The Effects of a Couples-Based Health Behavior Intervention During Pregnancy on Latino Couples' Dyadic Satisfaction Postpartum

Recruitment strategies in couple intervention studies: A systematic review of recruitment methods and sample characteristics in the United States from 2015 to 2020

Including diverse participants in couple intervention studies is critical for developing an evidence base that informs best practices for all potential clients. Research has shown that subgroups of clients respond differently to different interventions and that interventions that have been adapted to fit the needs of a given population are more effective than non-adapted interventions. Unfortunately, couple intervention samples often exclude participants with marginalized identities and culturally adapted couple intervention research is limited. The lack of information about best practices for diverse client subgroups perpetuates mental and relational health disparities. We conducted a systematic review to examine recruitment strategies and sampling characteristics of diverse races/ethnicities, incomes, ages, and sexual identities. We reviewed articles published between January 2015 and December 2020. Articles were eligible for inclusion in our review if they implemented an intervention with couples in the United States. Of 4054 articles identified, 54 articles were eligible for our review. Findings suggest that couple intervention studies lack diversity across multiple identity domains (i.e., races/ethnicities, incomes, ages, and sexual identities). Further, descriptions of recruitment strategies are often vague, limiting opportunities to better understand methods used to recruit diverse samples.

A special section: Recruiting and retaining couples from underrepresented backgrounds in intervention research

This special section represents a collection of papers on recruitment and retention of couples from underrepresented backgrounds in couple intervention research. Research shows that couples from underrepresented backgrounds tend to be missing from intervention research. This gap is concerning; conclusions about the effectiveness of these interventions are not being drawn from diverse and representative samples and it may be that scholars are inadvertently creating inappropriate and inaccessible services for these couples. Recruiting and retaining these couples require specialized efforts and attention. In this summary paper, we describe (a) the origins of this special section, (b) the existing research on recruitment and retention in couple intervention research, (c) an overview of the papers in this special section, and (d) future recommendations and directions for this aspect of methodology in couple research. This collection of papers elevates the need to involve community members from the beginning, reduce barriers to access, and create recruitment materials and a service delivery environment that is specific for the target population.

A longitudinal comparative study of a multicouple group and single-couple psychosocial intervention while experiencing infertility

This is a quasi-experimental, nonequivalent design study investigating the efficacy of multicouple group and single-couple intervention formats aimed at diminishing the psychosocial impact of infertility. The review studies carried out to date that have assessed this subject do not show consistent findings and although increasing the efficacy and efficiency of intervention formats more than justifies their analysis, there are no studies making this particular comparison. Eighty-seven infertile couples who were in assessment for their infertility and/or were close to undergoing some kind of assisted reproductive technology process participated in a psychosocial intervention either under the multicouple group or single-couple subconditions, or acted as controls. The variables of depression, anxiety, and fertility quality of life were used for evaluating psychosocial impact. Comparisons were made: (a) between the intervention condition and controls and (b) between the two subconditions. The results support the efficacy of the intervention both in the dyadic latent growth curve models analysis carried out and in the treatment effect calculation. Although in the comparison between the multicouple and single-couple format, some differences generally favoring the single format one were found, they were not conclusive. Therefore, the results are in line with review studies that did not find the group format to be more effective. Although this study provides valuable information, its limitations mean that further research needs to be carried out. When selecting the intervention format, therapists should also weigh up others aspects, such as the intervention goal, patient's needs and characteristics, reproductive history, and current stage of infertility.

Closeness with a partner and parental bond with a child during the transition to parenthood

OBJECTIVE

The aim of this longitudinal study was to examine the dyadic interdependence of the relationships between partners' perception of closeness with one another and their pre- and postnatal bonds with a child.

RESEARCH DESIGN AND PARTICIPANTS

A total of 213 first-time expectant couples participated in the study both during pregnancy (1st stage) and after the child's birth (2nd stage).

MEASUREMENTS

The participants completed the following measures: the one-item pictorial Inclusion of Other into the Self (IOS) scale and the brief maternal and paternal versions of the Antenatal Attachment Scales (MAAS/PAAS, respectively) and Postnatal Attachment Scales (MPAS/PPAS, respectively).

FINDINGS

The Actor-Partner Interdependence Models (APIM) for distinguishable dyads were performed and revealed the positive effect of parents' perceptions of closeness with their partners regarding both their own and their partners' bond with their child during pregnancy. However, after the child's birth, for both mothers and fathers, only their own perception of closeness with their partners was associated with their bond with their child. Moreover, only the actor effects of bonding with a child during pregnancy as well as the change in perception of closeness with a partner on the partner's bond with their child after birth were found (no partner effect).

KEY CONCLUSIONS

Couple attributes during the transition to parenthood should be emphasized to promote the development of parental pre- and postnatal bonds.

Smarthealth technology study protocol to improve relationships between older adults with dementia and family caregivers

AIM

The aim of this study is to develop a Smarthealth system of monitoring, modelling, and interactive recommendation solutions (for caregivers) for in-home dementia patient care that focuses on caregiver-patient relationships.

DESIGN

This descriptive study employs a single-group, non-randomized trial to examine functionality, effectiveness, feasibility, and acceptability of the novel Smarthealth system.

METHODS

Thirty persons with Alzheimer's Disease or related dementia and their family caregivers (N = 30 dyads) will receive and install Smarthealth technology in their home. There will be a 1-month observation phase for collecting baseline mood states and a 2-month implementation phase when caregivers will receive stress management techniques for each detected, negative mood state. Caregivers will report technique implementation and usefulness, sent via Ecological Momentary Assessment system to the study-provided smartphone. Caregivers will provide daily, self-reported mood and health ratings. Instruments measuring caregiver assessment of disruptive behaviours and their effect on caregivers; caregiver depressive symptoms, anxiety and stress; caregiver strain; and family functioning will be completed at baseline and 3 months. The study received funding in 2018 and ethics board approval in 2019.

DISCUSSION

This study will develop and test novel in-home technology to improve family caregiving relationships. Results from this study will help develop and improve the Smarthealth recommendation system and determine its usefulness, feasibility, and acceptability for persons with dementia and their family caregiver.

IMPACT

The Smarthealth technology discussed will provide in-home stress reduction resources at a time when older adults may be experiencing increasingly high rates of isolation and anxiety and caregiver dyads may be experiencing high levels of relationship strain.

TRIAL REGISTRATION

This study was registered with Clinical Trials.gov (Identifier NCT04536701).

Partner Assisted Smoking Cessation Treatment: A Randomized Clinical Trial

Background: Partner Assisted Smoking Cessation Treatment (PACT) was designed to improve smoking abstinence rates by integrating evidence-based relationship education strategies to build effective couple support into standard cognitive behavioral smoking cessation treatment (CBT). Methods: This small randomized clinical trial examined the feasibility, acceptability, and efficacy of PACT versus CBT in improving couple support processes and smoking outcomes, focusing on effect sizes. Thirty-eight smokers and their nonsmoking partners were randomized to and completed either PACT or CBT. Both treatments included 8 weekly group sessions and nicotine replacement therapy. Results: Treatment credibility and satisfaction were high and comparable between conditions, though perceived helpfulness and treatment engagement were higher in PACT (ds = .48-.68). Compared to CBT, PACT showed no difference in effects on perceived partner support, small effects on observed social support behaviors (ds = .23 to .46), a medium effect on dyadic efficacy (d = .63), and a large effect on active listening (d = .85). Biochemically-verified smoking abstinence rates did not differ between conditions at 12-week follow-up (CBT: 27.3%, PACT: 37.5%). Conclusions: PACT may have stronger effects than standard CBT on treatment engagement and some couple support processes, but not abstinence. Program refinement and testing in larger samples are needed.

Development and calibration of a novel social relationship item bank to measure health-related quality of life (HRQoL) in Singapore

BACKGROUND

Social relationships (SR) is an important domain of health-related quality of life. We developed and calibrated a novel item bank to measure SR in Singapore, a multi-ethnic city in Southeast Asia.

METHODS

We developed an initial candidate pool of 51 items from focus groups, individual in-depth interviews and existing instruments that had been developed and/or validated for use in Singapore. We administered all items in English to a multi-stage sample of subjects, stratified for age and gender, with and without medical conditions, recruited from community and hospital settings. We calibrated their responses using Samejima's Graded Response Model (SGRM). We evaluated a final 30-item bank with respect to Item Response Theory (IRT) model assumptions, model fit, differential item functioning (DIF), and concurrent and known-groups validity.

RESULTS

Among 503 participants (47.7% male, 41.4% above 50 years old, 34.0% Chinese, 33.6% Malay and 32.4% Indian), bi-factor model analyses supported essential unidimensionality: explained common variance of the general factor was 0.805 and omega hierarchical was 0.98. Local independence was deemed acceptable: the average absolute residual correlations were < 0.06 and 1.8% of the total item-pair residuals were flagged for local dependence. The overall SGRM model fit was adequate (p = 0.146). Five items exhibited DIF with respect to age, ethnicity and education, but were retained without modification of scores because they measured important aspects of SR. The SR scores correlated in the hypothesized direction with a self-reported measure of global health (Spearman's rho = - 0.28, p < 0.001).

CONCLUSION

The 30-item SR item bank has shown acceptable psychometric properties. Future studies to evaluate the validity of SR scores when items are administered adaptively are needed.

Unintended Effects of a Smoking Cessation Intervention on Latino Fathers' Binge Drinking In Early Postpartum

Background

Research suggests that when smokers reduce their smoking, they also reduce their alcohol consumption.

Purpose

To examine the effects of a smoking cessation intervention and actual quitting smoking on binge drinking behavior among Latino expectant and new fathers.

Methods

Logistic regression models were used to examine the effect of intervention arm and quitting smoking on past 30-day binge drinking measured at 3-months and 12-months postpartum while controlling for known covariates.

Results

Fathers in the intervention arm were significantly more likely to decrease their binge drinking at the 12-month follow-up (OR=0.57, 95% CI=0.35–0.93). Quitting smoking, measured by both 7-day and 30-day point prevalence, was positively associated with reduced binge drinking at 3-months (OR=0.25, 95% CI=0.14–0.45; OR=0.44, 95% CI= 0.26–0.75) and 12-months (OR=0.22, 95% CI=0.11–0.42; OR=0.43, 95% CI= 0.24–0.77).

Conclusions

The results of this study support the positive effects of a smoking cessation intervention on decreasing binge drinking behavior among Latino fathers in the postpartum period.