Better Together Online: A Pilot Study of a Relationship Education Intervention with Rural Female Couples.

Abstract

Relationship education (RE) programs have demonstrated efficacy in helping couples to maintain and improve the quality of their relationships. Culturally appropriate and effective RE programs for same-sex couples, however, are scarce. We conducted a small pilot study of Better Together Online, a web-based seven-module RE program for rural female couples. Our aims were to examine acceptability, appropriateness, and feasibility of the program and to explore preliminary evidence of efficacy. Eight female couples completed all modules and three additional couples completed at least four (N = 22 individuals). Acceptability, appropriateness, and feasibility ratings of each module were high and qualitative feedback from the couples included positive comments and some suggestions for improvement. Linear mixed-effects models indicated small effects on relationship instability at post-intervention (g =.27) and satisfaction at 3-month follow-up (g =.39); there were no effects on relationship confidence. Improvements in behavioral skills were more robust; there were small-to-medium effects on communication (g =.35-.56), problem solving (g =.23-.34), and mindfulness skills (g =.33-.64). and medium-to-large improvements in coping behaviors (g =.35-1.04). Small effects were also observed in increased stigma-related stress and positive identity. Some of these effects may have been influenced by unexpected arrival of COVID-19 during the intervention period. These preliminary results tentatively suggest that, with additional refinement and evaluation, Better Together Online may help maintain healthy relationships and prevent relationship distress and decline in rural female couples. Lesson learned and future directions are discussed.