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Can Interventions that Strengthen Couples’ Relationships Confer Additional Benefits for their Health? A Randomized Controlled Trial with African American Couples


This study examined the effects of the Protecting Strong African American Families (ProSAAF) prevention program on adults’ self-reported health outcomes 25 months after enrollment. ProSAAF is a couple-focused prevention program specifically designed to meet the needs of African-American families residing in the rural South. African-American couples (N = 346) with an early adolescent child participated in a randomized controlled trial of the program. Dyadic data analyses indicated significant direct effects on changes in couple functioning post-intervention as well as significant indirect effects of ProSAAF on changes in health through post-intervention improvements in couple functioning. These benefits were documented for men’s and women’s general health, depressive symptoms, and problematic sleep. There were no significant direct effects of ProSAAF participation on changes in health. Findings provide tempered optimism regarding the potential benefits of couple-focused programming for adults’ physical, mental, and behavioral health.

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Fig. 1


  1. To be eligible, the target child to be African-American, but not both parents. Ethnicity was not assessed in surveys completed by participants. Notes from research staff indicated that two caregivers (from different families) were not African-American. All participants were comfortable being identified as part of an African American family

  2. These two couples were excluded from analyses because data analytic techniques required dyads to be distinguishable by sex, and this subsample size precluded group comparisons

  3. Analyses comparing constrained models to the unconstrained model indicted no significant deterioration in model fit by imposing these equality constraints


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This research was supported by Award Numbers R01 HD069439 from the National Institute of Child Health and Human Development and R01 AG059260 from the National Institute on Aging to Steven R. H. Beach as well as P50 DA051361 from the National Institute on Drug Abuse to Gene H. Brody. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


This research was supported by Award Number R01 HD069439 from NICHD, Award Number R01 AG059260 from NIA, and Award Number P50 DA051361 from NIDA.

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Correspondence to Allen W. Barton.

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The authors report no conflicts of interest.

Research Involving Human Participants

All procedures were approved by the Institutional Review Board of the university at which the research was conducted and complied with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all couples prior to data collection and program participation.

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Barton, A.W., Lavner, J.A. & Beach, S.R.H. Can Interventions that Strengthen Couples’ Relationships Confer Additional Benefits for their Health? A Randomized Controlled Trial with African American Couples. Prev Sci 22, 386–396 (2021).

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  • African Americans
  • Couples
  • Health
  • Prevention
  • Relationship satisfaction