriers to care, prevent health deterioration, and effectively improve relationship health functioning. [ABSTRACT FROM AUTHOR]