Taking Relationship Education to the People:

A Home-Visitation Delivery Method for the Relationship Checkup Program

by Hailey Palmer

Bottom-Line First: Every relationship educator knows of the difficulty of recruiting couples to take the time to participate in relationship education (RE) programs. But what if we could take our helpful interventions to them? A new home-visitation delivery model of the Relationship Checkup program shows benefits in providing positive RE opportunities for low-income, at-risk couples, especially for those who were experiencing more distress.

In this fast-paced time with our increasingly busy schedules, we are grateful as more and more services and goods can be delivered right to our doorsteps. With the click of a mouse and a wait of 1-3 business days, innovative companies make it easy for us to acquire the latest trends in food, clothing, electronics, and more. But what if more than just consumer products could be delivered to our doorsteps? What if even relationship education programs could be taken straight to the homes of motivated couples and delivered face-to-face right in their own living rooms?

The creators of the Relationship Checkup program have implemented a delivery method that takes their intervention right into the homes of participants in hopes of positively affecting more low-income, at-risk couples.[1] Most relationship educators understand the difficulty of recruiting and retaining couples from low-income populations simply because of the barriers these couples encounter. They are more likely to lack the time, funds, transportation, and childcare to take advantage of relationship education services.[2]  It’s unfortunate that the couples most in need of relationship education are those who likely experience the most barriers to getting it.

The home-visitation delivery method seeks to overcome barriers to assist these at-risk couples. This delivery method has frequently been used in other government-funded intervention programs to strengthen parenting and child outcomes and has been shown to have positive effects.[3]

But is the home-delivery model effective for couple education? While we have previously reported on the effectiveness of the Relationship Checkup program as a whole, we want to provide relationship educators with a deeper look into this innovative delivery method. An evaluation study was conducted with as many as 1,312 participants to determine if this brief, home-based intervention significantly strengthened relationships. (A small proportion preferred to go to a local clinic rather than do it in their homes.) Each Relationship Checkup facilitator was required to participate in several training sessions before engaging with couples, as the nature of the program necessitates an understanding of some basic therapeutic skills. The intervention included a questionnaire, an in-person, 90-minute session assessing the relationship, and a 90-minute, research-based feedback session tailored to the specific needs of the couple (based on their questionnaire). Researchers sought to measure changes in participants’ relationship satisfaction, communication, relational aggression, and intimacy over time.

Here is a summary of the results:

  • Overall high satisfaction with program. The vast majority of participants reported that the program helped them understand the strengths of their relationship. Most stated that they would highly recommend the intervention to their friends and neighbors.
  • Improvements maintained over time. Though the intervention was brief, participating couples experienced small but significant improvements on all measures. Such improvements generally were maintained six months after the conclusion of the intervention, although at the follow up there was some diminishment of some effects.
  • Distressed couples showed greater improvements. Similar to past evaluations of RE programs,[4] this evaluation study found that couples who were clinically distressed before engaging in the program experienced greater increases in relationship satisfaction compared to non-distressed couples.
  • Decreased levels of relational aggression. Gender was a factor in this study; only women decreased in relational aggression after participating in the intervention.

Based on the findings, there are several implications for relationship educators to keep in mind:

  • Think convenience, lower barriers. This home-visitation delivery method brings helpful interventions into the homes of couples who need it most, lowering the barriers which many low-income, at-risk couples face. The intervention is brief with only two sessions, resulting in flexibility for couples with schedules that would not otherwise permit them to attend relationship education classes.
  • Think flexibility. Facilitators of this intervention are expected to tailor their instruction and feedback to the needs of each couple they assist. While each facilitator is given a manual and asked to memorize the required material, they are still expected to maintain flexibility as they cater to the specific needs of the couples rather than following a designated curriculum.
  • Think understanding vs skills. The main purpose of the Relationship Checkup program is to help couples understand one another and recognize the strengths and potential weaknesses of their relationship. This set-up is different than other RE programs that place a stronger emphasis on helping couples develop relationship skills.
  • Think regular check-ups. Because effects diminish over time, couples should be encouraged to participate in this intervention regularly. Just as individuals should regularly receive physical examinations from a medical professional, couples should regularly receive relationship check-ups from professionals skilled in relationship education. Thankfully, the home-delivery method makes regularity more possible.
  • Think recruitment. The evaluation study reported a high percentage of participants who asked facilitators to return another time to deliver the intervention to their loved ones. Because of the high satisfaction rate with this convenient intervention, relationship educators may find it most effective when participants recruit others.

The home-visitation delivery method for the Relationship Checkup program may have the potential to benefit the couples who need it most. For such a brief intervention, it is noteworthy that positive effects generally were maintained for six months, especially for distressed couples. Of course, it may be more expensive to deliver RE materials to couples in their home; we need good data about what the cost-per-participant is compared to traditional delivery methods. Still, relationship educators may do well to keep this delivery method in mind as they seek to find more ways to overcome the common barriers that may keep low-income, at-risk couples from engaging in relationship education programs.

 

Endnotes:

[1] Coop Gordon, K., Cordova, J. V., Roberson, P. N., Miller, M., Gray, T., Lenger, K. A., . . . Martin, K.An implementation study of relationship checkups as home visitations for Low‐Income At‐Risk couples. Family Process.

[2] Bradbury, T. N., & Lavner, J. A. (2012). How can we improve preventive and educational interventions for intimate relationships? Behavior Therapy43(1), 113-122.

[3] https://www.mdrc.org/publication/summary-results-mihope-and-mihope-strong-start-studies-evidence-based-home-visiting?utm_source=MDRC+Updates&utm_campaign=62665faf2a-EMAIL_CAMPAIGN_2019_01_30_05_40&utm_medium=email&utm_term=0_504d5ac165-62665faf2a-34956125

[4] Halford, W. K., Pepping, C. A., Hilpert, P., Bodenmann, G., Wilson, K. L., Busby, D., … & Holman, T. (2015). Immediate effect of couple relationship education on low-satisfaction couples: A randomized clinical trial plus an uncontrolled trial replication. Behavior therapy46(3), 409-421. Also, for a list of studies showing stronger effects for more disadvantaged and distressed couples, see: Hawkins, A. J., Erickson, S. E., & Yang, C. (2017). How does couple and relationship education affect relationship hope? An intervention-process study with lower income couples. Family Relations, 66, 441-452.