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Intervention Summary

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Creating Lasting Family Connections Marriage Enhancement Program (CLFCMEP)

The Creating Lasting Family Connections Marriage Enhancement Program (CLFCMEP) is a community-based effort designed for couples in which one or both partners have been physically and/or emotionally distanced because of separation due to incarceration, military service, substance abuse, or other circumstances. The principal goal of CLFCMEP is to build and/or strengthen partners' relationship skills by providing structure and the opportunity for participants to develop greater capacity in the areas of communication, conflict resolution, emotional awareness, commitment, and trust.

Two certified trainers implement the module-based program with a group of 4-15 couples through one of the following implementation options: (1) an 8- to 10-session format (with 2-hour sessions), (2) a 2- to 3-day weekend retreat format, or (3) an 18- to 20-session format (with 2-hour sessions) that includes all modules. The program is delivered through a combination of instructional and interactive formats, and trainers encourage partners to discuss ideas and practice skills with each other and with other couples both during and between sessions. CLFCMEP consists of up to three stand-alone interactive training modules:

  • Marriage Enhancement. This module consists of 12 marriage-focused, guided exercises that are designed to strengthen marriage through the learning of open, nondefensive communication skills. These skills include the partners' development of a shared vision, understanding of positive and negative traits, understanding of personal needs and the needs of his or her partner, active listening, expectations, compassion, romance, and fair fighting.
  • Getting Real. This module is designed to enhance marital relationships through clear and honest communication and the setting of boundaries, and it uses guided role-playing in which partners learn to identify the effects of verbal and nonverbal communications in their relationship.
  • Developing Positive Parental Influences. This module is intended for participants who are interested in positively influencing youth. Participants are expected to develop a greater awareness of facts and feelings about chemical use, abuse, and dependency; to review effective approaches to prevention; and to develop a practical understanding of intervention, referral procedures, and treatment options. This module includes an examination of personal and group feelings and attitudes toward alcohol and drug issues, as well as an in-depth look at the dynamics of chemical dependency and its impact on marriages and families.

Case management is a critical component of CLFCMEP, and program implementers are strongly encouraged to have an understanding of how to assess the needs of participants and link participants to additional support services in the community. In addition, before delivering the program, trainers must become certified through a 3-day implementation training.

In the study reviewed for this summary, CLFCMEP was delivered through both a 10-session format and a weekend retreat format. The program was provided to husbands who had been recently released from prison and/or substance abuse treatment and their wives. The husbands were felony offenders, and many of them had drug- or alcohol-related convictions.

Creating Lasting Family Connections programs have been developed for use with other targeted populations. The Creating Lasting Family Connections/Creating Lasting Connections program has been designed for use with families of high-risk youth, and the Creating Lasting Family Connections Fatherhood Program has been designed for use with fathers, men who are in fatherlike roles, and men who plan to be fathers; these programs have been reviewed separately by NREPP.

Descriptive Information

Areas of Interest Mental health promotion
Outcomes Review Date: January 2013
1: Relationship skills
Outcome Categories Family/relationships
Ages 18-25 (Young adult)
26-55 (Adult)
55+ (Older adult)
Genders Male
Female
Races/Ethnicities Black or African American
Hispanic or Latino
White
Settings Outpatient
Correctional
Other community settings
Geographic Locations Urban
Suburban
Rural and/or frontier
Implementation History CLFCMEP was first implemented in 2006 in a federally funded and evaluated project: the Jefferson County Healthy Marriage Initiative in Louisville, Kentucky. Since 2006, the initiative has served approximately 300 couples.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations No population- or culture-specific adaptations of the intervention were identified by the developer.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Selective
Indicated

Quality of Research
Review Date: January 2013

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Pacific Institute for Research and Evaluation. (2011, June). Addendum to Jefferson County Healthy Marriage Initiative: Final evaluation report.

Pacific Institute for Research and Evaluation & McGuire & Associates. (2011, May). Jefferson County Healthy Marriage Initiative: Final evaluation report.

Supplementary Materials

McGuire & Associates. (2011, September). Jefferson County Healthy Marriage Initiative: COPES, Inc. Semi-annual evaluation report: Year 5. Healthy Marriage Initiative Grant.

Shamblen, S. R., Arnold, B. B., McKiernan, P., Collins, D. A., & Strader, T. N. (2012). Applying the Creating Lasting Family Connections Marriage Enhancement Program to marriages affected by prison reentry. Family Process. Advance online publication. doi:10.1111/famp.12003

Outcomes

Outcome 1: Relationship skills
Description of Measures This outcome was measured by a 71-item questionnaire that assessed various relationship skills across nine scales:

  • Communication Skills (e.g., "I am able to express my true feelings to those whom I trust")
  • Conflict Resolution Skills (e.g., "Even when in a conflict with someone I trust, I can respectfully share my thoughts and feelings")
  • Intra-Personal Skills (e.g., "I am honest with myself about what I feel and need")
  • Emotional Awareness (e.g., "Those I trust can really understand my hurts and joys")
  • Emotional Expression (e.g., "I often let others know what I am feeling")
  • Inter-Personal Skills (e.g., "I'm open and honest with what I say to those I trust")
  • Relationship Management Skills (e.g., "I know I can count on some of the people in my life")
  • Relationship Satisfaction (e.g., "I am happy with how conflict is resolved in my relationships")
  • Relationship Commitment ("I trust my partner enough to stay with them")
Using a score ranging from 1 (strongly disagree) to 5 (strongly agree), participants rated each item. Scale scores were calculated from the average scores of items in each scale, then all nine scale scores were averaged to create a relationship skills aggregate summary measure for all skills examined.
Key Findings A study was conducted with husbands who had been recently released from prison and/or substance abuse treatment and their wives. Data from the couples, who participated in CLFCMEP together, were collected at pretest; at posttest, immediately following the end of the program; and at follow-up, 3-6 months after the posttest assessment. Husbands who received CLFCMEP were compared with a convenience sample of husbands who had been recently released from prison but who participated in other programs typically offered to prisoners upon release; these programs included contact with parole staff and aftercare programming, such as residential reentry centers, training and job assistance, substance abuse treatment, and group-based substance abuse support (e.g., Alcoholics/Narcotics Anonymous). Data were not collected from the wives of the husbands in the comparison group.

Findings from pretest to the follow-up assessment included the following:

  • Husbands who received CLFCMEP had an improvement in the relationship skills aggregate summary measure relative to husbands in the comparison group (p < .01). Specifically, husbands who received CLFCMEP had a large improvement from pre- to posttest and then a slight improvement from posttest to the follow-up assessment; husbands in the comparison group had relatively constant relationship skills from pretest to the follow-up assessment. The same pattern of results was found for eight of the nine scales (p < .01 for each of the eight scales); there was no significant between-group difference in scores for the Relationship Commitment scale.
  • Wives who participated with their husbands in CLFCMEP had an improvement in the relationship skills aggregate summary measure (p < .01) and in all nine scales (p < .01 for each scale). Like their husbands, the wives had a large improvement from pre- to posttest and then a slight improvement from posttest to the follow-up assessment for the summary measure and each scale.
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 3.0 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 18-25 (Young adult)
26-55 (Adult)
55+ (Older adult)
64.1% Male
35.9% Female
51% Black or African American
46% White
3% Hispanic or Latino

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Relationship skills 2.5 2.5 3.5 3.0 3.0 3.5 3.0

Study Strengths

The measure used to assess relationship skills was adapted from a validated measure to more closely align with the principles and content of the intervention. The study considered multiple aspects of fidelity, including the requirement of certification for implementers and the completion of session activity logs by workshop leaders, which demonstrated that all required activities were implemented in the sampled sessions. There were no significant differences in attrition between intervention and comparison groups. Where attrition was identified as being related to key variables, appropriate statistical corrections were used. Analyses were appropriate for the data and study questions posed.

Study Weaknesses

Cronbach's alpha values were low for three of the nine scales. It is unclear how the validated measure was adapted to meet the needs of the diverse sample. Although the Heckman two-step procedure offers a means of correcting for nonrandomly selected samples and helps address issues of selectivity, it does not eliminate all issues and weaknesses related to a quasi-experimental design. It is unclear how the husbands' use of typically offered services impacted the findings.

Readiness for Dissemination
Review Date: January 2013

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Council on Prevention and Education: Substances, Inc. (2012). Creating Lasting Family Connections Marriage Enhancement Program: Implementation training guide, program fidelity package, and national training and certification system. Louisville, KY: Resilient Futures Network.

Council on Prevention and Education: Substances, Inc. (2012). Creating Lasting Family Connections Marriage Enhancement Program: Master training certification training materials. Louisville, KY: Resilient Futures Network.

Council on Prevention and Education: Substances, Inc. (2012). Creating Lasting Family Connections Marriage Enhancement Program: Participant notebook. Louisville, KY: Resilient Futures Network.

Council on Prevention and Education: Substances, Inc. (2012). Creating Lasting Family Connections Marriage Enhancement Program: Retrospective survey kit. Louisville, KY: Resilient Futures Network.

Council on Prevention and Education: Substances, Inc. (2012). Creating Lasting Family Connections Marriage Enhancement Program: Survey kit for outcome evaluation. Louisville, KY: Resilient Futures Network.

Council on Prevention and Education: Substances, Inc. (2012). Creating Lasting Family Connections Marriage Enhancement Program: Trainer manual. Louisville, KY: Resilient Futures Network.

Council on Prevention and Education: Substances, Inc. (2012). Creating Lasting Family Connections: Secrets to successful facilitation. Louisville, KY: Resilient Futures Network.

Program Web site, http://www.copes.org/explore-marriage.php

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
4.0 4.0 4.0 4.0

Dissemination Strengths

The implementation and training materials are comprehensive, well organized, and easy to follow. A preimplementation assessment tool is available to help organizations determine their readiness to implement the program. The facilitation guide provides information on the roles and characteristics of a successful group facilitator as well as several suggested scripts. The training, which is required and can be tailored to the needs of the adopting organization, includes opportunities for practice and role-play. The materials for the optional master training include session-by-session instructions, preparation guidelines, goals, objectives, and notes for each program module. Ample materials for quality assurance are provided in the program fidelity package and the survey kit for outcome evaluation. The quality assurance instruments are designed to be used throughout the implementation process so that "course corrections" can be made as needed.

Dissemination Weaknesses

No weaknesses were identified by reviewers.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Participant notebooks (set of 24) $99.95 per set Yes
Trainer manual $75 each Yes
Secrets to Successful Facilitation $75 each No
Program package (includes trainer manual, set of 24 participant notebooks, program fidelity package, survey kit for outcome evaluation, retrospective survey kit, and carrying case for materials) $472.95 each No
3-day, off-site implementation training in Louisville, KY (includes national training and certification system materials, implementation training guide, program fidelity package, and up to 10 hours of implementation consultation by phone) $650 per participant (maximum of 18 participants) Yes (one implementation training option is required)
3-day, on-site implementation training (includes national training and certification system materials, implementation training guide, program fidelity package, and up to 10 hours of implementation consultation by phone) $2,400-$4,500 for up to 18 participants, depending on the trainers, plus travel expenses for 2 trainers Yes (one implementation training option is required)
5-day, off-site master training in Louisville, KY (includes training materials) $2,500 per participant (maximum of 12 participants) No
Additional phone consultation $65 per hour No
On-site consultation $520 per day, plus travel expenses No
Survey kit for outcome evaluation $149 each No
Participant outcome evaluation survey booklets (set of 24) $69.99 per set No
Retrospective survey kit $99 each Yes
Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation, contact:
Ted N. Strader, M.S.
(502) 583-6820
tstrader@sprynet.com

To learn more about research, contact:
David Collins, Ph.D.
(502) 238-7338
collins@pire.org

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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