Marriage Checkup in Integrated Primary Care: A Randomized Controlled Trial with Active Duty Military Couples

This study assessed the efficacy of the Marriage Checkup (MC), as adapted to integrated primary care settings and active duty military couples, for improving relationship health, depressive symptoms, and home-work stress spillover. Method: Married couples (N = 244, Mage = 32.4, 67.6 percent Caucasian) in which at least one member was active duty Air Force were recruited from several bases across the U.S. via online advertisement, emails sent from medical clinics to enrolled beneficiaries, social media posts, and flyers, and randomly assigned to active treatment or wait-list control. Treatment and control couples were linked in pairs sequentially and pairs completed 9 sets of questionnaires at baseline, and one- and six-months post treatment. Outcome measures included the Couples Satisfaction Index, Intimate Safety Questionnaire, Responsive Attention Scale, Partner Compassion Scale, Communication Skills Test, Center for Epidemiologic Studies Depression Scale Short, and the Home Work-Stress Spillover questionnaire. Results: A 3-level multilevel model indicated, after adjustment for multiple comparisons, treatment couples experienced statistically significant small to moderate improvements compared to the control group (Cohen's d from 0.21 to 0.55) at 1 month that were sustained at 6 months for relationship satisfaction, responsive attention, compassion towards their partner, communication skills, intimate safety, and depressive symptoms. The single outcome that did not differ between treatment and control couples was home work-stress spillover. A longitudinal randomized control trial of the MC supports the hypotheses that the MC significantly improves relationship satisfaction, intimacy, communication, partner compassion, responsive attention, and depressive symptoms. Implications for theory, treatment, and dissemination are discussed.