Mobile Intervention to Activate Couple Relationship Resilience

Background

Marital discord and unhappy relationships are significant risk factors for a range of emotional, behavioral, and physical health problems—including increased stress, anxiety, functional impairment, depressive symptoms, and substance abuse disorders.1-7 Work loss associated with marital problems costs U.S. employers approximately $6.8 billion annually due to absenteeism, reduced productivity, and increased healthcare costs.8

Proactive couple relationship skills training can serve as a preventive and early intervention approach to improve relationship quality, stability, and resilience. It has been shown to reduce marital discord and its associated problems.9-12

Love Every Day Intervention

With National Institutes of Health (NIH) funding, GlobalMed Wellness developed and tested Love Every Day, a mobile intervention that activates the daily use of positive interactions among married and cohabiting couples. Love Every Day is designed to promote habitual patterns of healthy couple interactions known to increase relationship stability, based on the National Extension Relationship and Marriage Education Model (NERMEM) 13 and habit-formation research. The app triggers NERMEM-based interactions, which in turn elicit reciprocal social and emotional rewards between partners, ultimately creating anticipation of reward and, thus, healthy couple habits. 

The Love Every Day mobile intervention uses text messages to engage both couple members in three weeks of brief daily questions carefully designed to prompt positive interactions within the app, generate meaningful in-person conversations, and create couple resilience. Couples work as a team, sharing their answers to 21 engaging and evocative questions about themselves, each other, and their relationship. When both partners answer a question, each member receives a bonus activity designed to elicit additional in-person interaction.

Study Design & Methods

To test the efficacy of the Love Every Day mobile intervention, we conducted a single-group trial with 43 cohabiting couples with little-to-moderate relationship distress in which at least one partner was employed at least part-time. Approximately half of the participants were recruited through an EAP partner organization. Others were recruited through various outreach efforts, including Meta ads, participants in prior GlobalMed Wellness studies, and others. 

Couples used the Love Every Day intervention for three weeks. Both partners independently completed online surveys before and immediately after completing the Love Every Day intervention (approximately three weeks after baseline). Primary outcomes included relationship distress, partner cohesion, relationship confidence, and relationship satisfaction. Other measures examined effects on crucial components of the NERMEM (e.g., knowledge of self and partner, care for one’s partner, shared identity, self-efficacy to manage conflicts). 

Results

Couples using Love Every Day reported highly significant and moderate-to-large improvements in all outcomes.

Primary Outcomes

  • Lower relationship distress (p < .001)
  • Higher partner cohesion (p < .001)
  • Higher relationship confidence (p = .003)
  • Higher relationship satisfaction (p < .001)

NERMEM Components

  • Higher knowledge of self and partner (p < .001)
  • Higher care for one’s partner (p < .001)
  • Higher sense of shared identity (p < .001)
  • Higher self-efficacy to manage conflicts (p < .001)

During the 3-week study period, a vast majority of couples consistently visited the Love Every Day app multiple times every day. On average, individuals answered the daily question nearly every day (0.9 times per day) and visited the question/answer screen 3.5 times per day. Partners completed an average of 3–4 in-person “bonus” interactions per week. Love Every Day users reported excellent usability (System Usability Scale = 89.5) and high satisfaction with their app experience.

Qualitative feedback from couples who used Love Every Day indicates that the app provided “a fun and quick way to stay connected” that improved or renewed their sense of partnership and commitment. Other comments support the quantitative findings that the app sparked positive in-person interactions and that many users experienced the anticipation of each day’s question and their partners’ answers, a key component of habit formation.

Conclusion

The Love Every Day minimum viable product yielded moderately large and significant benefits to relationship resilience, seen across a wide array of couple stability outcomes. Primary outcomes were confirmed by changes in the activating components of the National Extension Relationship and Marriage Education Model and by qualitative feedback indicating higher levels of partnership and relationship cohesion. Love Every Day users were very highly engaged throughout the entire three-week intervention, visiting the app multiple times per day and initiating positive in-person interactions three to four times each week.

References

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