The Protecting Strong African American Families Program: a Randomized Controlled Trial with Rural African American Couples

Couples' communication quality differs by topic

Extensive research has demonstrated that couples' communication quality is related to many aspects of couples' lives, including relationship satisfaction. However, the possibility that the quality of couples' communication might vary as a function of the topic of communication and the implications of this variability have received relatively little attention. Accordingly, this study sought to examine (a) within-person variability in communication quality between topics, (b) associations with relationship satisfaction, and (c) associations with stressors focal to specific topics. Black coparenting couples (N = 344) reported on their communication quality around four topics: finances, children, racial discrimination, and kinfolk. Results indicated that communication quality significantly differed across topics. Communication quality was lowest for finances and kinfolk, significantly higher when discussing problems with children, and highest when discussing racial discrimination. Moreover, communication quality when discussing finances, kinfolk, and racial discrimination each uniquely predicted relationship satisfaction, even after controlling for each other and for general communication skills. Experiencing more stress around finances and children was associated with poorer communication quality in the focal area (and for financial stress, in some other communication topics as well), whereas the extent of racial discrimination was not significantly associated with communication quality for any topic. These findings reveal significant variability in couples' communication across topics and demonstrate that considering communication for different topics can offer unique information about couples' relationship satisfaction beyond general communication skills. Further research examining topic-specific communication quality may enhance understanding of and interventions for couples' communication. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Strengthening couple functioning promotes resilience to COVID-19-related stressors among Black Americans

The COVID-19 pandemic resulted in substantial hardship for Black Americans, leading to increased stress and mental health difficulties. We used longitudinal data from the Protecting Strong African American Families (ProSAAF) intervention study to test the hypothesis that improved couple functioning following ProSAAF participation would serve as a constructed resilience resource during the pandemic, buffering the impact of elevated pandemic-related stressors on change in depressive symptoms. We found that COVID-19-related stress predicted change in depressive symptoms from prepandemic to during the pandemic, that ProSAAF predicted improved couple functioning, and that positive change in couple functioning buffered the impact of pandemic stressors on change in depressive symptoms. These effects resulted in a significant indirect buffering effect of ProSAAF on the association between COVID-19-related stress and change in depressive symptoms through its effects on change in couple functioning. The results suggest that relationship intervention may increase resilience to unanticipated community-wide stress and promote mental health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations between dyadic relationship quality and stepfamily functioning: A common fate modeling approach

Clinical and empirical literatures have highlighted the value of attending to distinct dyads within stepfamilies to ensure the needs of various relationships are being met. From a family systems perspective, the growth and maintenance of positive dynamics within one dyadic relationship can yield gains in other relationships and shape the larger stepfamily environment. Research seeking to link information about dyads and larger stepfamily systems is often marked by single-informant data or measures that represent individual-level constructs. Methods intended to leverage multi-informant data as indicators of dyad- or family-level constructs (i.e., common fate modeling; CFM) offer valuable opportunities to expand our understanding of stepfamily experiences. Using a sample of 291 stepparent-parent dyads, our study uses multi-informant data and CFM to assess three dyad-level constructs (i.e., marital quality, marital confidence, and stepparent-child relationship quality) as correlates of three stepfamily-level constructs (i.e., cohesion, expressiveness, and harmony). Our findings illustrate meaningful linkages among dyadic relationships and broader stepfamily-level dynamics, specifically emphasizing the role of stepparent-child relationship quality and marital confidence in shaping stepfamily cohesion, expressiveness, and harmony. The results also signal the potential for substantive findings to vary with respect to the selected unit of analysis.

Racial Discrimination and Private Regard Among Black Early Adolescents: Testing Between- and Within-Person Associations Over Time

The current study examined concurrent and longitudinal associations between experiences of racial discrimination and private regard (i.e., feelings about being Black and other Black people) among 346 Black early adolescents who completed four assessments over two years. Between-person (interpersonal) and within-person (intrapersonal) effects were tested to provide a rigorous and comprehensive examination of these associations. There was minimal evidence of significant between-person effects in which youth experiencing varying levels of racial discrimination differed in their private regard. However, at the within-person level, there were significant negative concurrent associations between racial discrimination and private regard, indicating that youths' positive racial identity was undermined at times when they were encountering higher levels of racial discrimination than they typically did. Results highlight significant intrapersonal links between racial discrimination and private regard and underscore the continued need for interventions to eliminate racial discrimination and to support Black youth experiencing it.

Changes in couple, parenting, and individual functioning following Family Expectations program participation

The current study investigated changes in couple, parenting, and individual functioning following participation in Family Expectations, a relationship and parenting education program for new or expectant parents. The sample comprised 339 couples who participated in most sessions of the Family Expectations program and completed assessments at three different time points over a 12-month period. Study analyses examined: (a) change shortly following completion of the program, (b) associations between short-term change and subsequent change in outcomes at 12-month follow-up, and (c) differences in short-term change between married and unmarried couples. Significant improvements were observed in all three domains at short-term follow-up. Short-term changes, particularly for psychological distress, were predictive of long-term change in multiple domains. Few moderation effects by marital status were evident; those that appeared suggested stronger effects for married participants compared to unmarried. Study findings inform ongoing discussions into the utility of federally-funded relationship and parenting programming.

African Americans' relationship quality and depressive symptoms: A longitudinal investigation of the Marital Discord Model

The present study was designed to examine the complex bidirectional associations between relationship quality and depressive symptoms among African American couples. Informed by the Marital Discord Model, particular attention was devoted to understanding the unique associations of positive and negative dimensions of relationship functioning with depressive symptoms over time, the time frames over which these effects occur, and the model's applicability for African American couples. One hundred seventy-four African American couples (N = 348 individuals) provided information on depressive symptoms, relationship satisfaction, ineffective arguing, and partner support four times over a 25-month period. Hypotheses were tested using Random-Intercept Cross-Lagged Panel Models to separate between- and within-person effects. Results indicated that between-person associations with depressive symptoms were significant for relationship satisfaction (negative association) and ineffective arguing (positive association), but not partner support. Within-person concurrent effects were also significant with depressive symptoms and each of the relationship processes under investigation. Within-person 8-month lagged effects were only significant for partner support and depressive symptoms (negative association); these effects were significant in both directions, but stronger from support to depressive symptoms than from depressive symptoms to support. Study findings provide increased conceptual and analytic precision for understanding the association between couples' relationship quality and African Americans' mental health, including malleable relationship factors that can be targeted in family-focused interventions to promote individual and couple well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Neighborhood disadvantage is associated with biological aging: Intervention-induced enhancement of couple functioning confers resilience

The accelerated pace of biological aging predicts mortality and morbidity later in life. The current study examines whether a change in supportive couple functioning buffers accelerated aging associated with stressful community environments among Black Americans who live in rural, Southern, disadvantaged neighborhoods. We examined 348 Black American middle-aged adults assigned randomly to receive the Protecting Strong African American Families (ProSAAF) intervention or a control condition. The program was designed to enhance supportive couple functioning among Black Americans. We used DunedinPoAm to quantify the methylation pace of aging and employed the Area Deprivation Index at the census block group level to measure neighborhood disadvantage. Neighborhood disadvantage was associated with the accelerated pace of aging. Further, participation in ProSAAF enhanced supportive couple functioning, and improvement in couple functioning protected participants from the harmful effects of neighborhood disadvantage on the accelerated pace of aging. These findings supported mediated moderation and suggested that family-based prevention programs that enhance couple support may decrease the erosive effects of neighborhood disadvantage and improve prospects for healthy aging among rural, Southern, Black Americans living in difficult circumstances. This may provide a supplemental strategy for decreasing health disparities due to neighborhood disadvantage by enhancing family systems.

Effects of the Sleep SAAF responsive parenting intervention on rapid infant weight gain: A randomized clinical trial of African American families

Responsive parenting (RP) interventions reduce rapid infant weight gain but their effect for underserved populations is largely unknown. The Sleep SAAF (Strong African American Families) study is a two-arm randomized clinical trial for primiparous African American mother-infant dyads that compares an RP intervention to a child safety control over the first 16 weeks postpartum. Here we report on intervention effects on rapid infant weight gain and study implementation. Families were recruited from a mother/baby nursery shortly after delivery. Community Research Associates (CRAs) conducted intervention home visits at 3 and 8 weeks postpartum, and data collection home visits at 1, 8, and 16 weeks postpartum. To examine rapid infant weight gain, conditional weight gain (CWG) from 3 to 16 weeks, the primary outcome, and upward crossing of 2 major weight-for-age percentile lines were calculated. Among the 212 mother-infant dyads randomized, 194 completed the trial (92% retention). Randomized mothers averaged 22.7 years, 10% were married, and 49% participated in the Supplemental Nutrition Assistance Program (SNAP). Adjusting for covariates, mean CWG was lower among RP infants (0.04, 95% CI [-0.33, 0.40]) than among control infants (0.28, 95% CI [-0.08, 0.64]), reflecting non-significantly slower weight gain (p = 0.15, effect size d = 0.24). RP infants were nearly half as likely to experience upward crossing of 2 major weight-for-age percentile lines (14.1%) compared to control infants (24.2%), p = 0.09, odds ratio = 0.52 (95% CI [0.24, 1.12]). Implementation data revealed that participating families were engaged in the intervention visits and intervention facilitators demonstrated high fidelity to intervention materials. Findings show that RP interventions can be successfully implemented among African American families while suggesting the need for modifications to yield stronger effects on infant weight outcomes.

Three tests of the Vulnerability-Stress-Adaptation Model: Independent prediction, mediation, and generalizability

Objective

Efforts to understand why some marriages thrive while others falter are (a) not well integrated conceptually and (b) rely heavily on data collected from White middle-class samples. The Vulnerability-Stress-Adaptation Model (VSA; Karney and Bradbury, 1995) is used here to integrate prior efforts and is tested using data collected from couples living with low incomes.

Background

The VSA Model assumes (a) that enduring vulnerabilities, stress, and couple communication account for unique variance in relationship satisfaction, (b) that communication mediates the effects of vulnerabilities and stress on satisfaction, and (c) that the predictors of satisfaction generalize across socioeconomic levels. To date, these assumptions remain untested.

Materials and methods

With 388 couples from diverse backgrounds (88% Black or Hispanic), we used latent variable structural equation models to examine enduring vulnerabilities, chronic stress, and observed communication as predictors of 4-wave, 27-month satisfaction trajectories, first as main effects and then interacting with a validated 10-item index of sociodemographic risk.

Results

(a) The three variable sets independently predict satisfaction trajectories; (b) couple communication does not mediate the effects of enduring vulnerabilities or stress on satisfaction; and (c) in 19% of tests, effects were stronger among couples with higher sociodemographic risk.

Conclusion

Effects of established predictor domains on satisfaction replicate in a diverse sample of newlywed couples, and most findings generalize across levels of sociodemographic risk. The failure of couple communication to mediate effects of enduring personal vulnerabilities and stress raises new questions about how these two domains undermine committed partnerships.

A culturally grounded prenatal coparenting intervention: Results of a randomized controlled trial with unmarried Black parents

This study examines the efficacy of a prenatal intervention designed to promote healthy coparenting relationships in families where low-income, unmarried mothers and fathers were expecting a first baby together. One hundred thirty-eight Black and mixed-race mother-father dyads participated. Coparent dyads were randomly assigned to either a treatment as usual (TAU) group, receiving referrals and navigation support to existing community services (control), or to TAU plus invitation to a series of six dyadic Focused Coparenting Consultation (FCC) sessions led by a male-female mentor team (intervention). Seventy-one percent of those prenatally assessed were later reassessed at 3 months postpartum. Both mothers and fathers contributed reports of coparenting, father engagement, physical and psychological intimate partner violence (IPV), and depressive symptoms. Intent-to-treat analyses indicated: (a) some evidence that mothers in the intervention group reported more positive coparenting communication at 3 months postpartum than did control group mothers; (b) mothers in the intervention group reported significantly more time spent by fathers with the child than did control group mothers; (c) parents in the intervention group had significant reductions in psychological IPV compared to parents in the control group; and (d) both mothers and fathers showed reductions in self-reported depression over time, with no differential impact of group. Findings suggest that the FCC intervention may produce modest but important benefits for unmarried, low-income Black coparents in the transition to parenthood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Relationship intervention indirectly buffers financial strain's effect on biological aging among Black adults

Black adults in the rural South experience elevated financial strain and other contextual stressors, increasing their risk for poor health. Supportive relationships, particularly positive romantic relationships, have been shown to offset these risks. The present study aims to provide experimental evidence of the buffering effect of supportive relationships by testing whether participation in a relationship enhancement program (ProSAAF) that improves couple functioning (Barton, Beach, Wells, et al., 2018) subsequently buffers the effect of cumulative financial strain on biological aging (weathering). Postintervention financial strain was assessed four times. Deoxyribonucleic acid (DNA) was extracted from peripheral whole blood collected 6 years after baseline (n = 348 individuals), and patterns of methylation were used to index accelerated pace of aging. Couple functioning was treated as a latent construct comprising four self-report indicators: effective communication, relationship confidence, relationship satisfaction, and perceived partner support. Results indicated that cumulative financial strain was associated with accelerated pace of aging with a medium to large effect size. This effect was moderated by change in couple functioning such that individuals with greater improvement in couple functioning showed less epigenetic aging in response to cumulative financial strain. Additionally, there was a significant indirect buffering effect of ProSAAF on the association between cumulative financial strain and accelerated pace of aging. This is the first study to demonstrate that a couple-focused preventive intervention can reduce the impact of financial strain on rate of aging by enhancing couple functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal Effects of Racial Discrimination on Depressive Symptoms Among Black Youth: Between- and Within-Person Effects

OBJECTIVE

Black youth experience racial discrimination at high rates. This study sought to further understand the longitudinal effects of racial discrimination on the mental health of Black youth by examining cross-lagged associations between perceived racial discrimination and depressive symptoms at the between-person (interindividual) level and the within-person (intraindividual) level.

METHOD

A group of 346 Black youths (mean age 10.9 years) from the rural southern United States reported racial discrimination and depressive symptoms 4 times over 24.5 months. A cross-lagged panel model was used to examine between-person concurrent and lagged effects, and a random intercept cross-lagged panel model was used to examine within-person concurrent and lagged effects.

RESULTS

There were significant concurrent associations at all waves in both models. Additionally, there were significant lagged effects from perceived racial discrimination to depressive symptoms, but not from depressive symptoms to perceived racial discrimination, in both models.

CONCLUSION

Youth experiencing higher levels of racial discrimination subsequently develop more depressive symptoms than youth experiencing less discrimination (between-person effects), and youth experiencing higher levels of discrimination relative to their own average subsequently report increases in depressive symptoms (within-person effects). These findings provide a rigorous test of conceptual models outlining the harmful effects of racial discrimination on mental health, add to a growing body of work documenting these effects on Black youth, and underscore the need for systemic changes to reduce the amount of discrimination Black youth experience and for interventions to promote resilience among Black youth in the face of cultural marginalization.

Helping couples achieve relationship success: A decade of progress in couple relationship education research and practice, 2010-2019

This article systematically reviewed 34 rigorous evaluation studies of couple relationship education (CRE) programs from 2010 to 2019 that met the criteria for Level 1 well-established interventions. Significant advances include reaching more diverse and disadvantaged target populations with positive intervention effects on a wider range of outcomes beyond relationship quality, including physical and mental health, coparenting, and even child well-being, and evidence that high-risk couples often benefit the most. In addition, considerable progress has been made delivering effective online CRE, increasing services to individuals rather than to couples, and giving greater attention to youth and young adults to teach them principles and skills that may help them form healthy relationships. Ongoing challenges include expanding our understanding of program moderators and change mechanisms, attending to emerging everyday issues facing couples (e.g., healthy breaking ups, long-distance relationships) and gaining increased institutional support for CRE.

Reducing mental health disparities among racially and ethnically diverse populations: A review of couple and family intervention research methods (2010-2019)

Racially and ethnically diverse and globally underserved populations continue to experience mental health disparities. The goal of this review was to examine the extent to which diverse populations were included in couple and family intervention research over the past decade and whether these studies were conducted with attention to issues of diversity. We performed a review of 271 articles reviewed in the current special issue on the efficacy and effectiveness of couple and family interventions across 11 mental health topics. Overall, only 68 of the 271 (25%) articles included predominately racial/ethnic minority samples or globally underserved populations. Among articles (n = 60) describing US-based research with racial/ethnic minority samples, there was a pattern of inattention to methodological considerations relevant to diverse populations. Although some progress was noted, more research is necessary. Specifically, we call for research that advances social justice by using critically conscious methods to promote mental health equity.

Strengthening lower-income families: Lessons learned from policy responses to the COVID-19 pandemic

Families are navigating an unstable economy due to COVID-19. Financial stressors have the potential to strain intimate relationships and exacerbate prior inequities across lower-income families. Notably, the economic impact of COVID-19 disproportionately influenced Black and Latinx families. As a response to families' economic adversity during the pandemic, the federal government initiated the CARES Act. This type of federal response to lower-income families, however, is not new. The purpose of this paper is to contextualize and historicize previous and current efforts to mitigate the consequences of financial hardship on families by comparing the assumptions and efficacy of the Healthy Marriages Initiative and the CARES act. We conclude with four recommendations to promote well-being in lower-income families: (1) acknowledging and reducing inequities that disproportionally impact families racialized as Black or Latinx; (2) intervening to mitigate stressors surrounding families; (3) using innovative methods to deliver relationship education; and (4) considering prevention versus intervention strategies.

Trajectories of relationship and individual functioning among waitlisted couples for an online relationship intervention

To inform research and practice with distressed couples, the current study was designed to examine patterns of change among distressed, help-seeking couples prior to receiving an intervention. Data from this study originate from 221 couples assigned to the waitlist control condition of a randomized controlled trial for couples seeking online help for their relationship. All couples self-selected into the online program and agreed to withhold seeking additional services for their relationship during the waitlist period. In contrast with prior findings, results from the current study indicated a general pattern of mean improvement in both self-reported relationship functioning (e.g., increased relationship satisfaction, partner emotional support) and self-reported individual functioning (i.e., decreased psychological distress, anger) over the six-month waitlist period. Nonetheless, the majority of couples continued to remain relationally distressed despite these improvements. Findings from the study indicate that distressed couples can, in fact, exhibit some degree of improvement absent of intervention. At the same time, overall levels of distress remained elevated, indicating that these improvements are not sufficient to result in high levels of functioning and suggesting that many distressed couples may benefit from empirically supported programs to realize greater gains. These results also highlight and underscore the importance of including control conditions in studies examining the efficacy of relationship interventions with distressed couples to ensure that any observed improvements in relationship functioning are attributable to the intervention rather than to naturally occurring changes.

Protective parenting behavior buffers the impact of racial discrimination on depression among Black youth

The adverse impact of racial discrimination on youth, and particularly its impact on the development of depressive symptoms, has prompted attention regarding the potential for family processes to protect youth from these erosive effects. Evidence from non-experimental studies indicates that protective parenting behavior (PPB) which occurs naturally in many Black families can buffer youth from the negative impact of racial discrimination. Of interest is whether "constructed resilience" developed through family-centered prevention programming can add to this protective buffering. The current paper examines the impact of constructed resilience in the form of increased protective parenting using 295 families randomly assigned either to a control condition or to the Protecting Strong African American Families (ProSAAF) program, a family-based prevention program previously shown to enhance protective parenting. We found that baseline racial discrimination was predictive of change in youths' depressive symptoms across the pre-post study period. Second, we found that parents participating in ProSAAF, relative to those randomly assigned to the control group, significantly improved in their use of an intervention targeting PPB. Third, we found a significant effect of change in PPB on the association of discrimination with change in depressive symptoms. Finally, we found that ProSAAF participation buffered the impact of racial discrimination on change in depressive symptoms through change in PPB. Results provide experimental support for constructed resilience in the form of change in PPB and call for increased attention to the development of family-based intervention programs to protect Black youth from the pernicious effects of racial discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Racial discrimination, depressive symptoms, and sleep problems among Blacks in the rural South

OBJECTIVES

Experiences of racial discrimination are common for Black Americans and have been associated with depression and sleep disturbance, factors likely involved in the insidious development of health disparities. The current study replicates these associations and examines longitudinal linkages.

METHOD

Black American couples (men: N = 248, M_age = 40, SD = 9; women: N = 277, M_age = 37, SD = 7) and their children, aged 9 to 14 (N = 276, M_age = 11, SD = 1), completed measures of experiences of racial discrimination, depressive symptoms, and sleep problems at baseline and 8-month follow-up. In separate analyses for men, women, and youth, we examined concurrent and prospective associations of racial discrimination with depressive symptoms and sleep problems, then used longitudinal indirect effect models to examine whether depressive symptoms in response to racial discrimination led to increased sleep problems, or vice versa.

RESULTS

Racial discrimination was associated concurrently with depressive symptoms and sleep problems for all family members. Prospective associations were also found with depressive symptoms and sleep problems in fathers and youth, and sleep problems in mothers. Longitudinal models showed significant indirect effects of racial discrimination on change in sleep problems through depressive symptoms for fathers and mothers, and a similar, but nonsignificant, pattern in youth. There were no indirect effects on change in depressive symptoms through sleep problems.

CONCLUSIONS

Persistent associations of racial discrimination with depressive symptoms and sleep problems reflect a lasting impact of racial discrimination. Because discrimination's effects on depression may contribute to increased sleep problems over time, interventions that buffer the effects of discrimination on depressive symptoms may also reduce sleep problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Comparison of Low-Income Versus Higher-Income Individuals Seeking an Online Relationship Intervention

Compared to higher-income couples, low-income couples experience higher rates of relationship disruption, including divorce and breakup of cohabiting relationships. In recognition of this disparity in relationship outcomes, relationship interventions have increasingly been targeted at this population. However, these interventions have had limited impacts on the relationships of low-income couples. Developing interventions that are effective and responsive to the needs of low-income couples requires descriptive data on the challenges those couples perceive in their own relationships and an assessment of how their needs compare to the more affluent couples typically served by relationship interventions. The current study sampled over 5,000 individuals at the time they were seeking an online relationship intervention and compared the relationship functioning and life circumstances reported by low-income individuals to that of higher-income individuals. Results indicate that low-income individuals seeking a relationship intervention had higher levels of relationship distress (lower relationship satisfaction, more intense primary relationship problems, and less relationship stability), and had greater levels of contextual stress (more children living at home, less likely to be employed full-time, and lower levels of perceived health). Results suggest that future interventions designed to target low-income couples, as well as practitioners working with low-income couples, should be prepared to handle higher levels of relationship distress and contextual stressors than they may typically see in more affluent couples.

Can Interventions that Strengthen Couples' Relationships Confer Additional Benefits for their Health? A Randomized Controlled Trial with African American Couples

This study examined the effects of the Protecting Strong African American Families (ProSAAF) prevention program on adults' self-reported health outcomes 25 months after enrollment. ProSAAF is a couple-focused prevention program specifically designed to meet the needs of African-American families residing in the rural South. African-American couples (N = 346) with an early adolescent child participated in a randomized controlled trial of the program. Dyadic data analyses indicated significant direct effects on changes in couple functioning post-intervention as well as significant indirect effects of ProSAAF on changes in health through post-intervention improvements in couple functioning. These benefits were documented for men's and women's general health, depressive symptoms, and problematic sleep. There were no significant direct effects of ProSAAF participation on changes in health. Findings provide tempered optimism regarding the potential benefits of couple-focused programming for adults' physical, mental, and behavioral health.

When poor communication does and does not matter: The moderating role of stress

[Correction Notice: An Erratum for this article was reported in Vol 34(6) of Journal of Family Psychology (see record 2020-62946-001). There are two errors in the last sentence of the fifth paragraph (Model 4: Fluctuations in Cumulative Stress X Fluctuations in Behavior) of the Results section whereby the text "less cumulative stress" and "less stress" should have read "more cumulative stress" and "more stress," respectively. Thus, the correct sentence is as follows: "Specifically, relative increases in observed dyadic negativity were associated with decreases in husbands' relationship satisfaction when husbands also experienced more cumulative stress, whereas decreases in observed negativity in the presence of more stress were associated with increases in husbands' satisfaction (t = -2.00, p = .045, see Figure 1 and Table 2, Model 4)." Note that the findings are correctly stated elsewhere in the article.] Although a number of theoretical perspectives in relationship science argue that variability in couples' relationship satisfaction over time is driven by changes in their communication, tests of this hypothesis have been limited to single assessments of behavior. To address this gap, we examine within-couple, across-time changes in communication, and we argue further that couples' external circumstances might combine with these behavioral changes to generate changes in relationship satisfaction. Using self-reports of satisfaction and in-home observational data collected 4 times at 9-month intervals from 414 newlywed couples, we show that fluctuations in dyadic behavior and spousal stress covary with fluctuations in spousal satisfaction. Tests of the interaction between fluctuations in stress and behavior reveal that husbands who experience upward fluctuations in negativity also experience decreases in relationship satisfaction at the same wave but only if they are concurrently experiencing greater stress than usual. Downward fluctuations in problem-solving effectiveness are associated with lower relationship satisfaction but only among spouses who had chronically high levels of cumulative stress; when chronic stress is low, reduced problem-solving effectiveness is unrelated to satisfaction. Exclusive focus on between-couple variability in couple communication, without regard for the stressors that couples face, will likely restrict the understanding and prevention of relationship distress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Direct and indirect effects of a couple-focused preventive intervention on children's outcomes: A randomized controlled trial with African American families

OBJECTIVE

This study examined the effects of the Protecting Strong African American Families (ProSAAF) prevention program on children's outcomes more than 2 years after enrollment, including direct effects of the intervention and indirect effects through couple functioning and parent-child relations.

METHOD

Three hundred forty-six African American couples with an early adolescent child participated; all families lived in rural, low-income communities in the southern United States. Families were randomly assigned to ProSAAF or control conditions and completed four waves of data collection. Couples reported couple functioning at baseline (Wave 1) and at 9-month follow-up (Wave 2), and parent-child relations at 17-month follow-up (Wave 3). Children reported their conduct problems, affiliation with deviant peers, substance use, sexual onset, depressive symptoms, and self-control at 25-month follow-up (Wave 4).

RESULTS

Path analyses indicated significant indirect effects of ProSAAF on children's outcomes through improvements in couple functioning and better parent-child relations. There were no significant direct effects of the intervention on children's outcomes or significant indirect effects through couple functioning alone.

CONCLUSIONS

This couple-focused prevention program has positive indirect effects on several child outcomes through the intervening processes of promoting improvements in couple functioning and better parent-child relations. These findings provide cautious optimism regarding the possible benefits of couple-focused programming on participants' children while suggesting ways in which future couple-focused interventions could yield stronger effects on these youth. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Interventions for Couples

Because relationship discord and dissolution are common and costly, interventions are needed to treat distressed couples and to prevent distress among vulnerable couples. We review meta-analytic evidence showing that 60-80% of distressed couples benefit from behavioral and emotion-focused approaches to couple therapy, but we also note that treatment effects are weaker in actual clinical practice than in controlled studies, dissipate following treatment for about half of all couples, and may be explained by factors that are common across models. Meta-analyses of prevention programs reveal reliable but smaller effects, reflecting a need to know more about whether and how communication mediates effects, about how risk and diversity moderate effects, and about how technology-enabled interventions can reduce attrition in vulnerable populations. Interventions for couples are improving and expanding, but critical questions remain about how and for whom they work.

Research on Marital Satisfaction and Stability in the 2010s: Challenging Conventional Wisdom

Although getting married is no longer a requirement for social acceptance, most people do marry in their lifetimes, and couples across the socioeconomic spectrum wish their marriages to be satisfying and long-lasting. This review evaluates the past decade of research on the determinants of satisfaction and stability in marriage, concluding that the scholarship of the past ten years has undermined three assumptions that were formerly accepted as conventional wisdom. First, research exploiting methods like latent class growth analyses reveal that, for most couples, marital satisfaction does not decline over time but in fact remains relatively stable for long periods. Second, contrary to predictions of behavioral models of marriage, negative communication between spouses can be difficult to change, does not necessarily lead to more satisfying relationships when it is changed, and does not always predict distress in the first place. Third, dyadic processes that are reliably adaptive for middle-class and more affluent couples may operate differently in lower-income couples, suggesting that influential models of marriage may not generalize to couples living in diverse environments. Thus, the accumulated research of the last ten years indicates that the tasks of understanding and promoting marital satisfaction and stability are more complex than we appreciated at the start of the decade, raising important questions that beg to be answered in the years ahead.

Improvements in coparenting conflict and child adjustment following an online program for relationship distress

Many children never receive treatment for their mental health symptoms-and those that do often receive it only after years of delay. Given that relationship and parenting conflict is an identified mechanism of child mental health symptoms, reducing distress in the parents' romantic relationship may help reduce this unmet need. In the current study, 213 couples with 1 or more children between the ages of 3 and 17 (inclusive) were randomized to receive the web-based OurRelationship program or to a 2-month waitlist condition. Intervention couples were also assessed in the year following the program. Couples in the OurRelationship program experienced a significant decrease in coparenting conflict during the intervention (Cohen's d = -0.27) but also a significant increase in coparenting conflict in the following year, reducing the long-term effects of the intervention (within-group d = -0.20 at 1-year follow-up compared with baseline). Additionally, parent-reported children's externalizing (within-group d = -0.40) and internalizing (within-group d = -0.27) symptoms significantly decreased from baseline to the 1-year follow-up. As hypothesized, improvement in relationship satisfaction during the program was significantly associated with a decrease in coparenting conflict which, in turn, was associated with reduction in both externalizing and internalizing symptoms in the children. These results indicate that online relationship-focused interventions offer an important, adjunctive approach to meet society's need for reducing children's mental health symptoms. Furthermore, the improvements in child functioning strengthen the evidence suggesting the cost-effectiveness of these relationship-focused interventions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Improving Couples' Relationship Functioning Leads to Improved Coparenting: A Randomized Controlled Trial With Rural African American Couples

Family-centered prevention programs for couples with children are being increasingly disseminated, with the hope that improving couples' romantic relationships will lead to other benefits for families. To date, however, it is unclear whether these interventions do in fact yield these benefits. The current study addressed this gap by examining whether postintervention improvements in couples' relationship functioning following family-centered prevention predicted longer-term change in coparenting, and whether postintervention improvements in coparenting predicted longer-term change in relationship functioning. We used four waves of data collected over 2 years from 346 rural African American couples with an early adolescent child who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program, an intervention designed to promote strong couple, coparenting, and parent-child relationships in two-parent African American families. Results indicated that ProSAAF had significant short-term positive effects on both romantic relationship functioning and coparenting and that these effects did not differ in magnitude. Over time, however, only romantic relationship functioning postintervention was positively associated with long-term changes in coparenting; coparenting postintervention was not associated with long-term changes in relationship functioning and this association was significantly weaker than the other pathway. These findings support a key premise underlying relationship enhancement programs for parents, indicating that improving couples' romantic relationship functioning can have longer-term benefits for the coparenting relationship as well. Further research examining long-term parent, child, and family outcomes following family-centered prevention for couples and the mechanisms of change underlying these outcomes is needed.

Emotion, Social Relationships, and Physical Health: Concepts, Methods, and Evidence for an Integrative Perspective

Emotional characteristics and processes are robust predictors of the development and course of major medical illnesses and premature mortality, as are a variety of indicators of the presence and quality of personal relationships. Despite clear evidence of close interconnection between these two domains of risk and protection, affective characteristics and relationships have largely been studied separately as influences on health. After a recent conference on integrative perspectives on emotions, relationships and health co-sponsored by the American Psychosomatic Society and the Society for Affective Science, the present review builds on prior calls for integration, related theory, and current research to outline what is known about the interconnection of these domains as it specifically relates to their overlapping influences on health. Areas of interest include the following: their interconnected roles over the course of development, which may inform current efforts to understand the influence of early life events on adult health; the parallel positive and negative factors in both domains that could have distinct influences on health; the role of emotion regulation in relationship contexts; and measurement, design, and analysis approaches to capture the dyadic and dynamic aspects of these interconnected influences on health. We conclude with a discussion of an emerging research agenda that includes the following: common biological foundations of affective and relationship processes, the cultural embeddedness of affective and relationship processes, the potential contribution of affective-relational processes to health disparities, and implications for intervention research.

Patterns of Family, School, and Community Promotive Factors and Health Disparities Among Youth: Implications for Prevention Science

Increasing knowledge of factors that promote health among youth from diverse backgrounds is an important step towards addressing health disparities. Although many promotive factors have been identified individually, there is an overabundance of research on risk factors, and a comparable dearth of knowledge regarding the influence of combinations of promotive factors. The current study examined how promotive factors across family, school, and community contexts co-occur to promote health among youth of different race/ethnicity. Utilizing a nationally representative sample of Black (10%), Latinx (12%), and White (77%) youth ages 12-17 (N = 30,668), latent class analysis was employed to identify classes of youth who endorsed homogenous patterns of promotive factors. Associations between class membership and health were explored. Each subsample was best characterized by its own 4-class model, with significant differences in patterns of promotive factors experienced by Black, Latinx, and White youth. Youth health outcomes also varied significantly by class membership (p < .05). Greater access to more promotive factors was associated with better health, and low access to community and school promotive factors was associated with worse health. Results suggest that increasing promotive factors in school, family, and community settings may help to prevent poor health outcomes; however, jointly addressing discrimination against racial/ethnic minority youth through education, policy, and practice is also needed to address health disparities.

Stress spillover, African Americans' couple and health outcomes, and the stress-buffering effect of family-centered prevention

This study investigated (a) the stress spillover pathways linking contextual stressors, changes in couple relationship functioning and depressive symptoms, and changes in individuals' physical health, and (b) the stress-buffering effect of participation in an efficacious, family centered prevention program designed to protect couples from the deleterious effects of stressors. The sample consisted of 346 rural African American couples (63% married) who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program. Participants were assessed at three time points across 17 months. Results examining stress spillover within the control group indicated that elevated current, but not prior, financial hardship was associated with decreased effective communication, relationship satisfaction, and relationship confidence as well as increased depressive symptoms; current levels of racial discrimination also predicted greater depressive symptoms. Relationship confidence and relationship satisfaction, but not communication or depressive symptoms, in turn predicted declines in self-reported physical health. Results examining stress-buffering effects suggested that participation in ProSAAF protected individuals' relationship confidence from declines associated with elevated financial hardship. In addition, the indirect effect linking financial hardship to declines in physical health through relationship confidence that emerged among participants in the control group was no longer evident for ProSAAF couples. Results highlight the effect of contextual stressors on African Americans' couple and individual well-being and the potential for the ProSAAF program to provide a constructed resilience resource, protecting couple's confidence in their relationship from the negative effects of financial hardship and, consequently, promoting physical health. (PsycINFO Database Record