Online Programs Improve Relationship Functioning for Distressed Low-Income Couples: Results From a Nationwide Randomized Controlled Trial

Objective: Although low-income couples experience greater relationship challenges, they have limited access to effective relationship interventions. Furthermore, most previous efforts to improve low-income couples' relationships have yielded very small effects (Hawkins & Erickson, 2015). In an effort to overcome these limitations, this study investigated the effectiveness of 2 web-based interventions for low-income couples. Method: In total, 742 low-income couples (N = 1,484 individuals; mean [M] age = 33; 55% White, non-Hispanic; 52% married; median [Mdn] annual household income = $27,000) were recruited nationally and randomized to the OurRelationship program, the ePREP program, or a waitlist control group. Couples were repeatedly assessed for 6 months using self-report measures of relationship satisfaction, communication conflict, intimate partner violence, emotional support, and breakup potential. Relationship status was assessed at 6-month follow-up. Results: Compared to the control group, intervention couples experienced significantly greater improvements in all 5 domains of relationship functioning (Mdn |d| = 0.46) by the end of the program; these effects were maintained in the 4 months after treatment. However, neither program significantly reduced the frequency of breakups by the 6-month follow-up. Differences between couples in the two interventions were minimal (Mdn Cohen's |d| = 0.11); however, couples in the OurRelationship program experienced significantly greater decreases in conflict (d = 0.24). Conclusions: The results indicate that brief, web-based interventions can serve a central role in delivering effective services to low-income couples. Additionally, the general equivalence of the two interventions indicates that both communication-focused and problem-focused interventions can be successful in improving the relationship functioning of low-income couples. What is the public health significance of this article? Web-based interventions are effective in improving relationship functioning of low-income couples. Brief interventions, narrowly focused on improving relationship dynamics, are effective in overcoming multiple barriers to intervention reach and effectiveness in low-income populations. Both communication-focused and problem/insight-focused interventions can be effective for low-income couples.