Montefiore Medical Center Healthy Marriage and Relationship Education Program

• ClinicalTrials.gov Identifier: NCT03697421
• Recruitment Status: Completed
• First Posted: October 5, 2018
• Last Update Posted: December 9, 2021
• Sponsor: Montefiore Medical Center
• Collaborators: Children's Bureau - Administration for Children and Families; Metis Associates
• Information provided by (Responsible Party): Traci Maynigo, Montefiore Medical Center

Study Description

Brief Summary:

The proposed program will flexibly provide an array of relationship promotion activities incorporating case management and job placement/career advancement activities: marriage and relationship education; pre-marital education and marriage skills; marriage enhancement and marriage skills for married couples; and divorce reduction and relationship skills. In addition, our proposed local evaluation will examine factors that might account for the observed impacts of attending relationship education programs (i.e., higher levels of relationship satisfaction), including dosage of workshops, relationship commitment and longevity, and skill learning.

Condition or disease	Intervention/treatment
Parenting; Family Relationships	Other: Relationship Education; Other: Employment Services

Detailed Description:

The objective of the proposed evaluation is to delineate those factors and sub-groups that account for the observed impact of HMRE services on the quality of relationships. Specifically, we are interested in investigating the following factors:

1. Commitment: Are couples that are more committed to each other (measured in terms of marital status, duration of relationship, or relationship commitment scale scores) more motivated to attend a greater number of HMRE workshops? Do they actually learn more relationship skills, and report improvements in their relationship quality?
2. Hopefulness: How does hopefulness about the relationship impact outcomes?
3. Dosage: Is attendance at a greater number of workshops related to improvements in relationship satisfaction and relationship quality?
4. Couple characteristics: How are various demographic factors related to observed outcomes?
5. Skill acquisition: How much did couples actually learn during the course of the relationship workshop?

In order to explore these research questions, we will be conducting an evaluation that utilizes pre-and post-survey data and qualitative interview information from participants. This will be a descriptive study and not a random assignment design. Data collection will begin when couples who expressed interest in the program attend a preliminary interview with one of Montefiore's clinical staff on site. The program and study will be explained to the couple and they will be asked to consent to participate. Once consent is gathered, on-site staff will administer measures required by our funders through an online system called nForm, or Information, Family Outcomes, Reporting, and Management. This online system was developed by Mathematica Policy Research, an agency contracted by the Department of Health and Human Services to conduct a Cross-Site evaluation of all grantees who received funding to provide relationship education services. Preliminary demographic information will be collected through surveys completed by participants online through secure web browsing at a Montefiore facility.

Study Design

• Study Type: Observational
• Actual Enrollment: 1029 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: Montefiore Medical Center Healthy Marriage and Relationship Education Program
• Actual Study Start Date: July 1, 2016
• Actual Primary Completion Date: September 30, 2020
• Actual Study Completion Date: September 30, 2020

Groups and Cohorts

Group/Cohort

Intervention/treatment

Local Evaluation; The SHR program intends to serves couples who are over 18 years of age, are in a romantic relationship, and have at least one child (biological or adopted) under the age of 18 residing in the home or are expecting.

Other: Relationship Education; We will provide the following 4 activities: 1) marriage and relationship education [using a modified version of the empirically supported Loving Couples, Loving Children (LCLC); 2) pre-marital education and marriage skills; 3) marriage enhancement and marriage skills for married couples; and 4) divorce reduction and relationship skills. All couples will be expected to participate in 24 hours of core relationship education workshops (including parenting education). Since parental financial support represents a core element of family stability, relationship education workshops will address motivation for providing financial support through employment for all couples (employed and unemployed) as well as how to manage conflicts over money. All couples will be invited to supplemental workshops (with couples from other cohorts) on topics of specialized interest, including employment services and financial literacy (i.e. budgeting, debt, etc.).; Other: Employment Services; For couples in need of job search, job retention, and career advancement services, we will provide employment services.

Outcome Measures

Primary Outcome Measures :

1. Change in Couples Satisfaction Index (CSI-32) [ Time Frame: Change from Baseline CSI at 6 months ]
   Considered the gold standard, this measure detects differences in relationship satisfaction with great precision. It is a 32-item scale, total score range from 0 to 161. Higher scores indicate higher levels of relationship satisfaction. CSI-32 scores falling below 104.5 suggest notable relationship dissatisfaction.
2. Change in Relationship Hope Scale [ Time Frame: Change from Baseline Relationship Hope at 6 months ]
   This is a newly developed 5-item scale by a major relationship researcher (Alan Hawkins), which has reportedly good psychometric properties. It will allow us to hone in on the level of hopefulness and cynicism among our couples. This is a 5-item scale, scores determined by mean, ranging 1-7. Mean scores less than or equal to 5 suggest low hope.
3. Change in Maybe I Do? Scale (Commitment) [ Time Frame: Change from Baseline Commitment at 6 months ]
   A 4-item measure of commitment developed by another major relationship research group (Scott Stanley and Howard Markman). This is a 4-item scale, with a total score range 1-20. Low commitment is indicated at a total score of 12 or below.
4. Change in Assessing Emotions Scale (Emotional Intelligence) [ Time Frame: Change from Baseline Emotional Intelligence at 6 months ]
   Assesses the extent individuals perceive, understand, regulate, and harness emotions adaptively. This is a 33-item self-report inventory focusing on typical emotional intelligence. Scores can range from 33 to 165. Low EI is less than or equal to 115 for females and 108 for males; average EI is 116-145 for females and 109-131 for males; high EI is greater than or equal to 146 for females and 132 for male.
5. Change Skills Assessment Measure (Skill Acquisition) [ Time Frame: Change from Baseline Skills at immediately post intervention and at 6 months ]
   Assesses whether the individual has/has learned the skills and knowledge taught through the program curriculum. There are two forms of this measure, A and B, each 14 items. Scores are percentages ranging from 0-100%. Higher scores represent a higher outcome.
6. Adverse Childhood Experiences (ACE) Survey [ Time Frame: Halfway through intervention (Week 6 of 12 weeks, or Week 5 of 9 weeks) ]
   The Adverse Childhood Experience (ACE) Questionnaire is a 10-item self-report measure developed for the ACE study to identify childhood experiences of abuse and neglect. Scores range 0-10. Higher scores suggest worse outcomes.

Secondary Outcome Measures :

1. Information, Family Outcomes, Reporting, and Management (nFORM) Applicant Characteristics [ Time Frame: Baseline ]
   This is a survey developed by the Office of Family Assistance utilized by all grantees participating in the national study, that gathers demographic information regarding participants.
2. Information, Family Outcomes, Reporting, and Management (nFORM) Pre-Program Survey [ Time Frame: At start of intervention (Week 1 of 12 or 9 weeks) ]
   This is a survey developed by the Office of Family Assistance utilized by all grantees participating in the national study that includes questions regarding relationship satisfaction, financial stability, and parenting.
3. nformation, Family Outcomes, Reporting, and Management (nFORM) Post-Program Survey [ Time Frame: Immediately post intervention (Week 12 of 12 weeks or Week 9 of 9 weeks) ]
   This is a survey developed by the Office of Family Assistance utilized by all grantees participating in the national study that includes questions regarding relationship satisfaction, financial stability, and parenting.

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes
• Sampling Method: Non-Probability Sample

Study Population

The population is 47% Hispanic and 44% African-American. The income level of the majority of the couples enrolled was at or below 200% of poverty level, and 36% received income from public assistance. The majority of couples we served (72%) had a high school degree or less, and nearly half (49%) of participants were unemployed at program enrollment with many more under-employed. Their average age was 36 years old, including 10% between the ages of 17 and 24. The average duration of marriage for couples in our program was 7 years; however, the range of relationship longevity was quite wide, spanning from newlywed couples married for a few months to couples married for over 30 years. All couples had at least one child under 18 years old living in the home (or were expecting a child), and we estimate that approximately two thirds of families in our program were comprised of at least one partner with a child from a previous relationship.

Criteria

Inclusion Criteria:

• In a committed relationship
• 18 years or older
• expecting a child or are caring for a child in the home at least 50% of the time (biological, foster, adopted, kinship care, etc.)

Exclusion Criteria:

• Active intimate partner violence and increased risk of intimate partner violence

Contacts and Locations

Locations

United States, New York

Montefiore Medical Center

Bronx, New York, United States, 10451

Sponsors and Collaborators

Montefiore Medical Center

Children's Bureau - Administration for Children and Families

Metis Associates

Investigators

• Principal Investigator: Scott Wetzler, PhD; Montefiore Medical Center

More Information

• Responsible Party: Traci Maynigo, Program Director, Montefiore Medical Center
• ClinicalTrials.gov Identifier: NCT03697421
• Other Study ID Numbers: 2015-5900
• First Posted: October 5, 2018
• Last Update Posted: December 9, 2021
• Last Verified: December 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Traci Maynigo, Montefiore Medical Center:

parenting; relationships; relationship education; couples; marriage