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Marriage checkup in integrated primary care: A randomized controlled trial with active-duty military couples

APA Citation:

Cigrang, J. A., Cordova, J. V., Gray, T. D., Fedynich, A. L., Maher, E., Diehl, A. N., & Hawrilenko, M. (2022). Marriage checkup in integrated primary care: A randomized controlled trial with active-duty military couples. Journal of Consulting and Clinical Psychology, 90(5), 381–391. https://doi.org/10.1037/ccp0000734

Abstract Created by REACH:

The Marriage Checkup (MC) is an evidence-based program designed to serve as a relationship health check. This study examined whether the MC was effective in a military primary health care setting (N = 244 Air Force couples randomly assigned to the MC or a control group). Using data from both partners across a 6-month period (i.e., baseline and 1- and 6-month follow-ups), this study examined whether the MC would improve couples’ relationship satisfaction, responsive attention (i.e., partners’ responses to bids for attention), partner compassion, intimate safety (i.e., the degree to which partners feel safe with each other), communication skills, depressive symptoms, and intentions of seeking marriage counseling. Overall, the effectiveness of the MC program in a military primary health setting was evidenced across various domains.


Mental health

Branch of Service:

Air Force

Military Affiliation:

Active Duty

Subject Affiliation:

Active duty service member
Spouse of service member or veteran
Guard/Reserve member
Military families


Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


Quantitative Study


Cigrang, Jeffrey A., Cordova, James V., Gray, Tatiana D., Fedynich, Ashley L., Maher, Emily, Diehl, Abby N., Hawrilenko, Matt


OBJECTIVE: This study assessed the efficacy of the marriage checkup, as adapted to integrated primary care settings and active-duty military couples, for improving relationship health and depressive symptoms. METHOD: Married couples (N = 244, Mage = 32.4, 67.6% Caucasian) in which at least one member was active-duty Air Force were recruited from 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 waitlist control. Treatment and control couples were linked in pairs sequentially and pairs completed nine sets of questionnaires at baseline, 1-, and 6-month posttreatment. Outcome measures included the Couples Satisfaction Index, Intimate Safety Questionnaire, Responsive Attention Scale, Partner Compassion Scale, Communication Skills Test, and the Center for Epidemiologic Studies Depression Scale. RESULTS: A three-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 toward their partners, communication skills, intimate safety, and depressive symptoms. CONCLUSIONS: A longitudinal randomized control trial of the MC supports the hypothesis that the MC significantly improves relationship satisfaction, intimacy, communication, partner compassion, responsive attention, and depressive symptoms. Implications for theory, treatment, and dissemination are discussed.

Publisher/Sponsoring Organization:

American Psychological Association

Publication Type:

REACH Publication

Author Affiliation:

School of Professional Psychology, Wright State University, JAC
School of Professional Psychology, Wright State University, ALF
Department of Psychology, Clark University, JVC
Department of Psychology, Clark University, EM
Wilford Hall Ambulatory Services Center, Lackland Air Force Base, AND
Department of Psychology, Springfield College, TDG
Department of Psychiatry and Behavioral Sciences, University of Washington, MH


help seeking, relationship satisfaction, marriage checkup

View Research Summary:

REACH Publication Type:

Research Summary


Grant (W81XWH-15-2-0025) from the U.S. Army Medical Research Acquisition Activity to Jeffrey A. Cigrang and James V. Cordova

REACH Newsletter:

  October 2022

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