We present an evaluation of the extent to which an empirically based couples' intervention program was successfully disseminated in the community. Clergy and lay leaders from 27 religious organizations who were trained to deliver the Prevention and Relationship Enhancement Program (PREP) were contacted approximately yearly for 5 years following training to determine whether they still used PREP and which aspects were used. Results indicated that 82% continued to use at least parts of the program, especially parts dealing with communication and conflict management. Results also showed that clergy and lay leaders extended the use of the curriculum from premarital couples to married couples. We discuss implications for future efforts toward disseminating empirically based programs into community settings.
Key Words: dissemination, divorce prevention, marriage education, religious organizations, social policy.
Spreading the word about intervention programs that hold promise for ameliorating or preventing important social problems is one of the broad goals of the field of prevention (Coie et al., 1993). As effective, theory driven, empirically based interventions are developed and empirically validated, we need to learn more about how to get these interventions into the hands of people who can put them to use. Thus, data are needed on the outcomes of dissemination efforts (Sobell, 1996; Weissberg, 1990). In this article, we describe an evaluation of the dissemination of an empirically based marriage education program (The Prevention and Relationship Enhancement Program [PREP]; Markman, Stanley, Blumberg, Jenkins, & Whitely, 2003; Stanley, Blumberg, & Markman, 1999). PREP is a 12-hour marriage education program based on longitudinal research on risk factors for marital distress and divorce and protective factors for healthy marriages. PREP participants learn how to regulate negative emotions, manage conflict, and protect, preserve, and restore the positive aspects of relationships. Here, we present results on the continued use of PREP over a 5-year period by trained clergy and lay leaders delivering marriage education within religious organizations (ROs).
Much work remains to be done to promote the dissemination of empirically based interventions (e.g., Christensen, Doss, & Atkins, in press). Despite the existence of well-validated treatments for various psychological problems, clinicians typically do not use them (e.g., Hahlweg & Klann, 1997). In fact, interventions to prevent or treat marital distress are not regularly delivered to the couples who need them most (Halford, Markman, Kline & Stanley, 2003; Sullivan & Bradbury, 1997). Although the use of preventive premarital education has increased in recent years, only about one third of couples marrying today are likely to receive such services. Of those who go on to divorce, the rate is far lower at 18% (Johnson et al., 2002). Further, only a small percentage of couples who divorce ever see a therapist for marital problems (Halford & Markman, 1997; Johnson et al.), and when couples do see a therapist, providers make little use of empirically based approaches (Hahlweg & Klann; Kaiser, Hahlweg, Fehm-Wolfsdorf, & Groth, 1998). The same is likely true for preventive services. There are concerns about the effectiveness of premarital training currently provided by community practitioners (Schumm & Silliman, 1997; Sullivan & Bradbury). These issues take on added importance given the increasing public interest in providing marriage education programs to couples who desire to improve their chances of marital success (e.g., Horn, 2003; Parke & Ooms, 2002).
Characteristics of Empirically Based Strategies
We focus on preventive interventions for couples-specifically marriage education, as opposed to interventions designed to treat marital distress. More knowledge is needed about the effectiveness of marriage education programs with differing types of couples and practitioners. …