Kim Halford

A couple-based intervention for female breast cancer

Objective: Although womens breast cancer affects both women and their male partners, as well as their relationships, few interventions have been developed to work with couples confronting breast cancer. The current investigation presents the pilot results from a new couple‐based intervention program for breast cancer that teaches couples how to minimize negative effects and maximize positive functioning during this difficult time.

Do Couples at High Risk of Relationship Problems Attend Premarriage Education

The effectiveness of premarriage education is limited by whether couples at high risk of future marital problems attend such education. In the current study, 374 newly married couples were assessed on a range of risk factors for future marital problems as well as whether they had attended marriage education. Couples with certain indices of relationship risk (nonreligious and premarital cohabitation) were underrepresented in premarriage education. Suggestions are offered to attract more couples, particularly those at high risk for future problems, to relationship education.

Psycho-education to enhance couples' transition to parenthood

A substantial proportion of couples struggle to adapt to parenthood, feel stress in caring for their infant, and experience a significant decline in their couple relationship adjustment. Moreover, there is a substantial association between effective parenting of infants and sustaining a mutually satisfying couple relationship. This paper reviews randomized controlled trials of psycho-education to assist new parent couples with parenting and their couple relationship. The majority of programs target either the couple relationship or parenting, with few programs addressing both areas. The best outcomes seem to be achieved when programs are accessible by couples at home, when skill-training is provided, and possibly when programs target couples at high-risk of maladjustment to parenthood.

Assessing how much couples work at their relationship: The behavioral self-regulation for effective relationships scale

It is widely believed that satisfying couple relationships require work by the partners. The authors equated the concept of work to relationship self-regulation and developed a scale to assess this construct. A factor analysis of the scale in a sample of 187 newlywed couples showed it comprised 2 factors of relationship strategies and effort. The factor structure was replicated in an independent sample of 97 newlywed couples. In both samples the scale had good internal consistency and high convergent validity between self- and partner-report forms. Self-regulation accounted for substantial variance in relationship satisfaction in both newlywed samples and in a 3rd sample of 61 long-married couples. The self-regulation and satisfaction association was independent of mood or self-report common method variance.

Does working at your marriage help? Couple relationship self-regulation and satisfaction in the first 4 years of marriage.

Relationship self-regulation (SR) is how much partners work at their couple relationship, and it has been hypothesized to predict relationship satisfaction. To test this hypothesis, the authors assessed 191 newlywed couples on SR and relationship satisfaction annually for 5 years. They conducted a multilevel analysis predicting satisfaction with SR as a time-varying covariate. The intercept and slope of relationship satisfaction varied across participants, and the slope showed an average slight decline for both men and women. There was mixed support for the primary hypothesis. SR cross-sectionally and prospectively predicted the intercept, but it did not predict the slope, of relationship satisfaction.

ProsCan for Couples: randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer who receive radical prostatectomy.

BackgroundProstate cancer is the most common male cancer in the Western world. The most substantial long term morbidity from this cancer is sexual dysfunction with consequent adverse changes in couple and intimate relationships. Research to date has not identified an effective way to improve sexual and psychosocial adjustment for both men with prostate cancer and their partners. As well, the efficacy and cost effectiveness of peer counselling as opposed to professional models of service delivery has not yet been empirically tested. This paper presents the design of a three arm randomised controlled trial (peer vs. nurse counselling vs. usual care) that will evaluate the efficacy of two couples-based sexuality interventions (ProsCan for Couples: Peer support vs. nurse counselling) on mens and womens sexual and psychosocial adjustment after surgical treatment for localised prostate cancer; in addition to cost-effectiveness.Methods/designSeventy couples per condition (210 couples in total) will be recruited after diagnosis and before treatment through urology private practices and hospital outpatient clinics and randomised to (1) usual care; (2) eight sessions of peer-delivered telephone support with DVD education; and (3) eight sessions of oncology nurse-delivered telephone counselling with DVD education. Two intervention sessions will be delivered before surgery and six over the six months post-surgery. The intervention will utilise a cognitive behavioural approach along with couple relationship education focussed on relationship enhancement and helping the couple to conjointly manage the stresses of cancer diagnosis and treatment. Participants will be assessed at baseline (before surgery) and 3, 6 and 12 months post-surgery. Outcome measures include: sexual adjustment; unmet sexuality supportive care needs; attitudes to sexual help seeking; psychological adjustment; benefit finding and quality of life.DiscussionThe study will provide recommendations about the efficacy of peer support vs. nurse counselling to facilitate better sexual and couple adjustment after prostate cancer as well as recommendations on whether the interventions represent efficient health service delivery.Trial RegistrationACTRN12608000358347

Couple relationship education at home: does skill training enhance relationship assessment and feedback?

To evaluate the effective components of couple relationship education, 59 newlywed couples were randomly assigned to one of two couple relationship programs (CRE): (1) RELATE, which involved receiving feedback on their relationship based on the on-line RELATE assessment; or (2) RELATE + Couple CARE, which was RELATE plus completing the 6 unit Couple CARE relationship skill training program. Relative to RELATE, RELATE + Couple CARE produced more improvement in couple communication, and high relationship satisfaction across the next 12 months in women. Men sustained high and similar relationship satisfaction in either condition. Skill training CRE has additional benefits for couples beyond assessment and feedback.

Couple communication and female problem drinking: A behavioral observation study

Couples with alcohol and relationship problems often report poor communication, yet little is known about the communication of maritally distressed couples in which the woman abuses alcohol (MDWA couples). Compared with maritally distressed couples without alcohol problems (MDNA) and couples with neither problem (NDNA), MDWA couples showed a distinctive pattern of negative communication. Similar to MDNA men, MDWA men spoke negatively to their partners but listened positively to their partners much like NDNA men. MDWA women listened negatively, much as MDNA women did, but spoke positively, like NDNA women did. The interactions of MDWA couples can be characterized as a male-demand-female-withdraw pattern, which is a gender reversal of the female-demand-male-withdraw pattern often observed in MDNA couples.

Environments for Healthy Living (EFHL) Griffith birth cohort study: background and methods.

The health of an individual is determined by the interaction of genetic and individual factors with wider social and environmental elements. Public health approaches to improving the health of disadvantaged populations will be most effective if they optimise influences at each of these levels, particularly in the early part of the life course. In order to better ascertain the relative contribution of these multi-level determinants there is a need for robust studies, longitudinal and prospective in nature, that examine individual, familial, social and environmental exposures. This paper describes the study background and methods, as it has been implemented in an Australian birth cohort study, Environments for Healthy Living (EFHL): The Griffith Study of Population Health. EFHL is a prospective, multi-level, multi-year longitudinal birth cohort study, designed to collect information from before birth through to adulthood across a spectrum of eco-epidemiological factors, including genetic material from cord-blood samples at birth, individual and familial factors, to spatial data on the living environment. EFHL commenced the pilot phase of recruitment in 2006 and open recruitment in 2007, with a target sample size of 4000 mother/infant dyads. Detailed information on each participant is obtained at birth, 12-months, 3-years, 5-years and subsequent three to five yearly intervals. The findings of this research will provide detailed evidence on the relative contribution of multi-level determinants of health, which can be used to inform social policy and intervention strategies that will facilitate healthy behaviours and choices across sub-populations.

Assessing adult adjustment to relationship separation: the Psychological Adjustment to Separation Test (PAST).

Relationship separation is associated with substantial adult adjustment problems. The Psychological Adjustment to Separation Test (PAST) was developed as a self-report measure of 3 key dimensions of separation adjustment problems: lonely negativity, ex-partner attachment and coparenting conflict. Two independent samples (n = 219 and n = 169, respectively) of recently separated adults, 60% of whom had children, completed the PAST and other measures of general adjustment. Exploratory and confirmatory factor analyses demonstrated a replicable 3-factor structure, with each factor showing satisfactory test-retest and internal reliability and good convergent and discriminant validity. The PAST meets initial criteria for a potentially useful new measure of adult separation adjustment.