Marital discord and unhappy relationships are significant risk factors for a range of emotional, behavioral and physical health problems—including increased stress, anxiety, functional impairment, depressive symptoms and substance abuse disorders.1-7 Work loss associated with marital problems costs U.S. employers approximately $6.8 billion per year, due to absenteeism, reduced productivity, and increased healthcare costs.8
Proactive couple relationship skills training can serve as a preventive and early intervention approach to improve relationship quality, stability and resilience, and has been shown to reduce marital discord and its associated problems.9-12
With NIH funding, ORCAS developed and tested Love Every Day, a mobile intervention that activates daily use of positive interactions among married and cohabiting couples. Love Every Day is designed to elicit habitual patterns of couple interactions known to encourage couple stability, based on the National Extension Relationship and Marriage Education Model (NERMEM) 13 and habit-formation research. The app triggers NERMEM-based interactions, which in turn elicit reciprocal social and emotional rewards between partners, ultimately creating anticipation of reward and, thus, healthy couple habits.
The Love Every Day cooperative game uses text messages to engage both members of a couple in 3 weeks of brief daily questions carefully designed to prompt positive interactions within the app, generate meaningful in-person conversations and create couple resilience. Couples work as a team, sharing their answers to 21 visually engaging and evocative questions about themselves and each other. When both partners answer the question, each member receives a bonus activity designed to elicit an additional in-person interaction.
Study Design & Methods
To test the efficacy of the Love Every Day mobile intervention, we conducted a single-group trial with 43 cohabiting couples with no-to-moderate relationship distress in which at least one partner was employed at least part time. Approximately half of the participants were recruited through an EAP partner organization. Others were recruited through a variety of outreach efforts including Facebook ads, participants in prior ORCAS studies and others.
Couples used the Love Every Day intervention for 3 weeks. Both partners independently completed online surveys at baseline and immediately after completing the Love Every Day intervention (approximately 3 weeks after baseline). Primary outcomes included (a) relationship distress; (b) partner cohesion; (c) relationship confidence; and (d) relationship satisfaction. Other measures examined effects on key components of the NERMEM (e.g., knowledge of self and partner, care for one’s partner, shared identity, self-efficacy to manage conflicts).
Couples using Love Every Day reported highly significant and moderate-to-large improvements in all outcomes.
- Lower relationship distress (p < .001)
- Higher partner cohesion (p < .001)
- Higher relationship confidence (p = .003)
- Higher relationship satisfaction (p < .001)
- Higher knowledge of self and partner (p < .001)
- Higher care for one’s partner (p < .001)
- Higher sense of shared identity (p < .001)
- Higher self-efficacy to manage conflicts (p < .001)
During the 3-week study period, a very large majority of couples consistently visited the Love Every Day app multiple times every day. On average, individuals answered the daily question nearly every day (0.9 times per day) and visited the question/answer screen 3.5 times per day. Partners completed an average of 3–4 in-person “bonus” interactions per week. Love Every Day users reported excellent usability (System Usability Scale = 89.5) and high satisfaction with their app experience.
Qualitative feedback from couples who used Love Every Day indicate that the app provided “a fun and quick way to stay connected” that improved or renewed their sense of partnership and commitment. Other comments support the quantititive findings that the app sparked positive in-person interactions and that many users experienced anticipation of each day’s question and their partners’ answers, a key component of habit formation.
The Love Every Day minimum viable product yielded moderately large and significant benefits to relationship resilience, seen across a wide array of couple stability outcomes. Primary outcomes were confirmed by changes in the activating components of the National Extension Relationship and Marriage Education Model and by qualitative feedback indicating higher levels of partnership and relationship cohesion. Love Every Day users were very highly engaged throughout the full 3-week intervention, visiting the app multiple times per day and initiating positive in-person interactions 3-4 times each week.
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